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HomeMy WebLinkAbout2800 TAMARACK AVE ECHN BLDG DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT Application is her TOWN OF SOUTH WINDSOR PERMIT# 6P BUILDING DEPARTMENT O 1540 SULLIVAN AVENUE �`l9 644-2511 ext. 230 Bldg. Permit# Date ing nspector Application must be printed or typed FEE SCHEDULE Location of Job: F $0-$1,000=$15.00 Street Lot No. Over$1,000=$15.00 per$1,000or any fraction thereof gnation Apt.No. APPLICANT .e h 4-- APPLICANT ADDRESS � APPLICANT PHONE# �. O W N S F,q OWNER OWNER ADDRESS men 42 CO) OWNER PHONE C F - ESTIMATED COST$ U x IS THIS A CONTRACT COST? _Yes _No FEE ENCLOSED$ 1� � TYPE OF JOB: �S�R OR-CO _New Installation _Alteration/Addition/Repair ' g Revised 4/01//2002 APPLICATION FOR PLUMBING PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A ❑RESIDENTIAL BUILDING PERMIT APPLICATION? ❑ YES ElNO ❑BUSINESS CURRENT USE AND OCCUPANCY ❑ASSEMBLY ❑MERCANTILE❑EDUCATIONAL FUTURE USE AND OCCUPANCY ❑INSTITUTIONAL ❑FACTORY ENGINEER'S NAME PHONE ❑ STORAGE ❑GARAGE ADDRESS ❑MIXED USE (Other please specify) CITY STATE ZIP TYPE Or- INSTALLATION SIZE OF MAIN DRAIN NO.OF TOILETS STYLE NO.URINALS STYLE NO.OF BATHTUBS NO.OF SHOWERS NO. OF LAVATORIES NO.OF CONDUCTORS SIZE NO.OF STACKS SIZE AREA OF ROOF NO.OF CATCH BASINS NO.OF FLOOR DRAINS NO.OF OTHER FIXTURES KIND ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW ❑YES ❑NO SIZE OF WINDOW IF NONE C.F.M.OF VENTILATOR SIZE OF DUCTS SEWER OR SEPTIC TANK SIZE OF WATER MAIN SIZE OF WATER PIPING&RISER WATER HEATER: TYPE MANUFACTURER DESCRIPTION OF WORK 14LI ORL DwG. R 8 Del eLe - THE UNDERSIGNED HEREBY APPLIES FOR A PER IT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE Revised 4/01//2002 v DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: � ] � BUILDING DEPARTMENT uTT APPROVErA 1540 SULLIVAN AVENUE Bldg.Permit# 16 W 644-2511 ext. 230 Date Building for Application must be printed or typed FEE SCHEDULE Location of Job: .,Lho LA M tzkn k LavE. of fvsrs►� �"V t�,gl�� $0-$1,000=$15.00 Street No. Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT ���/►1ra C_ LI cJ-11 4C APPLICANT ADDRESS L/ c �F i F/Z- APPLICANT PHONE# A 0 ;zaJ l R U o OW N 3 OWNER ''d Ili Un.kj L �. '� q< OWNER ADDRESS 2 a 3 a OWNER PHONE 0 C ESTIMATED COST$ C , C U • G u �.� Now IS THIS A CONTRACT COST? Yes _No FEE ENCLOSED$ ' O�� TYPE OF JOB: OR C New Installation _Alteration/Addition/Repair r � APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION? ❑ YES ❑NO ❑ RESIDENTIAL ❑BUSINESS CURRENT USE AND OCCUPANCY ✓/J C ►�N� ❑ASSEMBLY ❑MERCANTILE ❑ EDUCATIONAL FUTURE USE AND OCCUPANCY Or. ❑ INSTITUTIONAL ❑ FACTORY ENGINEER'S NAME PHONE ❑ STORAGE ❑GARAGE ADDRESS ❑MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION/WIRING METHOD k1( F/P1 L �� t SIZE OF SERVICE c�'00 A SIZE OF MAIN CONDUCTORS 3 S� NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? ❑YES f (NO NUMBER OF LIGHT CIRCUITS �I NUMBER OF POWER CIRCUITS NUMBER OF SWITCHES � c/ NUMBER OF OUTLETS NUMBER OF LIGHT FIXTURES NUMBER OF HEAT CIRCUITS NUMBER OF A/C CIRCUITS SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED. DESCRIPTION OF WORK / F 4 A C.Z. 2JLp N-� T.!l 1,F`4i S THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT r DATE U em c ELECTRICAL CONTRACTORS Established 1946 February 2, 2007 � Town of South Windsor Building Department 1540 Sullivan Ave. South Windsor, CT RE: Dr. Messinger-Orthopedic Suite 2800 Tamarack Ave Evergreen Walk South Windsor, CT Gentlemen: This correspondence will serve to introduce Mike Williams, who will serve as my Agent for Semac Electrical Contractors during the construction of the above referenced project. Please issue the permit application attached. My license number is CT103163, which expires on September 30, 2007. Thank you in advance for your cooperation. Very truly yours, �Tm " , E " M. Scanlon, ` , Vice President TMS/cm Attachment 45 Peter Court, P.O. Box 638, New Britain, Connecticut 06050-0638 (860) 229-0800 • FAX (860) 229-0406 • www.semacelectric.com Connecticut License No. 103163 • Massachusetts License No. 11247A • Florida License No. EC0001789 DEPARTMENT DECISION APPLICATION FOR SPRINKLER PERMIT PERMIT Application is hereby: TOWN OF SOUTH WINDSOR 5 BUILDING DEPARTMENT APPROVEIJ,, 1540 SULLIVAN AVENUE Bldg.Permit# 6� LE2 644-2511 ext. 230 Date � uildmg•In or Application must be printed or typed FEE SCHEDULE Location of Job: FTenant -- — $0-$1,000=$15.00 Street Lot No.Over$1,000$15.00 per$1,000 -- or any fraction thereof gnation :;A�p_t. APPLICANT />r LG�SrX APPLICANT ADDRESS d ia14 APPLICANT PHONE# ZY(.-77�/ OWNER �e Aj _ 0�J N S Fq< OWNER ADDRESS Z 5 `n OWNER PHONE 0 C ESTIMATED COST$ 7,Uw IS THIS A CONTRACT COST? ----yes _No FEE ENCLOSED$ ��s TYPE OF JOB: R-Cod New Installation XAlteration/Addition/Repair Revised 4/01//2002 M APPLICATION FOR SPRINKLER PERMIT (Continued from reverse side) TYPE OF BUILDING TYPE OF CONSTRUCTION USE GROUP NO. OF STORIES ❑RESIDENTIAL BUSINESS IS THIS APPLICATION ASSOCIATED WITH A ❑ASSEMBLY BUILDING PERMIT APPLICATION? ❑ YES ❑NO ❑MERCANTILE ❑EDUCATIONAL CURRENT USE AND OCCUPANCY ❑INSTITUTIONAL ❑FACTORY FUTURE USE AND OCCUPANCY ❑ STORAGE ❑GARAGE ENGINEER'S NAME PHONE ❑MIXED USE (Other please specify) ADDRESS CITY STATE ZIP KIND OF INSTALLATION SIZE OF MAIN DRAIN Z WATER PRESSURE AT STREET(PSI) ARE SPRINKLER HEADS ALTERED? a-YES ❑NO IF YES,CHECK ALL THAT APPLY: ❑ADDED ❑DELETED ALTERED IF MORE THAN 3 HEADS ARE ADDED HYDRAULIC CALCULATIONS ARE PROVIDED BY(CHECK ONE) ❑PROFESSIONAL ENGINEER ❑INSURANCE COMPANY WATER FLOW WATER PRESSURE AT SPRINKLER HEADS(PSI) ARE PUMPS REQUIRED? ❑YES ❑NO IF YES,CHECK ALL THAT APPLY: ❑FIRE ❑BOOSTER ❑OTHER ARE STANDPIPES PROVIDED? ❑YES ❑NO IS A SPRINKLER SYSTEM PROVIDED? ❑YES ❑NO SPRINKLER SYSTEM MAIN WATER SUPPLY RATING GPM TOTAL DYNAMIC HEAD(TDH)OF FIRE PUMP PSI DESCRIPTION OF WORK /(`5LD c � L�r;vLiJs �v� "j n,ba,f— / c-'7 . THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK, nn e/ CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE 3'�-� 7 ALLSTATE PO. Box 2350 ■ Hartford, Connecticut ■ 06146 FIRE SPRINKLER (860) 246-771 1 ■ FAX (860) 246-7707 INC. March 3, 2007 Town of South Windsor Attention: Building Department RE: Application for Permit Job Number: #3427 Gentlemen: In accordance with Public Act 91-95, this letter authorizes the below named agent to sign the above referenced application for Thomas L. Jacquel (License#F10590). Fire Sprinkler Contractor: Allstate Fire Sprinkler, Inc. PO Box 2350 Hartford, CT 06146 Project Name: Dr. Messinger Tenant Space @ ECHN Project Location: 2800 Tamarack Road Authorized Agent: James Forristall Thank you for your cooperation. Sincerel , Thomas L. Jacq President i8cCertified Small Business Enterprise AA AND"�"TRACTI MW Conn. Contractor's License #F10590 DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: BUILDING DEPARTMENT —F-� APPROTE::,:; 1540 SULLIVAN AVENUE Bldg.Permit# 4) 644-2511 ext. 230 Date Building for �+ /�- Application must be printed or typed 02:5 FEE SCHEDULE [Tenant � 2� at'o fJ b:NSA $0-$1,000=$15.00 Street Lot No. Over$1,000= $15.00 per$1,000or any fraction thereof gnation�c�✓`�� � �r � Ap�. APPLICANT /�JD oex,,/APPLICANT ADDRESS Lo4;W- ��jLyyI/ri y -AP f-// GT APPLICANT PHONE# ydb U ' 6-7 4. ZZ Z Z O W N S Fq OWNER �2. /19�3s"ir�ti�2 O.�?/i�Pv aee Sv:7c OWNER ADDRESS 0,0 OEr OWNER PHONE C ESTIMATED COST$ IS THIS A CONTRACT COST? Yes _No se�� FEE ENCLOSED$ Le oS 3 1� TYPE OF JOB: �SO R•C0� ✓New Installation _Alteration/Addition/Repair APPLICATION FOR HVAC PERMIT (Continued from reverse side) TYPE.OF SYSTEM: TYPE OF BUILDING: I(HEATING ❑RESIDENTIAL UwC (COMMERCIAL ❑VENTILATION ❑ INDUSTRIAL HEATING ❑ STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS. ❑HYDRONIC ❑WARM AIR ❑ UNIT RADIANT HEATER EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT LOSS(BTUH) OF(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.) GROSS HEATING CAPACITY(INPUT-BTUH) NET RATING(OUTPUT-BTUH) TYPE OF FUEL ❑OIL-GPM OIL TANK LOCATION :❑ INSIDE❑ OUTSIDE CAPACITY 0 6AS-INPUT LPG TANK CAPACITY ELECTRIC-KW AIR CONDITIONING DESIGN TEMP.OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT GAIN(BTUH) (HEAT GAIN SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL COOLING EQUIPMENT(INCLUDING MAKE&MODEL NO.) SA," TONNAGE COOLING CAPACITY(BTUH) VENTILATION DESCRIBE ALL AIR HANDLING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT) TOTAL SIZE OF SYSTEM(CFM) "` FRESH AIR INTAKE(CFM) (PLANS MUST ACCOMPANY APPLICATION) FURTHER DESCRIPTION OF WORK THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. 28�6z"L3�35z13 5A*f /,. 5_/ CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE j Z ' Z-G ' MODERN MECHANICAL SYSTEMS, INC. Public Act No. 91-95: An act concerning the requirement that licensed contractors as defined in Section 20-330 of the General Statutes, must personally sign each building permit application. Date: 12-23-06 Town of: South Windsor Re: Application for HVAC Gentlemen: In accordance with Public Act 91-95, this letter authorizes the below named agent to sign the above reference permit application. 1. Project Name: ECHN—Medical Building @ Evergreen Walk DR. MESSINGER-ORTHOPEDIC SUITE UPPER LEVEL Project# 897-011 2. Location: 2800 Tamarack Road 3. Starting Date: 12/26/05 4. Licensed Contractor's Name: Jeffrey A. Clement 5. Licensed Contractor's Trade License No.: SM-1 #2896, S-1 #303543 6. Name of Agent: Edward Hlasyszyn 7. License Numbers of all Contractors involved in the work, if applicable: Sincerely, MODERN MEC AL SYSTEMS, INC. /Jeffre A. Cie President JAC:m 519 COOKE STREET • P.O. BOX 492 • FARMINGTON. CT 06034-0492 PHONE 860 / 677-2222 • FAX 660 / 676-8305 An E,qualOpportunity Employer CPLr02 Rev 09/03 STATE OF CONNECTICUT M02 DEPARTMENT OF CONSUMER PROTECTION 165 Capitol Avenue + Hartford Connecticut 06106 Attached is your license. Such license shall be shown to any properly interested person on request. No such license shall be transferred to or used by any other person to whom the license was issued. Visit our website at www.ct-gov/dcp. RECE�QED A UG 0 7 2006 1 ONNECTICUT DEPARTMENT OF CONSUMER PROTECTION Modern pj Ochanlcal�y8t9m3 Inc. HEATING,PIPING&COOLING UNLIMITED CONTRACTOR !— S1 JEFFREY A CLEMENT JEFFREY A CLEMENT PO BOX 492 I S19 C60U ST FARMINGTON, CT 06034-0492 FAPN1INGT0N,CT 06033-0492 LIC./REG NO, FE IVE'; EXPIRES 303543 t ou09/01/2006::-`,` ` 08/31/2007 SIGNED WON— STATE OF CONNECTICUT ♦ DEPARTMENT OF CONSUMER PROTECTION i Be it known that i JEFFREY A CLEMENT 519 COOKE ST FARMING.TON;':E�' 06034-0492 1 has been certified by the epartment'Qf l nsumer Protection as a I y i HEATING, PIPING & CCOLIIVV I1I.tMIITED CONTRACTOR f A. /I4 I ;) All Effective: 09/01/2006 - Expiration: 08/31/2007 Edwin R Rodriguez-,Commissioner ��:.}.�'N..�� � \^ ��: ,� �; `" :-,,,�y,•i,` `;;�r�',"�.'�e�.,,J ''��7" ,.vim;.sjy � '',�'� -'�,.+�'," �" ,�. '��y;. ,,y :�;�• :.•f�.r:� .,n.�4,��,,�'a 'r:+,.^.:; i�v 24i�3;,� �„ �w�.,��?Y���.�., \ �+?:k�\ N,!$a..,i'.. ;»!y`�`.;, ,Jf., fQu..'..,i:, •.- � Mil �.a\` '1'% .p, E,U9�f/-c• ;!+7eJ .rtti��k'�.�/,`.i'��VJeJ ;4�\a�' ,Ch`� •si,;�:'��r' �' S:h::h�, K;v'. �• ,�\h'�d•'-J,:��'�` n:�,:� is�:K��,.�..:;6r;.Sn. 15v�.. 'M •ti` .:•Y}t :UGH ,1 `h' ,.`„r... .3 '�- '� �•, G�:;\ ��Mr����. ����v it;�.. ,.s, ..5. .y.e '•k... �S�e. '�.�C- ••<sSt ''.v�:._ �f.� ax•. '{�-" ...G%ti �i4:.� •'...v��',•G.tip�. ��'Z�4i�'-�.y, ` k. �•�. `�it�'i�S,�'<��'!)` rk•Y?i CPL-02 Rev 09/03 STATE OF CONNECTICUT n502 DEPARTMENT OF CONSUMER PROTECTION 165 Capitol Avenue + Hartford Connecticut 06106 Attached is your license. Such license shall be shown to any properly interested person on request. No such license shall be transferred to or used by any other person to whom the license was issued. 60 at www.ct.gov/dcp. AUG 0 7 2006 STATE OF CONNECTICUT Modem Machanical Systems DEPARTMENT LIMITED SHEET METAL CONTRACTOR S1.M1 JEFFREY A CLEMENT JEFFREY A CLEMENT PO BOX 492 I 519 COOKE ST FARMINGTON, CT 06034-0492 FARMINGTON,'CT 06034-0492 LIC.!REG NO: FE IVE,I' # .r EXPIRES 2896 O';09/01/2006,,,`" 08/31/2007 ....`�.RAN.Sr SIGNED 'r a r �' ^ ;s , ' s EN r NJ N I.w 4 L N yJ , T f 29. r � STATE OF CONNECTICUT + DEPARTMENT OF CONSUMER PROTECTION Be it known that I JEFFREY A CLEMENT 519 COOKE ST FARMING-XON;' ', 06034-0492 ` �!:I;`�ji`��•�S %lid\ has been certified by the: epar�`tmenkof Consumer Protection as a14, i LIMITED SHI:ET:"1VjF�TALC(]►1V'TRACTOR SML Effective: 09/01/2006 Expiration: 08/31/2007 �1 Ed w R - -- - -- a Rodriguez,G�ommissionec :v�;.a�t.'xx,,• ✓a.. .,..��'F• i,����', =� �J" r�•�' �J• ,`�++�r;:• V`��. v:.t'7!,, ST;H .+;1[fR� 'a:�.'T,�.�:,1�?r"a +n`. fir, •�1Tp �N At-'t T+�.t+ ,h � a .,�.•.,;3%.. ••.�,,� .�,;.L.. ,;��: _ ,,Q\;.:'• ?9'T �• .� ���:, �� (r+°"�?:�;+i, '� � •� +sr. .fib .tit, _ ..•c yJ:: �'�.v73''�. ''�\c:.�;ur•. �:'• •�f, �,r;:, :.r•, ,•r.• -,•r: ,,;a'� � \. 3�:;, � �� � ,c�_ •.�. �n��., �f,r,,�o-� .�' :•5h� �'.'¢+,�n .¢�..r �n��.r `s.i - :7�f���.i> ��L��'.rr.��L� y!��ar',.1,h4� ::���•:,vy, �''Nw' ..,M.n .,n� ,s� ��� �, '�• _ 2.. 'r2.+ },_?tip' ..s ���-.,�kv- �Gkv��4`_ is✓'L"y�'''4����y;}��`,-,�F`'7,4.r'�'�,{.',�•'<-.•rr..,': •1 �Sr-. y.... 1. l rye• Client#; 38061 MODEMEC " JACORD- CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) PRODUCER 03/31/06 Hilb Ro al 8r Hobbs of CT, LLC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION g ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 10 State House Square HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P.O. Box 232100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Hartford, CT 06123-2100 INSURED INSURERS AFFORDING COVERAGE NAIC# Modern Mechanical Systems Inc INSURER A: Hartford Insurance Group 29424 P.0.BOX 492 INSURER 8: Farmington, CT 06034 INSURERC: INSURER O: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD" LTR INSRI TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION ATE MM/DD/YY 0 MMIDD Y LIMITS A GENERAL LIABILITY 02UUNUF6230 03/31/06 03/31/07 EACH OCCURRENCE S1 OOO OOO X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED S11 0 0 0 CLAIMS MADE FE OCCUR MED EXP(Any one person) $1 OOD PERSONAL d ADV INJURY $1 00O OOO GENERAL AGGREGATE $2 000 DOD GEN'L AGGREGATE LIMIT APPLIES PER: POLICY M PRO? LOC PRODUCTS-COMP/OP AGG $2 00O 000 A AUTOMOBILE LIABILITY 02UUNUF6230 03/31/06 03/31/07 X ANY AUTO COMBINED SINGLE LIMIT (Es accident) $1,000,000 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ X HIRED AUTOS X NON-OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE _ (Per accident) GARAGE LIABILITY ANY AUTO AUTO ONLY-EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ A EXCESSIUMBRELLA LIABILITY 02XHUUF5468 03/31/06 03/31/07 EACHOCCURRENCE X OCCUR CLAIMS MADE $5 000 D00 AGGREGATE $5 000 000 DEDUCTIBLE $ X RETENTION $10 000 $ A WORKERS COMPENSATION AND 02WBNK4584 03/31/06 03/31/07 C WCSTATU- OTH• $ EMPLOYERS'LIABILITY I ANY FIROPRIETOR/PARTNER/EXECUIIVE E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? II es,describe under E.L.DISEASE-EA EMPLOYE $500 000 SPECIAL PROVISIONS below OTHER E.L.DISEASE-POLICY LIMIT $50,000 DESCRIPTION OF OPERATIONS I LOCATIONS I V HIC NDO SEMENT I SPECIAL PROVISIONS APR 0 4 2006 Modem Mechanical Systems,Inc. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Modern Mechanical Systems, Inc. DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL _ An DAYS WRITTEN P.O. BOX 492 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Farmington, CT 06034 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER.ITS AGENTS OR REPRESENTATIVES. AIjTfjORIZEO REP. ENTATIV ACORD 25(2001/08) 1 of 2 #M218437 GAD 0 ACORD CORPORATION 1988 IZ i IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER I The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer,and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. I i i i I i I I I I ACORD 25-S(2001/08) 2 of 2 #M218437 / Z� 1 2 1 2 F� 9 A- A- A- A- W OM �Z m cL OL) _ A w X 9 PL-4 A VA ' /+ H Hi TYP. EXAM :1. NORTH LE EXAM 5 ! 2 MESS118 XA MESS117 CASTING 1 ---� CASTING 2 MESS111 MESS110 VESTIBULE MESS116 MESS115 PLC - - 16 ® ex. PLC MD VIEWING 1 CORRIDOR '1 4 ING 2 I A 17 MESS128 1 PLA MESS129 8 •s'-o-t z• �- �s-o-t z I - •�.a EXAM 6 EXAM _.._. .. T 8 it at ,I MES5109 3 1: .• � b 12 --------- a F= 4' 4 4- 4 •� A- 8 -Cr a - 19 SUB-WAFTING =F O •� QTYnI _ MESS108 _-_ ! _ Ito 4 p(Alq 7 4 minor 4 S G. S 18 DULING MESS122 ATET • 13 MEESS 007N 29 OI EXAM B MESS120 COAT a INREovumLENTs w/OWNER O �� s O A CLOSET \ MESS130 - 5 MESS125 X-RAY I TEL ` AREA 0.) H.C. 1 CORRIDOR 8 •altsma e I MESS114 ROOM O7 MESS131 I MESS121 MESS106 -- -_-- - -_- n` O MESS123 BOARD. ON COORDINATE E WITH ON sNEI.vMCrsEE oET •�j 4 'REF - PL-3 BOARD;COORDINATE YIftH ON PACE MS 0 TO4ANi n` AIM NEW WALL ItRTFI W 4 4 1 22 I - - _ _R AOM - - - REHABILITATION COLUMN C 8 MES 105 MESS128 4 TANK rtam�"' �C, 4 ----- -- ON ------- 04 ADD TAC CODARD:SAME AS IN �1 ��•�C' 2S ONT WAITNG ROOM AS SHOWN ON 1� 1 2 CORRI R 6 ELEV. /1/A41. 30 RH� �, N --- O O MESS132 1 ©3 I ___.. .___ ___ 4 1 n q RADIUS I.TO FOLLOW RADIUS 5 4 TENANT TO HUNG C E i • ELEC. ATA -2 1-- of CEILING ABOVE MANAG I _ L54 DEG. ESS103 \ E--. . r SHEL LNG O BE WW�� MESS126 RECEPTI N I H .TOILET 4 © M MESS127 .I MESS12 FH.M. FRAM IDOR N 4 S 1 31 ANTE ROOM ELEVATOR MESS130 2 HR. ' I 1 H q ell ® NEW PEDESTAL 1 1 -DO NOT WRAP BASE INTO PL-1 t—© WAITING TENANT TO 24*W ® ALCOVE, OVIDE TWO Ila'A CABINETS 0 241Y R� 1 O ' MESS 100 x 12-1 4'D.x 79-1/2".CONTRACTOR 2£ 1 1 I `•-- - --- 2 ------ I . ILD SOFFIT O CABINET - --- , ODATE HEX:Hf OF CABINET s I IV" lug z MAR 13 2009 A—1 m PIt0011CT INstALIED BY O ? ex. South Windsor BUILDING DEPAF VASNT MILLWORK TO BE PRICED BY BKM t G.C.FOR COMPETITIVE BIDS i LJ_ LEGEND PUnmIN?%2f •F 0 JWM PL-1 PEDESTAL SINK BY AMMKAN STANDARD/0115.411.COLOR: 0 Architectural 01 DOOR NUMBER CASEWORK TO BE BID BY WB /N SINGLE HANDLE LAVATORY FAUCET/K-121E1. Group BKM t CASLE PL-2 WALL MOUNTED SINK BY PORCHER J25011-PORCHER.WHITE k LL OA HOLLOW METAL BORROWED M CASEWORK PURCHASED DIRECTLY BY FAUCET BY KOHLER /K-12183.BRUSHED NICKEL LITE FRAME DESIGNATION INSTALLED BY CONTRACTOR PL-3(REVISED 11-8-06) ADA COMPLIANT SUINLESS on KITCHEN A CASEWORK DESIGNATION PROVIDE AT SINK ELKAYBY �G-2521 L -W.X 21-1/4-DJO-3/ab.) w/ (SEE DRAWING HER A BIN INDICATED LOCATION PL-4 EXAM SINK BY BLANCO 300-340.SATIN STAINLESS; FAUCET BY « Q FEC FIRE EXTINGUISHER CABINET ALL Pl1ri1BIU0 FIXTURES R IN)LE AVAILABLE wWWFAUCETDIRECT.COY. Liar BlANCO-t11CSON BAR FAUCET/iS7-008,SATIN Nx:KEL p�T BtANCO•RICSON-BAR FAUCET PL-S (DELETED tI-OB-06)SELF RIMMING OVA.VANITY SINK BY KOHLER 0wWW FD(TUREUI'NERSE.COM • m • 4) • 0 F\\ NEW DOORS /K-2075-IL 22-1/8-X 16-1/47.COLOR:WHITE W/FAICET BY M ALL ACCESS)RIES BY OWNER u a UC KOHLER/K-122265-4. BRUSHED NICKEL »ALL HANDICM, RAILS IN BATHROOMS TO BE BULDIN STANDARD TO tvigma K Cr oan PL-6 (REVISED 9-08-06)TOILET PER BUILDING STANDARD Cry EXISTING DOORS °763