Reimbursement Application
Application Data
First Name |
Frederick
|
Last Name |
Kyeremeh
|
fredkyeremeh@yahoo.com
|
|
Phone |
18606597356
|
Mailing Address |
18 River Mead
AVON, Connecticut 06001 |
Tested Home Address |
53 Jeffrey Alan Drive
Manchester, CT 06042 |
Date Home Built |
1991
|
Date Home Addition Built |
|
Addresses which Share the Foundation | |
Test Date |
2021-08-02
|
Type of Test Performed |
Visual Inspection
|
Total Invoice for the Test |
450.00
|
Lab/Engineer Contact |
Michael Bugbee, PE
|
Lab/Engineer Phone |
(860) 930-8612
|
Lab/Engineer Email |
Bugbeeinspectionservices@gmail.com
|
Test Lab Name |
Bugbee Inspection Services, LLC
|
Is the Engineer Licensed |
Yes
|
Engineer License Number |
0031922 (unverified)
|
Prior Reimbursement |
|
Number of Cores Tested |
|
Test Result Files |
Foundation Inspection Report for Kyeremeh.pdf |
Proof of Ownership Files |
BOA Tax Statement_2020.pdf |
Additional Photos and Documentation | |
Documentation of Payment |
Inspection Invoice Kyeremeh.pdf |
Waiver Request: Unsigned | |
Waiver Request: Approved | |
Application Status |
Paid
|
Date Application Submitted |
2021-10-15 11:51:11
|
Last Modification Date |
2022-03-25 09:50:35
|
Application Last Reviewed By |
Laura Quintiliani
|
Signature |
|
Date Paid |
2021-11-01
|
Check Number |
17346
|
Check payable to |
Frederick Kyeremeh
|
Check Amount |
400
|
Voucher Amount |
400
|
Was Damage Present? |
1
|
Was Pyrrhotite Present |
0
|
Pyrrhotite Percent |
0
|
Damage Level |
Severe (imminent threat of failure)
|
Damage Location |
Floor and walls both
|
House Features |
Gutters;Finished Basement
|