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Home My WebLink AboutGas Line to Fireplace 2002 Town of Montville Building Department Date 7 P2-5 / oZ Field Inspection Notice Permit # Job Location kgs pp fat, Approved Type of Inspection 6-AS Not Approved - Please call for re-inspection when the following corrections have been completed: Bu ding Official Town of M'ntville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville,CT 06382 860-848-3030, Ext. 82 Mechanical Permit Permit Number: M2002-108 Permit Date: 15-Jul-02 Permit Code R5 lob Location 185 PARK AVENUE EXTENSION UNIT: MAP/LOT: 096/005-000 Job Description: gas piping Owner Contractor CLAIR F+JACQUELINE A HOSSLER E.Osterman Propane CLAIR F+JACQUELINE A HOSSLER TRUSTEES 410 Bank Street 185 PARK AVE EXT Unit: New London,Ct.06320 UNCASVILLE CT 06382 Telephone: 447-0341 Lic/Reg Type: G1 Use Group R4 Lic/Reg Number: 388504 Code 1995 CABO Exp Date: 8/31/02 Construction Type 5B Construction Values Permit Fees Building Value: $0.00 Building Fee: $0.00 Plumbing Value: $0.00 Plumbing Fee: $0.00 Mechanical Value: $200.00 Mechanical Fee: $10.00 Electrical Value: $0.00 Electrical Fee: $0.00 Other Value: $0.00 Other Fee: $0.00 Total Value: $200.00 C/O Fee: $0.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $0.03 Total Fees: $10.03 It is the owners responsibility to schedule the following required inspections(minimum 48 hours notice requested): ❑ Footing-Prior to pouring concrete ❑ Rough HVAC • Backfill-Footing drains and waterproofing ❑ Fireplace Throat ❑ Concrete Slab-Prior to pouring ❑ Fireplace Final ❑ Rough Framing ❑ Chimney-One flue above thimble ❑ Rough Electrical ❑ Firestopping/draftstopping ❑ Electrical Service ❑ Insulation ❑ Rough Plumbing and Leak Test ❑ Fin. Inspection V Gas Piping and Pressure Test % - ifica - ofOccu..' ri• re use or occupancy Building Official's Signature: � � lifr Town of Montville Building Department Permit# 42..cx7-z_—/off 310 Norwich-New London Tpke. Tel. 848-3030, Ext 82 Uncasville, CT 06382 Fax. 848-7231 One & Two Family LP-Gas Permit Application Form Job Location I icy eco, k yki),- E X r Job Description/Materials V Z C o Pp. do ev '}Oh L .� A-D PW-,e p 6 Owner aim,- ttig S t-P,4_- Mailing Address Cit' tJ tk oc g i_3:1‘k k[.. State d_'ls: Zip e)(2,3 Tel VS b LI/ CI(il a '2_.6 1 Contractor E ©,S Mailing Address ti l t) c3-(4._ Sri' City Ki c e.4) ‘....b t %go-..- State ('1- Zip )636 O Tel i:36 / y LID/ OW ) Contractor's License/Registration Type&Number 6 — 1 ri g S'S 0 if Exp. Date / 3 ( / O 2- I I hereby certify that the proposed work will conform to the Basic Building Code and all other codes as adopted by the State of Connecticut and the Town of Montville and further attest that the proposed work is authorized by the owner in fee and that I am authorized to make application for a permit for such work as described above. Owner/Agent Signature �Q 1 "I 0„.„,,,, Date ' / / Z / 1) L Construction Value Fee Building $ $ Plumbing $ $ Mechanical $ lz 0 0, 0 0 Electrical $ $ Other $ $ Certificate of Occupancy $ Plan Review Fee $ State Education $ D•0 3 Total $ 2c''O May 24 02 09: 01a OSTERMHITPROPfINE 860 564 2313 p. 1 A Fay Cwn/isci A,J iii...foN1,1 Bt.,3 SNCE 1960 rj (jiterittaft i-jropatte SPECIALISTS IN THE DISTRIBUTION OF PROPANE P0. BC?' 124 • 40 Ceiwatel Puad • Plai,&e IC 063/4 Telephone (360)5E4-2731 • !e()))537.85;7• STMT. OF CONNECTICUT INT iittitio.yok(0 FIEATI NG,PIPING&COOLING LIMITED coNTKACTOR MICHAEL H FARMER 40 LONGPOND ROAD S LEDYARD,CT 06339 TYttg ki ErFtelivE U‘PiF—TE-t— 388504 I yy/O.t/200 I 3431/2002 SEIJ /i1/ 7c;"7(1 (-!. "6-- / 771 sz e. .177 ex 1- • Town of Montville Building Department Receipt Date ? / i z / Z No. 01918 From: . ---------------- Job Address: /6 5 PAJ Jr Ava x-r- Amount $ ----- 0? Cash Chcc Check # 6/ ( nes Received by Vh.--tY-..t.4 Pen-nit # /'/Z 7 Z —/0 5 Asa213D CEt TJF1 ,4T OF ILrA ,L,f% tib i1RA PADDUClA �eE DATE(MM,ODM'1 Gaudette Insurance Agency Inc. yc�rrrlcw IS iS311EO A3 ,� IIMETT!'q OF 106/24n2 One P lumm,er s Corner f NC mows UF'ON THE CERTIFICATE r 6Ik. �tin8 si l lta ! *OLD THIS CERTIFICATE 00ES NOT AWING Vali aa. 508 234-633'4' MA 01588-21gp s T(v! Aoe ,l,rrpuDeo eY THE IaauclEs eELow INSURERS AFFORDING COVERAGE E- Osterman Gds Service, Inc. aSJAEAA;UtiCt► Mutua3ir�e I Memorial Square �ms..,AFAa,�"—_ �-.-- _ urance_Camioany P BOX 29 -,_._._ Wb l 1:1 Ime:JAfA C -_--w- - T78Irk Z 8 MA t31 6R MSR-tAFq 7; _,..,__ C041E54ADES MB�REAM �. ____ —___ -_ 7wE P0lI01E8 OF IM6UR�9A�UMW dELG7H'�kE Saw I _-- ANY f1EOWREMENT. TERN OR coNGITION OF ANN co$44 GT OA THE INeUF�p NAMED ABOVE FOpTHEPCLICY MAY PE'RINN.,TRE 01 Eb EY THE PCi1CIEs DE �� T PER><7f7INDIQA" NpTY�{fl{gfgw °R g. �iTE EJMIfR___MAY HAVE,swat Hides IS .O ALL M TERM Co CESo 1rrIGATE r OM 9E N+)OP{7 OR _sem__ DY PAID Q.AM9 8t DJECT TO ALL 71f[TERMS,D00!_U8K}vSMVP C9NDRtONB CA s 1CH N MEW:MI_—_ 'oIiOYNUMEEl1 UM TI A �{�slNE11TYPE0/R.T�Ir CFP23476iN '10r�' -----"-----`-----`----- i'IS ),V1TP TornnAL(AeolErmLL,AS,L're 10/01/01 10/01/02 ■AcNooct.I�Ir�pF nn ..,M ;JJ.NeM•f.T.AIX9,C�cr.I FiA!9AMAQErAnydMS(;r.�S� • a V V Q ! fi 5 0�QQ O I 1 IYEo CXPSA(yrdNpor porno) _s5 400 _ '4 ! I P�rSONAL4ADVINJI:RY Sl 000 ciao .®�_SQURfi7ATELIM,TAPPL'e9PER:l �'wTcriPIA_i1$gKEOATE E2 '�� X0.0., M7_.Cr F"Qr ; 1 LOC j --t—,� 'PRODUCTS• ProrROO s2,000.000 A �m4cuT�.As.1Tr, HAC234T680 10/01/01 10!01/02 �"- ---~-- cousiNec�aINaLELiMrt i IiALLDWN:JAdTOS i �rtA�oatl.nq *I, 1'�O0,tiU't� .. i L 1 SCriED.:',f,UNUTpg BDOiLY N;UAY ( - -1 f.A(r perm!. S -4 L , wv i +X von•,wveoAu*09 re+a.elvmIX Drive atner pAOPEN7Y DAMAG6 ` ��o M(7i %AAASLIS MUTT I r"i0�(�t-'SAAGG'�J: 1` � i__________.... A `ilc Cti willow CUI+PZ34?686 A(3G s J '10/01/01110/01/02FACHCCCURRENCE i20,000., o0' J OCCuA ILJ CLA M£MADEI I AB4RIX9ATE I }-_• _ *20, 000,00 {_—_, „_ t `_.�7E :,I:"P..5 . — � X i •c" hR TG110000 I !: A 'WOAKEASCOMAEMSATIOMAMO 1WC2347661 X10/01/01 10/01/02 ti ? ' - SMPI.OYEAS UAs LI (' q3�M�7R I°Fv I L`.l.:a4lvAOQI3eNT_.._._ 11 000l000- I IEL_DIEEAR E-EAEMPLOY-E 31 ,tai 0,Otl0 I ornEn, -- r., a;SFArr'-PaL,CrLiN?r,s1, 900,090 I DESCR.■TONOFOPEAATiONI/tOCAtioneivEMIOLES/IXOLWIONEADDEDIY£NoOAEEMs riareciALP IOVISIONI ! 'Vb P3r V• x f.xt ls.1, nlkp .0 CEATIFICATENOLDER 1 AOCRr904MJ AI.I,s *Eo:+ AEnLETTiA CANCELLATION 7111mOULOAINOFTI$EAYQViOESClN*EDPOLICIEHIEGANCELtEDBEFDgiTriDPP+fon oATETMEAWf.TAEissom(nwlUFiERit,1.LE's 1>voPkloSo ,LC_._%MSWIty'Ryh Town of Montville, Attn: iNMM t,nr47DTF-PERTFiCUY2. 10iRNET• AMED10TOWL ;UTF,vLUFETODOSOVPA SuiIdirzq TnerpeCtorLL 344 b oveich Mew tandast Turmgi.ka IMb ENoo)LiOATIOMoAL,AI'L'rr OF ANY K MO!FOM T M l,N SU RIR,TS&SENTS OF. U»casville, CT 06382 I AEPA Ef EMTA TIV Ew (fs I AUT QP IEC A6P1YMTATIVE t ACOFfOZS•SE71s7I Z of }E¢ 55 DL2SI a ACO AD CORPOAArION TNI