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Home My WebLink About3 120 LP Tanks and Lines TOWN OF MONTVILLE Building Department 310 NORWICH-NEW LONDON TURNPIKE UNCASVILLE, CT 06382-2599 TEL. (860) 848-3030 X382 FAX. (860) 848-7231 MECHANICAL PERMIT Permit Number: M2017-0128 Date: 31-Jul-17 Map/Lot: 067/001-000 Owner ID: 2658000 Project Location: 4 HALEY ROAD Unit: Job Description: Set Three 120 LB Tanks&Run Line from Outside Tank to Boiler&Grill Owner Nam Steven A and Kim B Meyer Tenant Name N/A Careof: 4 Haley Road Uncasville CT 06382- Telephone: (860)608-3253 Applicant Name Norman Sylvia Telephone: (860)848-5510 DBA: Suburban Propane Lic/Reg Type GI Lic/Reg N 407019 262 Gallivan Lane Exp Date: 31-Aug-17 Uncasville CT 06382- Construction Value Permit Fees Construction Information Building Value: $0.00 Building Fee: $0.00 Use Group: IRC g` Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 2016 State Building Code Mechanical Valu $1,079.00 Mechanical Fe $30.00 Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type IRC t Total Value: $1,079.00 Penalty Fee: { $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comment Plan Review Fe $0.00 Fire Marshal Tank Set Fee of$20 Paid State Ed Fee: $0.28 Total Fee Paid: $30.28 i It shall be the owners repsonsibility to schedule the following inspections a minimum of 2 business days in advance: Field set of approved construction documents shall be available onsite during all inspections. BUILDING PERMIT INSPECTIONS PLUMBING,MECHANICAL, ELECTRICAL PERMIT INSPECTIONS t ❑ Footing-Prior to pouring concrete ❑ R Plumbing and leak test ❑ Deck Piers ❑ R Electrical 1 ❑ Backfill-Footing drains and waterproofing ❑ Elec Trench-with conduit installed ❑ Concrete Slab-Prior to pouring concrete ❑ Pool Bonding ❑ Anchor Bolts-with sill plate and prior to floor frami ❑ Electrical Service CRS No: 0 ❑ Framing ❑ R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble El Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation El Certificate of ,-.proval IN - ifi2 - of Occupancy c..--,,--- Building Official's Approval: . ..., ..., /4— Town of Montville Building Department 310 Norwich-New London Tpke. Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 RESIDENTIAL PERMIT APPLICATION FORM Permit No.: k Dt1--7—aIr Type of Work Occupancy Type Permit Type 0 New Construction 0 Single Family ❑ Building ❑Addition ❑Two-Family ❑Plumbing El Alteration ❑Townhouse ! , echanical ❑Accessory Structure�r ■ Electrical CRS#: , Property Address: "1 7'icley IQ4. Um......Ac t c1 (Number) (Street) (Unit) Job Description: gHn 1 . bvh-s,>J 'fro._ -1,,•k 4. Lt.:4,-- + t r;l S'e4 , 3 - /Do's (4.,4..f Owner: S-kv. 1- k.r A90- Address: : .Address: L 14q'ty Rd. City: UM'eJ 11.'1 ie State: ( 7 Zip Code: 06)S 1 Telephone($GO )608' - 3 a S 3 Applicant: /14r:—,q.—, SYI,.ia DBA: S..bv-ix, Punt Address: d 6 a GI/,V._ 4.- City: UrfAJv;ftL State: C? Zip Code: 063$1 Telephone( 8P ) eq$- 5S/D Contractors - Complete the Following: , License Type: 6"- I License No/TF! 0 tI o7oq-Expiration Date: 0 8/30aa I hereby certify that the proposed work will conform to the State 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. By checking this box, I will follow the requirements of the 2014 NEC as the alternative compliance per section E3401.1 of the Residential Code, instead of the electrical requirements in chapters 34 through 43 of the Residential Code. Owner/Agent Signature:___„,a7-2--- _ E Date: 07la042/ Construction Value Permit Fees Building Value: Building Fee: Plumbing Value: fr2-77�--■ ,...V'r.. 10ct_(.J(.J Plumbing Fee: Mechanical Value: Mechanical Fee: &). Electrical Value: Electrical Fee: Total Value: Penalty Fee: C of 0 Fee: Ha ee: 9.0-00 State Ed Fee: . t Total Fee: 5o.,4 fc Revised:August25,2007 Town of Montville Building Department File Receipt Date: 28-Jul-17 ReceiptNo: 12498 Received From: Suburban Propane Job Address: 4 Haley Road Town Fees Collected State of Connecticut Fees Collected Bldg Cash: S0 no State Cash: SO 00 Bldg Check: 530.28 State Check: SO 28 Bldg Credit: 50.00 State Credit: X0.00 Fire Cash: 50.00 Fire Check: 520.00 Fire Credit: g0 00 Construction Value: S1 079 00 Demolition Value: $0.00 CheckNo: 263 Received By: Carmen Kneeland l Q/IIPYUUe1 (y\, L I/waif:1A Address: 4 Haley Road ITEM QTY $/UNIT TOTAL Building Plumbing Mechanical Electrical BUILDING AREA Basement,Finished SF $ 41.96 $ - $ _ Interior Renovations SF $ 36.09 $ - $ - $ _ AMENITIES Kitchen EA $ _ $ _ $ Full Bathroom EA $ - $ _ Half-Bathroom EA $ _ $ GARAGE Detached SF $ 71.53 $ - $ MECHANICAL Warm-Air n Y/N $ - Hot Water n Y/N $ - Electric n Y/N $ _ Air Conditioning n Y/N $ - ELECTRICAL SERVICE Upgrade Amps $ _ Subpanel EA $ 699.00 $ _ Gen Set EA $ 3,850.00 $ _ SOLID FUEL BURNING APPLIANCES Prefab Metal Fireplace EA $ 6,497.70 $ - Masonry w/1fireplace EA $ 7,096.65 $ - Masonry w/2 fireplaces EA $ 11,095.70 $ - Wood Stove,free standing EA $ 2,692.25 $ - Wood stove insert EA $ 1,859.77 $ - DECKS,PORCHES,SUNROOMS Deck SF $ 44.07 $ - Porch SF $ 149.38 $ - Sunroom SF $ 176.90 $ - $ _ POOLS&HOT TUBS Hot Tub EA $ 8,016.25 $ - $ _ Inground Pool EA $ 31,550.00 $ - $ _ Above Ground Round EA $ 6,299.46 $ - $ _ Above Ground Oval EA $ 7,019.75 $ - $ _ Pool Heater EA $ 8,984.25 $ - $ Inflatable Type Pool EA $ 1,200.00 $ - $ SHEDS w/o electrical SF $ 25.55 $ - w/electrical SF $ 26.85 $ - $ _ RENOVATIONS Roofing,Overlay SF $ 3.50 $ - Roofing,Strip&reroof SF $ 4.50 $ • - Roof Sheathing SF $ 1.51 $ - Siding SF $ 6.75 $ - Windows EA $ 550.00 $ - Skylights EA $ 1,051.10 $ - Doors,Exterior EA $ 601.50 $ - Oil Tank,275 Gallon EA $ - Oil Tank,550 Gallon EA $ - MISCELLANEOUS CALCULATIONS $ 1,078.42 Solar Install n TOTALS $ - $ - $ 1,078.42 $ - PERMIT FEE CALCULATIONS Construction Value Fee Building $ _ $ _ Plumbing y $ _ $ Mechanical y $ 1,079.00 $ 30.00 Electrical y $ - $ Plan Review Fee y $ Certificate of Occupancy Fee $ Plan Review Fee $ State Education Fee $ 0.28 TOTALS $ 1,079.00 $ 30.28 Figures are based on the 2006 RS Means Residential Cost Data STATE OF CONNECTICUT DEPARTMENT OF CONSUMER PROTECTION HEATING,PIPING&COOLING LIMITED CONTRACTOR NORMAN E SYLVIA III 1447 OLD COLCHESTER RD OAKDALE,CT 06370-1222 LIC./REG NO. EFFECTIVE EXPIRES HTG.04�07019-G1 07/05/2017 08/31/2018 Ac Ro D CERTIFICATE OF LIABILITY INSURANCE0929' '2916 DATE(MMIDD/YYYV) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES-NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. 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). PRODUCER CONTACT MARSH USA,INC. NAME: 445 PHONE UTH STREET j //c,No.Eat): I FAX MORRISTOWN,NJ 079606454 E-MAIL j(A/C,No) Ann:Morrison.CertRequeslf(rnarsh coin Fax:212.948.0979 ,ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# CLIE American Insurance Company 2 --��." INSURERA: ACE .661 =6- INSURED 1 SUBURBAN PROPANE PARTNERS,L.P _- . INSURER a:Indemnity Insurance Company of North America 43575 _ _...__. 240 ROUTE 10 WEST INSURER c;ACE Fire Underwriters Insurance Company ; __ 20702 WHIPPANY,NJ 07981 INSURER D: INSURER E! _INSURER F: COVERAGES CERTIFICATE NUMBER: NYC-007655291-25 SION NU : THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED E NAM D ABOVE BOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR.OTHER DOCUMENT WITH RESPEC r 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR LTR TYPE OF INSURANCE POLICY EFF POLICY EXP INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X 1 COMMERCIAL GENERAL LIABILITY HDO G27856329 10/01/2016 10/01/2017 EACH OCCURRENCE $ CI.AIMS-MADE n OCCUR ' 2.01X).000 DAMAGE TO occ S—---._... - ---.. ._ -._._._ ,.PREMISES(Ea oco,ueiue) _ $ 250.00(1 —i -- MED EXP(Any one person) . $ 10 000 - PERSONA!.8 ADV INJURY I S 2 000 081 GEN'L AGGREGATE LIMIT APPLIES PER '— --- - - I X POLICY( I JECOT I '..._l LOC GENERAL AGGREGATE I — _ —�(a 2.iN1ilINN) PRODUCTS•COMP/OP AGG I S 2.00001)0 • OTHER — A AUTOMOBILE LIABILITY ISA H0904506,5 l $ X 10/01/2016 10/01/2017 COMBINED SINGLE LIMIT I ANY AUTO ,.t-P,88CCocIgntf. S 2.000.000 X ALL OWNED X SCHEDULED BODILY INJURY(Per person) I S AUTOS AUTOS --------__.. _ X X NON-OWNED BODILY INJURY(Per accident) g HIRED AUTOS AUTOS PROPERTY DAMAGE JPeraccn}enn S I UMBRELLA LIAR OCCUR I EACH OCCURRENCE EXCESS UAB CLAIMS-MADE ---- ' — — AGGREGAIL 1 DED RETENTION S S B WORKERS COMPENSATION ) g AND EMPLOYERS'LIABILITY 'AND 048611175 (AUS) 10/07/2016 10/01/2017� x i PER i 'OTII- A ANY PROPRIETOR/PARTNER/EXECUTIVE V/N WLR C448611163 (CA.MA) 10/01/2016 10/01/2017 )STATUTE IFR C OFFICER/MEMBER EXCLUDED'? I N I N/A E I EACH ACCIDENT (Mandatory In NH) ISCF C48611187 (WI) 10/01/2016 10/0112017 �•_ - - $ 1.000.(1!X) I. II yes describe under DESCRIPTION OF OPERATIONS below I E L.DISEASE•EA EMPLOYEE $ 1.00(1000 ----- E.L.DISEASE-POI ICY I IMIT $ - 1.0001100 I DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) — EVIDENCE OF COVERAGE – —--' CERTIFICATE HOLDER CANCELLATION SUBURBAN PROPANE PARTNERS.L.P. 1 SUBURBAN PLAZA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE P.O BOX 206 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN WHIPPANY.NJ 07981-0206 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukher)ee ..a. .� ..r ...14...........z‹.r`4, c ©1988-2014 ACORD CORPORATION. All rights reserved ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Town of Montville g Building Department CONSTRUCTION PERMIT APPROVAL Prope4 Address jef T& L Lin_ +(:). Rcw cLiAlk wt ►-t Job Description Required Department Approval ' Permit Issuance Approval Tax Collector � /g /i Signature date Comments: g ®k/ Fire Marshal } 7�a�Sli7 Signature/date Comments: ❑ Planning & Zoning Required for all permits except Signature/date Plumbing, Electrical,Mechanical,Roofing,Siding,Windows&Doors ❑ Health Department Required for properties with private septic or well Signature/date Comments: WPCA, Administrative O Per e is Required for properties on sewer �� /I cm Signature/date Comments: ❑ WPCA, Operations When Required by WPCA Signature/date Comments: ❑ Department of Public Works Required when project includes driveway work or certain drainage requirements Signature/date Comments: - ❑ Montville Police Department Required for all permits EXCEPT one and two family residential Signature/date Comments: ❑ Copy of State Dept. of Transportation Certificate Required for Structures over 100,000 sq.ft or with more than 200 parking spaces-Official copy of STC Certificate of Operation required—per CGS 1¢311 Signature/date Building Department Final Inspection Revised March 23,2015