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Two 120 Gal. LP Tanks and Line to Generator 2013
Field Inspection Notice Town of Montville Building Department 860-848-3030 Ext.382 Address: 10 Partridge Hollow Job Description: Install Two 120 Gallon A/G LP Tanks & Run Line to Generator Permit Number(s) M2013-0144 Permit Date: September 5,2013 INSPECTION Date: Not Approved Comments Approval Special Date Conditions Gas pressure test • 15 PSI 10/16/13 DJ • Final inspection and • certificate of approval 10/30/13 DJ Rev.Date: 1/18/06 Page 1 al 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: M2013-0144 Date: 05-Sep-13 Map/Lot: 028/005-079 Owner ID: 536.2.000 Project Location: 10 PARTRIDGE HOLLOW Unit: Job Description: Install Two 120 Gallon A/G LP Tanks&Run New Line to Generator Owner Nam Sherry Timothy Cowen III&Frances Cowen Tenant Name N/A --------- ---- Careof: 10 Partridge Hollow --__-_`_-_-- — -_ - —---'^--Oakdale CT 06370- Telephone: (860)961-9025 Applicant Name: All Gas Telephone: (800)255-4277 DBA:.______ Lic/Reg Type Gl Lic/Reg No 401781 3150 Main Street Exp Date: 31-Aug-14 Hartford CT 06120- Construction Value Permit Fees Construction Information Building Value: $0.00 Building Fee: $0.00 Use Group: IRC Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 2005 State Building Code Mechanical Valu $1,000.00 Mechanical Fee $30.00 Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type IRC Total Value: $1,000.00 Penalty Fee: $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comment Plan Review Fe $0.00 Fire Marshal Fee of$20 Paid State Ed Fee: $0.26 Total Fee Paid: $30.26 It shall be the owners repsonsibility to schedule the following inspections a minimum of 2 business days in advance: Field set of approved construction documents shall be available onsite during all inspections. BUILDING PERMIT INSPECTIONS PLUMBING,MECHANICAL,ELECTRICAL PERMIT INSPECTIONS 0 Footing-Prior to pouring concrete ❑ R Plumbing and leak test 0 Deck Piers ❑ R Electrical ❑ Backfill-Footing drains and waterproofing ❑ Elec Trench-with conduit installed ❑ Concrete Slab-Prior to pouring concrete ❑ Pool Bonding 0 Anchor Bolts-with sill plate and prior to floor framin ❑ Electrical Service CRS No: 0 ❑ Framing ❑ R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation ertific• e of Approval to icate of Occupancy Building Official's Approval: �� Town of Montville Building Department 310 Norwich-New London Tpke. Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 RESIDENTIAL PERMIT APPLICATION FORM PermitNo.: O'Lau3-01 4 Type of Work Occupancy Type Permit Type ❑New Construction8ingle Family ❑Building )RLAddition 0 Two-Family ❑Plumbing ❑Alteration ❑Townhouse Techanical ❑Accessory Structure ❑Electrical CRS#: Property Address: f Inc 4"rl C lq ee, N o l'cA7 (Number) j$treet) / ,� (Unit) Job Description: (�h T 1 9 O QI(�� . n/2? L tifty RC1 o run neL.D Lc/Y cE6 Jen erainr q- Owner: —1-7 1 1 ( c'i j e I Address: �,,, f O I%I' r i g Ho( I( o Q� City: (� ��es tate: Ci 1 Zip Code: Telephone& QSC°) (p I - 9005- Applicant: 0 )E5Applicant: !4) ( 0_03 DBA: Address: y �� ., Ii Q��, n City \ f State: ( , I Zip Code: c 7 (9C) Telephone( O& ) All - C�a� Contractors - Complete the Following: 67 License Type: H-7(1-2 C`7 =- License No.:47Q/7&1 Expiration Date: < l 3 i /i Lt { f 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. 0, By checking this box, I will follow the requirements of the 2005 NEC as the alternative compliance per section E3301.2.1 of the Residential Code, instead of the electrical requirements in chapters 33 through 42 of the Residential Code. Owner/Agent Signature: I -_���� Date: A 3 Construction Value Permit Fees Building Value: Building Fee: Plumbing Value: { Plumbing Fee: rv, Mechanical Value: I C O° Mechanical Fee: 30 .00 Electrical Value: Electrical Fee: Total Value: Penalty Fee: C of 0 Fee: FI►� o?© .00 State Ed Fee: Total Fee: -6© ,atp Revise&,august 23,2007 Town of Montville Building Department File Receipt Date: 04-Sep-13 ReceiptNo: 8756 Received From: All Gas Job Address: 10 Partridge Hollow Town Fees Collected State of Connecticut Fees Collected Bldg Cash: $0.00 State Cash: $0.00 Bldg Check: $30.26 State Check: $0.26 Bldg Credit: $0.00 State Credit: $0.00 Fire Cash: $0.00 Fire Check: $20.00 Fire Credit: $0.00 Construction Value: $1,000.00 Demolition Value: $0.00 CheckNo: 8293 Received By: Carmen Kneeland OM ut_DA l^„ - h,„ „ _ f e^ VP ThitALLIG4s Equipment Municipality: /O A<j/G 4yc /101/0 w 04/ /4 / C/ Job Name: 7--;',/ C cv ems./ Starting Date: Job Description: j a -iso /'eW //,ye �U Ge/C,9-roti. ✓2P,fsc�Ce j of j i�.t .vw wf�PGi�U,✓ Per Public Act 91-95 • \ This letter authorizes baU geiirl Ucco, to sign the permit as an agent of The ALL-GAS & Equipment Company, for t e above mentioned job and municipality. Application License: STATE OF CONNECTICUT /✓ fDEPARTMENT OF CONSUMER PROTECTION II C� F,ATING, IP & IJ :NG COOLING LIMITED CONTRACTOR Tyrone Dostie ` 0-47 TYRONE R DOSTIE License #: HTG.0401781-G1 360 WINDSOR ST Expiration: 08/31/14 r.IANCHESTER,CT 06042-1644 LIC./REG NO EFFECTIVE j EXPIRES II ' 401781-G1 09/01/ 13 08/31/2014 SIGNED yruoti y�. 4011* d°1 3150 MAIN STREET, HARTFORD, CONNECTICUT 06120 PHONE (800) ALL-GASS • FAX (860) 527-2376 VISIT US AT: www.allgasandequipment.com es r7Y1 b$ 1 Id rir r ¢ t-� v � p C ss, 1 p -1 n Q c 64 tot d o E AC AEROALL-CL BFEARON CERTIFICATE OF LIABILITY INSURANCE OATEp-1r.1D0Yvvvl 411 9 120 1 3 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 endorsementls). PRODUCER CONTACT ast, Smith Brothers insurance,Inc. - NAME: 68 National Drive, Suite 2 PHONE g60 652-3235 IAx (A'C No,F a(860) (A c t,ol: (860)652-3236 Glastonbury.CT06033 E MALI ADORE SS- INSURE R(S)Al FORDING COVERAGE HAI('I RED III SURF R A:Indemnity Insurance Co. of NA 43575 Ill SURE RB:Ace USA 22667 The Aero All-Gas Company INSURE RC:RSUI Indemnity Co. 22314 3150 Main Street diSuRER0:LM Insurance Corporation 33600 Hartford,CT 06120 IN SURERE : IN SURER : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREDNAMEDABOVE 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS UI TYPE OF INSURANCE ADO!. P t TRSUBR XICY EFF PCN ICY EXP INSR win POLICY NUMBER (MANDOl'YY) (MM'UD'YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 A X COMMERCIAL GENERAL UABIUTY MCRD36718948 3/26/2013 3/26/2014 DMGORE a ocRaEnDtnu; $ 100,000 CLAIMS MADE X OCCUR MED EXP IA n,one person: S 5,000 PERSONAL&ADS INJURY 5 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN L AGGREGATE UWIT APPLIES PER PRODUCTS•COLIP/OP AGG S 2,000,000 POLICY J CT X LOC S AUTOMOBILE LIABILITY CCIIBRIED SINGLE LIMIT (Ea accident; $ 1,000,000 B X ANY AUTO CALH08273935 3/26/2013 3/26/2014 BODILY'Ir1JURr(Per person; 5 ALE.OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident $ HIRED ALnOS FgNOWNFO PROPERTY DAMAGE AUTOS OPER ACCIDENT, S $ X WERE LLA LIAR X OCCUR C ExCEsSIiAB EACH 0CCURtENCE S 10,000,000 CLAIMNH S-MADE A063060 3/26/2013 3126/2014 AGGREGATE S DEc, X RETENTION$ Aggregate s 10,000,000 YORK(RS COWEN SATION4CSTATU- 0TH- AND EMPLOYERS'LIABILITY X TORY LIMITS ER D -.raY PROPRIETCfLFART?ER'EXECIJTII'E Y N WC531 S389005-012 12/31/2012 12131/2013 OFFICER/NEMEREXCLUDED', y N;A E L EACH ACCIDENT S 1,000,000 (Mandatory M NN) E L DISEASE-EA EMPLOYEE S 1,000,000 it,es describe under DESCRIPTIONOF OPERATIONS aglow E L DISEASE-POLICY LIMIT S 1,000,000 BE SC RIPTION OF OPERATION S'LOCATION S.b£H IC LE S (Attach ACORD 101,Addmorel Remad,s Schedule,if more space is required) Evidence of Insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE For Information Only THE EXPIRATION DATE THEREOF, NOTICE WNL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTTHORIZE/0 RE PRE SENTATIVE L 1`i M+s.1{s4{d "le{t 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Town of Montville Building Department CONSTRUCTION PERMIT APPROVAL Applicant is responsible for obtaining all of the required approvals. No permit will be issued until all the required signatures are obtained. 10 (=6 kiVicisy Ho I I C2 e , a� Property Address Sine-:l I a- I a0 . A/, Lr0 zm.h., run nap Cute e e iev .4___ p 5(X� escription f equired Department Approval Permit Issuance Approval II Tax Collector -d, ,J A,,,_ 13 Signature/date r Comments: 1111 Planning & Zoning ( .0.53_, _ S kil LS Comments: Signature/date 111 Fire Marsh �1 ��/� Comments: C' 1 1 V E I -fes / r Signature/date n Health Department IRequired for properties with private septic or well Comments: ❑ WPCA, Administrative Required for properties on sewer Signature/date Comments: Li 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 t Comments: S• ❑ Montville Police Department Required for all permits EXCEPT one and two family residential Signature/date Comments: ❑ State Dept. of Transportation 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 14-311 Signature/date Building Department Review Complete Signature/date RevisedMay 23,2011