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120 Gal. Tank and Line for Pool Heater 2006
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: M2006-0084 Date: 16-Jun-06 Map/Lot: 093/009-000 Owner ID: 5397000 Project Location: 24 PENNSYLVANIA AVENUE Unit: Job Description: gas line, 120 gal.Tank for pool heater Owner Name: Jeffrey 3 and Anita M Dugan Tenant Name: N/A Careof: 24 Penn Ave Oakdale CT 06370- Telephone: Contractor Name: Uncas Gas Co. Telephone: (860)889-7700 DBA: Lic/Reg Type: SI Lic/Reg No: 387812 906 Route 32,P.0. Box 17 Exp Date: 31-Aug-06 North Franklin Ct 06254- 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 Value: $500.00 Mechanical Fee: $8.00 Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type: IRC Total Value: $500.00Penalty Fee: $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $0.08 Total Fee Paid: $8.08 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 ❑ Footing-Prior to pouring concrete ❑ R Plumbing and leak test ❑ Deck Piers ❑ R Electrical ❑ 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 framing ❑ Electrical Service CRS No: 0 ❑ Framing ❑ R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble ❑d Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation Certific. - a .. :.. Certificate '"0 upa Building Official's Approval: Alf E 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.:ife„, O —06 if Type of Work Occupancy Type Permit Type ❑ New Construction ❑Single Family ❑ Building El Addition ❑Two-Family El Plumbing ❑Alteration ❑Townhouse ❑ Mechanical ❑Accessory Structure El Electrical CRS#: Job Address: 1 e (11/Ct 16 Ave - (Number) 1 (Street) (Unit) Job Description: UIJC.a-5 6>, Li-4(N- #A,s�k. j•-/ 0413_�c P v Adevauz.x. o LP 64-s Pip. roid/roil/IT/act - Owner: Gon Address: Y I 111 V)is Ave City: Cati {. State: CT Zip Code: a03`7 6 Telephone: - 967/ Contractor: V1C-A-5 C- DBA: n Address: b(o 3Z'- Po-t ,c 14. City:tsJ . t%.. J State: E} Zip Code: 0- Telephone:Q p�rovS'.191 License Type: Si License No.: 3 g• -€12_ Expiration Date: a 1111 La 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 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: audit0,Liaft__, Date: 0/57d6 Construction Value Permit Fees • Building Value: 5-00 Building Fee: Plumbing Value: Plumbing Fee: Mechanical Value: Mechanical Fee: Electrical Value: Electrical Fee: Total Value: Penalty Fee: C of 0 Fee: Plan Review Fee: State Ed Fee: Total Fee: vired(December 31,2005 Town of Montville Building Department File Receipt Date: 05-Jun-06 Receipt No: 1361 Received From: Anita Dugan Job Address: 24 Penns Ivania Ave Fees Collected State Educational Training Fee Cash: $8.08 Cash: $0.08 Check: $0.00 Check: $0.00 Check No: 0 Short/Over: $0.00 Construction Value: $500.00 Demolitio Value: 441111111111.... $0.00 AY'V Received By Vernon D Vesey II Address: ITEM QTY S/UNIT TOTAL Building Plumbing Mechanical Electrical BUILDING AREA New Construction SF $ 114.17 $ - $ - Basement,Finished SF $ 20.87 $ - $ - Basement,Unfinished SF $ 11.28 $ - $ - Crawl Sapce SF $ 8.46 $ - Interior Renovations SF $ 31.90 $ - $ - $ - MANUFACTURED HOMES Ground Anchors SF $ 5.86 $ - $ - $ - Basement SF $ 11.28 $ - $ - $ - Crawl Space SF $ 8 46 $ - $ - $ - AMENITIES Kitchen EA $ - $ - $ - Full Bathroom EA $ - $ - Half-Bathroom EA $ - $ - GARAGE Attached SF $ 49.41 $ - $ - Detached SF $ 63.21 $ - $ - Under SF $ 9.12 $ - $ Carport SF $ 18.08 $ - MECHANICAL Warm-Air N Y/N $ - Hot Water N Y/N $ - Eleclric N Y/N $ - Air Conditioning N VM $ - ELECTRICAL SERVICE Upgrade Amps $ - Overhead,new Amps $ - Underground,new -Amps $ - Subpanel EA $ 545.00 $ - Gen Set EA $ 3,500 00 $ - SOLID FUEL BURNING APPLIANCES Prefab Metal Fireplace EA $ 5,907.00 $ - Masonry w/lfireplace - EA $ 6451.50 $ - Masonry w/2 fireplaces EA $ 10,08700 $ - Wood Stove,free standing EA $ 2,44750 $ - Wood stove insert EA $ 1,690.70 $ - DECKS,PORCHES,SUNROOMS Deck SF $ 39.16 $ - Porch SF $ 135.80 $ - Sunroom - SF $ 160.82 $ - $ - POOLS&HOT TUBS Hot Tub EA $ 7,287 50 $ - $ - IngroundPool EA $ 19,430 40 $ - $ - Above Ground Round EA $ 5,472.50 $ - $ - Above Ground Oval EA $ 4,635.88 $ - $ - Pool Heater EA $ 8,167.50 $ - Infatable Type Pool EA $ 1,542.42 $ - SHEDS w/o electrical SF $ 18.50 $ - w/electrical SF $ 18.50 $ - $ - RENOVATIONS Roofing,Overlay SF $ 3.38 $ - Roofing,Ship&reroof SF $ 3.76 $ - Roof Sheathing SF $ 1.19 $ - Siding SF $ 2.30 $ - Windows EA $ 423.50 $ - Skylights - EA $ 955.54 $ - Doors,Exterior EA $ 401.50 $ - Oil Tank,275 Gallon EA $ - Oil Tank 550 Gallon EA $ - MISCELLANEOUS CALCULATIONS $> 50000 TOTALS S - S - $ 500.00 $ - PERMIT FEE CALCULATIONS Construction Value Fee Building $ - $ _ Plumbing Y $ - $ _ Mechanical Y $ 500.00 $ 8.00 Electrical $ - $ _ Working before Permit Issuance N $ _ Certificate of Occupancy Fee $ Plan Review Fee $ - State Education Fee $ 0.08 TOTALS $ 500.00 $ 8.08 Figures are based on the 2006 RS Means Residential Cost Data INF",' ; -"' 8606424171 06/06/06 01:41pm P. 002 a V A 1 i ,► ♦ r ,•_• . • . • . • r . • . ► . ,r ♦. t 4 M . ►r I STATE OF CONNECTICUT + DEPARTMENT OF CONSUMER PROTECTION -�' Be it known that a DARYL B SCOTT 68 WATERMAN ST 3 F DANIEISON,.CT 06239 �} 1. L. has been certified by t e Department Stf:Cdti3umer Protection as a f ; HEATING, PIPING & CC. EIC. LITED CONTRACTOR , �. le SI r, `- 11 . 12 4 . ...,. .... . ,. : '°-I`t's—f.4'r ...„.ill, ' . ,,..... �...-. f - . ,. ,...., Ef Effective: 09/01/2005j' 'f „... Expiration: 08/31/2006 g=2= I --i Edwin R Rodriguez,Commissioner ;n►' ,4'' 4 y.. 4 a. 4* a 4 4 :4 4 4 t. 4' X 4 •• 4 a 4 % 4 `• 4 .M ♦ i F :. 64'47, 4.:!4's--,$ aaa 'J Jfi:'::',.,.:4:::.:I 'J :A.."'�aa. "!.$1 t %k,;,44 C'Z-4 .0\t:',:- fy' L 1.”:. ',:54:,t,.. , µ K,:, ry' '' ,x3:8 ............._._... LILAC-E 1;A'= 8805424171 06/06/06 01:41pm P. 008 uABILIT ACORD CERTIFICATE OF Y:tNnsu ANeE . . VIII DAMO(yyY PRODUCER T f 11/28/2005 Jamaaon McLain Corporation ONC TE K SUED At! A MATTER OF INFORM11Ti0� NQLDER.LYTHIS UPON THE CERTIFICATE P.O.Box 621146NOT AMEND, EXTEND OF 1123 Dt1va ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Oviedo FL 32762 _ INSURERS AFFORDING COVERAGE NAC I INSURED Northeast OU S Propane,Inc Uncal Gas eesuRER A Fairmont 1pecfelly!Ranger Ins Co. P.Q.Box 264 i a Wit Insurance Company �_ INSURER C: Danielson CT 06239 INSURERD: COVERAGES MJSURER E THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO NE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR 011-EER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OF MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND OONDITIONS OF SUCF POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR IADP' o' ::,' e , •. . . ....h POLICY NUMBER ' Y'•1POLiCY EXPIRA11ON ,. I ,•.1 ilia OMITS GENERAL LIABILITY AEll EACH OCCURRENCE S 1,000,000 ■ COMMERCIAL GENERAL LIABILTIY EPP 000021000711 12111/2005 12/1112006 DAMAGE TO RENTED $100 000 — CLAIMS MADE X OCCUR IIIEXP An one•.. . $3000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000 000 GEM_AGGREGATE LIMIT APPLES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY ■ PRM LOC AUTOMOBILE LIABILITY A © AMY AUTO EPP 000021000711 12/1112005 12/11/2006 (Ca acc COMBINED SINGLE uMlr s 1,000,000 alALL OWNED AUTOS f _ 111SCHEDULEDAUTOS BOOILY INJURY $ I(Per person) I X MIRED AUTOS EI © NON-OWNED AUTOS 1 BODILY(�� INJURY S © COMP DED S 1,000 i f ( I X COLL DED$2,000 I PROPERTY DAMAGE I f (Per accident) I GARAGE LIABILITY I I j AUTO ONLY-EA ACCIDENT I S `ANY AUTO ! l I 1 I I OTHER THAN EA ACC I S ` I I AUTO ONLY-. AGO I S EXCESS/UMBRELLA LIA81LFTY --I--- A X LEACH OCCURRENCE �S 1,000,000 oCcuR I cLAIMs MADE EUB 000029000480 12/11/2005 i 12/11/2006 I AGGREGATE I$1000000 IDEDUCTIBLE I I 1 I S 1S X RETENTION S 10,000 I I S WORKERS COMPENSATION AND i I WC STATU- 1 GTN. B I EMPLOYERS'LIABILITY TInCY l ATT-! 1 FR ANY PROPRfETOPJPARTNERlEJ(C-CUTIVE WC007I1750 112/11/2005 12111/2006 I E.L.EACH ACCIDENT is 500,000 I ANY PfEi /MEMBER AFIcLUDED'� I I ;K describe under I EL DISEASE-EA EMPLOYEES 500,000 __ SPECIAL PROVISIONS below I E.L.DISEASE-POLICY LIMB II S 500,000 OTHER I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate Holder is Listed as Additional Insured with respects to General Liability. Re:Grandeville at the Commons,South Kingstown,Rhode Island CERTIFICATE HOLDER CANCELLATION .-- • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE F_XPI RAT? .Lown of Montville , CT DATE THEREOF,THE ISSLIB,G INSURER wIu ENDEAVOR TO MAIL 30 DAYS WRITT NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO 00 30 SHA IMPOSE NO OBLIGATION OR LIABILITY OF AMY KIND UPON THE INSURER.RS AGENTS RTHOHSENTAE'ES. S21116Ame....... AUT/wJRgED RE�+REsi7/� Town of Montville Building Department 310 Norwich-New London Tpke. Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 CONSTRUCTION PERMIT APPROVAL T • # 1 /► _.. • di co370 Property Address inSCal pfd, heak' - . Job Description The applicant is responsible for obtaining all of the required approvals checked off on this form. No building permit will be issued until all of the required signatures have been obtained. Required Department Permit Issuance Approval Approval Tax Collector -- —R-- S��'o 10 10 Comments: WPCA, Administrative -Thci\V4/14dt Je `j av (, .)t?a tui'.:! do e Comments: ❑ WPCA, Operations Signature/ date Comments: [ Planning & Zoning Signature/ date Comments: ❑ Health Department Signature/ date Comments: ❑ Department of Public Works Signature/date Comments: ❑ State Dept. of Transportation 'gnature/date Comments: A // Fire Marshal , L� U Ce , Signature/ date Comments: I V � R I iskC L -4,� L.� Wrvisedfugust 5,2005