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Home My WebLink AboutBoiler 2003 Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville,CT 06382 (860)848-3030, Ext. 382 Mechanical Permit Permit Number: M2003-0243 Date: 11-Dec-03 Map/Lot: 072/045-000 Owner ID 116001 Job Location: 9 PEOUOT ROAD Unit Job Description: Replacement Boiler& indirect hot water(57 gal.) Owner: Contractor: Barrie H Bearse McCarthy Heating Oil Services P.0. Box 332 707 Norwich New London Turnpik Quaker Hill Ct. 06375- Uncasville CT 06382 Telephone: (860)443-2839 Lic/Reg Type/No. S1 302650 Exp Date: 31-Aug-04 Tenant: Self Telephone: Construction Values Permit Fees Construction Information Building Value: $0.00 Building Fee: $0.00 Use Group: R2 Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1996 BOCA Mechanical Value: $5,500.00 Mechanical Fee: $34.00 Construction Type: 5B Electrical Value: $0.00 Electrical Fee: $0.00 Permit Code: R5 Other Value: $0.00 Other Fee: $0.00 Comments: Total Value: $5,500.00 CO Fee: $0.00 Plan Review Fee: $0.00 State Ed Fee: $0.88 Total Fees: $34.88 It is the owners responsibility to schedule the following inspections(minimum 48 hours notice required): ❑ Footing-Prior to pouring concrete ❑ Rough HVAC ❑ Backfill - Footing drains and waterproofing ❑ Fireplace Throat ❑ Concrete Slab- Prior to pouring concrete ❑ Chimney-One flue above thimble ❑ Rough Framing ❑ Firestopping/draftstopping ❑ Rough Electrical ❑ Insulation ❑ Electrical Service ❑d Final Inspection ❑ Rough plumbing and leak test ❑ Certificate of Occupany ❑ Gas piping and test Building Official's Signature: Town of Montville Building Department Receipt Date / " / // / 6 .�-� No. 03431 From: i/ c- i Ai gir Job Address: /� . . teargillit , Amount $ ��' �y• Cash6r:-1----( Check # � (Ore Received by i rr . � _- Permit # /it-3o� �-,-- i %. N Town of MQntville Building Department Permit#/ ds-5"O 2 Y5 310 Norwich-New London Tpke. Tel. 848-3030,Ext 82 Uncasville,CT 06382 Fax. 848-7231 One &Two Family Trades Permit Application Form DP(umding ❑ECectrica( J�fechanicaf .Air Condi twnzng —Gas piping ❑ter Job Location !i. Q v o ) 47.4f) 6V C42f V i 1 Job Description/Material s---._ n I , .. 4 # A 4 ►. A . y A Ait. 6 >l(ii\) ---rivp) Vvi3Lij1 Owner 67D if it 1- CI ia r( L Mailing Address 7 07 Ai a n w,C,L 1VL- de City V ti Cop S t State C) Zip 66 2 g A, Tel Z_V$'—y`Q_6./ "' Contractor CCC!o 4716 I y6 0 a ( Mailing Address ("b ��Ok. "..n City Jr°1(it" P j1I Statee Zip()6, 3 7Tel WY kaa,_/_17? Contractor's License/Registration Type &Number a o , .. 6 C-0 --C-- / Exp.Date r 3/ / ___07/ 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 Signa :== s - 1 • Date J)/ /_O 3 Construction Value Fee Building $ $ Plumbing $ $ Mechanical $ cv—. 7i )`0- ) $ V� Electrical $ $ Other $ $ Certificate of Occupancy $ Plan Review Fee $ State Education $ Total $ $ , ACORD CERTIFICATE OF LIABILITY INSURANCE DAIL rMMLOOFYY) PRODUCER .-. D�lzo,o, 860-739-3322 THIS CERTIFICATE IS ISSUED AS A MATTER OF`NFORMATION Smith Insurance,Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 15 Liberty Way ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Niantic, CT 06357 COMPANIES AFFORDING COVERAGE COMPANY A Hilb,Rog &Hamilton Co INSURL D McCarthy Heating Oil Service, DomemY B Inc , James P. McCarthy P 0. Box 332 COMc c Quaker Hill CT 06375 COMPANY l D COVERAGE$ < '1:: > >...;<K THIS is TO CERTIFY THAT THE POLICIES CF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE'INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTIMTHSTANDNG ANY REQUIREMENT,TERM OR CONDITION CF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TE NIS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COI TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION LTR POI ICY NUMBER I DATE(NMOONY) DATE IMM/DDIYYI LIMITS I GENERAL LIABILI l Y - CIMFACIAI GENERAL LIABILITY GENBIAL AGGREGATE 5 CM . PRODUCTS COMPIOP AGG 3 CLAIMS MADE f l OCCUR MOWN S8 CONTRACTOR'S PROI PERSONAL &ADV INJURY 3 EACH OCCURRENCE 3 FIRE DAMAGE (Arty ux.Ori) 3 AiI7OMOBLP'TAMMY EXP(Any one parsec!) 5 ~ T ANY AUTO COMBINED SINGLE LIMIT I J 1 ALL CLAMED AUTOS I SCHEDULED AUTOS BODILY INJURY Pei Imam) HIRED AUTOS t—_. NON-OWNED AUTOS BODILY INJl1Rr Perxcafanq 3 — t PROPERTY DAMAGE GARAGE r_ UABLITY I AN, AUTO AUTO ONLY EA ACCIDENT 5 OTHER THAN AUTO ONLY - - ` EACH ACCIDENT 5 — IJXCESS LiARIIITY AGGREGATE 5 L___ UMBRELLA FORM EACH OCCURRENCE 5 AGGREGATE ()THEP IRAN UMBRELLA 1-ORM A WORKERS COMPENSATION AND WC376720902 5 EMPLOYERS'LIABILITY lO/OtlOO ,OlDI/D� -�ATU TUT}.I- _ X (TORY LIMITSI I ER _ THE PROPRIETOR/ EL EACH ACCIDENT 3 500000 . PARTNERS/EXECUTIVE X INCL _ — OFFICERS ARE EL DISEASE-POLICY LIMIT 3 500000 IXCL OTHER El.DISEASE-EA EMPLOYEE'3 500000 it 1 LLSCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS L`Ei{TFIcA'rE HOLDE�i SHOULD ANY Of THE ABOVE DESCRIBED POUCICS BC CANCELLED BLIORIN L T . INSURANCE PURPOSES ONLY EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR 7O MAI, 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOI DER NAMED TO THE TEET, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UABLITY Of ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRE ENT IVF MMQRDZ5,-.$.�l f:. .. .., ,>..<,;A I#„32 1 , /(j ��ILA) 0Q Town of Montville Building Department 848-3030,Ext 382 COMMERCIAL PERMIT SIGN-OFF SHEET I Y-Q, k-'," 1 n49 1/ fl/1_pS (i)k Property Address Job Description: C f j/la AO) CIZAA4 (�Q ,� 149 ce y,,,t p,, "U ` y 'I' ,AL The owner/agent shall be responsible for the completion of the form, no certificate of occupancy will e issued until all signatures below have been obtained. HEALTH DISTRICT 848-3030-Ext.339 Approved ❑ Permit#: ❑ Not Applicable Septic System Date Inspected and ❑ Approved ❑ Not Applicable Food Service Establishment Date Approved ❑ Permit#: ❑ Not Applicable Private Well Date WPCA DEPARTMENT 848-3030,Ext 881 Approved ❑ Permit#: ❑ Not Applicable Municipal Sewer Date House Trap ❑ Outside ❑ Inside Approved ❑ Permit# ❑ Not Applicable DEPARTMENT OF PUBLIC WORKS 848-7473 Approved ❑ Permit#: ❑ Not Applicable Director Date POLICE DEPARTMENT 848-7510 Approved ❑ Permit#: ❑ Not Applicable Officer in Charge Date PLANNING &ZONING DEPARTMENT 848-3030,Ext 381 In-Compliance ❑ Permit#: ❑ Not Applicable Zoning Date In-Compliance ❑ Permit#: ❑ Not Applicable Inland-Wetlands Date FI' MARSHA OFFICE 848-3030 Ext 384 / Approved =`A 4/ 1#16 -if Permit#: ❑ Not Applicable Fire Marshal ` ate