HomeMy WebLinkAboutGas Tank and Line to Stove 1999 TOWN OF MONTVILLE
BUILDING DEPARTMENT
310 NORWICIH-NEW LONDON TPKE.
UNCASVILLE, CONNECTICUT 06382
&SA-a4s-tick)ok) Fax 860-1348-T131
Mechanical Permit Page: 1
Permit Number: MC1999-54 Printed: 8/11/99
Approved:
Applicant: Suburban Propane Zoning:
, P.O.Box 385 Addition:
Uncasville, Ct 06382 Block:072 Lot(s): 043-000
Parcel Number: PARC1999-365 Section:
11 Pequot Rd. Township:
Uncasville, Ct 06382 Range:
Area:
Legal Description:
Heating Suburban Propane
P.O.Box 385 Voice: 860-848-5510
Uncasville, Ct 06382 Fax:
Local License: State License: G-5 307591
Fees and Receipts:
Number Description Amount
FEE1999-1266 Trades 2000 $10.00
FEE1999-1267 State Educational Training Fee $0.03
Fees Total: $10.03
Furnace<100K Btu:
Ventilation Fans:
Mechanical Exhaust Hood:
Furnace>100K Btu:
Suspend/Reces/Floor Htr:
Floor Furnaces:
Incinerators:
Boilers/Compressors:
Air Handling Units:
Cubic Feet per Minute:
Evaporative Coolers:
Documentation: set tank, run gas line to range
7:_dAd e
Building Officials Signa ure Date
Town of Montville
Building Department
310 Norwich-New London Tpke. , Uneasville, Ct . 06382 Tel . 848 '166
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APPLICA QN OR BU DING PERMIT OR TRADES PERMIT, Please fill out co, Dletely
O r: / I•�"'""' Mailing Address : j / 1.7e,, t401'
Cit ; : (/lv'lCaSU Q State: Zip Code 06&01 Tel : 56/1"7C0 (7
Job Location: (( Y (,�(�� 14, Map/Block/Lot : 6742 6 73 - COO
Contractor: SuLY60 a,,u Mailing Address : IO / 'i 3gj
City: (inCa,sv.�u.Q State: 1i1 Zip Code: OC3'DN Tel : � - 5SS(O
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Stick Built : Modular Home: Manufactured Home: Commercial
Addition: Garage: Car Port : Shed: Remodeling : Ro !:ing: __
Sidi .g: Fireplace: Chimney: Windows : Pool : Demol .ion:
Plurr_,ing: Heating : Electrical : _ Air Conditioning : Ga: :
Patio: _ Porch: Deck: RetaininglWall : New: Repair/Replac'
Job Di cripti�n;L?at�rials used: �t �w/�-K r /, i ra.Age •
kyvk
Size: Type of Heat : Fireplace: _
No.of Stories : No. Rooms : Breezeway:
No. Baths : Garage: Use:
I hereby certify that the proposed work will conform to the Bas:
Builcir_g Code and all other Codes as adopted by the State of Connect rut, and
the 'Own of Montville and further attest that the proposed work is ai horized
by t' e owner in fee and that I am authorized to make application for a permit
for such work as described
above.
Owner/Agent SignatureY1/40'0i/4L___ 1 i
Date
If signed by Contractor , type of license/registration & No:
******************************************************************** *********
Building Department Use Only
Construction Value Fee
Building .
Plumbing
Heating
Electrical
Air Cond._
Other (,. /0 —
Certificate of Occupancy
Plan Review
Total
Check
JOY n
D 03
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4.
Suburban Propane
262 Gallivan Lane • P.O. Box 385 • Uncasville,CT 06382
Office 860-848-5510 • 800-573-3757 • Fax 860-848-5517
http://www.suburbanpropane.com
DATE: 96,
JOB NAME: I , ---- , RI.fet
�'1JOI
JOB ADDRESS: / /) STATE OF CONNECTICUT
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This is to certify that under therittvlsions of the General Statutes
STARTING DATE: _ao Qr G the following persorior 9rmriq licensed or registered.
(( , HEATING,PIPING&COOLINq LTD CONTRACTOR-G5
THOMAS TT GARDINER ' .�...
188 STARKWEATHER RD
CONTRACTOR'S AGENT: �/�/', ��jj�;Lkyy
fiL MOOSUP CT 06354
Y JAI LIC./REG.NO. 1 EFFECTIVEEXPIRES
00307591 9/01/98 I 8/31/99
TO: CITY/TOWN or J1IJ(�i
s SIGNED:PLEASE BE ADVISED THAT THE ABOVE REFERENCED AGENT HAS BEEN AUTHORIZED
TO OBTAIN A PERMIT FROM YOUR BUILDING DEPARTMENT FOR THE SPECIFIED PROJECT
IN 'HIE NAME OF THE CONTRACTOR.
NAME: THOMAS J. GARDINER
SIGNED: Vijrnv... •1a_a.`��� --
LICENSE# 00307591
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44 (� r ALTER THL COVERAGE AFFORDED BY THE POLICT S Briow,
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