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HomeMy WebLinkAboutLP Tank, Lines, and Logs (100 Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville,CT 06382 (860)848-3030, Ext.382 Mechanical Permit Permit Number: M2003-0045 Date: 02-Apr-03 Map/Lot: 028/005-028 Owner ID 117011 Job Location: 25 PHEASANT RUN Unit Job Description: gas lines,tank&gas logs 1 Owner: Contractor: Linda R Kabelis Advance Gas 183 East Haddam Road 25 Pheasant Run Salem Ct. 06420- Oakdale CT 06370 Telephone: (860)859-9070 Lic/Reg Type/No. G1 386875 Exp Date: 31-Aug-03 Tenant: Self Telephone: Construction Values Permit Fees Construction Information Building Value: $0.00 Building Fee: $0.00 Use Group: R4 Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1995 CABO Mechanical Value: $400.00 Mechanical Fee: $10.00 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: $400.00 CO Fee: $0.00 Plan Review Fee: $0.00 State Ed Fee: $0.06 Total Fees: $10.06 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 0 Final Inspection ❑ Rough plumbing and leak test ❑ Certificate of Occupany O Gas piping and test Building Official's Signature: , Town of Cry9ntville Building Departmc Receipt Date / / / X3 No. 02593 From: Job Address: e/e1. � AGt-Ai Amount $ Cash 1CM Check # /41r5.-- (circle 416circle one) Received by „b //__ ��1'. � Permit # Ao2e,O 3 -r' � • Town of Montville ,, Building Department ` Permit# 310 Norwich-New London Tpke. Tel. 848-3030, Ext 82 Uncasville, CT 06382 Fax. 848-7231 One&Two Family LP-Gas Permit Application Form Job Location Off, P c n 4 Job Description/Materials F',v ;ne-5 +"1S Owner �� '', Mailing Address City Statef'1 Zip cTel /e34 g"/(-L,6 Contractor f c-k. Y 4 n Mailing Address 1ic.;f , '- c ik City e rv1 State Zip,"DU-L) Tel ma Contractor's License/Registration Type&Number (�1 Ni ( '3 Exp.Date ,")a"/ ) / 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 Signature NDate 3 / �1 / Construction Value Fee Building $ $ Plumbing $ $ Mechanical $ $ Electrical $ $ Other $ 13. 06 Certificate of Occupancy $ Plan Review Fee $ State Education $ Total «-?,kirys®�ili.1, P/u1�Qlti��/oriiklri, ; ibliilit,9�lu�©hR�riAi Jn�®l+it�©'1 Iph ' ®iiia/ukri,oriimptikro �l��lloiP/ STATE OF CONNECTICUT + DEPARTMENT OF CONSUMER PROTECTION P r Be it known that . MARK A MARTIN &> 67 FORSYTH RD 1115. SALEM,CT 06420 has been certified by the Department of Consumer Protection as a licensed iiiN HEATING, PIPING & COOLING LIMITED CONTRACTOR TYPE:G1 License # 386875 op 1 Effective: 09/01/2002 :® Expires: 08/31 `„ 2003 =-- `� Jam T. Fleming,Commissioner112 ftwiPlitt®lith i/4i.74m. ii7 -f -; ...._ - -.. ... -