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Home My WebLink About50 Gal. LP Tank and Lines to Logs 2005 Field Inspection Notice Town of Montville Building Department December 5, 2005 Address: 26 Pheasant Run Job Description: Gas & Logs Permit Number(s): M2005-0180 Permit Date: 11/10/05 INSPECTION Not Approved Approval t" Deficiencies Special Conditions Date GAS LINE TEST •• 12/05/05 DJ • INSERT INSTALLATION 12/05/05 DJ • CERTIFCATE OF 12/05/05 DJ COMPLITION Rev.Date: 10/18/05 Page 1 of 1 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: M2005-0180 Date: 14-Nov-05 Map/Lot: 028/005-059 Owner ID: 5466000 Project Location: 26 PHEASANT RUN Unit: Job Description: Set tank, run gas line for log set Owner Name: Joseph A&Teri L Hochdorfer Tenant Name: N/A Careof: 26 Pheasant Run Oakdale CT 06370- Telephone: Contractor Name: Uncas Gas Telephone: (860)889-7700 DBA: Lic/Reg Type: S1 Lic/Reg No: 387812 P. 0. Box 17 Exp Date: 31-Aug-06 Franklin Ct 06254- Construction Value Permit Fees Construction Information Building Value: $0.00 Building Fee: $0.00 Use Group: R-4 Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1999 State Building Code Mechanical Value: $250.00 Mechanical Fee: $8.00 w/2004 Amendment Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type: 5B Total Value: $250.00 Penalty Fee: $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $0.04 Total Fee: $8.04 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: Framing 0 R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble V Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation ❑ Certi icate of Approval ertificate of Occupancy Building Official's Approval: ,� Towxl►of Montville t Building Department Tel. 848-3030,Ext 382 310 Norwich-New London Tpke. Uncasville,CT 06382 Fax. 848-7231 Residential LP-Gas Permit Application Form � � n Ej..8 7 �(Family [] Two-(Family 0 Townhouse Permit# 07ee 4-7— O� Job Address (Number) (Street) (Unit) Job Description 5� p WUr\ -14,k ,/�, 2 �( ( �� rc� 4rJ Lois Owner .Jaec/,Oitr-�,--` Mailing Address SI 'ti., City Q a 4,4, State Zip Tel N 7/ ' '.:3(,,0 Contractor (jA(A S cLS Mailing Address /9‘i. x r 7 j City r)/)'Z-. State (T—Zip /-- Z n Tel / Pefl I Contractor's License Type&Number 74f /7_ s- Exp. Date / / 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. Separate applications are required for electriccal./ Owner/Agent Signature cZgi �i/ 7 Date / ( / r / 5 Construction Value Fee Mechanical $ zsG Electrical $ $ Plan Review Fee $ State Education $ �� tl� $ o. u� o.oy Total $ $ T.0 1--) ¶cwrreiseptem6ier9,2004 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) PRODUCER p 12/02/2004 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Jamerson McLean Corporation • ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O.Box 621149 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND 'OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 825 Executive Drive Oviedo FL 32762 INSURERS AFFORDING COVERAGE INSURED Northeast Oil&Propane,Inc. NAIL# INSURER A Ranger Insurance Company Uncas Bottled Gas INSURER e: Westport Insurance Company P.O.Box 264 INSURER C: — Danielson CT 06239 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L' I POLICY EFFECTIVE I POLICY EXPIRATION LTR INSRO TYPE OEINSURANCE POLICY NUMBER I GENERAL LIABILITY �EDO� DATE/MM/Ooml • LIMITS EACH OCCURRENCE g 1,000,000 A - I X I COMMERCIAL GENERAL LIABILITY ENG 0237643 12/11/2004 12/11/2005 DAMAGE TO RENTED I I I CLAIMS MADE X OCCUR PREMISES+Ea occurencel g7643 1• 2/ I _ _- MED EXP Any one person) :g 5,000 • _ _ I PERSCNAL&ADV INJURY 'g 1,000,000 GENERAL AGGREGATE 's 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:I I ' POLICY PRO- I I PRODUCTS-COMP/OP AGG 3 2,000,000 JECT LOC AUTOMOBILE LIABILITY A X�ANY AUTO SBA' 0362858COMBINED SINGLE LIMIT g 1,000,000 12/11/2004 12/11/2005 Ea a=cenq ALL OWNED AUTOS • f SCHEDULED AUTOS BODILY INJURY (Per erscnl X HIRED AUTOS ' X NON-OWNED AUTOS BODILY'NJURY (Per cent) g X COMP DED S 1,000 ' X I COLL DED S 2,000 PROPERTY DAMAGE (Per ac ent) g GARAGE LIABILITY AUTO ONLY-EA ACCIDENT 3 ANY AUTO OTHER THAN EA ACC 3 AUTO ONLY: AGG 3 EXCESS/UMBRELLA LIABILITY A X - OCCUR CLAIMS MADE CUP 0421295 EACH OCCURRENCE 3 1,000,000 ' 12/11/2004 12/11/2005 AGGREGATE i g 1,000,000 • • I DEDUCTIBLE g X I RETENTION g 10,000 3 ' ' g • WORKERS COMPENSATION AND WC STATU- !0TH-. B EMPLOYERS'LIABILITY ! WCX 002142912111/2005 TORY I NITS ' FR .ANY PROPRIETOR/PARTNER/EXECUTIVE ! 1 211 112 0 0 4 ' 1 2/1 112 0 0 5 E.L.EACH ACCIDENT ' g 500,000 OFFICER/MEMBER EXCLUDED? ' I yes.describe under E L DISEASE-EA EMPLOYEE 3 500,000 iSPECIAL PROVISIONS below OTHER EL.DISEASE-POLICY LIMIT g 500,000 �� DESCRIPTION � � OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS FAX#860-848-7231 1 CERTIFICATE HOLDER CANCELLATION Town of Montville SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Building Department DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Attn:Vernon Besey NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE J _ 4%...._ ACORD 25(2001/08) 3CORD CORPORATION 1988 Jef ,, 11.• ......ve-^r .. _ • _ _ �-'►' 1�- •• ` e 4 /• b a • • •' • J y ii.!;!/• _ " ;.,+.� mar-,-- .__—j._._ .. AP_ �•- ,� , • . - .. ....). . ...�T.Y11.M.p,.y +.04....4.„,.F,4.„,.....,,,,,,„„ +if e_..j_ STATE OF CONNECTICUT-_ ":.DEPARTMENT'OF COlk'SUMER':L';RiO fl CT : 1 •�i•i_" i0. .. '% _ '_ _ ,[f .A1 N\A!t(f, _ j s: �, :.:'i •,C •. ■/••'.moi. ' li`' j'.'.� .- .. �•i� .. r _ ,�. a -DA Y1, B�SCOTT '�c _ :i y. }1 r d a 68 WAT RMW t •;; `DAN GT'.-06 39. '- - . _ it: ., has been certified byt en1: : -:;?,..... ' '� • ! , • Protection as a, �� ! HEATING, PIPING&C 1 ED CO II s{ _ • y:It r 1,• it( x 'id ��:. . j --44 b,� ##380 ' fj r yt+1Effective: ,� 09/01/2005 i ';,: '4 Expiration: 08/31/2006 f'. ' Rodrigues,Cotnnu ioncr i Li :E el'Vw,�,�'` ,�ti ,�,� ;*...,,ti i Edwin R RoL _. gni . t p h,r.1. Tow/i-of Montville Building Department 848-3030, Ext 382 RESIDENTIAL LP-GAS PERMIT CONSTRUCTION PERMIT APPROVAL 6 F',J74.9-As-A .J /zcr(J Property Address $AS L�h,ts— g -TA J.1k 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 Approval Depai talent Permit Issuance Approval Tax Collector �Om s \‘ 18 t oS IIJJ ;t_nat� t. dais WPCA '� ign btu diate ❑ Planning&Zoning Signature'date ❑ Health Department Signature date ❑ Fire Marshal Signature, date Comments/Conditions: 41viseiSeptemfer9,2004