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Home My WebLink About50 Gal. LP Tank and Line for Logs 2001IIMPIMPRIIRIMPrpaamprepormeirwprq--wm^197"—" ,*-7 "•"- 410 Town of Montvilleflit Field Inspection Notice Permit # Location: 3 7 Ph.e G,c a- JZ u r Type of Inspection: GAS Pi PiN Ct Issued to: Delivered to: APPROVED NOT APPROVED The following orders are hereby issued for their correction: Please call for inspection when corrections have been c. • • ted 860-848-716 Date: ‘/Vo r B -' / Building Official Town of Montville Building Department RESIDENTIAL GAS INSPECTION CHECKLIST CONTROL DEVICES TANK INSTALLATION ❑ Automatic appliances shall be equipped with a ❑ Underground containers minimum 10 ft from listed and labeled device or devices that will shut basements, structures which extend below grade off the fuel supply to the main burner in the event level or adjoining property lines(2611.4) of pilot or ignition failure(1308.1) A DOT & ASME containers shall have a readily visible the firm name and emergency telephone ,ROUGH-IN numbers(NFPA 58;2-2.6.6) /2c Pressure test (air, CO2, or nitrogen) 10 psig for [ ASME containers shall have the firm name and minimum 15 minutes OR 6" mercury measured telephone numbers a minimum of '/2 inch in with monometer or slope gage(2603.3.1) height(NFPA 58;2-2.6.6(a)) ❑ Welded piping and piping for appliances in 1 Tank protected from vehicular traffic (NFPA 58; excess of 14"wc shall be tested at 60 psig for 3-2.4.1(c)) minimum 30 minutes(2603.3.1) Shut-off valve to be located within 6 ft of appliance(2606.3) ❑ Sediment trap(2608.2.2) ❑ Meter located min. 3 ft from sources of ignition when installed indoors(2604.1) GAS PIPING INSTALLATION ❑ Min. 12" burial depth for metallic piping below grade(2608.1.1) ❑ Min. 18" burial depth for plastic piping below grade(2608.1.1) ❑ Protected against corrosion (2608.1.2) ❑ Min. #18 AWG yellow insulated copper tracer wire conductor shall be installed adjacent to underground nonmetallic gas piping and shall be accessible(2608.1.6) ❑ Hanger spacing-tubing max.6 ft—rigid up to'/<" max. 10 ft—rigid 1"and up max. 12 ft(2608.2.6) ❑ Yellow label "GAS" @ 5 ft intervals were exposed piping except for black steel (2608.8) ❑ Metallic gas piping to be bonded to the grounding electrode(2608.9) Above ground piping to be protected from physical damage(NFPA 58; 3-2.8.7) LPG TANK LOCATIONS MINIMUM HORIZONTAL DISTANCE FROM: Tank to Buildings, Pressure-relief Pressure-relief Fill Connection CONTAINER TYPE SIZE(Water capacity Device to and Gage Vent in gallons) Structures or Device to Sources of to Sources of Property Lines Building Openings Ignition or Vents Ignition or Vents (feet) (feet) (feet) (feet) DOT Exchanged Less than 125 None 3 5 — DOT Site Filled Less than 125 None 3 5 10 ASME Less than 125 None 5 5 10 ASME 125 to 500 10 — — 10 Revised 5/I/0I Town of Montville Building Department Phone: 848-7166 310 Norwich New London Tpke Fax: 848-7231 Building /Trades Permit Permit Number M2001-74 Permit Date 5/25/01 Permit Type Mechanical Permit Code R5 Job Street# 37 Job Location PHEASANT RUN Map/Lot 028/005-029 Job Description Gas Piping Owner Contractor Robert B. Haynes Hendel's Inc. Address 37 Pheasant Run Address 35 Great Neck Road City Oakdale State Ct. City Waterford State Ct. Zip 06370 Telephone Zip 06385 Telephone 443-5337 Lic/Reg Number 308397 Lic/Reg Type G1 Exp Date: 8/31/01 Use Group R4 Code 1995 CABO Type Construction 5B Building Value $0.00 Building Fee $0.00 Plumbing Value $0.00 Plumbing Fee $0.00 Mechanical Value $50.00 Mechanical Fee $10.00 Electrical Value $0.00 Electrical Fee $0.00 Other Value $0.00 Other Fee $0.00 Total Values $50.00 CIO Fee $0.00 Comments: Plan Review Fee $0.00 State Ed Fee $0.01 Total Fees $10.01 r Building Official's Signatu - / Date / (7 / C+ It is the owners respo, -'! Ay o schedule the following required inspections(minimum 24 hours notice required): ❑ Footings - prior to po ng concrete ❑ Backfill -footing drains and waterproofing ❑ Fireplace Throat ❑ Concrete Slab, prior to pouring ❑ Fireplace Final ❑ Rough Framing ❑ Chimney-one flue above thimble ❑ Rough Electrical ❑ Firestopping/draftstopping ❑ Electrical Service ❑ Insulation ❑ Rough Plumbing and leak test ❑ Pool bonding ❑ Gas piping -pressure test and installation ❑ Final Inspection ❑ Rough HVAC 0 Certificate of Occupancy - PRIOR to use or occupancy Town of r ,)ntville Building Department Receipt I 1110 Date ,3"/,:Q S— / p / No. 06739 / E From: rQ &vP Job Address: p_..,..4„...„....7"- Amount $ /-12- -0--i- Cash Check Check # (Circle one) Received by �i . :. i /✓._moi ,..r�% Pen-nit # //42,6W- 7y Town of Montville ,-- Permit # //pee/ ~77 Building Department / 310 Norwich-New London Tpke. Tel. 848-7166 Uncasville, CT 06382 Fax. 848-7231 Application for Building or Trades Permit Building Permit Trades Permit ❑ New Construction ❑Accessory Structure ❑atumbing ❑9Kecfranica( LI Action ❑CDemolrtion ❑Etectricat .7feating (1 Alteration ❑Other Air Conditioning � � f Gas(1 ping Job Location S 7 qz.),L�6,i"v l kVI ., . Job Description/Materials g(4/0 k-N e 'TO it f" -C Lo t— f; c - G-,49- L Owner Q,b 19 l� ( B - 1 1 u j / e5 Mailing Address --Ci: A- e--- city (341 04 L State C__( Zip D.`326 Tel / / Contractor /47/</A) ac2.-L 5 Mailing Address 3c g/ 19 'T fru e Gk Ii City 141-€,- CJL17 G- State G I Zip O63�Sr Tel Cl7 3 ,..s /..? aJ Contractor's License/Registration Type&Number 3 v D 3 cl 7 Exp. Date 9- /3 / / C 1 New Home Construction Contractors: Have you entered into a contract with a consumer for the proposed new home? ❑ Yes ❑ No 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 (7 ' at° 2 0 Date / / Construction Value Fee Building $ ,.5C)-" $ '/ Plumbing $ $ Mechanical $ $ Electrical $ $ Other $ $ Certificate of Occupancy $ Plan Review Fee $ State Education $ , ejf Total $ $ /0 i 0 f ndan LP GAS SERVICE AGREEMENT 35 GREAT NECK ROAD WATERFORD,CT 06385 443-5337 I TYPE 1 SERVICE yR..✓CJ I NUMBERLE NUMBER ER I �2 THIS AGREEMENT,ETHE TERMS AND CONDITIONS OF WHICH ARE PRINTED ON REVERSE MADE THIS DAY OF `'�` / ' / ,BY AND BETWEEN THE HENDEL'S PETROLEUM CO.,("COMPANY"),AND NAME /v� C / �_ v` Q F --7LAST / ��^ �,!� FIRST / DNAME ' ' —/ (CUSTOMER) ? INSTALLATION ADDRESS / OC�%lT J/T/v /J Ore' ' i C-7 ---eTC,17O e',P- ir . 0. BOX OR STREET CO < a TOWN STATE ZIP CODE PHONE y MAILING ADDRESS ,,S41 " WS BOX OR STREET TOWN STATE ZIP CODE PHONE a PERMANENT ADDRESS � BOX OR STREET TOWN STATE ZIP CODE S,Q,. . PHONE PROPERTY OWNER'S NAME ��lL�( LAST ,¢,,y FIRST MIDDLE NAME PROPERTY OWNER'S MAILING ADDRESS �� ` BOX OR STREET TOWN STATE ZIP CODE PHONE CUSTOMERC /r ../17//;/:://E---6. �yf�/v EMPLOYED BY /1-‘-#449E. J ��+��/17� L F-� I ADDRESS 2r j9-j,ver - IP 6.0 64.ti l NOTICE: SEE REVERSE SIDE REGARDING YOUR RIGHTS'.X.tied"CC NOTICE TO CUSTOMER:(1)DO NOT SIGN THIS CREDIT AGREEMENT TO DISPUTE BILLING ERRORS. -- /R/(.i c/044) BEFORE YOU READ IT OR IF IT CONTAINS ANY BLANK SPACE.(2)YOU AR ENTITLED TO A COMPLETELY FILLED IN COPY OF THIS SERVICE AGREEMENT.KEEP IT TO THE HENDEL'S PETROLEUM CO.("COMPANY") PLEASE PROTECT YOU: EG:L RIG S. SIGN ► LP GAS SE' 'Nei'EEM' c--� / �/ ACCEPTED > (i< HERE CUSTOMER ,ice BY 1 ( C. %S .__ I DIST ICT NA ER SOCIAL SECURITY NO. DRIVER'S LICENSE NO. INSTALLED EQUIPMENT-INITIAL WHETHER COMPANY/CUSTOMER OWNED J CO. CUS. SERIAL El NAT BO DOT INSTALLATION FEE OF $ 4/!G PAID BY PROPERTY OWNER ID TENANT ❑ OWN OWN ITEM SECURITY DEPOSIT OF $ PAID BY PROPERTY OWNER . 0 TENANT 0 N0NO. DATE / 111CONTAINER I Ib/eOP -111 DATE PROMISED DATE SCHEDULED . CSIZETAINER lb/Gal --■- S1URCE II CONTAINER ■ no ,.� OTHER SIZE Ib/Gal METER WP 111111111111111111111111.11111 ! . II III MODEL* -� i - - - 111 II RT111MEGULAODEL T,OR -I READING IIREGULATOR MODEL# I INDEX DEALER I N I I I MAP OF AREAI I I I 1 1 INSTRUCTIONS: (1/0(' / W± E -r-r_7- -r-r-r-r-7_7-7- S I I I I I I I I I I -r-T-T-7-7--I--1----r-r-r-r-r-r-T-T--1- I IIII I IIIIII / A I r-r-r-r-r-t-y-y -1--I r r r r t t-t-y- I I I I I I I I 1 I I I --r-r-r-+-+-+-4-1-1--I------r-I--r-+-+-+-4-1_ 1 I I I I I I I I I I I 1 1 1 1 1 1 1 1 1 1 1 1 t- I- L 1 1 4 4 1 - -r - I- L L L 1 1 4 { -I �.r. c L L L L 1 1 1 1 J _I I_ L L L 1 1 1 4 1 .c�5�' '` 1C3.' CQ, I I I I I I I I I I I I L L L 1 1 1 1 4 ,J J L L L L 1 1 1 1 1 I I I I I I I I I I I L L L L 1 1 4 J J L L L L 1 1 41 1 IIII I IIIIII I L L L 1 1 1 J L L 1 1 1 J SUBMITTED BY r I I I 1 1 1 1 1 1 I I I I I I 1 I 1 II I OYEE OR AUTHORIZED REPRESENTATIVE I I 1 I1 I I i i i I i CONTINUED ON BACK OF REVO CARD 1 I I I I I r r r r I -r T 7 i -i r r r r T T 7 ; SYSTEM TESTS I I I I I I I I I I I OPERATING PRESSURE-FULL LOAD r r r r T 7 7 7 1 1 r r r r T 7 7 7 WC I I I I I 1 I I I I -r-r-r-r-T-T-7--1- - ----r-r-r-r-r-r-T-T- I 1 REGULATOR LOCK UP WC 1 1 1 1 1 I 1 1 1 1 I --r-r-r-r-t-t-y-y-y--I 1--r-r-r-t-t-1-y- LINE LEAK TEST-START WC I I I I I I 1 1 1 1 I 1 I 1 I I I IIII 1 AFTER 10 MINUTES WC - __F_F_}-4,--+-+--I-41-�_� F._F_F_}_+_4_i_.�- SIGNATURE OF CUSTOMER DATE II- I I 1 1 I 1 I I 1st STAGE LEAK TEST-START P31 t- t- 4- 4- 4- 4 4 -I -4 -1 I- I- L 1 4- + + -I I 1 1 1 I I I I I I I AFTER 10 MINUTES L L L 1. 1 4 4 4 J -I 1- L L L 1 1 1 1 1 PSI SIGNATURE OF INSTALLATION MAN I I I I I I I I I I I 1 IIII I I I I I I TIME:ARRIVE LEAVE USE BALLPOINT PEN -PRESS FIRMLY. 1-7433/ Reorder from CURTIS 1000. uort1.....W.HARTFORD.CONN.06110