Loading...
HomeMy WebLinkAbout120 Gal. LP Tank and Lines to Generator and Heater 2012 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: M2012-0218 Date: 27-Dec-12 Map/Lot: 078/015-000 Owner ID: 5445000 Project Location: 90 PEQUOT ROAD Unit: Job Description: Move Existing LP Tank&Add 120 Gal Tank.Reconnect to Generator&Heater Owner Nam Todd F.and Monica A.Pomazon Tenant Name N/A Careof: 90 Pequot Road Uncasville CT 06382- Telephone: (860)908-5085 Contractor Nam Amerigas Telephone: (860)537-5925 DBA: Lic/Reg Type GI Lic/Reg No 402952 275 South Main Street Exp Date: 31-Aug-13 Colchester CT 06415- Construction Value Permit Fees — Construction Information Building Value: $0.00 Building Fee: $0.00 Use Group: IRC Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 2005 State Building Code Mechanical Valu $500.00 Mechanical Fee $30.00 Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type IRC Total Value: $500.00 Penalty Fee: $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comment Plan Review Fe $0.00 Fire Marshal Fee of$20 Paid State Ed Fee: $0.13 Total Fee Paid: $30.13 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 framin ❑ Electrical Service CRS No: 0 ❑ Framing ❑ R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble El Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation Q Certi' ate of Approval %7 •ertificate of Occupancy Building Official's Approval: own oI 1vionnvuie Building Department 310 Norwich-New London Tpke. Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 RESIDENTIAL PERMIT APPLICATION FORM Permit No.:(Yjr71( — Type of Work Occupancy Type Permit Type ❑New Construction ❑Single Family ❑Building ❑Addition ❑Two-Family ❑ Plumbing ❑Alteration ❑Townhouse ❑ Mechanical ❑Accessory Structure 0 Electrical CRS#: Property Address: / �lJp id (Number) /f (Street) (Unit) �/ `Q,- Job Description: AO .41 i� ,��.• _i d ✓ "�_' �/ Owner: 7GYd 6'Am -tZ-D f) Address: 9D 6071 4gc Pty: CeU U!11e— State: Zip Code: 0 '3 60 Telephone( (4Q) 9•4C/- Applicant: vo -Applicant: AMERIGAS DBA: 275 SOUTH MAIN ST Address: COLCHESTER, CT 06415 (860)531-592 City. tate: Zip Code: Telephone( ) Contractors - Complete the Following: • License Type: Z7L�L� License N "C 9_5:2. y3iii,j � Expiration Date: I hereby certify that the proposed work will conform to the State 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. ❑ By checking this box, I will follow the requirements of the 2005 NEC as the alternative compliance per section E3301.21 of the Residential Code, instead of the electrical requirements in chapters 33 through 42 of the Residential Code. &.64-17,4, Owner/Agent Signature: i Ci� - Date: )4/c% &/P-- Construction Value Permit Fees Building Value: Building Fee: Plumbing Value: Plumbing Fee: Mechanical Value: Mechanical Fee: Electrical Value: Electrical Fee: Total Value: Penalty Fee: C of 0 Fee: PJae=eetieseeFser GpC1 Ctate-Ed r\: �^A,3 Total Fee: A.evised august 23,2007 Town of Montville Building Department File Receipt Date: 26-Dec-12 ReceiptNo: 8028 Received From: Amerigas Job Address: 90 Pequot Road Town Fees Collected State of Connecticut Fees Collected Bldg Cash: $0.00 State Cash: $0.00 Bldg Check: $30.13 State Check: $0.13 Bldg Credit: $0.00 State Credit: $000 Fire Cash: $0.00 Fire Check: $20.00 Fire Credit: $0.00 Construction Value: $500.00 CheckNo• Demolition Value: $0.00 • 1143 Received By: Carmen Kneeland AmenGas America's Propane Company • R E l I A O l E, SAC E, R E 3 P O M$1 V r Date: Building Official: Town of ' ; Dear Sir and/or Madam: Today, Amerigas Propane is applying for a permit for a propane gas installation. As an employee of Amerigas, and a G-1 license holder, please accept this letter as a proxy, in lieu of a personal appearance for a permit application. Our customer's name is: / C/I )°,1 az4 zo Ili The work will be performed at: 90 P.,2, .U p 1 ie c, Below is a copy of my current G-1 license. My agen Ai/_Ai_, i Clkwill process the necessary paperwork on my behalf. Thank you for your cooperation STATE OF CONNECTICUT DEPARTMENT OF CONSUMER PROTECTION Tim Roberts HEATING,PIPING&COOLING LIMITED CONTRACTOR Service Technician TIMM HY S ROBERTS Amerigas Propane 19 OLD KENTWQOD RD EAST HADDA:M,CT 00234263 I' LIC./ REG NO FFECTIVE^i` EXPIRES j 4 . :8/31/2013 HTG.0402952=G �a ;Q9�U1/ 21t,,w ' ntaxsro-4 /-2012 09:068 FROM:GAS SOLUTIONS LLC 8608226988 TO:8605376614 P.2/2 RESIDENTIAL IN 'ALLATIO', SET-UP FORM AYE / DATLO '�ITE CHECK: i COMPL. ED ST: ,/ // TBr1Z r plea- k1 l.-- Z6 l2.- 1 Aea / 1c '7i.4, / /DDRE8Ma /� ,c / ff ff —90 e�— �O�S DIRECTIOk8 TO SITE: ILII np 1-*z4- )<'a- 0-eAlt, . t st FILL PRICE: RENT QUOTED. INET LL Carr? fire,,,.-,,,, - I'��TALL DATE: PROPOSAL?© N 2, r/ yeV ,r/ y.7.' 1,-.),_,,„‘ TANK SWAP NEW INSTALL NEW APPLIA ,CE I MAN JOB 2 MAN JOB SIZE OF TANK(S): aa ( z D ft . } .G ESTIMATED JOB TIME: 3 yse.r. TANK SET CONCERNS CALL AHEAD SLOPE F"' STAIRS SEPTIC FENCE ( PETS Sp/TUBING TO BE RUN LENGTH: S / SIZE: 3�4- /� TYPE: COPPER PLAIITIC ' 1 BLACK IRON TRAC PIPE THRU: WOOD BRICK CONC 'ETE ALUMINUM VINYL SPECIAL TUBING INSTRUCTIONS: f 2. Lt44j4.- 4 /' , e -. - Q.4 4 G.v l Zn; . r k-z, s lc :cc✓ jLa. .."-G1 e.-oG� 8' CIA QUIPM N D • 0•IN-T LLATION(LA•D R,DRILL,: •V L, C. CODE VIOLATIONS NEEDING CORREC ON: / T"4 k -'o col-.c. .0 W.4eX 04.0f. ` . OTHER REQUIREMENTS(CONVERSION KIT,VENTING,810IN0 KIT,ETC.): I, 1 INSTRUCTIONS:INDICATE WHERE TANK(S)ARE TO :: INSTALLED&IF 'EQUIRED BY THE LOCAL JURISDICTION,INCLUDE MEASUREMENTS TO EACH SURROUNDING PROPERTY LI . , NOTE DRIVE MS,SEPTIC SYSTEMS,WALLS,FENCES,SLOPES,ETC. SCoIi/ in •. �;, V —e-- -1 0 01: I 4,v \ ,,____,.--'///— i I I, < ":•ONTOFHOU-. Marsh Page 1 of 2 r MEMORANDUM OF INSURANCEDATE 29-Jun-2012 This Memorandum is issued as a matter of information only to authorized viewers for their internal use only and confers no rights upon any viewer of this Memorandum.This Memorandum does not amend,extend or alter the coverage described below.This Memorandum may only be copied, printed and distributed within an authorized viewer and may only be used and viewed by an authorized viewer for its internal use.Any other use,duplication or distribution of this Memorandum without the consent of Marsh is prohibited. "Authorized viewer" shall mean an entity or person which is authorized by the insured named herein to access this Memorandum via http://www.marsh.com/moi?client=E784.The information contained herein is as of the date referred to above. Marsh shall be under no obligation to update such information. PRODUCER COMPANIES AFFORDING COVERAGE Marsh USA Inc. ("Marsh") colt ACE American Insurance Company INSURED co.B Indemnity Ins. Co. of North America AmeriGas Propane L.P. and its Subsidiaries P. O. Box 858 Co.0 Valley Forge, Pennsylvania 19482 United States co.D 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 MEMORANDUM 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY POLICY LIMITS LTR EFFECTIVE EXPIRATION LIMITS IN USD UNLESS OTHERWISE DATE DATE INDICATED A GCOMMERCIAL 01-Jul-20 2000000 REG GENERAL LIABILITY OCCURRENCE PRODUCTS- 2000000 COMP/OP AGG PERSONAL AND 1000000 ADV INJURY EACH OCCURRENCE 1000000 FIRE DAMAGE(ANY 1000000 ONE FIRE) MED EXP(ANY ONE 10000 PERSON) A AUTBOL OBILE I SAH0870949A 01-Jul-2012 01-Jul-2013 CO IT INED SINGLE 1000000 LTY ANY AUTO BODILY INJURY (PER PERSON) BODILY INJURY (PER ACCIDENT) PROPERTY DAMAGE EXCESS LIABILITY EACH OCCURRENCE AGGREGATE GARAGE LIABILITY AUTO ONLY(PER ACCIDENT) OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGATE B OMRICERS PE SATION/ WLRC46784583 01-Jul-2012 01-Jul-2013 WORKERS COMP Statutory A EMPLOYERS LIABILITY WLRC46784662 01-Jul-2012 01-Jul-2013 LIMITS THE PROPRIETOR/ EL EACH ACCIDENT httrr//mni march nnm/MarshPnrtal/PortalMain?PID=AnpMoiPublic&C=com.marsh.moi.g... 6/29/2012 Marsh Page 2 of 2 • A PARTNERS/ SCFC46784741 01-Jul-2012 01-Jul-2013 1000000 EXECUTIVE OFFICERS ARE:INCLUDED EL DISEASE- 1000000 POLICY LIMIT EL DISEASE-EACH 1000000 EMPLOYEE The Memorandum of Insurance serves solely to list insurance policies,limits and dates of coverage.Any modifications hereto are not authorized. MEMORANDUM OF INSURANCE29D oT 012 This Memorandum is issued as a matter of information only to authorized viewers for their internal use only and confers no rights upon any viewer of this Memorandum.This Memorandum does not amend,extend or alter the coverage described below.This Memorandum may only be copied,printed and distributed within an authorized viewer and may only be used and viewed by an authorized viewer for its internal use.Any other use,duplication or distribution of this Memorandum without the consent of Marsh is prohibited. "Authorized viewer" shall mean an entity or person which is authorized by the insured named herein to access this Memorandum via http://www.marsh.com/moi?client=E784.The information contained herein is as of the date referred to above. Marsh shall be under no obligation to update such information. PRODUCER INSURED Marsh USA Inc. AmeriGas Propane L.P. and its Subsidiaries ("Marsh") P. 0. Box 858 Valley Forge, Pennsylvania 19482 United States ADDITIONAL INFORMATION The Memorandum of Insurance serves solely to list insurance policies, limits and dates of coverage.Any modifications hereto are not authorized. Click here for a printer-friendly version of this document. httn://moi.marsh.comfMarshPortal/PortalMain?PID=AppMoiPublic&C=com.marsh.moi.g... 6/29/2012 Town of Montville Building Department CONSTRUCTION PERMIT APPROVAL Applicant is responsible for obtaining all of the required approvals. No permit will be issued until all the required signatures are obtained. LProperty Address -',e t'e Th,t' ' ,9c/o/ arro �, (0`'�a 'faI . Job Descripn Required Department Permit Issuance Approval Approval Tax Collector .-✓. ���t- ��/��.�� ,�__ Signature/date Comments: Planning &Zoning - i z /Z(. /4 2 l G/ 1 /z/z, date Comments: ,p�ll1� I • Fire Marshal /w 2 \Zl,;( (L�/ Signature/date Comments: ` c , til�_1� '[ ❑ Health Department Required for properties with private septic or well Comments: WPCA, Administrative �ce l Required for properties on sewer Sig ature/date Comments: ❑ WPCA, Operations When Required by WPCA Signature/date Comments: [ Department of Public Works Required when project includes driveway work or certain drainage requirements Signature/date Comments: ❑ Montville Police Department Required for all permits EXCEPT one and two family residential Signature/date Comments: ❑ State Dept. of Transportation Required for Structures over 100,000 sq.ft.or with more than 200 parking spaces-Official copy of STC Certificate of Operation required-per CGS 14-311 Signature/date Building Department Review Complete Signature/date Revised May 23,2011