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HomeMy WebLinkAboutMFH Two LP Tanks for Water Heater and Stove 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: M2007-0079 Date: 22-Jun-07 Map/Lot: 074/015-T76 Owner ID: 5502000 Project Location: 76 PINK ROW Unit: Job Description: 2-120 gal.Tanks for heat, hot water&cooking Owner Name: Catherine Vine Tenant Name: N/A Careof: 18 Bluminthal Dr. Uncasville CT 06382- Telephone: Contractor Name: Samuel Sugawara -- --•---- Telephone: (860)447-0341 DBA: Osterman Propane Lic/Reg Type: G1 Lic/Reg No: 394019 7 Enterprise Lane Exp Date: r 31-Aug-07 Oakdale Ct 06370- 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 Value: $450.00 Mechanical Fee: $8.00 Electrical Value: - ----------- ...__.._. _ $0.00 Electrical Fee: $0.00 Construction Type: IRC Total Value: $450.00 Penalty Fee: $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comments: Plan Review Fee: $0.00 State Ed Fee: _ $0.08 Total Fee Paid: $8.08 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 E Electrical Service CRS No: 0 D Framing ❑ R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble [/J Gas Piping and leak test Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION Insulation Certificate of Approval Cep' __ - o ! pan. Building Official's Approval: Town of Montville Building Department 310 Norwich-New London Tpke. Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 RESIDENTIAL PERMIT APPLICATION F Fax. 860-848-7231 ORM Permit No.: Wle Family a -79P_e_mitTpTNewonstroikonOccSuing0 BuildingAddition 0 Two-Family 0 Plumbing❑Alteration 0 Townhouse Mechanical❑Accessory Structure ro Electrical CRS#: Job Address: 7 A. I 4 / (Number) - cs�//L6 e,treet) Job Description: a -/ Z-0 / (Unit) Owner: /V / Iv - 444)1/4 6-6neleEnt7- Address: CO '�K��./e - City: I) /, . State:�7 Telephone: J24 - 6+ Zip Code:i Contractor: DBA: Address: 0 owr City: Z) .1-6- LT State: Irr Telephone: ��7-- 341 / / Zip Code: 06 License Type:(7� License No.: (_________ Expiration Date: -.I. Allr_ I hereby certify that the proposed work will conform to the State Building Code and all other codes as adopted bythe of Montville and fu attest that the proposed work is authorized by the owner in fee and that I am authorized to make work as described then above. State of Connecticutrand thefTownuc ❑ By checking this box, I will follow the requiremei of the 005 ► application for a permit for such instead of the electrical requirements in cha. • 33 thr• Cas the alternative compliance per section E3301.21 of the Residential Code, �� � �the Residential Code. Owner/•gent Si. ature: � 411111WOV Construction Value Building Value: Perm---it Pees Plumbing Value: Building Fee: Mechanical Value: %lir Plumbing Fee: Electrical Value: Mechanical Fee: Total Value: Electrical Fee: Penalty Fee: C of 0 Fee: Plan Review Fee: State Ed Fee: ©S Total Fee: 08 &vita Deam6er31,2005 Town of Montville Building Department 310 Norwich-New London Tpke. Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 CONSTRUCTION PERMIT APPROVAL 6/1/V0 7b PiNk tfaw Property Address 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 Department Permit Issuance Approval ■ Tax Collector�(r� G 7 Comments: Signature/gate ❑ WPCA, Administrative tc L C-� Comments: ❑ WPCA, Operations Comments: >ig of ,' ;< i - ❑ Planning & Zoning ig Comments: Signature/ate ❑ Health Department Comments: Signature/:date - ❑ Department of Public Works Comments: Signature/ date ❑ State Dept. of Transportation (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) omments: Signatures date tauFire Marshal ���,,. ^ 1Kf7 A CoI M(-it 4 '1 ,1-M . LI �'ig'utt tre'date � RFvise lugust 5,2005 Town of Montville Building Department File Receipt Date: 18-Jun-07 Receipt No: 2449 Received From: Osterman Propane Job Address: 76 Pink Row Fees Collected State Educational Training Fee Cash: $0.00 Cash: $0.00 Check: $8.00 Check: $0.08 Check No: 0 Short/Over: $0.00 Construction Value: $450.00 Demolition Value: $0.00 Received By David Jensen ... Nov 9. 2006 9: 56AM No. 2223 P. 1/2 Client#:25489 EOSTE ACORDN CERTIFICATE OF LIABILITY INSURANCE 1DATE 0n3/08D ) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Conifer Insurance Agency,inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 10 Centennial Drive HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Peabody ,MA 01960 978 532-5445 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Liberty Mutual Insurance Company 23043 E.Osterman Gas Service Inc. INSURERS: Lexington Insurance Co P.O.Bax 29 INSURER c: Arch Speciality Insurance Company One Memorial Square Whitinsville, MA 01588 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 Ao0'L Policy EPPECTNE POLICY EXPIRATION LTR WSRC TYPE OF INSURANCE POLICY NUMBER DATE EMMIQDfff DATE IM IUQITY) LIMBS A GENERAL LIABILITYT131640435284055 11101/06 11/01/07 EACH OCCURRENCE 11,000,000 X COMMERCIAL OEN ERA'.LIABILITY „DREMI�c TO/Fe RENTED $50,000 ff� CLAIMS MADE LI OCCUR MED EXP(Any one person) ,$5,000 PERSONAL$ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMP/OP ASS $2,000,000 POLICY L.>48i Ti LOG - A AUTOMOBILE LIABILITY A81640435284045 11/01/06 11/01107 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY S SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS (Peractiden0 $ X Drive Other Car PROPERTY DAMAGE (Per acciaent) $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO f — OTHER THAN FA ACC S AUTO ONLY: AGO S B EXCESS/UMBRELLA LIABILITv 6760868 10101/06 11/01/07 ,EACH OCCURRENCE 0,900,000 C X OCCUR ❑CLAIMS MADE UXP0018093 10/01/06 11/01/07 AGGREGATE s5,000,000 : 5 DEDUCTIBLE $ _ X RETENTION $10000 $ rA WORKERS COMPENSATION AND WC184G435284065 11/01/06 11/01/07 WC sTATU-rI 0TH- EMPLOYERS'LIABILITY 7¢RY IIMITS l I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? r E.L.DISEASE-EA EMPLOYEE $1,000000 If yea.Oesodbo under SPECIAL PROVISIONS below B.L.DISEASE-POLICY LIMIT $1,000,000 OTHER DESCRIPTION OP OPERATIONS!LOCATION?I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS 860-848-7231 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION Town of Montville DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN 310 Norwich-New London NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Turnpike IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Uncasville,CT 96382 REPRESENTATIVES. AV.THOEMED REPRESENTATIVE ACORD 25(2001/08)1 of 2 #52458 BDO o ACORD CORPORATION 1988 1 iiiiiiii