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HomeMy WebLinkAboutLP Tank and Line to Cooktop 2015 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:M2015_0074 Date: 02-.t(in-15 Map/Lot:Q19/0gceQQ Owner ID: 5530000 Project Location: 82 PIKES DRIVE Unit: Job Description: 1nsfap_Gas_Line front ank-to Cookjoo Owner Nam _Trayyq_8c_A1is,ia Miller Tenant Name_NLA___ Careof: 251 Norrncic nsctt Avenl ip Fast Wakefield RI _02829- Telephone: 160715925912 Applicant Name _AltaaWells Telephone: 8.60)27.1,020 DBA:,)DJ C_Eoera_vLic/Reg Type S1 Lic/Reg N 3031105_ _410BcncStteet Exp Date: 3_l-Aua-15 1Vew ondsm CT C-nnc+n er}inn Wilt so ROMA Fcaec Co stnicfion_Inforrgtion Building Value: 517.00_ Building Fee: SOLO_ Use Group: IRC Plumbing Value: $Q QQ Plumbing Fee: SQ.QQ_ Code: 2005 State Building Code Mechanical Valu S700Q0_ Mechanical Fe Electrical Value: S�QQ_ Electrical Fee: SQ.OQ Construction Type IRC Total Value: S700.00 Penalty Fee: SfL00— Permit Code: R5 _ C of 0 Fee: ST100_ Comment Plan Review Fe _ SQAQQ_ State Ed Fee: Total Fee Paid: S30.18__ 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 El 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 frami ❑ Electrical Service CRS No: 0 ❑ Framing ❑ R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble E Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation ❑/ Certifico e of Approval ■ o ificate of Occupancy _Buildirla 0lflciel'sAoblcLv_aL Town of Montville 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.: nii. 005•- 7y Type of Work Occupancy Type Permit Type El New Construction ❑Single Family ❑Building ❑Addition El Two-Family ®Plumbing ID Alteration ❑Townhouse ❑Mechanical 0 Accessory Structure 0 Electrical CRS#: Property Address: 8,`,r, 5P1 R> S Da;J I LA A,_\ >v (Number) (Street) i (Unit) Job Description: n)S.TA-I t 9 A3 1,10 t~ 2r�►•r. t4-_,,,.)k --4---t, C-bo k t-01 i C-OppE _ .o"c:-1-. --_________—___.—_— Owner: c:{-- Owner: tt2AV1S VV( 11IE(2-- Address: I I\I ARRA i 4M s - A.4./ . • E City: JAllcar rc-idl State: 1s'• 1. Zip Code: OcA --ic Telephone(607 ) 59a- (oct( a. Applicant: DBA: JDLC, ENErL9( Address: L-110 np4‘.1 k 84", City:A 19 L-DnJClO r.) StatelA04 I) Zip Code: 0 b�aD Telephone('&60 )42,7/ - aogso Contractors -Complete the Following: License Type: • ( License No.:303(60 Expiration Date: 9-3(`IS 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 ahoy= • ily Owne /Agen;Signature: ,� I/11/d , Date: 6 - / �S Construction Value Permit Fees Building Value: Building Fee: Plumbing Value: t .70C, Plumbing Fee: Mechanical Value: Mechanical Fee: Electrical Value: • Electrical Fee: Total Value: Penalty Fee: C of 0 Fee: Plan Review Fee: State Ed Fee: Total Fee: wised August 23,2007 Town of Montville Building Department File Receipt Date: O1-Jun-15 ReceiptNo: 10395 Received From: Connecticut Permit Services Job Address: 82 Pires Drive Town Fees Collected Bldg Cash: State of Connecticut Fees Collected $0.00 Bldg Check: State Cash: $0.00 $30.18 Bldg Credit: State Check: $0.00 $0.18 Fire Cash: State Credit: $0.00 $0.00 Fire Check: $0.00 Fire Credit: $0.00 Construction Value: $700.00 CheckNo: Demolition Value: 1248 $0.00 Carmen Kneeland Address: 82 Pires Drive ITEM QTY S/UNIT TOTAL Building Plumbing Mechanical Electrical BUILDING AREA Basement,Finished SF $ 41.96 $ - $ _ Interior Renovations SF $ 36.09 $ - $ - $ _ AMENITIES Kitchen EA $ - $ - $ - Full Bathroom EA $ - Half-Bathroom EA - $ GARAGE Detached SF $ 71.53 $ - $ _ MECHANICAL Warm-Air n Y/N S - Hot Water n Y/N $ - Electric n Y/N $ - Air Conditioning n Y/N $ ELECTRICAL SERVICE Upgrade Amps $ - Subpanel EA $ 699.00 $ _ Gen Set EA $ 3,850.00 $ _ SOLID FUEL BURNING APPLIANCES Prefab Metal Fireplace EA $ 6,497.70 $ - Masonry wit fireplace EA $ 7,096.65 $ - Masonry w/2 fireplaces EA $ 11,095.70 $ - Wood Stove,free standing - EA $ 2,692.25 $ - Wood stove insert EA $ 1,859.77 $ - DECKS,PORCHES,SUNROOMS Deck SF $ 44.07 $ - Porch SF $ 149.38 $ - Sunroom SF $ 176.90 $ - $ _ POOLS&HOT TUBS Hot Tub EA $ 8,016.25 $ - $ - lnground Pool EA $ 31,550.00 $ - $ _ Above Ground Round EA $ 6,299.46 $ - $ _ Above Ground Oval EA $ 7,019.75 $ - $ _ Pool Heater - EA $ 8,984.25 $ - $ - Inflatable Type Pool EA $ 1,200.00 $ - $ _ SHEDS w/o electrical SF $ 25.55 $ - w/electrical SF $ 26.85 $ - $ _ RENOVATIONS Roofing,Overlay SF $ 3.50 $ - Roofing,Strip&reroof SF $ 4.50 $ - Roof Sheathing SF $ 1.51 $ - Siding SF $ 6.75 $ - Windows - EA $ 550.00 $ - Skylights EA $ 1,051.10 $ - Doors,Exterior EA $ 601.50 $ - Oil Tank,275 Gallon - EA $ - Oil Tank,550 Gallon EA $ - MISCELLANEOUS CALCULATIONS $ 700.00 TOTALS $ - $ 700.00 $ - $ _ PERMIT FEE CALCULATIONS Construction Value Fee Building $ _ $ _ Plumbing y $ 700.00 $ 30.00 Mechanical y $ _ $ Electrical y $ _ $ Working before Permit Issuance $ _ Certificate of Occupancy Fee $ _ Plan Review Fee $ State Education Fee $ 0.18 TOTALS $ 700.00 $ 30.18 Figures are based on the 2006 RS Means Residential Cost Data AUTOMATIC Automatic TLC 36 Brownstone Avenue, Portland, CT 06480 TLC ENERGY (800) 815-1128 Fax: (860) 342-4455 Date _ 6- I Is To M004-1/i‘ I ( F ATTN: Town Building Inspector Re PERMIT AUTHORIZATION LETTER Dear Sirs: In accordance with Connecticut Statute 20-338B, this letter serves as written authorization and notification that Connecticut Permit Services, Inc. Employee listed below have the authority to represent us in the procurement of permits and pertinent documentation on our behalf as detailed below. Project Start Date 15 4e Project End Date Project Type: L,° 9 1( et Location: V S JA i s8 9. (,'rte 5 _Da-• Authorized Agent Connecticut Permit Services, Inc. Service Agent name f 413 Very truly Yours, Licensee Signature /(0/111/n11 _, Printed Name Richard Johnson License Number S1-303006 Notary Public Printed Name Commission Expires Notary Public Signature Sep. 6. 2014_ 1 48AM. valley oil • 1� •1��c �a4;. .rtri:4).f%`.%. :4 : .�-..,> < 1 .. 1 , �..'•v-•v�' ,�,.:i., 3t4o. 2623, rP. 1 ,. .. ,•i• •.! a. .•1 �SS•.,iY ,A•!d }7 •, c •' \' �. Q. Cl-�1j�f •�.,rJt ,(�fx'�t��vVV x' v.. Phi: ilVs• r I fv, 11ry' > •\• �� i• k\\�f�. Y:fiRo•- Z•5:,6'•1d a..,��lyd,:, �c}'A �• •`•;;:y N..a A t d rli•AL ••�•.,., .e." '•if.r r. "w3P?,i'` r ip:t 1 4,i�t;:l:1,T. Vekz,.alfi Sr��'}y1lg 1i <!`c•:wo i 7:1Emfm i Sp '• w t .}�'v .n t ! tv...,w, .4J ".A. 0�t�(�, 7414.•,_,A -.O0 •d'f k' F�f t •�• .J tIt i ..- '�.., •LO �•41, 01- s•. 461.1• tft?hi' 4i i' •o .Ft, .:0.;t,�(p 4.k1�-�,-�t•°'$. .i../i�1% f i '�l ---0,.e•—• - ,v ,, • ''''"� . 1 .. .y._.... — l R PROT�CTIOIV� � �-5'�'; ( T O CONSUME r STATE OF CONNECTICUT + DEPARTMENT`I N ; • that L `. 0:4 Be it)Znown r A 444 • RICHARD Ie •J0H1NS0N JR., :: • •At, 243 'T IMB R TRX.• , F f w‘i •EAST JTIARTFORD, CT '06118-3583 .,� 3 • • • • PrS • .:; ;. •J�tirl1, a't,• 1>a8 been corafied by the Department o£Conaumer Pro F� _ a r.'''i. . • ' ..4... . • %.� �,�ABEATING, PIPING COOLING I � X ZZD CO � � t .yL.J • ry ( =° License -4 HTG.0303006-,S1 I ; v a. ( J • �` Effective: ` = ,�� , •. • t. ::: t4: ;, ' ' •. Expiration: 08/31/Z015. . . . . • • ;~,;: �) O DATE(1.1f.110DIYYYY.).0/24./2014 • THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS �� � �A ll�l �� OF �0 0 ��� H0.��5�1IfA1`� � 1NO RIGHTS UPON THE CERTIFICATE U10LDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. - . IMPORTANT: If tile certificate ho(dr%r is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,spbject to - the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen((s). CONTACT PRODUCER NAME: PG Genalt Group LLC PucNEFAICII : - - i81✓z9Z_ ntO.Nom.r- 11:.516 8G9 878= 3333 NEW HYDE PARK RD E-MAIL ADDRESS: SUITE 409 NAtcrr NEW HYDE PARK NY 11042 • INSURER(S) COVERAGE _ 1 INsuRERA:First Mercury insurance Comp_6n IN& INSUREDBlsURERB Sfansporlation Insurance Co. 20494_ Hop Energy LLC INSURER C:Valley Forge 10508 CT Refining INSURER 0:Travelers Properly Casually Co of - . 4 West Red Oak Lane • RJsuRERE:Lexinq(on Insurance Company L9437 While Plains NY 10604 - INSURER F: COVERAGES CERTIFICATE NUMBER:1408132863 REVISION NUMBER: THIS IS TO PERIOD IND CATED.CFY NOTIWITHSTANDING ANY T THE IREQ REQUIREMENT,TERM OR CONDIES OF INSURANCE LISTED TION ON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TOHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THELICY 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADBL CUBE POLICY Er--F POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR MO POLICY NUMBER (Lil.110DA'YYYI (MMlD0lYYYYI A GENERAL LIABILITY MACGL000001090G03 10127/2014 10127/2015 EACI I OCCURRENCE S1.000.000 DAMAGE YO RENTED 550,000 ���—; X COMMERCIAL GENERAL LIABILITY PREMISES(Ea ocurrtcnu) • MELDEXP(Any one per.MI 5 • CLAIM5•MAOE l i OCCUR PERSORAL L ADV INJURY 51.000.000 X SIRS100,000 GENERAL AGGREGATE 52.000.000 PRODUCTS-COMPIOPAGG 52.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: S I POLICY 5P81' LOC _ cOUrilNED SINGLE1.11111 B AUTOMOBILE LIABILITY / BUA2098344188 10/27/2014 10127/2015 (Ea accident) 51.000.000 X ANY AUTO _ BODILY INJURY(Pcrpmcnl S • - -^ ALL OWNED SCHEDULED BODILY INJURY(Pcrocidcnl) 5- AUTOS AUTOS NON•OWNED PROPERTY P DAMAGE 5 HIRED AUTOS AUTOS S E X UJ,IORELLA LIAR X015375003 10127/2014 10/27/2015 EACII OCCURRENCE 54,000,000 OCCUR . • AGGREGATE 54,000.000 EXCESS LIAR CLAl1.tSI�ADE S 050 X RETENTION 510.000 1—I WC STATU- O1H- C CORNERS cOJ.IPENSATI0'1 ^WC2090344093 10/27/2014 10!2712015 X TORY I WITS .FR D AND EMPLOYERS'LIABILITY Y/N 5670309514 10/27/2014 10127/2015 Et_EACH ACCIOErIT 51,000,000 ANY PROPRIETORJPARTNE:JEXECLJTIVE I N/A OFFICERJf.IEMDER EXCLUDED? E.L.DISEASE-EA EMPLOYEE 51.000,000 (Mandatory In NH] . If Yes.describe under / E.(_DISEASE-POLICYIII.IIi 51.000,00(1 DESCRIPTION OF OPERATIONS below DESCRIPTION OF-OPERATIONS l LOCATIONS!VEHICLES (Allaclr ACORO 101,AddIlloncl Remarks Sc(tcdulc,If more space Is required) CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED • CERTIFICATE HOLDER • CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE / THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE VJITH THE POLICY PROVISIONS. AUTIIORIZED REPRESENTATIVE /AZ /4••••L.-------- I ©1900-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) ' 1 The ACORD name and logo are registered marks of ACORD , t i 411;1" 13DDLC ENERGY 3 410 Bank Street,New London, CT 06320 888-225-5540 C .1- k www.DDLCEnergy.com , li .iENE CT LIC#S1-303006 HOD#385 1 Residential Propane Fuel Contract(this 'Agreement") CUSTOMER INFORMATION t_ Acct#: Applicant: Travis Miller Home phone: (607)592-6912 Co-Applicant: E-mail: tim287@gmail.com Billing address: 251 Narragansett Ave E. Wakefield, RI 02879 Delivery address: 82 Pires Dr. Oakdale,CT 06370 0 Owner occupied r Landlord name: Tenant occupied Landlord phone: SERVICE AND TANK INFORMATION in 60-month Agreement(underground tanks) 0 36-month Agreement ❑ 18-month Agreement Rental tank 1 Customer-owned tank. YOU AFFIRM THAT Per-gallon Promotional Rate*for first YOU OWN THE TANK(S)THAT DDLC propane delivery: ENERGY WILL DELIVER TO UNDER '' $ 0.999 THIS AGREEMENT -Th--0" (initial here) To receive this Promotional Rate,YOU must 0 sign and return this AGREEMENT by�: 05/25/2015 Tank Monitor * See paragraphs 3 and 4 of the Terms and Conditions DDLC ENERGY tank description: for more information about propane pricing. ASME Underground tank(s) ASME Above ground tank(s) Automatic Will Call Tank size: (dO 40V-, C ui.S lk.0 lZ Delivery: Delivery: ptt�ttt7 Additional tank information: i -\ Use: "2'6? . Heat 0 Tank and Equipment Rental Fees: i Hot Water 0 • Tank installation charge: $ Cooking 0 • Tank rental charge(per month): $ Dryer 0 • Tank monitor rental charge(not (. Pool Heater ❑ applicable to heating or hot water Space Heater 0 customers) (per month): $ Fireplace GI Purchase Option Purchase Price(applicable Generator 0 to DDLC ENERGY-owned ASME Other: underground rental tanks): • Price during Initial Term: • Price at end of Initial Term: $ (AGREEMENT CONTINUES ON THE FOLLOWING PAGES) } PRODDL 022414 Page 1 i` f pp$; i i k AUTOMATIC TLC -7--IN rl > 4-'"2. EI��nGY 64 Oakland Ave East Hartford, CT 06108 Date of request 105/22/2015 Mechanical Permit Request Form Date needed I I Propane Project start date 1 I Cost of Job 1700.00 Type of Work to Be Performed 'INSTALL SUPPLY LINES TO COOK TOP The submission of this Permit Request Form in any manner including but not limited to facsimile,electronically or by postal service,does hereby authorize Connecticut Permit Services,Inc.and its employees and agents,to apply for and procure this permit on your company's behalf. Your submission of this Permit Request Form further means that you understand and agree that you are liable to reimburse us any municipal cost involved in the procurement of this Permit,together with our Permit Service Fee.In the event that you notify Connecticut Permit Services,Inc.that you wish to Cancel this Permit Request form,you agree to reimburse and pay Connecticut Permit Services,Inc.for any and all costs incurred by CT Permit Services pertaining to the processing and procurement of this Permit Request,along with a Cancellation Fee of twenty five($25). No Cancellation Fee will be applied if your Cancellation request is received within the first forty-eight hours after original receipt of this Permit Request. Multi Family 34 0 Type 'Residential I Contractor Job number: I I Customer Name 'TRAVIS MILLER I Customer Address 182 PIRES DRIVE OAKDALE Address of Work(if different than Above) I I City Slag ICT 1 Zip code 106370 I Phone number 1 I Brief Description of Work to be Performed (INSTALL SUPPLY LINES TOCOOKTOP • Base Info: ' 111 C'Vl C-C4{J L' 30 �-L�-1 ' n'I .0e___. Number of tanks I 1 I I Drawing of Property and Placement Size of tanks I I Location of Shut off valve I Underground Tank Q rimes Q no Type of unit to be powered I I In accordance with Public Act 91-95,this letter serves as written authorization and notification that Connecticut Permit Services,Inc.and its employees and agents have the authority to represent us in the procurement of permits and pertinent documentation on our behalf. This letter or a photocopy thereof may be regarded by any building official as its authority to recognize Connecticut Permit Services,Inc..as our authorized Agent to sign on our behalf applications for permits and any other related documents that may be required by you,and we agree that,for all purposes,we and not CT Permit Services or its employees and agents shall be deemed to be the signer of any such applications and related doc Authorized Agent Name I I Signature I I Date I By Signing below, the Licensee understands and agrees that the information contained herein is true to the best of their knowledge Licensee Signature I I License Number I I Printed Name I I Date I I Town of Montville Building Department CONSTRUCTION PERMIT APPROVAL Applicant is responsible for obtaining all of the required approvals. No •ermit will he issued until all the re.uired si.natures are obtained. • �; £s .1012- , . CA-k8Al E Property Address N k coo k o,• Job Description Required Approval Department Permit Issuance Approval Tax Collector � � ' /� ���_ Comments: Signature/date Planning &Zoning 6f h r Signature/date Comments: /V d% Fire Marshal _ n PU 7#44/ t (tc U ( Signature/date aq-1 LI Comments: [[[ f i I 1 Health Department Required for properties with private septic or well . Comments: I I WPCA, Administrative Required for properties on sewer Signature/date Comments: I I WPCA, Operations When Required by WPCA Signature/date Comments: I I 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: • ( I State Dept. of Transportation Re.uired for Structures over 100 000 s..ft or with more than 200 •arkin• s.aces-Official co. of STC Certificate of O.eration re•uired—.er CGS 14-311 Signature/date Building Department Review Complete Signature/date 7teviredMay 23,2011