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Home My WebLink About60 Gal. LP Tank and Line to Cooktop 2017 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: M2017-0136 Date: 09-Aug-17 Map/Lot: 103/087-000 Owner ID: 5662000 Project Location: 15 PORACH ROAD Unit: Job Description: Set One 60 Gallon Propane Tank&Run Lines to Cook Top Owner Nam Jean R.Gilsaint&Maria A.Rodrigues Tenant Name N/A Careof: 15 Porach Road Uncasville CT 06382- Telephone: (860)383-2700 Applicant Name Daniels Oil Company Inc. Telephone: (860)342-1200 DBA: Lic/Reg Type Si Lic/Reg N 385517 8 High Street Exp Date: 31-Aug-17 Portland CT 06480- 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: 2016 State Building Code Mechanical Valu $650.00 Mechanical Fe $30.00 Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type IRC Total Value: $650.00 Penalty Fee: $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comment Plan Review Fe $0 Fire Marshal Tank Set Fee of$20 Paid State Ed Fee: $0.17 Total Fee Paid: $30.17 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 frami ❑ 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 Certific• - of Approval V ificate of Occupancy Building Official's Approval: it / 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.: _O/Nr--)1 / Type of Work Occupancy Type Permit Type ir New Construction ❑Single Family ❑ Building ❑Addition ❑Two-Family ❑ Plumbing ❑Alteration ❑Townhouse ❑Mechanical ❑Accessory Structure ❑ Electrical CRS#: Property Address: IS To-ro.c%A R7• (Number) (Street) (Unit) Job Description: SST 1 (go 1:23-44-s L v Tv Owner: Vik.ACZAA Z0t)t ,�,�5 Address: City:UV 445 V(Ls.-i State: &t. Zip Code: OG32rc Telephone( 383 - Z70'S Applicant: 7/4M)lLE -S 6ILCo. DBA: Address: e L( t AT. 3CriL jZ City: 1 Tl. RW0 State: et. Zip Code: O Telephone(5260 ) 342 - i Zvo Contractors - Complete the Following: License Type: .'- l License No t36,--C 1 tt 7 Expiration Date: $--�l-1 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. Er By checking this box, I will follow the requirements of the 2014 NEC as the alternative compliance per section E3401.1 of the Residential Code, instead of the electrical requirements in chapters 34 through 43 of the Residential Code. Owner/Agent Signature: .�� Date: `'- l e "l'7 Construction Value Permit Fees Building Value: Building Fee: Plumbing Value: Plumbing Fee: Mechanical Value: le J5D Mechanical Fee: 30 Electrical Value: Electrical Fee: Total Value: Penalty Fee: 6 of A rev. aZC--) Plan Review Fee: State Ed Fee: ; 17 Total Fee: 56 .1-7 Revised August 2,2007 Town of Montville Building Department File Receipt Date: 18-Jul-17 ReceiptNo: 12470 Received From: Daniels Pronane I LC Job Address: 15 Porach Road Town Fees Collected State of Connecticut Fees Collected Bldg Cash: 50.00 State Cash: $0.00 Bldg Check: 530.17 State Check: $0.17 Bldg Credit: 50.00 State Credit: 50.00 Fire Cash: 50.00 Fire Check: $20.00 Fire Credit: S0.00 Construction Value: 5650.00 Demolition Value: 50.00 CheckNo: 27475 Received By: Carmen Kneeland Ow al I_if \ (W QCT DANIELS DANIELS PROPANE LLC P.O. Box 32 Phone 860-342-1200 P'Pro'pane 8 High Street Fax 860-342-4203 «< Portland, CT 06480 CT Lia Y S 1302857 Date '7- Town/City of 7-Town/Cityof MpKyr v LL�� Licensed Contractor/Agent Authorization Form Connecticut General Statutes Sec. 20-338b. Building Permit Applications. Who may sign. Any licensed contractor, as defined in section 20-3330, who seeks to obtain a permit from a building official, may sign the permit application personally, or such licensed contractor may delegate the signing of the building permit application to an employee, subcontractor or other agent of the licensed contractor, provided,the licensed contractor's employee, subcontractor or other agent submits to the building official a dated letter on the licensed contractor's letterhead, signed by the licensed contractor, stating that the bearer of the letter is authorized to sign the building permit application as the agent of the licensed contractor. The letter shall not be a copy or facsimile, but shall be an original letter bearing the original signature of the licensed contractor. The letter shall also include: (1) The name of the municipality where the work is to be performed; (2)the job name or a description of the job; (3) the starting date of the job; (4)the name of the licensed contractor; (5)the name of the licensed contractor's agent; (6) the license numbers of all contractors who shall be involved in the work. (P.A. 91-95.) Daniels Propane LLC 8 High Street, P.O. Box 32 Portland, CT 06480 CT License#385517 I David J. Daniels authorize—R%--1J4,..9 (Licensed Contractor) (Agent) To sign the Building Permit Application as my agent to perform work at: Address 1 'P®R neA-4 P. Job Name or Description \" t P �� S Starting Date License p- • Number S1 - 0385517 Agent Signature cs_ E ' (•,1 Licensed Contractor Signature 't`'''.7 ;rWit: I.7..ti t, ..g:OrQP-.•:;,, +t�l:$VM./::�>,!!:.:. "qty;• 1:`�c.a .; .x ..a+, .�t�r... �t• v ...;,.t.. .c. ..tk r•.wi'I h. ..:^. "VS�' �.:ay: vV::� ;V:g .-.tea• ':v- •'�.,.Q�! St.. •,`I.>Y .x,...',t• 1 .tt r. .i t.NE '"ia� •.tY,, a'4.. .V:; :V:;;•e A:;V':;' tV:as;' .i. c � .1F.�. _ z��. ,.fit••, t :;,:�: r.. :r..,;.ra. _t.�. �:..i. +..t '••;1:� r v.�:::::..,:.v;,n.L: _.:'.t/'.. _cnt ":.,�::. ..:_ ..._..t�.�:\.:::<,�.�,_...� i5o. .n` ::•.t•.t. 7�. .'.. .f--:�'�,. ?.t.l.. �.it'.:J.-.. u:: -.o�Y... • ? -t*a ,/�� t. t�:;; �J� :• r c - t'. :�' � :�: �+\.;ay7� :t� I�. J�° m �. y:. � F_ C t ! 1 . t � S c.'.'(' `' . A. I j. - `-�' . `0• 4.A.. .w Y. - As'. ,t ^.v, r, . '1 e1 4 ..� 4,tar:.•' �ite-E., 111 rC\ :E. • :,fes _t//I ' • ' STATE OF CONNECTICUT + DEPARTMENT OF CONSUMER PROTECTION ..;•: _ Be it known that DAVID J•DANIELS ) a �: } . 29.MYRTLE RD PORTLAND, CT_ 06480-1643 ...g.....„.-i i • s I has been certified by the Department of Consumer Protection as a licensed HEATING, PIPING & COO• LING UNLIMITED CONTRACTOR1',5...,-_..-f -. ' . ::::,=.:-....,--.4.1,Livens a #kITG.0385517-S1 Effective: 1 .> 09/01/2016 f - .Expiration':. �� -• -` '' • a . � 08/31/:2017 •�- ��` Jo athan A.Hnrris,Commissioncr .. . - I iFA i ..%''f.*..yrt T 7 t.r1�t► t r y r r a t _ t t 1.. 'F i 1 Si�:e y�v gigi efj.•'t+,>�Y';,-: 11. n.,.:A.•t•Y,�; . . :411,.;f:?:./.4.0i1,;;;' V t - y. �y r� 1 :1 �r 1 11 S:r.', diti+p. 10 : \, .J,,+ :,,. .11:;',.:(:•4117.1%::4','•:.•$:...P :Y (ik1.• .:N1 -'t t t. - i�t + ? '-3• >.i Qfee . A•, tP:. t.h.,?r 1�"--A t''g 4. 7.-%. :\ 'u" 14` az �Jr��.•r .\'�$.' !Y�Y•.y?° �.. k,,.� S(:i' Ji /' ft1 .,iy .• .g{;• t V 3�,, 1 l.. •. t >;.'tNL+.••._ `mi.`.'44. 7.-j J� '/r� f' �%1•. ii' /1 -��.. }il.� '��`. tet. �. .:l l I. .a .i, h.•..i., •.1:��, `?�ii. �.jt.•�yu �'iii tlh'a��l�'�``' h---��}ir�� 'STATE.OF CONNECTICUT .. DEPARTMENT OF CONSUMER PROTECTION HEATING,PIPING& .OQLiN UNIT IITED CONTRACTOR P.1 .1;.-,4:1•.. x•i l .'. I,•`1. DAV J DANIELS PORTi..A 'F=-064$x1643 LIC,/REG NO. ,EFFECTIVE •.< ' . , EXPIRES HTG.0385517-81.• .09/01/ ";.. .. 08/31/2017 .Y 2 SIGNED - -----, ® u�altlmrv�w,,,,i, ACORD CERTIFICATE OF LIABILITY INSURANCE 03/06/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. 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 the certificate holder is an ADDITIONAL INSURED,the poilcy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject 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 endorsement(s). PRODUCER CONTANAME:CT CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY (PHOE A CNNo,Ext):888-333-4949 FAX No):507-446-4664 HOME OFFICE: P.O. BOX 328 OWATONNA, MN 55060 ADDRESS:CLIFNTCONTACTCENTER(aZFEDINS.COM INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 227-847-1 INSURER B: DANIELS OIL COMPANY INC, DANIELS PROPANE LLC INSURER C: PO BOX 32 INSURER D: PORTLAND,CT 06480 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:70 REVISION NUMBER:0 THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POUCY NUMBER POUCY EFF POUCY EXP LIMITS LTR INSR WVD (MM/DDIYYYY) (MMIDDIYYYYI X COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED $100,000 PREMISES(Ea occurrence) MED EXP(My one person) EXCLUDED A N N 9066767 04/01/2017 04/01/2018 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRG- X PRO- JECT LOC PRODUCTS-COMPIOP A00 $2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED A AUTOS _AUTOS N N 9066767 04/01/2017 04/01/2018 BODILY INJURY(Per accident) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident' X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $10,000,000 A EXCESS LIAB: CLAIMS-MADE N N 9371257 04/01/2017 04/01/2018 AGGREGATE $10,000,000 -- DED RETENTION WORKERS COMPENSATIONOTH- X PER STATUTE ER AND EMPLOYERS'LIABILITY - Y/N E.L.EACH ACCIDENT $1,000,00C ANY PROMEMBERIEXCLUDED?XEGUTIVE N I A N 9221763 04/01/2017 04/01/2018 A (Mandatory In EH EXCLUDED? E.L DISEASE-EA EMPLOYEE $1,000,00C (Mandatory In NH) If yes,describe under E.L DISEASE-POLICY LIMIT $1,000,00C DESCRIPTION OF OPERATIONS below • DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more specs Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOR THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED II ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE • 0 1988-2014 ACORD CORPORATION.All rights reservec ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Town of Montville Building Department CONSTRUCTION PERMIT APPROVAL 1 Po{cam Pcc b Property Address 501,-0 Le GA VI n Pro ecNAQ j-k----0., \ Lin r_, Z Cs c� k-T Job Dlescription Required Department Approval Permit Issuance Approval 11,1 Tax Collector .&o-e-� A,_ -7 /Ii p// 7 Signature/date Comments: Z ® Fire Marshal (-we_ q (,L4 1 .• dture/date (� Comments: ? ❑ Planning & Zoning Required for all permits except Signature/date Plumbing, Electrical,Mechanical,Roofing,Siding,Windows&Doors g ❑ Health Department Required for properties with private septic or well Signature/date Comments: t; i II WPCA, Administrative C.Kmt re-r- 0ickr iz_ 8-17/-7 Required for properties on sewer Sib g e/natur 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: ❑ Copy of State Dept. of Transportation Certificate 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 74-377 Signature/date Building Department Final Inspection RevisedMarch23,2015 • • M ' N •