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HomeMy WebLinkAboutLine to Gas Logs 2002 Town of Montville gji Date 6.--/ / Building Department /� �� Field Inspection Notice Permit #A26aZ-07p Job Location b•Stkpproved Type of Inspection II Not Approved - Please call1�1� for re-inspection en the following corrections have been completed: Building Official Town of Montville Building Department Date 5-7 � ' / D Field Inspection Notice Permit #/lf,po,? ,.,07•Z Job Location / 76 r, PCZ._ �� I I Approved Type of Inspection c 50><r Not Approved - Please call for re-inspection when t e following corrections have been completed: L--Lf 6 Ps J �� r_?1 _) L N r= lis"l <� 1 v /"lir Building Official Town of Montville BUILDING DEPARTMENT 310 Norwich-New LordOn Turnpike Uncasville,CT 06382 860-848-3030, Ex.t 82 Mechanical Permit Permit Number: M2002-072 Permit Date: 06-May-02 Permit Code R5 Job Location: 170 PRUETT PLACE UNIT: MAP/LOT: 004/004-Q00 Job Description: gas piping&gas logs Owner Contractor LEE R+ ROWENA H JAMES Michael Jager 125 Westbrook Road 170 PRUETT PLACE Unit: Essex,Ct.06426 OAKDALE CT 06370 Telephone: 860-767-2601 Lic/Reg Type: G1 Use Group R4 Lic/Reg Number: 308258 Code 1995 CABO Exp Date: 8/31/02 Construction Type 5B Construction Values Permit Fees Building Value: $0.00 Building Fee: $0.00 Plumbing Value: $0.00 Plumbing Fee: $0.00 Mechanical Value: $800.00 Mechanical Fee: $10.00 Electrical Value: $0.00 Electrical Fee: $0.00 Other Value: $0.00 Other Fee: $0.00 Total Value: $800.00 C/O Fee: $0.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $0.13 Total Fees: $10.13 jt is the owners responsibility to schedule the following required inspections(minimum 48 hours notice requested): ❑ Footing-Prior to pouring concrete ❑ Rough HVAC ❑ 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 E Final Inspection El Gas Piping and Pressure Test lU ertificate . .ccu ' p•� 'o o use or occupancy Building Official's Signature: 111,1p , Town of Montville Building Department Permit #hc2Go,2 Q7,2 310 Norwich-New London Tpke. Tel. 848-7166, Ext 82 Uncasville, CT 06382 Fax. 848-7231 One & Two Family LP-Gas Permit Application Form Job Location j 0 Pu PI a CQ Job Description/Materials YR 5` 1( yv..4„,) Yd- ' c•)` , _i , •.• n 14' h Owner t_QQ ] / -'r&J Mailing Address /76) -P, v e`cr tof, Ce City CSC 4.4(42.. State C Zip OCe3170 Tel 24o / 1i( / 9 Q G Contractor Vv•\.�G -.., v a.f..c,\_ __Mailing Address /c1.5' (,./40Y- o..ek W City State CC Zip ©(p(6:,z, Tel he /67 /a(pp I Contractor's License/Registration Type& Number G( — 3 0 8 .s a Exp. Date F/ 3/ /O 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 Date / 3 /O�� Construction Value Fee Building $ $ Plumbing $ g c9 ., cs.o $ /O cfcj Mechanical $ $ Electrical $ $ Other $ $ Certificate of Occupancy $ Plan Review Fee $ State Education $ 13 Total $ 3 &t0 - amp $ /6 ;3 Town of Montville Building Department Receipt . Date 5-7 _3 / o,p, No. 016.93 0From: /11e11.64 d"c -TAG k_ Job Address: / 17O pp i,„ y?... , (;) Amount $ v /3 Cash i' Check # 3 O , (Circle one) // i Received by -"� Permit # i • • STATE OF CONNECTICUT' DEPARTMENT OF CONSUMER PROTECTION HEATING,PIPING&COOLING LIMITED CONTRACTOR Type:G1 MICHAEL D JAGER 329 SAWMILL RD GUILFORD, CT 06437 EFFECTIVE EXPIRES LIC./REG. NO.• 08/31/2002 308258 09/01/2001 SIGNED: * • _ _ ACQRQ, CERTIFIICA`TE OF LIABILITY INSURANCE DATE(MMIDD,'Yyy 'R^J'..VCER (.2,03;2 ----3FAX (203)281-0414 THIS CERTIFICATE IS ISSUED AS A MATTER or INFORMAT IION002 MBI Company Group LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 3308 Whitney Avenue HOLDER_THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Hamden, CT 06518 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Carolyn Delahunt I INSURERS AFFORDING COVERAGE -- N$URED Sager, LLC 125 WEST BROOK RD, NSURER.A; The Hartford Insuranc Group ESSEX, CT 06426 INSURERe: Hartford Und. Insurance Co. INsuRERC: Hartford Casualty Insurance Co H INSURER C' MVERAGES INSURER F: THE POLICIES OF INSURANCE LISTED BEI OW HAVE SEEN ISSUED TO THE INSURED NAtMIED ABOVE FOR+THE POLICY PERIOD IM ICATED,NOTWITHSTANDING ANY.REQUiREh1EI,;T,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 9E IS$GED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERE).N IS SUBJECT TO ALL THE TERME,EXCLUSIONS A,ND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, 'I - Srt �TYPE OF INSURANCE POLICY NUMBER POLIGY EFFECTIVE PO PiRATION GENERALLIABILIYY 315BAPA1958 DATE MM/DD/YY) DATE MMIDDjyy LIMITS 02/01/2002 02/01/2003 EACH CCCURRErJC5 s 1 r 000,000 COMMeRlaiLI GENERAL LfAB1LfTY' CLAIMS 4e.ADE L1 OCCUR I I 'I FIRE DAMAGE.(Ani 71 (Any : S 300,000 • _ 1 A ENP 1pr,ane peremJ $ 10,000 PeascwZ u AD•a INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER;` ��'rIER4L +G uGAT: S 2.040,000 I FCJO.Y I�J CT 7 LOC ?RODUGT$-COh1P,'OP AGE s 2,000,000 AUTOMOBILE LIABILITY 31UECIB2076 02/01/2002 02/01/20031 X ANY AUTO I COMBINED SINGLE LIMIT (Es acciaecl) 500,000 TA�iiOS ` $ 3 I I SC,HEDULEDJryITOg I I BOOIL'✓IIJJURY -- I HIRED A.UTOg • NON-OWNED AUTOS I I BODILY INJURY (Per accident/ 5 I ' °ROP,ERT,;DAAtADE S GARAGE LIABILITY (Per accident) 1 AGE AUTO AUTO ONLY-BA ACCIDENT S _ OTHER THAN EA ACC 5'T AbO G-4•44.1-'; AGG $ ExcESS LIA1,SILrrY BAPA1$c8 02/01/M02 42/01/2403 st, ri acct. Nce s OCCUR 1 I CLAIMS MADE 1 Qoo oQ� AGGREC-OTE r 1,QQ0,004 CED;IGTIE;,E _ S 5 RETENTION WORKERS COMPENSATION AND 11WECGI2279Z 102/01/2Q02 02/01/2003 TO' - EMPLOYERS'LIABILITY - O i H. " TOF'YLIr.11TS ER E.L.EACH ACCIDENT S 100,000 E.L.DISEASE-EA EMPLOYEE $ 100,000 OTHER E4.DY:iEEASE-PC/L.ICYL.IEr1T 13 500,000 i r ISCR!PTION OF OPERATIONS;LOCATIONSNEHI CLES;EXCLUSIONS ADDED BY ENDORSEYIENT,'SPECIAL PROVISIONS ERTIFICATE HOLDER ! ADDITIONAL INSURED;INSURER LETT _ CANCELLATION ---I SHOULD ANY OF THE ABOVE DESCRI6EO POLiCIES BE CANCELLED BEFORE THC EXPIRATIDN DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, TOWN OF MONTVILLE I BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY BLII]13ING DEPARTMENT OF ANY D UPON TWE C45:5PAIYY,in AGENTS DR REPRESENTATrvgS. ATTN E VESSEY 2ND AuTHOAIZED REPRESENTATIVE CORD Afl (: VERNONV /cao1yn Delahunt CAROLY ` { ice )ACORD CORPORATION 1988 I /u (,4_U e'_-11 1'1_I`I C 6- ,-- -. ZONING PERMIT ZONING PERMIT NUMBER l / z (t OR ❑N/A EXPIRATION DATE 6/ /x/2'6 C) APPLICANT L--e- -:1-- . 0(.-LJe �_,)001)5 APPLICANTS ADDRESS I-7( 1 '(U'ff Oka,6,_. C�� `�+e 4? TELEPHONE ��� _4/gee) PROPERTY OWNER-7I(.�-e `k- C)L J 11/2- �QLk'fl LOCATION l Pjl,€ 1 t,�( no.06-, - 6.,erida le - tL`OT AREA ' /Z 1-/--- ZONE C- ( L V ASSESSOR'S MAP NUMBER 1 LOT NUMBER 6& BUILDING HEIGHT �P/ROPOSED FLOOR AREA NATURE OF REQUEST/PROPOSED USE O( jz2 e 11 511C . SKETCH ON REVERSE OR PROVIDE TWO COPIES OF PLANS DRAWN TO A SCALE OF AT LEAST 1"=40'SHOWING:DIMENSIONS OF THE LOT,THE SIZE,AREA, AND LOCATION OF EXISTING, PROPOSED, PRINCIPAL AND ACCESSORY STRUCTURES, DRIVEWAYS, SANITARY FACILITIES AND WATER SUPPLY, PARKING FACILITIES,AND ADJACENT STREETS;DISTANCES OF PROPOSED STRUCTURES FROM PROPERTY LINES. IN THE CASE OF FILL OR EXCAVATION REQUESTS (UNDER 500 CUBIC YARDS), DIMENSIONS OF FILL OR EXCAVATION AREA MUST BE INCLUDED. A PLAN PREPARED BY A CONNECTICUT REGISTERED LAND SURVEYOR MAY BE REQUIRED. THE PROPOSED USE SPECIFIED ABOVE SHALL NOT BE AUTHORIZED UNTIL AN ACTUAL CERTIFICATE OF COMPLIANCE IS ISSUED BY THE COMMISSION OR ITS APPOINTED AGENTS. SKETCH PLAN OR GRADING PLAN ( YES ❑N/A SEPTIC PERMIT glJYES ❑N/A DRIVEWAY PERMIT (STATE,LOCAL) ❑ YES T(� N/A WETLANDS PERMIT OYES giN/A HAS A VARIANCE EVER BEEN GRANTED FOR THIS PROPERTY OYES ONO HAS BOND BEEN FILED OYES ©N/A FEE PAID ❑ CASH ❑ CHECK# ❑ N/A THE APPLICANT AGREES TO: 1. ADHERE TO ALL THE APPLICABLE REQUIREMENTS OF THE ZONING REGULATIONS. 2. NOTIFY THE COMMISSION OR ITS APPOINTED AGENT OF ANY ALTERATION IN THE PLANS. 3. CALL FOR FINAL INSPECTION AND REQUEST CERTIFICATE OF COMPLIANCE BEFORE ISSUANCE OF C.O. / 1 r},,C APPLICANTS SIGN•TURE42u-eeita----) d/ 7ZC� . DATE (1�Gt / / - dLcck Out? 9F � 2 C-4, EOCC)d COMMISSION AGENT DATE CERTIFICATE OF COMPLIANCE DATE THIS SIGNED PERMIT AUTHORIZES THE APPLICANT TO PROCEED TO THE BUILDING DE(ARTMENT FOR ANY REQUIRED PERMITS CONTACT THE ZONING OFFICER (848-8549) AT LEAST 24 HOURS BEFORE CONSTRUCTION BEGINS TO ALLOW ZONING OFFICER TO INSPECT LOCATION. REV. 9/14/98