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HomeMy WebLinkAbout1999 - Propane Tank & Lines to Cooking Range TOWN OF MONTVILLE BUILDING DEPARTMENT 310 NORWICH-NEW LONDON TPKE. UNCASVILLE, CONNECTICUT 06382 Mechanical Permiel• 860-848-7166 Fax 860-848-7231 Page: 1 Printed: 2/19199 Permit Number: MC1999-7 Approved: Applicant: Suburban Propane Zoning: 262 Gallivan Lane, P.O.Box 385 Addition: Uncasville, Ct 06382 Block: 081 Lot(s): 043-000 Parcel Number. PARC1999-41 Section: Township: 36 Beechwood Rd. Range: Oakdale, Ct 06370 Area: Legal Description: Heating Suburban Propane P.O.Box 385 Voice: 860-848-5510 Uncasville, Ct 06382 Fax: Local License: State License: G-5 307591 Fees and Receipts: Number Description Amount FEE1999-66 Trades 2000 $10.00 Fees Total: $10.00 Furnace <100K Btu: Ventilation Fans: Mechanical Exhaust Hood: Furnace >,100K Btu: Suspend/Reces/Floor Htr: Floor Furnaces: Incinerators: Boilers/Compressors: Air Handling Units: Cubic Feet per Minute: Evaporative Coolers: Documentation: set 50 gallon propane tank, run gas line for cooking range 9V Buildi g 20fricials Signatu a Date TOWN OF MONTVILLE, Building Department Telephone 860-848-7166 Fax 860-848-7231 APPLICATION FOR BUILDING PERMIT OR TRADES PERMIT FILL IN THIS SECTION COMPLETELY. Owner: Mailing Address: 36 &hkov l ~Dazc City: ~~U{ State: Zip Code Tel Job Location. 3& 9W. Map/Block/Lot : 1/?S~1 D C3 Contractor- gubax h4d /FAA-," Mailing Address: 46, 7? 6 3 & City: State: Zip Code: ~Tel: $'S.___SIfd Stick Built: Modular Home: Manufactured Home: Commercial: Addition: Garage: Car Port: Shed: Remodeling: Roofing: Siding: Fireplace: Chimney: Windows Pool: Demolition: Plumbing: Heating: Electrical: Air Conditioning: Gas: Patio: Porch: Deck: Retaining Wall: New: Repair/Replacement: Job Discripti^on/Materials used: 6P--t Cd-adl? 0000;74 L"4p, 64,5 Size: Type of Heat: Fireplace: No.of Stories: No. Rooms: Breezeway: No. Baths: Garage: Use 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. Owner/Agent Signature: Date: If signed by Contractor, type of license/registration & No: 6 05 Building Department Use Only FEE Permit # Estimated Cost °00 Building T 1~ Plan Review C.O. Total_ Cash/Check V Suburban Propane P.O. Box 385 - 262 Gallivan Lane - Uncasville, CT 06382 Office 860-848-5510 - 800-573-3757 - Fax 860-848-5517 http://www.suburbanpropane.com SUBURBAN PROPANE 262 GALLIVAN LANE\ P.O. BOX 385 UNCASVILLE, CT 06382 (800)-573-3757 - (860) 848-5510 FAX - (860)-848-5517 DATE_ JOB NAME_ J/.t, / JOP ADDRESS: ~mh~zlm This is to certify that under the prtDvieions of the General Statutes the following persorfo;Nnn;lg IiCensed or registered. Y'. . HEATING,PIPING & COOLINfa' I-`I'D CONTRACTOR-G5 STARTING DATE: I r~~ THOMAS_J GARDINER l 188 - - WEATHER RD_.; 01m t MOOSUP CT 06354 CONTRACTOR'S AGEN _ LIC./REG. NO. EFFECTIVE EXPIRES 00307591 9/01/98 8/31/99 SIGNED: Y►'a"~-r ~ GA~t-~--..J TO: CI"i1'/TOWN OF © PLEASE BE ADVISED THAT THE ABOVE REFERENCED AGENT HAS BEEN AUTHORIZED TO OBTAIN A PERMIT FROM YOUR BUILDING DEPARTMENT FOR THE SPECIFIED PROJECT IN THE NAME OF THE CONTRACTOR. NAME: 'THOMASJ. GARDINER SIGNED: LICENSE # 00 073 591 AcoRD.„, CERTIFICATE OF LIABIOTY INSURANCE rltoDUCPA THIS C.ET7TIFiCATE 1'•3•ISSUF_T] An A MATTER tar iNs (wMATION ONLY AND CONFERS NO RIGHTS UPQN T1iL CI J I IFICATF HoLbtn. 71410 C6Fflf-JOATE DOEn NOT AMEND, f`-=:iT:Tlp OTT ;LI)GWICK OF LVEW JERSEY, INC . ALTER THE GOYEFTAGi= AFFOFTDED BY THE T'OLfCIF.3 Tl(?LoW. 3 DECKER FARM ROAD _COMeANWq AFrQSDING COVEHAGL____. ROSELAND, NU 07068 COMP/'wVY f----'J -_A PACFzC'_tdPLC?YERS 12TH r MWPANY sUBU1 SAN PROPANW, L.P. 13 P.O. BOX 206 COMPANY WHIPPA14%, NJ 07981 coMrnNv 66Vl9RAGE5 y-- - - - - - 1-His Is TO GEHTIPY THAT THE t 01,1QIE;N uF INsUFWMt:r Us)'EU Hr•:LOW HAVE t3bbN I:>bV6U'i 1)'rHF INSUHEU NAmiEU AbuVE Pm ThE Na~.IL r o'N")u INGIcATED, NOTWITHSTANDING ANY;4GoUTA6MENT, TERM by CgNprnQN Or- ANY CONTRACT OR OTHER DOCUM_NT WITH FIESPEG•1- T() W 11C1i I'HM CERTIFICATE MAY 9E 16SUED OR MAY PERTAIN, THE INSURANCE AFFORDED I3Y THE POLICIES DESCRISEP HEAEIN IS 5UWLC1-10 ALL II IL: IE!11,10, R_ - i_ EXCLUSIONS AND CONDITIONS OF SUCii P~UCIES~L~IMITS ~SF(~IN~Ql~~,1iAV~,~~iF,~lF~1 ] 11Y PAIL) CLAIM I PCUCV EFFECTIVE POLICY DCPIRATIOW UMITJ LTH T(F4 or 111OUrw4ct rouuy NUMOCR I DATE (MWODrM DATE (NWDONY) A oENSRALumxuT`! - I 11130 GI 232601.9 ~ 311/98 3/1199 Gma LAGGFEGATE I GVMMEI9GIAl'3Er1EFYU LNEIIIiV PPNUVC=r~ ' CLAJM.' PAW M OCCUR PERSONAL A Any INJUriY _ S 1 0001 000 ~ 1 i~" ~ F1 EACH o:11ARUVGf A. _ r. 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