HomeMy WebLinkAbout275 Gal. Tank 2001 Town of Montville
Building Department
Phone: 848-7166 310 Norwich New London Tpke Fax: 848-7231
NIMIV
Building / Trades Permit
Permit Number PL2001-45 Permit Date 6/19/01 Permit Type Plumbing Permit Code R5
Job Street# 21 Job Location RANKIN COURT Map/Lot 101/059-000
Job Description Fuel Tank
Owner Contractor
Mary Connelli Service Station Equipment
dress 21 Rankin Court Address 33 Leffingwell Road
City Uncasville State Ct. City Uncasville State Ct.
Zit) 06382 Telephone 848-8015 Zip 06382 Telephone 848-2278
Lic/Reg Number 208469
Lic/Reg Type P.-1_ Exp Date: 10/31/01
Use Group R4 Code 1995 CABO Type Construction 5B
Building Value $0.00 Building Fee $0.00
Plumbing Value $175.00 Plumbing Fee $10.00
Mechanical Value $0.00 Mechanical Fee $0.00
Electrical Value $0.00 Electrical Fee $0.00
Other Value $0.00 Other Fee $0.00
Total Values $175.00 C/O Fee _ $0.00
Comments: Plan Review Fee $0.00
State Ed Fee $0.03
Total Fees $10.03 II
Building Official's Signature
//��: '' --- -------1
Date � / �', ii
It is the owners respon tv s�Chedule the ollowinq required inspections(minimum 24 hours notice required):
❑ Footings -prior to pouring concrete
❑ 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 ❑ Pool bonding
❑ Gas piping -pressure test and installation 41 Final Inspection
O Rough HVAC Certificate of Occupancy - PRIOR to use or occupancy
Town of Montville Permit # '0�c::?d if)/
Building Department
310 Norwich-New London Tpke.
Tel. 848-7166 Uncasville, CT 06382 Fax. 848-7231
Application for Building or Trades Permit
Building Permit Trades Permit
❑New Construction D Accessory StructurecPlum6i
❑Action ��DemoCition � n9 ❑9VlechanicaC
❑Alteration ❑Other �EfectruaC Heating
Air Conditioning
Gas Piping
Job Location 1i R/40k1Al cc p� UV.)C_4Svi[CL U 0638-2_
Job Description/Materials--)Z-E)-..1-6 - d--.3j{S poSor 6 S s ,,,ti T.
aI5T1 n.6- 015 GA-Lc-ori/ c4ST .TN ( CsvNen►T
Owner /1#041 Co NN ELL( Mailing Address g.,( Rtr/kfAJ Cv U
city ()j is 5 v j LLL State GT Zip 0 63 9 Z Tel 260 / r&(q.'"/ $915
ContractorftVU S%.9 l o rJ Co(pMC,kr;-04KMailing Address 33 Gtr(A)6.LA-) g o,�
City 0/Jca Su/CLL State C Zip 063F2— Tel FS66 / /
Contractor's License/Registration Type&Number„2 jjg St/ 7/PI Exp. Date /o / 3( /o)
New Home Construction Contractors:
Have you entered into a contract with a consumer for the proposed new home?❑ Yes ❑ No
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 /Di /3 /a
Construction Value Fee
Building $
Plumbing $ X75 d- $ ' ")
Mechanical
Electrical $ $
Other $ $
Certificate of Occupancy $
Plan Review Fee $
State Education $ D 3
Total $ $ / i 4) 3
1
Sep -OS-00 1G - 06A spec 31ty ins 8600 -)6750
ACORDry CERT1FIC` C'1-E OF LIABILITY INSURA'(4'�CE DATE(Ii
M 1k/OJm"1)
9/5/0C.PRDDUcF-
THIS CERTIFICATE IS ISSUED AS A MATTER Of INFORMATION
ONLY ANO CONFERS 140 SPECIALTY INSURANCE& BONDING,INC. HOLDER. THIS CERTIFICATE (DOES GHTS NOT UPON THE CERTIFICATE
OR
230 CRYSTAL LAKE ROAD ALTER THE COVERAGE AFFORDED DY IRE EXTEND Pp
GROTON,CT 06.340 COMPANIES AFFORDING COVERAGE
COMPANY
A STAR INSURANCE COMPANY
INSURES --- - — -
SERVICE STATION EQUIPMENT INC. COMPANY
33 LEFFINGWELL ROAD EI
__...__..._..__. . .. ... _._.__ _._...__._
� COMPANY
- ---.
UNCASVILLE,CT 06382
C
I CONRANY
0
COVERAOE9 NAMED
IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED ED ABOVE FOR THE POLICY PCR)OU '
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 B Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO All. THE TENMi
EACLUSIONS AND CONORgNS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
co
LTA TYPE OF W3URANCE POLICY IIUMDER 1 PoUCY EFFECTIVE I PCUCY EXPIRATION
pATC(MY'ODrI'YI OUT!(MMYDOYYI LIMITS
C)El1ERAL 11ABLRY r I GENERAL,AOGRiCATj i
. I COMMEIIVAL OENERAL LIAtlLT1' ,
—j CUU6 MADE 00Cpq i PROLX/CTS:COMPIOP AU3 I
PERSONAL i ADV INJURY ' I
-- W
OVER'S[CONTRACTOR'S DRC! -
EACH OCCURRENCE i
-. . - __. ._--• FIRE DAMAGE Any ono hi.] I . ...
' I ;MED EXP (Any ono P«con) I I
'_ALT 06106LE LIA6ILITY —
—^i ANY AUTO , COMBING!)SNGIi UNIT I
ALL OWNED AUTOS I
--._._ ........... ...
SCHEDULED AUTOB I eoou v NAur+r E
Plv
,(Pm « n)
HIRF_D AUTOS -1-''---------
NON-OWNED AUTOS 8001LY tlIJURY i
-. (PM icwon1)
—
I I PROPERTY DAMAGE i
GARAGEL1A81LlY T IAUTO ONLY•EAACCOEhI i
—' ANY AUTO ... . _-------
' OTHER THAN AUTO ONLY
—_._._._....... _ _ E[CHACC DENT i
1—
ACC)LEW.1E . 3
exam LIABILITY 11 EACHOCCURRENCE i 1 — -
UMBRELLA FORM , • I AGGREGATE 1
I CTHER TrV,N UMBRELLA FORA( 1
S
A IrlrsoctRaCQO'EN3Anom ANO –WCO125564 x 1 WC[ili I ont —•--i,
E►sLOYEP$LIABILITY 8/25/00 8/25/01 mar uMrE...�.. ,� -- - - -_
TK w0911fElw, EL EACH ACCIDENT i 100,000 '
k•ATNE l[rtAminrt X I INCL CL DISEASE••POLICY UMn 1 f
OFF10Eii ARE EXCI L. 500 QQQ I
I OTHER
— 1 EL OlBEASE•EA EMPLOYEEr$ 100,000
•I
,
crEuTioNB/GATii VrciatmsPECATTTFT3 I
DC
EVIDENCE OF COVERAGE FOR VARIOUS PROJECTS.
i CERTIFICATE F1OU)E:R
CANCELLATION --
i
SHOULD ANY OF DE ABOVE DESLTEWEU POUCEEU St CANCELLED BeFOR1 Tit
EXPIRATION DATE THEITLOf, THE IS5UWO OOM►ANY Y11LL EttUEAV[$ T• TAIL
1`DAYS VAIRTEN MOT$ci TO TNS C
EATUICATi HOLDER NAMED TO THE UF t.
OUT AjLu&TO MAIL OUCTI NOTTCEPUNA IMPOOE MOOBLJGATIoN ORIlia UI1
Co ANY KIND UPON THE COMPANY I'Il AE ENTS OR REPRESCNTATIVE!
/ ED R /FSE/1fT*xp� m -
(ACOJ2D 26-5 144L t{� /�^ C•'
FOR WORKERS COMP ONLY, ON BEHALF OF SMITH BROTHERS, INC., MCA FOR CCIA P OO ANi T N
vow
ervice Station
111[\19
Equipment
ervice Inc. Specialties: Gas Pumps - Lifts - Self Service Specialists
33 Leffingwell Road Sales, Service & Installation
Uncasville, CT 06382 STATE OF CONNECTICUT
(860) 848-2278 • 1-800-801-TANK /)J IARjn/(.yr HI ( HHV (IMJ R PROTECTION
PLUMBING&PIPING LIMITED CONTRACTOR
Type:P9
Date: 61/3`0/ MARTIN D MCKINNEY JR
RFD#1 8 TOTEM LN
City/Town: /lea v�rf�c i GRISWOLD,CT 06351
LIC./REG. NO. EFFECTIVE 1 EXPIRES
208469 11/01/2000 10/31/2001
RE: Application for Plumbing Permit
SIGNED:
Licensed contractors, as defined in section 20-338b of the Connecticut General Statutes,
must personally sign each building permit application. This letter authorizes the below
named agent to sign the above referenced permit application.
Project Name: /1n/ ANN ea-i-i
Address: ,9,t RA-vJKI d Coy/LT--
to)c4s-vit_c_e 1
..oy/Zt'vNCASvrt_LC( LT o63rt-
Starting Date: 7-f3�
Licensed Contrator's Name: Martin D. McKinney, Jr.
License Number: 00208469
Agent Name: Mth'vvry
"Tanks Alot",
/7
Marti . McKi , Jr.
Service Station Equipment Service, Inc.
PROPOSAL Page No. of Pages
SE'VICE STATION414ct_`r�'G`4 n d,
EQUIPMENT, NC.
Residential Tank Specialists Lic.# 00208469 L,()V- 70( " `7 ".°
33 Leffingwell Road U - __ 2 Z_Ct i7C)
UNCASVILLE, CONNECTICUT 06382
(860) 848-2278
Toll Free 800-801-TANK 0 i 3 0
PROPOSAL�{ SUBMITTED TO PHONE
f'li2ca !)''y)��'21 CO/Jf\I a Q G�n(' DATE //
STREET ` ( "��r"Oi� ��uaf�Q�
JOB NAME
At RPI-1.)K[N Co u 27-
CITY,STATE and ZIP CODE JOB LOCATION
U1Jc4Ivru_ , Cr' c6332-
ARCHITECT DATE OF PLANS �� KliU Cr., NS v` � Cr
JOB PHONE
'X— fk& -PL-'/41-G- s1 or^ R.6,
We hereby submit specifications and estimates for: 2r yr,,t7✓� t, 1)IS posem` 0 t f�) S r 6�L�N U 'T
f %
A^ i) 1 N %fI
5Z Li 77 d,0O F (t 1 ?G�7 qt n./ A-s T .Dv &9-4t Ey
ti O(?Thi N PE-miY A- CoNT(tcT F I RC pia-PS k I At--
4 Convipe-L T . S7,9u4-47onl 4F owrue e. pu2c ,mei 271-0 coAJ fl-5r ...pvs6,11e- -
Eris FI 4-V r PI Pel d Gti,9c ,�S Sr, ��Seri-c-42.37) 70 C4306.-
c ec Pnz 12.G 77i12u CIS i CeN,ver "v iz1) Fv�2 C.4 AJ TO /LiJ4Ce-
1 712k i 'FL up T23 a-7 S- Grp-u-6 Air a f- Fv(.2 Di L F/24 vvi U5 r 7o A-'3 r
4 ev -u/>r(r(2.1,-.Yt o�✓c_-, ESM e ad-D 15 pv 5C' 0 f=- Ci 1 SoL-a CG4Z" 4)v US T
4 (2,�cKF-(CL 17 " cj[,r24 C.L 9 J (vwTrt.aRI_
4 -roe SOIL # 5'Cc_)
. 0',f. ' 1= -1- , LL ,t L-.. / crof-T TO 6ww-rZ_
111
a — 1
Ike FT:LLowi fu Cr- N • i 66,c'/L.1) •
•
SC) L Cie 6./T fyYt/Ai/jfilcYv CL f= -Aiv, Pc\T) •
Din aNA'f. S-0IC y►,j2Le-5 Si S . = --, " - L a
kl Qu I o(S u>b cr !2-i�'yt ov er.._ I t S po sem- ( yr/• P YZ Gomco,.., (p\13 °
0 Asii1- -Liv.s//�Z2t///Z-le/ i111/TL-
� /VI o f & L4-C L� j�
-
4j jpf-x�c sy pe-- R e4,9-iiL or Or,rr) 5c p 6^
We Propose hereby to furnish material and labor— complete in accordance with above specifications, for the sum of:
CANE TZ 3/MN-0 Tz 0 Ho No(Leo 79wn 72.x)e 4 -7-- Five r 714.0\
Payment to be made as follows: �J dollars($ /�Z Z� C �i1 C
SO !d 6✓V 1 C-C&PT n/C C
/ C 0k Timk 1Z0140✓111--
All material is guaranteed to be as specified. All work to be completed in a workmanlike
manner according to standard practices. Any alteration or deviation from above specifications Authorized
involving extra costs will be executed only upon written orders, and will become an extra Signature
charge over and above the estimate. All agreements contingent upon strikes, accidents or
delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Our Note:This proposal may be 7 KJ
workers are fully covered by Workman's Compensation Insurance. withdrawn by us if n•t accepted within
days.
Acceptance of Proposal _The above prices,specification
and conditions are satisfactory and are hereby accepted.You are authorized to do the - _- • e iJJe' _� .J�,.
work as specified.Payment will be made as outline above. `— II
of Acceptance: x (.3 ✓ / Signature
/ )'To
Town of "ontville Building Departmr 't Receipt
Date ______4±2,____,./ /
f
No. 00797
Fs From: 1
ot
Job Address: 1/ ' fii
r111*.
Amount $_
Cash OW
Check #
Received by 1��-_
_ __ ___ "0', •/•______-__________-____________--
/• Permit #0a4:2612217/4(5--