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Two 120 LP Tank and Line to Generator 2013 Field Inspection Notice Town of Montville Building Department 860-848-3030 Ext. 382 Address: 24 Rankin Court Job Description: Install Two 120 AIG LP Tanks & Run Line to Generator Permit Number(s) M2013-0240, E2014-0074 Permit Date: December 30,2013 Not Approved Approval INSPECTION Comments Special Date • Gas Line Pressure 04/23/14 VV Final inspection and certificate of approval **NOTE** After one re-inspection additional inspection fees payable prior to re-inspection,are as follows: Residential inspections(except SFR CIO& SFR Additions C/O)-$10.00 SFR and Additions C/O re-inspections -$10.00 Commercial re-inspections(except Certificate of Occupancy- $25.00 Commercial Certificate of Occupancy- $50.00 Rev.Date: 1/18/06 Pape 1 of 1 TOWN OF MONTVILLE Building Department 310 NORWICH-NEW LONDON TURNPIKE UNCASVILLE, CT 06382-2599 TEL. (860)848-3030 X382 FAX. (860) 848-7231 ELECTRICAL PERMIT Permit Number: E20j4-Q014 Date: 15-Anr-1 Map/Lot: 101/051,000........ Owner ID: 5788000 Project Location: 24 RANKIN COURT Unit: Job Description: _install 20.10NGenerator&Aulonnaticironsfer_Switch Owner Nam JvlacLAnn_Blair Tenant Name Careof: 24 Rankin Court ll a le CT (14382- Telephone: Applicant Name C,• - • • Telephone: 1fa0)886,2232 DBA:AClllCJnductrial Flectric Lic/Reg Type J71 Lic/Reg N - _122124 44 Yantis Flats Road Exp Date: 30:Sen.: 4 Yontic CT 0ó389- Cooe+.iCtion\/olulea Pa►mit Fees Canstnrction_IDfor n ion Building Value: SQOQ Building Fee: $S100_. Use Group: IRC Plumbing Value: SQ 00 Plumbing Fee: MOD_ Code: 2005 State Building Code Mechanical Valu S0.00 Mechanical Fe $(1.00_ Electrical Value: S10.50.0.0Q Electrical Fee: S132Q0_ Construction Type IRC Total Value: 0_0,500,00 Penalty Fee: SQ UU_ Permit Code: R5 C of 0 Fee: SfOQ Comment Plan Review Fe $1100_ State Ed Fee: $2.73 Total Fee Paid: $1.3_4-73 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 1 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 ❑ Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation Illrfif sate gf Approval /E3 Ce 'f tie of Occupancy J3�aildino Officiars_Aooroval: Town of Montville (1© On k c l< Building Department t. 310 Norwich-New London Tpke. Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 RESIDENTIAL PERMIT APPLICATION FORM Permit No.: ( -) - brilii Type of Work Occupancy Type Permit Type ❑ New Construction El Single Family ❑ Building ❑Addition 0 Two-Family El Plumbing ❑Alteration 0 Townhouse ❑Mechanical 0 Accessory Structure ❑ Electrical CRS#: 0" / Property Address: 7 / -r-/A)j( 1,11 COO A, (Number) (Street) �— � /� (Unit) Job Description: 1/c--- 111/9-1,)"T-614) } /p L L-- 01 6 /c Li ( 74' '&L/D/4.) /24 7 / i o4i %7 G Jh-/'4'J i 4titi )tt//7 07t1 Owner: /4/9/b) /%)J J 1,2,9/A, Address: d 7 12/91)1( Ca az//L l City: O/v f 9.S/// L State: G/ 'Zip Code: OoJj°'s Telephone( ) - Applicant: ,^1, li..6;j 6;1/N 41 Li'' DBA: /2 C ©6 _217,,e oS7A1, L- C;CAC6T i C Address: �/ ,��,�_677 /ci /–L/t7/S City: A7741Ti (--) State: Ci Zip Code: "?,::11/ Telephone(,(715--e ) YRS_p ✓' Contractors - Complete the Following: OKI' , License Type: 4' / ".:nse No.: AVOW Expiration Date: n 1e I hereby certify that the proposed work w' o . to t - State Building Code and all other codes as adopted by the State of Connecticut and the Town of Montville and further attest that . • pm..sed w•rk is authorized by the owner in fee and that I am authorized to make application for a permit for such work as described:bove./ Owner/Agent Signature: Date: `�/�/ / Construction Value Permit Fees Building Value: Building Fee: Plumbing Value: Plumbing Fee: Mechanical Value: Mechanical Fee: I' Electrical Value: Electrical Fee: / 3 s 'od , Total Value: Penalty Fee: C of 0 Fee: Plan Review Fee: State Ed Fee: Total Fee: Revised August 23,2007 Town of Montville Building Department File Receipt Date: 14-Apr-14 ReceiptNo: 9280 Received From: Charles A.Carroll Jr. Job Address: 24 Rankin Court Town Fees Collected State of Connecticut Fees Collected Bldg Cash: $0.00 State Cash: $0.00 Bldg Check: $134.73 State Check: $2.73 - Bldg Credit: $0.00 State Credit: $0.00 Fire Cash: $0.00 Fire Check: $0.00 Fire Credit: $0.00 Construction Value: $10,500.00 Demolition Value: $0.00 CheckNo: 634 rt Received By: Carmen Kneeland UCLAWLy ' , \ ` iA,_51.(10 4 Address: 24 Rankin Court ITEM QTY $/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 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 $ - Masonryw/lfireplace EA $ 7,096.65 $ - Masonry w/2 fireplaces EA $ 11,095.70 $ - Wood Stove,free standing EA $ 2,69225 $ - 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 $ - $ Inground 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 $ 10,500.00 TOTALS $ - $ - $ - $ 10,500.00 PERMIT FEE CALCULATIONS Construction Value Fee Building $ _ $ - Plumbing y $ - $ _ Mechanical y $ _ $ Electrical y $ 10,500.00 $ 132.00 Working before Permit Issuance n $ _ Certificate of Occupancy Fee $ _ Plan Review Fee $ State Education Fee $ 2.73 TOTALS $ 10,500.00 $ 134.73 Figures are based on the 2006 RS Means Residential Cost Data Town of Montville Building Department CONSTRUCTION PERMIT APPROVAL Applicant is responsible for obtaining all of the required approvals. No permit will be issued until all the required signatures are obtained. DL\ r0-11 1L_L j\ ( ‘2,( �^ Property Address . O te l) G e-ai 0--kt i ,j- Job Description Required Department Permit Issuance Approval Approval / Tax Collector Signature/date Comments: / v Planning & Zoning (�PILY, _ �-7 L/// Signature/date t Comments: ® Fire Marshal Signature/date Comments: ❑ Health Department Required for properties with private septic or well Comments: ✓ WPCA, Administrative � _ /y/,:=2-01 / Required for properties on sewer S 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: ❑ State Dept. of Transportation 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 14-311 Signature/date Building Department Review Complete Signature/date Revised May 23,2011 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: p112013_0240 Date: 30-oecc-i 3 Map/Lot:j111L05 000 Owner ID: 5788000 Project Location: 24 RANKIN COURT Unit: Job Description: InsfaUj o 1 0 GgLAboyg Gro_u_adLe_Tanks&_RuQ_Line_to Generator Owner Nam Mary Ann Blair Tenant Name_N/A Careof: _22.Rankin .aurt JJnaasville _CT _06382- Telephone: l_860)fi4R-7354 Applicant Name All Gass Telephone: 1860)255-4277 DBA: Lic/Reg Type G1 Lic/Reg N 395387 3150 Main St[eet Exp Date: 31-A _ELadfard CT _ -06120- l'nnctdictinri_vok Pam iLFees _ Construction nfojmoion Building Value: $2_00 Building Fee: SA00 Use Group: IRC Plumbing Value: $c0 Plumbing Fee: 50.00 Code: 2005 State Building Code Mechanical Valu 51.000.00 Mechanical Fe 531100_ Electrical Value: S0.00 Electrical Fee: Sn,QO_ Construction Type IRC Total Value: $L0_0_0,00 Penalty Fee: S0.00 Permit Code: R5 C of 0 Fee: $Q.QO Comment Plan Review Fe S11.00 Fire Marshal Fee of$20 Paid State Ed Fee: $1126 Total Fee Paid: 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 0 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 0 Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation 0 Certificate o Approval • . of Occupancy Buildina QificjQJlAaolovaL %ftie� _ Town of Montville Building Department 310 Norwich-New London Tpke. Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 40 RESIDENTIAL PERMIT APPLICATION FORM Permit No.: 006(3-(7 " Type of Work Qtqupancy Type Permit Type ❑New Construction aicZingle Family 0 Building Addition 0 Two-Family Plumbing Alteration 0 Townhouse echanical ❑� Accessory Structure 0 Electrical CRS#: Property Address: O-1 `01/411 �1 f l� (Number), f I 3 n (Street) J kG (Unit) a�( Job Description: l 0 �l�t - � o • i /& CPn (i1 . 9v run ! l Pty..) 0 C{�1�P.V(t�71Y _96 nUY-0 Owner: r"'1 (1 Y-( 1 r�nn 13)01AJ Address: "� e)(1/r)h� n aT City. LX/r 1 cQ )v Lt 1 e State: a-r- Zip Code: Telephone( CO ) >`ATO 7361 Applicant: n i DBA: Address: 2)1 )a frCI � H rum eZif ity. p�� �Q /` Ct \ State: �i I Zip Code: I(O )Telephone( CXJ U ) t 1 I I - ``7Ci 35 Contractors - Complete the Following: Q� _Com' 2 I License Type: H TCS License No.:393 I� Expiration Date: S ) 31 / LI 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. ❑ By checking this box, I will follow the requirements of the 2005 NEC as the alternative compliance per section E3301.2.1 of the Residential Code, instead of the electrical requirements in chapters 33 through 42 of the Residential Code. Owner/Agent Signature: /�.� ��� Date: / //q//3 Construction Value Permit Fees Building Value: Building Fee: Plumbing Value: Plumbing Fee: Mechanical Value: __ Mechanical Fee: 2C) •lJ`� Electrical Value: Electrical Fee: Total Value: Penalty Fee: C of 0 Fee: werrREMor az. a0 .U O State Ed Fee: cDlP Total Fee: 21r vied august 23,2W7 Town of Montville Building Department File Receipt Date: 20-Dec-13 ReceiptNo: 9082 Received From: All Gas Job Address: 24 Rankin Court Town Fees Collected State of Connecticut Fees Collected_ Bldg Cash: $0.00 State Cash: $0.00 Bldg Check: $30.26 State Check: $0.26 Bldg Credit: $0.00 State Credit: $0.00 Fire Cash: $0.00 Fire Check: $20.00 Fire Credit: $0.00 Construction Value: $1,000,00 Demolition Value: $0.00 CheckNo: 8560 Received By: Carmen Kneeland C ' ij.-r l Y l �6JA 6 TheALLGt Equipment Municipality: J41 ,2, (1/1,--/N C,/, (/N C IJ v///e c i Job Name: /74C y- ,2i1//N 4L4/i( Starting Date: Job Description: SeT a /ao 7�/-sw/rJ ieuti .i/c...t, 2/w p o 5Pry Pie-.9 16/C/OgcJf v/(-C Te'J T ,i1/4.._ 7"& iv iv,fie c-/'O / Per Public Act 91-95 This letter authorizes 1 U a OcJJ(t a to sign the permit as an agent of The ALL-GAS & Equipment Company, fore above mentioned job and municipality. Application License: STATE OF CONNECTICUT DE ARTMENT OF CONSUMER PROTECTION .4 . ,,, ,,,,,... HEATING,PIPING&COOLING LIMITED CONTRACTOR MICHAEL J PROUTY Michael J. ProutyI 25 BROAD BROOK RD License #: HTG.0395387-G1ELLJNGTON,cr 06029 Expiration: 08/31/14 LIC./REG NO. • EFFECTIVE EXPIRES • IHTG.0.395387-c41 09/01/2013 . 08/31/2014 !SIGNE C ".01� 41* CP 3150 MAIN STREET, HARTFORD, CONNECTICUT 06120 PHONE (800) ALL-GASS • FAX (860)527-2376 VISIT US AT: www.allgas.com _�..—....4s AEROALL-CL BFEARON '°,ARD CERTIFICATE OF LIABILITY INSURANCE DATE YYI 4/19/2013 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 policy(les)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). CONTACT PRODUCER NAME: Smith Brothers Insurance,Inc. PHONE 860 652-3235 FAX Flo): (860)652.3236 68 National Drive Suite 2 (SVC CNo,Exp:( ) Glastonbury,CTb6033 E-MAIL Glastonbury, IN SURER(S)AFFORDING COVERAGE NAIC N INSURER A:Indemnity Insurance Co.of NA 43575 INSURED IN SURER B:Ace USA 22667 The Aero All-Gas Company INSURER C:RSUI Indemnity Co. 22314 3150 Main Street INSURER D:LM Insurance Corporation 33600 Hartford,CT 06120 INSURERE: IN SURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 IN SR ADDL SU BR POLICY EFF POLICY EXP LIMIT LTR TYPE OF INSURANCE INSR VVVD POLICY NUMBER (MIXDDYYYY) (MMUD'YYYY) GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 3/2612013 3/26/2014 PREMISES DAMAGE TO RENTED 100,000 A X COMI,tERCIALGENJERALLIABILITY MCR D36718948PRELIISES!Eaoccurrence; S CLAILIS-MADE X OCCUR MED EXP(Any one person; 5 5,000 PERSONAL A Aar'INJLRY 5 1,000,000 GENERAL AGGREGATE 5 2,000,000 GEN L AGGREGATE UMIT APPUES PER- PRODUCTS-COLIPJOP AGG 5 2,000,000 POLICY JECPRO- X LOC S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT(Ea accident; 5 1,000,000 B X ANY AUTO CALH08273935 3126/2013 3126/2014 BODILY INJURY(Per person; S ALL OWNED SCHEDULED BODILY INJURY(Per accident! 5 AUTOS AUTOS PROPERTY DAMAGENU -0WtJED (PER ACCIDENT) S HIRED AUTOS AUTOS S X UMBRELLALIAR X OCCUR EACH OCCURRENCE 5 10,000,000 C EXCESS UAB CLAIMS-MADE NHA063060 3126/2013 3/26/2014 AGGREGATE S _ DED X RETENTION Aggregate s 10,000,000 WORKERSCOMPENSATION X WC ST MITS °J41- AND EMPLOYERS'LIABILITY YIN D ANY PROPRIETO1,000,000 R+PARREWE(ECUTIVE WC631S389006-012 12/31/2012 12/31/2013 EL EACH ACODENT S OFFICERfl EMEEREXCLUDED/ Y IJ'A (Mandatory In NH) EL.DISEASE.EA EMPLOYEE 5 1,000,000 II Les.describe under DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT 5 1,000,000 DE SC RI PTION OF OPERATIONS I LOCATION S I VEHICLE S (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Evidence of Insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WLL BE DELIVERED IN For Information Only ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED RE PRESENTATIVE Rl Mai,S(?. Ko()4 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010/06) The ACORD name and logo are registered marks of ACORD - — - 4111.11•1111111111111111111111 I 1 •No•'aurora., 1 0 r.4 e. A C —< (,); ;j+e c 3- 4 ro 1 • Town of Montville Building Department CONSTRUCTION PERMIT APPROVAL Applicant is responsible for obtaining all of the required approvals. No permit will be issued until all the required signatures are obtained. azo t)A i ;.j C Property Address thr.\ (2.) 120 9.Grr(fy pr,, W ry ,� � -Ai- Job Description Required Department Approval Permit Issuance Approval Tax Collector ,�.�-+��/ (,��.—� / 1.1_,o1/3 Signature/date Comments: Planning & Zoning CelL Iat 3 Signature/date Comments: Fire Marshal t 212 f-A Signature/date Comments: ❑ Health Department Required for properties with private septic or well Comments: ❑ WPCA, Administrative Required for properties on sewer Signature/date Comments: ❑ WPCA, Operations When Required by WPCA Signature/date Comments: ❑ Department of Public Works Required when proiect 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: ❑ State Dept. of Transportation 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 14-311 Signature/date Building Department Review Complete Signature/date Revised Mali 23,2011