HomeMy WebLinkAbout120 LP Tank and Line to Stub Out 2012 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: M2012-0200 Date: 06-Dec-12 Map/Lot: 087/002-106 Owner ID: 5814750
Project Location: 260 RAYMOND HILL ROAD Unit: 6
Job Description: Set One 120 LP Tank&Install Gas Lines to Stub Out
Owner Nam Eldridge Luther Tenant Name N/A
Careof:
26 Marquardt Lane
Groton CT 06340- Telephone: (860)449-0879
Contractor Nam James Saporito Telephone: (860)859-9070
DBA: Spicer Advanced Gas Lic/Reg Type Gl
Uc/Reg No 388986
183 East Haddam Road Exp Date: 31-Aug-13
Salem CT 06420-
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: 2005 State Building Code
Mechanical Valu $500.00 Mechanical Fee $30.00
Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type IRC
Total Value: $500.00 Penalty Fee: $0.00 Permit Code: R5
C of 0 Fee: $0.00 Comment
Plan Review Fe $0.00 Fire Marshal Fee of$20 Paid
State Ed Fee: $0.13
Total Fee Paid: $30.13
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 framin ❑ Electrical Service CRS No: 0
❑ Framing ❑ R HVAC
❑ Masonry Fireplace Throat or Chimney Thimble I Gas Piping and leak test
❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION
❑ Insulation d❑ Certificate of App,lval
❑j . e . .ccuanc- y
Building Official's Approval:
Liil. Town of Montville
Building Department
4 310 Norwich-New London Tpke.
Tel.860-848-3030, Ext 382 Uncasville, CT 06382 Fax.860-848-7231
RESIDENTIAL PERMIT APPLICATION FORM Permit No.: &l 6143---0a01
Type of Work Occupancy Type Permit Type
❑New Construction 121-Single Family 0 Building
Addition 0 Two-Family ❑ rnbing
�]Alteration 0 Townhouse ['Mechanical
0 Accessory Structure 0 EElectric�al /�CRS#:
Property Address: k9l//0V i Vit O'VlcJ if t,tr &z1 11/14 cad C4(I ire a
(Number) (Street) (Unit)
Job Description: - 1 -1 L(9 G q S 1 JTn1 K 1 Sf� va c .. �ch.
Foo 61 (� ( 4 �- .b -1 .
Owner: A L L C1 14 i'
Address: �d.+ '�6(p MQ( G{0( rd.1— 1---0A4-02---
- �y
City: alb 411 ° State: C1 Zip Code: //^^V 3 `tv Telephone( SW/ )1-/g_/- 0 g 7ci
Applicant: •-l'Al YI eS gi(4-e0 r l 4-a--
DBA: 4 (c.- T Cr✓a vi c e d 6s �
Address: i D 1. I "r M 4i t� iJ' ' 4
6
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City. .S41 --ko State: C 1 Zip Code: Opo Telephone( &C ) 575-c)- 90 70
( foo.2F)
Contractors - Completel! the Following: q�
License Type: fT T6 `(Yl License No.: 74�/11pp�p Expiration Date: tW/3//20/3
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 lam authorized to make application for a
permit for such work as described above.
r By checking this box, I will follow the requirements of the 2005 NEC as the alternative compliance per section E3301.21 of the Residential Code,
instead of the electrical requirements in chapters 33 through 42 of the Residential Code.
Owner gent Signature: _I �_� Date: /071/45//Z
Construction Value Permit Fees
Building Value: Building Fee:
Plumbing Value: �1D Plumbing Fee: ,,��
Mechanical Value: r--1Mechanical Fee: ^T
d .( -
Electrical Value: Electrical Fee:
Total Value: Penalty Fee:
C of 0 Fee:
Plen-Revlew-1 ee: cDO , 00
State Ed Fee: . I
Total Fee: S 2) _ 1
-21
Revise&August 23,2007
Town of Montville
Building Department
File Receipt
Date: 05-Dec-12 ReceiptNo: 7978
Received From: Ann Marie Rios
Job Address: 260 Raymond Hill Road, Lot #6
Town Fees Collected State of Connecticut Fees Collected
Bldg Cash: $0.00 State Cash: $0.00
Bldg Check: $30.13 State Check: $0.13
Bldg Credit: $0.00 State Credit: $0.00
Fire Cash: $0.00
Fire Check: $20.00
Fire Credit: $0.00 Construction Value: $500.00
Demolition Value: $0.00
CheckNo: 1783
Received By: C--CV\i'vl..t A h/\. Y 1 _4(k_cdrt.
Town of Montville
Building Department
310 Norwich-New London Tpke.
Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 850-848-7231
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.
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Property Address
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Description
- Required for all permits ® - At least one required for all permits ❑ -Required as indicated below
Required Department Permit Issuance Approval
Approval
Tax Collector
Signature/date
Comments:
® Planning & Zoning ( .M �-✓--- f 4.1/ 12---
Signat re/date
Comments:
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Fire Marshal I
Signature/date
Comments:
® Health Department
Required for properties with septic systems-Not required for Plumbing,Electrical. Mechanical,Roofing.Siding,Windows&Doors
Signature/date
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 project includes driveway work or certain drainage requirements Signature/date
Comments:
O State Dept. of Transportation
Required for Structures over 100.000 sq.ft.or with more than 200parking spaces-Official copy of STC Certificate of Operation required-per
CGS 14-311
Signature/date
Building Department Review Complete
Signature/date
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Advanced Gas
A DIVISION OF SPICER PLUS. INC
36 Thames St., Groton,Ct. 06340• 183 E. Haddam Rd.,Salem, Ct. 06420
(860)445-2436•(860) 859-9070
Fax- (860)445-2313 •(860) 889-3627
www.spiceradvanced.com
HOD# 0000744 -N #11 I"
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I designate name of authorizedperson) i]rl_ aLe__L(OS
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agent.
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This work is to be performed in (name of town) ( ps,g,21_ •cliti—tri
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This work is to be performed at (street address) ►i'm �41. ^_.
Our Anticipated start date is (expected start date)
I, James L. Saporita, am the licensed contractor.
My license number is:HTG 0388986, (Type) Cl . Expiration Date: 08/31 /2013
This request is made pursuant to Connecticut General Statute, Sec. 20-338b
I Ad
S nature of Licenses Contractor
Ct. Lic. #388986 • R.I. Lic. #00007469 • Ct. H.O.D. #0000744
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STATE OF CONNECTICUT + DEPARTMENT OF CONSUMER PROTECTIONv,,
Be it known that "
JAMES L SAPORITA "
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MYSTIC' C i `063.55-:4016 'f J
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has been certified by the Department of Consumer Protection as a licensed , y -h,
' HEATING, PIPING & COOLING LIMITED CONTRACTOR ?=
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License # HTG 0388986-G1 -J
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Effective: 09/01/2012 � ,
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Expiration: 08/31/2013 -' ' %-
William M.Rubenstein,Commissioner ',`�
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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(SI,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 I5 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).
PROGUCBR CDNTACT
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P O Box 1729 ra (618j 479-72x4 lac Nor(618)479.7251 I
Albany,NY 12201-1729 E-mAtl.
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INSUREA(SI AFFORD*IG COVERAGE NAIL I
INSURER A:Century Surety Company 36951 •
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INSURER e:GRANITE STATE INSURANCE CO. 23809 i
S.P.TRANSPORT LLC INSURER C: •
36 THAMES STREET INSURER D:
GROTON,CT 06340-3629
INSURER E:
INSUItERF:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED 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.
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COMNERCIAI.GENERAL LIABILITY PREMISES(Ea ow+rence) 3 „
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PERSONAL&ADV INJURY S
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DESCRIPTION OF OPERATIONS txbw
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach AC ORD 101,AddlEonal Remarta Schedule,it more space Is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL. BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHGTEZED REPRESENTATWE
CD 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD
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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.
() r2mond 4-(,
Property Acldress
0 l Le YVlo(otie
Job Descnpti n
Required Department Permit Issuance Approval
Approval
fII Tax Collector ;,�a �, /�.
Signature/date
Comments:
,/ • Planning &Zoning /0 s___ /)120/IZ
r_ r— Signature/date
Comments: I(,(0 71+ cti °A 4v1S1P1—
✓o Fire Marshal �.. (. t 11 ( (
i Signature/date
Comments: C�► L '� rwt.�L L L_ l
❑ 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 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 a(ay 23,2011