The URL can be used to link to this page

Home My WebLink AboutGas Line, Tank & Gas Logs i Town of Montville Building Department Field Inspection Notice Address: 11 Andersen Lane Job Description: Gas Permit Numbers: NO PERMIT Footing Not Approved: Approved: Comments: 1• Backfill Not Approved: Approved: Comments: 1• Framing Not Approved: Approved: Comments: 1• Rough Electric Not Approved: Approved: Comments: 1• Electrical Service Not Approved: Approved: Comments: 1 Rough HVAC Not Approved: Approved: Comments: 1• Rough Plumbing Not Approved: Approved: Comments: 2- Gas Line Not Approved: Approved: 10/25/04 JS Comments: 1• Fireplace Throat / Not Approved: Approved: Chimney Comments: t• Fire/Draftstopping Not Approved: Approved: Comments: 1• Insulation Not Approved: Approved: Comments: 1• Certificate of Not Approved: Approved: Occupancy Comments: 1• Not Approved: Approved: Comments: t• Not Approved: Approved: Comments: 1• Not Approved: Approved: Comments: i• Comments: Page I 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 MECHANICAL PERMIT Permit Number: M2004-0228 Date: 25-Oct-04 Map/Lot: 131/047-000 Owner ID: 75000 Project Location: 11 ANDERSEN LANE Unit: Job Description: Gas Line & Tank for gas logs Owner Name: Tammy R Gibb Tenant Name: N/A Careof: 11 Andersen Lane Oakdale CT 06370- Telephone: Contractor Name: E. Osterman Propane Telephone: (860)447-0341 DBA: Lic/Reg Type: G1 Lic/Reg No: 394019 7 Enterprise Lane Exp Date: 31-Aug-05 Oakdale, Ct 06370- Construction Value Permit Fees Construction Information Building Value: $0.00 Building Fee: $0.00 Use Group: R-4 Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1999 State Building Code Mechanical Value: $450.00 Mechanical Fee: $8.00 w/2004 Amendment Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type: 5B Total Value: $450.00 Penalty Fee: $8.00 Permit Code: R5 C of O Fee: $0.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $0.07 Total Fee: $16.07 It shall be the owners repsonsibility to schedule the following inspections a minimum of 2 business days in advance: Field set of approved construction documents shall be available onsite during all inspections. ❑ Footing - Prior to pouring concrete ❑ R Plumbing and leak test ❑ Backfili - Footing drains and waterproofing ❑ R Electrical ❑ Concrete Slab - Prior to pouring concrete ❑ Elec Trench - with conduit installed ❑ Framing ❑ Electrical Service CRS No: 0 ❑ Fireplace Throat - One flue above throat ❑ R HVAC ❑ Chimney - One flue above thimble ❑d Gas Piping and leak test ❑ Firestop Draftstopping ❑ Final Inspection ❑ Insulation ❑ Certificate of Occupancy Building Official's Approval: r. Town of, Montville Building Department 310 Norwich-New London Tpke. Tel. 848-3030, Ext 382 Uncasville, CT 06382 Fax. 848-7231 Residential LP-Gas Permit Application Form Wingfe Family ElTwo-Fami6i F-ITownhouse Permit # o' ~J 69 0 Job Address (I A 11/D0Z5(:)NJ 2>A LC (Number) / (Street) ) ~ ~ (Unit) Job Description ~ L -j&9 ~ / 20 &4L L-PG % 74^W~ rDpc 6~,/.S Z-g S Owner K EEkHm Mailing Address City _)x Cr- State UT Zip 370-Tel- / 7 / 1 Z 9 Contractor'5-i'N1.EL S06*tA,Ae, + Mailing Address 7=AAKMISe-mom < ee:$ ~ Y>S-TcT~/►~~ City I--- //~~/State G~ Zip Tel Contractor's License Type & Number G/ " 39 `7D/ q Exp. /1.5 / 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. Separate applications are required for c Owner Agent ignature Date/ I'Z Construction Value Fee Mechanical $ $ Electrical $ Plan Review Fee $ State Education $ b 2 Total $ $ az &vUedSeptem6er9, 2004 I ` Town of Montville Buildin~g Department Receipt Date/ No. 0 ` 3 From: Job Address: Amount $ Cash Cficc~ Check # C i rcle one) Received by ' f Permit #C "`pt 10,121/2004 12:0E ?M FROM: Fax Gaud to Irisu:anc:e TO: 786094'10399 FACE: 602 OF 00:i Clie nt#: 2427758 OS TE RGAS aCORD,. CERTIFICATE OF LIABILITY INSURANCE CAT2(&W D,-f" PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Gaudette Insurance. Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE One Plummers Comer HOLDER. THIS CERTIFICATE DOES NOTAMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Whitirtsvills, MA 01588-2100 508 234-6333 INSURERS AFFORDING COVERAGE NAIC 0 INSURED INSURERA: Liberty Mutual Insurance Company AIG003 E. Osterman Gas Service, Inc. INSURER B: American Home Assurance One Memorial Square Whitinsviile, MA 01588 INSURER C' INSURER 0: INSURER E: COVERAGES THE POLICIES CF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION 0° ANY CONTRACT OR OTHER DOCUA4EM WITH RESPECT TO 11(HICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE A=FORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERtJS, EXCLUSIONS AND CONDITIONS OF SUCH POLICES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. t_POLI TR TYPE OF INSURANCE POLICY NUMBER P Y EffECTIYE POLICY IXPIRA IOp6ij N uMlrs A GENERAL LIABILITY' BINDER290468 10101/04 10/01105 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABIL TI DAMAGE TO RENTED $50,000 CLAIMS MACE a OCCUR i PIED EXP (Any one person) $ PERSONAL & ADV ;N.,URY $1 000 000 GENERAL AGGREGATE $2 000 000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOPAGG s2,000,000 PCLICY JI-ECOT LOC A AUTOMOBILE LIABILITY BINDER285108 10101104 10101105 X COMBINED (Ee acc accldenl) ent) ELIMIT $1 OOO,000 Ee ALL OWNED AUTOS - BODJURY SCHEDLILED AUTOS I (Per 11I Nrsar) $ (Per pe X HREDAUTOS $ X NON-CIMNED AUTOS I BODILY INJURY X Drive Other Car PROPERTYDA.MAGE (Per accident) $ GARAGE LIABLLITY AUTO ONLY' - EA ACCIDENT $ ANY AUTO EA. ACC $ OTHER THAN AUTO ONLY: AGG $ B EXCESS,uMBRELLALIABILITY BINDER285109 10101!04 10/01105 EACHOCCURRENCE 0000000D OCCUR 7 CLAIMS MACE AGGREGATE $10 0-0-01-0-0-0 $ DEDUCTIBLE X RETENTION $ 10000 $ $ A woRKERSCOMPENSATiONAND BINDER285107 10101/04 10101105 WCSTAnJ- OTH- EMPLOYERS' LiANLm ANY PRCPRIETOWPARTNEWEXECUTNE EL, EACH ACCOENT $1,000,000 OFFICEWMEMBER EXCLUDED? It ~/es, cescriba under E L, DISEASE - FA. EMPLOYEE $1,000 Q0O SPECIAL PROVISIONS below E L. DISEASE - POL CY LIMIT $1 ,000,000 OTHER I L DESCRIPTION OF OPE RATIONS / LOCATIONS /VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL. PROVISIONS CERTIFICATE HOLDER CANCELLATION ~~~i/ „ BMOU D ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION. EREOF. THE ISSUING INSURER WILL ENDEAVOR TO MALL An DAYS WRITTEN ® NO CE TOTHE CERTIFICATE HOLDER NAMED TO THE LEFT, BUTFAILURETO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OFANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) 1 Of 2 #SS05391MS0402 Mpg D ACORD CORPORATION 1988