Loading...
HomeMy WebLinkAbout2001 - Electrical Town of Montville Q Field Inspection Notice Permit # Location: L9 7 PA 2-k A Ve v=)cr Type of Inspection: k'. G Issued to: Delivered to: APPROVED,..) NOT APPROVED The following orders are hereby issued for their correction: Please call for inspection when corrections have been com•lete. 860-8 Date: _ 5/30/0) By: / Building Official Ii fI Town of Montville co) Field Inspection Notice Permit # Location: !t? PA>ai-c_. Type of Inspection: )2. L La C. Issued to: Delivered to: APPROVED NOT APPROVED The following orders are hereby issued for their correction: p. AJe hod. Please call for inspection when corrections have been corn•leted 860-848-7166 Date: 5/ zS/"1 '� Building Official Town of Montville Building D.spartment Phone: 848-7166 310 Norwich New London Tpke Fax: 848-7231 Na Building / Trades Permit Permit Number EL2001-101 Permit Date 5/23/01 Permit Type Electrical Permit Code R5 Job Street# 47 Job Location PARK AVENUE EXTENSION Map/Lot 096/036-000 Job Description Electrical Owner Contractor Guy O'Brien = Guy O'Brien Address 47 Park Avenue Ext. Address 47 Park Avenue Ext. City Uncasville State Ct. City Uncasville State Ct. Zip 06382 Telephone 848-4698 Zip 06382 Telephone 848-4698 Lic/Reg Number Lic/Reg Type Exp Date: Use Group R4 Code 1995 CABO Type Construction 5B Building Value $0.00 Building Fee $0.00 Plumbing Value $0.00 Plumbing Fee $0.00 Mechanical Value $0.00 Mechanical Fee $0.00 Electrical Value $300.00 Electrical Fee $10.00 Other Value $0.00 Other Fee $0.00 Total Values $300.00 C/O Fee $0.00 Comments: Plan Review Fee $10.00 State Ed Fee $0.00 Total Fees $20.05 1 Building Official's Signature � Date / 2-11, a) it is the owners respo 1 'to schedule the following 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 LI Final Inspection ❑ Rough HVAC V Certificate of Occupancy - PRIOR to use or occupancy Town of Montville Permit # EZa200/-' l4/ 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 []Accessory Structure []cplup "ng 11191ecfianica( Addition ['Demolition rig lectrical .7(eating ❑Alteration ❑Other AirCorulitioning Q Gas Tilling Job Location 9 7/ a/11-1G,Ve k . Job Description/Materials W" e m" �"` / l S Owner 0`/ �'`�'� Mailing Address 9/7/ erAfe- G )G City /1/64A-' tri`( � State 83:6- Zip06:73ez-- Tel tC /o5e/ v6(02 Contractor Mailing Address City State Zip Tel Contractor's License/Registration Type&Number Exp. Date New Home Construction Contractors: Have you entered into a contract with a consumer for the proposed new home?❑ Yes 0 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 5 / 1.7/c1 Construction Value Fee Building $ $ Plumbing $ $ Mechanical $ $ Electrical $ CO -3 $ e9'© vo Other $ $ Certificate of Occupancy $ co oCI' Plan Review Fee $ State Education $ p Total $ $ ,9O 1 STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors (Conn. 6) n.Gen. Stat. § 31-286 Property located at 4 7/ _ e c X t In the town of t4 N Com` Name of building permit applicant: Please check one: 1. V I am the owner of the above property. 2. I am the sole proprietor of a business. 2A.Name of business 2B. Federal Employer Identification Number(FEIN) Pursuant to § 31-286b, "a property owner or sole proprietor[who] intends to act as a general contractor or principal employer"may provide either a certificate of workers' compensation insurance or a"sworn notarized affidavit... stating that he will require proof of workers' compensation insurance for all those employed on the job site in accordance with this chapter." Please check o 1. I do no -'tend to act as a gen 1 contractor or principal employer. [Si: � ,'.. sti 'r 4 S.:nature of applicant 2._I intend to act as a general contractor or principal employer. Applicant must either provide a certificate of workers' compensation insurance or sign the affidavit below. Affidavit I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor, subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to § 31-275 C.G.S., officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office; and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. Signature of applicant Subscribed and sworn to before me this day of ,200_. (Notary Public/Commissioner of the Superior Court) Town of Montville Building Department Receipt Date .4' / /8 / d / No. 00713 From: N y Of 'qdt-"/ elki Job Address: 9 7 r . /11/(- i x /I �l ,.' © Amount $ 40Cash 'P Check # _./ 3 (C it (nc) Received by Y/2(19.461, Permit # �Ln (� / -' 0/