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Home My WebLink AboutElectrical Conversion from Fuses to Breakers 2002 Tpwn of Montville 9 Building Department Date , / 3 / Q p7 Field Inspection Notice Permit #, ' d7—O✓' ? Job Location j.Approved Type of Inspection Not Approved - Please call for re-inspection when the following corrections have been completed: m Z. L. -el pc, _ I Building Official Town of Mb.itville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville,CT 06382 860-848-3030, Ex.t 82 Electrical Permit Permit Number: E2002-056 Permit Date: 19-Mar-02 Permit Code R5 Job Location: 72 PARK AVENUE EXTENSION UNIT: - MAP/LOT: 096/057-000 Job Description: Electric Service Owner Contractor FRANCIS C+IRENE N HUTCHINSON KDS Electric 1 Ayers Drive 72 PARK AVE EXT Unit: - Canterbury,Ct.06331 UNCASVILLE CT 06382 Telephone: 546-6658 Lic/Reg Type: El Use Group R4 Lic/Reg Number: 125397 Code 1995 CABO Exp Date: 9/30/02 Construction Type 5B Construction Values Permit Fees 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: $1,000.00 Electrical Fee: $10.00 Other Value: $0.00 Other Fee: $0.00 Total Value: $1,000.00 C/O Fee: $0.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $0.16 Total Fees: $10.16 ;t is the owners responsibility to schedule the following required inspections(minimum 48 hours notice reauested): ❑ Footing-Prior to pouring concrete ❑ Rough HVAC ❑ 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 ❑ •••'.I Inspecti.- ❑ Gas Piping and Pressure Test I Certifi - e of Occupancy-Prior to use or occupancy Building Official's Signature: 1 /,00F Town of Montville Building Department Permit # 310 Norwich-New London Tpke. Tel. 848-7166, Ext 82 Uncasville, CT 06382 Fax. 848-7231 One & Two Family Trades Permit Application Form Tlum6ing Electrical ❑ i1echanicaf .feating Air Conditioning 0 Gas'ping Other Job Location 7Z +— Job Description/Materials C c _Q_ S.QJr v C t to O 4-04 p e r � S �t; Owner r-QAC.-t__ Irk ci Svc Mailing Address Pcx- v-t City Mori-kJ (A-Q__ State CI' Zip 0 C, 3c(V- Tel lac�/ -uy/ 711 q Contractor (LOS KZ,crC rit I C Mailing Address 1 4 %-st-rp D �-- 0 33/ City('cam i r State Ccr Zip 156,W Tel 6100 / Sys / 665 Contractor's License/Registration Type&Number CI— f 4 / 9-5-3Q`l Exp. Date C5 c / 3 b / D 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 Signature3� Date 3 / / '3 / Construction Value Fee Building $ $ Plumbing $ $ Mechanical $ $ Electrical $ ( Ob d.- $ Other $ / Certificate of Occupancy $ Plan Review Fee $ State Education $ t / Total $ f 0 00 _ . Town of Montville Building Department Receipt lir Date /,/ / 0 iZNo. 01553 I From: K D 5 ��'G to- i ,4___r_A. Job Address: 7,r ,_ _ _ 'NC) Amount $ ,,/° ,14 -Cash Check Check # , / (circle one) Received byStdk ,e_.",/. Permit #&—c;7CiOo:"P" 1OS,1 • IDear to Whom it does concern, Please allow lain Cloutier to acquire a permit to change a IOU amp fuse circuit system to a I00 amp circuit breaker service at the address of Irene Hutchinson of 72 Park Avenue Ext., Montville,CT. 1 )1 cIONA] Iii ( Sincerely Keith Stott, tow 1/1 41.KsjA,1\ ,Stke I AYERS ORM CANTEReUI W.CT 06331 12b307 10/01/2:1011 00/3tY2002 VtLeCAD 416:Pif VC01410. h STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION Buildin. Permit Affidavit for Pro le Owners or Sole Pro.rietors (Conn. Gen. Stat. § 31-286b) Property located at 72 . ..� ki /J--, (r + In the town of ,14 ,Y c}- 1, Name of building permit applicant. ( -1) . ircTr( tC Please check one: 1. I am the owner of the above property. 2.a-�am the sole proprietor of a business. _2A.Name of business 2B.Federal Employer Identification Number 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 not intend to act as a general contractor or [Sign and stop here] principal employer. k C7 Signature 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 orkers'compensation contractor, subcontractor,or other worker before he/she engagesinwork the above for every accordance with the Workers'Com on property in Compensation Act(Chapter 568). I understand that pursuant to § 31-275 C.G.S., officers of a corporation partnership may elect to be excluded from coverage by filing a er with partners 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)