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HomeMy WebLinkAbout2011 - Bathroom Remodel Electrical 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: E2011-0034 Date: 17-Mar-11 Map/Lot: 096/125-000 Owner ID: 5342000 Project Location: 168 PARK AVENUE EXTENSION Unit: Job Description: Electrical for Bathroom Remodel Owner Nam Eric S Swanfeldt Tenant Name N/A Careof: 168 Park Ave Ext Uncasville CT 06382- Telephone: (860)608-7869 Contractor Nam Home Owner Telephone: DBA: Lic/Reg Type Lic/Reg No 0 Exp Date: 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 $0.00 Mechanical Fee $0.00 Electrical Value: S0.00 Electrical Fee: $0.00 Construction Type IRC Total Value: $0.00 Penalty Fee: $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comment Plan Review Fe $0.00 Fees Included with Building Permit State Ed Fee: $0.00 Total Fee Paid: $0.00 It shall be the owners repsonsibilitv 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 ❑ Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation El Certificate Approval 111. ate of Occupancy Buildin. Official's •..royal: AO! _ ,_ — Town of Montville Building Department 310 Norwich-New London Tpke. Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 RESIDENTIAL PERMIT APPLICATION FORM Permit No.: C ail --CL'0. Type of Work Occupancy Type Permit Type ❑New Construction 0 Single Family ❑ Building ❑Addition ❑Two-Family 0 Plumbing ❑Alteration ❑Townhouse ❑ Mechanical 0 Accessory Structureectrical CRS#: Property Address: 6`.4 PACK AVC b (Num er) (Street) (Unit) Job Description: 1,q/COLI evyl C Owner: 2k.'/C S. SCJAN 6 l,� 11 I, Address: / PACK AVL CSX City: VN C&S V11 L L State: (2•( Zip Code: 06J GD Telephone(k(.L ) Applicant: S4'4 T DBA: Address: City: State: Zip Code: Telephone( ) Contractors - Complete the Following: License Type: License No.: Expiration Date: 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. 0 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: �� A- 4.15" C Date: 3-/6 - // Construction Value C Permit Fees Building Value: Building Fee: Plumbing Value: Plumbing Fee: Mechanical Value: Mechanical Fee: Electrical Value: Electrical Fee: Total Value: Penalty Fee: C of 0 Fee: Plan Review Fee: State Ed Fee: Total Fee: Reviser[August 23,2007 State of Connecticut 7A Workers' Compensation Commission %,,,•� Please TYPE or PRINT IN INK et Proof of Workers' Compensation Coverage when Applying for a Building Permit for the Sole Proprietor or Property Owner who WILL NOT act as General Contractor or Principal Employer APPLICANT FOR BUILDING PERMIT Name of Applicant for Building Permit t I C 5 . SC��c,,r\--if ' Property located at I r G Pct( 1,1W e Y in the City/Town of l,\l 1 ( V( l i' 0( 1 ) ATTEST If you are the owner of the above-named property or the sole proprietor of a business doing work on the site of the construction project at the above-named property and you WILL NOT act as the general contractor or principal employer,you are not required to have workers'compensation insurance coverage. CHECK ONE(1)BOX ONLY and complete the following: I am the OWNER of the above-named property.I WILL NOT act as the general contractor or principal employer. Signature of OWNER Applicant ❑ I am the SOLE PROPRIETOR of a business doing work at the above-named property.I WILL NOT act as the general contractor or principal employer. Name of Business Federal Employer ID#(FEIN) Signature of SOLE PROPRIETOR Applicant 1 V tc•1 O2 0% G GI aCrl I 4 rrta ' 6z-- I M F 91 V'J / HIT fit'^ 8 � 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. I U <C Pc,( k_ 1 Property Address nn Job Description Required Department Permit Issuance Approval Approval ■ Tax Collector Signature/date Comments: ■ Planning & Zoning 3 I Il, l Signature/date g Comments: � f 11 Fire Marsp-1 Comments: Iti�� -i 1 11�/L / Signature/date � (‘- 31 C7 Health Department rsequired for all permits except Plumbing,Electrical,Mechanical, Roofing,Siding,Windows&Doors Signature/date Comments: WPCA, Administrative Required for properties on sewer ignature/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: ❑ 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 March 19,2010