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Home My WebLink AboutSFR Heating 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: M2004-0262 Date: 08-Dec-04 Map/Lot: 097/034-000 Owner ID: 5354000 Project Location: 8 PARK ROAD Unit: Job Description: Heating Owner Name: Habitat for Humanity Tenant Name: N/A Careof: 377 Broad Street New London CT 06320- Telephone: Contractor Name: Thomas McHugh Telephone: (860)442-7890 DBA: Lic/Reg Type: 51 Lic/Reg No: 301516 68 Smith Street Exp Date: 31-Aug-05 Niantic Ct 06357- 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: $0.00 Mechanical Fee: $0.00 w/2000 Amendment Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type: 5B Total Value: $0.00 Penalty Fee: $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comments: Plan Review Fee: $0.00 Included on Building Permit State Ed Fee: $0.00 Total Fee: $0.00 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 framing ❑ 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 ❑ Certificate of Approval ■ ate . Occupancy Building Official's Approval / �/1z� TOWN OF MONTVILLE Building Department 310 NORWICH-NEW LONDON TURNPIKE UNCASVILLE, CT 06382-2599 TEL. (860) 848-3030 X382 FAX. (860) 848-7231 PLUMBING PERMIT Permit Number: P2004-0130 Date: 08-Dec-04 Map/Lot: 097/034-000 Owner ID: 5354000 Project Location: 8 PARK ROAD Unit: Job Description: Plumbing Owner Name: Habitat for Humanity Tenant Name: N/A Careof: 377 Broad Street New London CT 06320- Telephone: Contractor Name: Thomas McHugh Telephone: (860)442-7890 DBA: Lic/Reg Type: P1 Lic/Reg No: 201357 68 Smith Street Exp Date: 31-Oct-05 Niantic Ct 06357- 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: $0.00 Mechanical Fee: $0.00 w/2000 Amendment Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type: 5B Total Value: $0.00 Penalty Fee: $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comments: Plan Review Fee: $0.00 Included on Building Permit State Ed Fee: $0.00 Total Fee: $0.00 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 framing ❑ 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 ❑ Certificate of Approval -•. cate . Occupancy ---- Building Official's Approval: Town of Montville Building Department 310 Norwich-New London Tpke. Tel. 848-3030,Ext 382 Uncasville, CT 06382 Fax. 848-7231 Residential Trades Permit Application Form 02-Op b ? Permit# I — 0/ e 1,]plum6ing Electrical feclw.nical " CSS # ;5(.7/eating Air Conditioning Gas Wiping [k Single'Family El Two-'Family El 'Townhouse Job Address 9 P4, Jr R (Number) (Street) (Unit) Job Description R 0 6h „p i k 6 4-1-�a I 1 t,(, Owner / / / , 1 f A /km 9,4.1tyMailing Address ea DP) RR o s0 S'7 City/L'/= �t. c3> �L State L I' Zip 6 p Tel / 2 / /7/-10 Contractor—27'0,4�s Q ..i'W e// )1 Mailing Address 3 s Aof h h 5" 7- City State Gjr" Zip efii6 35^7 Tel /6'9/ / cam/ Contractor's License Type&Number / ' j 357 Exp. Date /' / 3/ /a ,r /.S'/ Q J' — 3/- a5— 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 l./,/ :1Y))7_11_7) Date / 3 / 0,1- -Construction Value Fee Plumbing $ $ Mechanical $ $ Electrical $ $ Plan Review Fee $ State Education $ Total $ $ (Complete reverse side) Revised Septem6er 9,2004 Town of Montville Building Department 310 Norwich-New London Tpke. Uncasville, CT 06382 Tel. 860-848-3030, Ext. 382 Fax. 860-848-7231 CONSTRUCTION PERMIT APPROVAL 1-4" R RchProperty Address 13 .,4LJ :14.. Job Description The applicant is responsible for obtaining all of the required approvals checked off on this form. No building permit will be issued until all of the required signatures have been obtained. Required Department Permit Issuance Approval Approval i1 Tax Collector ( jcs,lv�. w, 'a.\. \o f Sianatt date - WPCA , 164oL) %,�� • signature/ date ❑ Planning&Zoning Signature/date ❑ Health Department Signature/ date ❑ Department of Public Works Si<unature.date ❑ State Dept.of Transportation Signature/date ❑ Fire Marshal Signature/ date Comments/Conditions: 4cviseiSeptem6er 9,2004 7A - 7 B - 7 C State of Connecticut N Workers' Compensation Commission < ..; J DIRECTIONS DIRECTIONS for FILING FORMS 7A,7B and 7C Building Permit Requirements for Workers' Compensation Section 31-286b of the Workers'Compensation Act requires anyone who requests a building permit to first submit"proof of workers' compensation coverage for all of the employees who are engaged to perform services on the site of the construction project for which the permit was issued." The only exceptions to this law are the sole proprietor or property owner who will not be acting as general contractor or principal employer. What to give to the Building Official to obtain a Building Permit: 1. The General Contractor or Principal Employer must provide a written certificate of workers' compensation insurance for all of the employees on their project.This certificate may not be for liability, disability or any other type of insurance. 2. The Sole Proprietor or Property Owner who will not act as a general contractor or principal employer is not required to have workers'compensation coverage. In order to obtain the building permit, a FORM TA should be completed and given to the building official. 3. The Sole Proprietor or Property Owner who will act as a general contractor or a principal employer must provide a written certificate of workers' compensation insurance for all of the employees on their project and must file a FORM 7B with the building official—OR he will sign a sworn notarized affidavit on FORM 7B, stating that he will require proof of workers'compensation insurance for all those employed on the job site. 4. The General Contractor or Principal Employer who has properly excluded himself from coverage using the appropriate WCC form (see NOTE below)must file the FORM 7C with the building official.This form certifies that they have properly excluded themselves, and attests that they will require proof of workers' compensation insurance from every employee that works on the designated job site. NOTE: The general contractor or principal employer may exclude himself from workers'compensation coverage by filing one of the following forms with the appropriate Workers' Compensation Commission district office: Form 6B for employees who are Officers of a Corporation or Managers/ Members of an LLC Form 6B-1 for employees who are Members of a Partnership v�v 7A Da' .,. State of Connecticut N •.` Workers' Compensation Commission Please TYPE or PRINT IN INK tx tmliz f/ 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 ,I/44 ea 7 _j/ /"r c /c v 9 4 Property located at e i< - .7(-3 616` k;v1°Pr V 1 I I e i( 'r in the City/Town of t v w t tit [ (e, ( 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 j v—1 Jv+ V J L j t w ) (^ (� W ]/ Federal Employer ID#(FEIN) (4-- l / 1 Signature of SOLE PROPRIETOR Applicant y1�j-�� 9/1-1)/4.4G�� STATE OF CONNECTICUT DEPARTMENT OF CONSUMER PROTECTION PLUMBING&PIPING UNLIMITEDCONTRACTOR P1 THOMAS D MCHUGH I 68 SMITH ST NIANTIC,iCT 06357 LIC./REG NO. I 4 EFFECTIVE' EXPIRES 20135771._/, °{-',i1/02/2,004�`'' 1 10/31/2005 SIGNED1-‘...?1-4-,-,4,-_,)17-42)R. '/ _______�__ STATE OF CONNECTICUT DEPARTMENT OF CONSUMER PROTECTION HEATING,PIPING&COOLING UNLIMITED CONTRACTOR SI THOMAS D MCHUGH PO BOX 473 NIANTIC,CT 06357 LIC./REG NQ EFFEOI1VE:.'-. EXPIRES 301516 " # 0,;, 11/03/2004 4-08/31/ 005 .4*,, SIGNED _� /