HomeMy WebLinkAboutHot Tub 2001 FASU-030
STATE OF CONNECTICUT
DEPARTMENT OF CHILDREN FAMILIES
POOL INSPECTION
To: Building Inspector Date: / /
From: DCF Worker:
Office: Telephone Number:
Please complete the bottom section of this form certifying your inspection of an: hof 1-&.b
❑ above ground pool ❑ in-ground pool
at the address listed below to assure that the pool is in compliance with state and local
regulations. Thank you for your cooperation in this matter.
Name of Occupant: (;ep0c
Address: 3-1 RkSndCA7 -4-0 E t
City,State,Zip Code: CJ Cka. C .I 00-Y)0
Telephone Number: SbD- -(S 3y a,
Directions to reaching home:
I, dav,'ci jell , Building Inspector in the Town of Moi,-,f,A
State of Connecticut, have on this date, 4:0//77/o , inspected the14.3.e1 at the address
indicated above and found the usage to be: orf,46
Vin compliance with state and local regulations
❑ not in compliance with state and local regulations, as specified below:
t SIGNATURE-
rel 9?) / ?//0
Inspector Date/
Town of Montville
Building Department
Phone: 848-7166 .r. 'r+`
310 Norwich New London Tpke Fax: 848-7231
Building / Trades Permit
Permit Number BP2001-103 Permit Date 4/2/01 Permit Type Building Permit Code R4
Job Street# 37 Job Location PARTRIDGE HOLLOW Map/Lot 028/005-069
Job Description Hot Tub
Owner Contractor
Joseph Summers Joseph Summers
Address 37 Partridge Hollow Address 37 Partridge Hollow
City Oakdale State Ct. City Oakdale State Ct.
Zip 06370 Telephone 848-3425 Zip 06370 _ Telephone 848-3425
Lic/Reg Number
Lic/Reg Type Exp Date:
Use Group R4 Code 1995 CABO Type Construction 5B
Building Value $6,000.00 Building Fee $34.00
Plumbing Value $0.00 Plumbing Fee $0.00
Mechanical Value $0.00 Mechanical Fee $0.00
Electrical Value $400.00 Electrical Fee $10.00
Other Value $0.00 Other Fee $0.00
Total Values $6,400.00 C/O Fee
Comments: Plan Review Fee $0.00
State Ed Fee $1.03
Total Fees $44.03 II
Building Official's Signatur7Date t) / .3. /c-'L
It is the owners respo itv o 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 VI Pool bonding
❑ Gas piping -pressure test and installation ❑ Final Inspection
❑ Rough HVAC li Certificate of Occupancy -PRIOR to use or occupancy
Town of Montville 'vie Permit # /3 Pact /O5
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 21 Accessory structure Plumbin
g ['Mechanical
❑ Addition
❑ Demolition Electrical Heating
❑ Alteration ❑ Other
Air conditioning
Gas piping
Job Location 3`2 PArz-r-2 I 1> 61;.-- )-/bGi 0(.,c
Job Description/Materials Hors 71)0
Owner o S.‹,o, i,.- 1-rN e r) Mailing Address 3) Pc rt C,h,c )-,r L-L j
City EN.h_c)hL.c State Cr Zip 06.374 Tel.T60 -4B - 3i4-2_5
Contractor LF Mailing Address
City State Zip Tel. - -
Contractors License/Registration Type&Number Exp. Date / /
New Home Construction Contractors: Have you entered into a contract with the consumer for the proposed
work ? ❑ Yes ❑ 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 . application for a permit for such work as described above.
Owner/Agent Signature Date 3 / a 6 / o
l
Construct' alue Fee
Building $ 60oo-- $ 3 Li --
Plumbing $ $
Heating $ $
Electrical $ HO 0 — $ Jo
Air Conditioning $ $
Other $ $
Certificate of Occupancy $
Plan Review Fee $
State Education Fee $ o-
eelj
Total $ t.'/O o — $
Town of Montville Buildingii
Department Receipt
voloo
r 471; Date =/_/o /—
—�- NoQ Q 5 $.
( From: .J�5S EP/1 ,S
nwe was
Job Address:
_17_ T DGS 0(404.4.)
L 410 Amount $ -"'
7y Check
diii0Check #
(circle one)
i
Received by ,T
i-, Vii., •
Permit # 6P,, ,O/_l0 3
STATE OF CONNECTICUT
WORKERS' COMPENSATION COMMISSION
Building Permit Affidavit for Property Owners or Sole Proprietors
(Conn. Gen. Stat. § 3I-286b)
Property located at 7 ) c c-cJs- /%d` c ._.
In the town of ,.-L 'r
Name of building permit applicant:
Please check one:
1. 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 § 3 1-286b, "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 one:
1."7 I do not intend to act as a general contractor or principal employer.
[Sign an. top here]
' natu of a.
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)
a
.uTES:
1. THIS SURVEY AND MAP WERE PREPARED PURSUANT TO THE REGULATIONS OF CONNECTICUT STATE AGENCIES
SECTIONS 20-300b-1 THROUGH 20-300b-20 AND THE "STANDARDS FOR SURVEYS AND MAPS IN THE STATE OF
CONNECTICUT"AS ADOPTED BY THE CONNECTICUT ASSOCIATION OF LAND SURVEYORS, INC. ON SEPTEMBER 26, 1996.
IT IS A DATA ACCUMULATION PLAN CONFORMING TO HORIZONTAL ACCURACY CLASS D. NO PROPERTY/BOUNDARY
OPINION IS PRESENTED HEREON. THIS MAP IS INTENDED TO DEPICT THE LOCATION OF THE PROPOSED HOUSE
AND GRADING. TOPOGRAPHIC INFORMATION DEPICTED HEREON CONFORMS TO TOPOGRAPHIC ACCURACY CLASS T-D.
2. PROPERTY LINE AND TOPOGRAPHIC INFORMATION SHOWN HEREON IS BASED ON CLASS A-2 SUBDIVISION PLANS
ENTITLED: "ROBIN HILL ESTATES PREPARED FOR OWNER/DEVELOPER DIOLINDA AND ALEJO ORTEGA LOCATED ON
BLACK ASH SWAMP ROAD, MONTVILLE CONNECTICUT" BY JOHN KOPKO JR. & ASSOCIATES, DATED JAN. 1990 AND
REVISED JULY 1990.
3. THIS PARCEL IS ZONED R40. IT WAS APPROVED IN ACCORDANCE WITH SECTION 5.5 OF THE MONTVILLE ZONING
REGULATIONS AMENDED THROUGH AUGUST 1, 1988 AS A CLUSTER SUBDIVISION. SETBACKS ARE GENERALLY:
FRONT 40'; SIDE 12'; REAR 40'.
�,OPEN SPA fE IL375.8-a�) _f� °w _ 1-478().36'
ro� c�.o
N19 51 533.36.• 1
16215' ,I!!c
40 FEET 0 20 40
Ill!t
SCALE: 1"=40'
,,LL LOT 69
39,048 sq. ft. ;
, ,, 0.896 acres 11114 77�
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o/
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,�1 Ns') 0I ' / /
cn t*6I.,, ,j
G '
t Co H L Dt6
tk
o�I_N cD , m •' ,: 24' X 24' FUTURE
. I - ' ' I SHED OR POOL AREA
'
FOOTING._�M '`��•" 4 b• l° .�
OUTLET :-
tri o ru B
ELEV. = 465.0' - `�
/etip Le)cAi- Discon.2Nrc_j'
,F7 ►N' 5 F+- AG.I. Y
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I S / I. NrracoNJ� Nca own--C1'
^
LOT 68
coBL-c-44 DIScoNN Ecj'
1 PROPOSED 1-10V-SE9SE 2.0[::/f
ki
LOT 70 1 I ;- F.F. = 476.0' o 1
oW GAR. 474.0' `22.0' 1 .0
q :50.0' q"I
,' ,;�
o LEGEND
1 \ J - - PROPERTY/STREET LINE
% L_67 51 v ii — — — YARD/SETBACK LINE
432 EXISTING CONTOUR
-..."-Nts______
'. PROPOSED CONTOUR
SF SILT FENCE
INLAND WETLANDS
INLAND WETLANDS BUFFER
•
1 46.35' 207.44'