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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� N I 1111c. - h o/ I / ,�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 ��• 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'