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Home My WebLink AboutHot Water Heater 2001 Town of Montville Building Department Phone: 848-7166 310 Norwich New London Tpke Fax: 848-7231 Building I Trades Permit Permit Number PL2001-82 Permit Date 9/18/01 Permit Type Plumbing Permit Code R5 Job Street# 12 Job Location PEACHVALE DRIVE Map/Lot 084/115-000 Job Description Hot Water Heater Owner Contractor Michael Bianchi Paul LaJeunesse Address 12 Peachvale Drive Address 20 Susie Avenue City Uncasville State Ct. City Moosup State Ct. Zit) 06382 Telephone 848-1365 Zip 06354 Telephone 564-3840 Lic/Reg Number 279715 Lic/Reg Type P1 Exp Date: 10/31/01 Use Group R4 Code 1995 CABO Type Construction 5B Building Value $0.00 Building Fee $0.00 Plumbing Value $464.00 Plumbing Fee $10.00 Mechanical Value $0.00 Mechanical Fee $0.00 Electrical Value $0.00 Electrical Fee $0.00 Other Value $0.00 Other Fee $0.00 Total Values $464.00 C/O Fee $0.00 Comments: Plan Review Fee $0.00 State Ed Fee $0.07 Total Fees $10.07 II 7:Building Official's Signature C��er77( 1 C��_ Date / It is the owners responsibility to schedule the following requirh nspections (minimum 24 hours notice required): Footings -prior to pouring concrete Backfill -footing drains and waterproofing Ll 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 ❑ Pool bonding ❑ Gas piping -pressure test and installation 4 Final Inspection ❑ Rough HVAC Certificate of Occupancy-PRIOR to use or occupanc Town of Montville Permit # L 2crl— VZ_ 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 ❑Accesso ry Structure Eirr&—m6ing ❑WecFianuaC ❑Action ❑Oemoiztion ❑ECectricaC ❑Afteration [Ill Other Nesting Air Conditioning Gas(ping Job Location / ?: ��R C h t) P LL D >z Job Description/Materials L c ,j^ c.... (A) 6%--.J---J26 _ 4€gt---/--e/t z)....farea_c-e -- 1 , SCS , ...(-- -.A--z Owner f i b C.k0-e—Q B M/a 11/4)C If-J Mailing Address /2 ?4_-;7:-A- c IN V A-L C= 4j . Cit' aAt c_ A-5 U l L.J__ State Zipa3S--.2, Tel �l vi / /3C S-- Contractor Contractor ?/}f-t I d41 vir-,. IV SSfMailing Address cW S s 76--- A �' , City f L I' 0 oc` State C-41—Zip 06 3 . Tel 8-4-0, a i3 O U Contractor's License/Registration Type&Number 02 ") er 7 / S Exp. Date /v/ 3/ / .0/ New Home Construction Contractors: Have you entered into a contract with a consumer for the proposed new home? ❑ Yes Er 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 make application for a permit for such work as described above. Owner/Agent Signature �(_ G< < C'='"� �� `-�'� Date U Construction Va ue Fee Building $ $ Plumbing $ y& t./, U`) $ /G Mechanical $ $ Electrical $ $ Other $ $ Certificate of Occupancy $ Plan Review Fee $ State Education $ Q 07 Total $ y(' $ /0 c7 Town of Montville Building Department Receipt Date 9 / /9 /0) No. 61084 From: _gygtlizt rJ Job Address: 7 PlaAc Y.0 11; Amount $ O7 Cash AP Check ((ircle onc) Received by Permit # Lou z..... • STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors (Conn. Gen. Stat. § 31-286b) Property located at / In the town of V'' (M- (,`–SZ Name of building permit applicant: Please check one: 1. I am the owner of the above property. • 2.t-- f am the sole proprietor of a business. 2A.Name of business IO i cA,(_k a_eL' 2B. Federal Employer Identification Number(FEIN) C7-`1,3 c2p 5�/ 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 one: 1.d not intend to act as a gene .1 contractor or principal employer. [Si:n and stop here] Signature of applic.. 2.—I intend to act as . 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 ept erage. Signature of applic Subscribed and sworn to before me this day of ,200 . (Notary Public/Commissioner of the Superior Court)