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Home My WebLink AboutRemodel Entire MFH 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: E2017-0203 Date: 15-Aug-17 Map/Lot: 021/006-T15 Owner ID: 710000 Project Location: 350 CHESTERFIELD ROAD Unit: 15 Job Description: Electrical for Interior Renovations Owner Nam Donald Wilkins Tenant Name N/A Careof: 261 C Route 163 Montville sl 06353- Telephone: (860)884-2182 -- Applicant Name Property Owner Telephone: DBA: Lic/Reg Type Lic/Reg N 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: 2016 State Building Code Mechanical Valu $0.00 Mechanical Fe $0.00 Electrical Value: $0.00 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 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 ❑Q 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 frami ❑ Electrical Service CRS No: o ❑ Framing ❑ R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble ❑ Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation ❑d Certificate of Approval ❑ Certificate of Occupancy Building Official's Approval: y� o"i- 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.: Cr -7-CGO3 Type of Work Occupancy Type Permit Type El New Construction ❑Single Family ❑ Building ❑Addition El Two-Family ❑ Plumbing ❑Alteration ❑Townhouse ❑Mechanical ❑Accessory Structure RElectrical CRS#: Property Address: 35 O CIA Q,S r"),e/c1 Cd (Number) (� (Street) (Unit) 'Job Description: Ei�� t-�<<c�( 4 t om( —k.' is r �e flUJaf't CVIS Address: 10/ C / �4 l6 ? city:/l�n,v f t;r/JP State:C 7� Zip Code:UG g..57.„7 Telephone(S )4 -/ -,.,?/ . Applicant: f'rerer^-ly Q 4.(we( 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. ❑ By checking this box, I will follow the requirements of the 2014 NEC as the alternative compliance per section E3401.1 of the Residential Code, instead of the electrical requirements in chapters 34 through 43 of the Residential Code. Owner/Agent Signature: 67.-..e � �� Date: �'I/— 1 /> Construction Value Permit Fees Building Value: Building Fee: Plumbing Value: Plumbing Fee: Mechanical Value: Mechanical Fee: Electrical Value: Electrical Fee: Total Value: Penalty Fee: C of O Fee: Plan Review Fee: State Ed Fee: Total Fee: Revised August 23,2007 c State of Connecticut N 7A ;7' I fWorkers' Compensation Commissional re 5 tzr 4' ci? Please TYPE or PRINT IN INK 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 on, x-- C Property located at 3S[�C_Ai e:-;, t C e4 pa `* vs in the city/Town of l^n C cc„.S J t c_ (-1 GL03 o c7 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: (am the OWNER of the above-named property.I WILL NOT act as the general contractor or principal employer. Signature of OERApplicant _ Zi ❑ 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 Town of Montville Building Department CONSTRUCTION PERMIT APPROVAL ChesJrXge ( LC) 11 Property Address P-crn0(? __f 1-- -r(c)f trt Mcijt 1- 01C-- Job 01 C-. Job Description Required Department Approval Permit Issuance Approval ® ,� Tax Collector �-�-- S 1, /17 Signature/date Comments: ® Fire Marshal l4/ 7 / Signature/date Comments: ❑ Planning & Zoning Required for all permits except Signature/date Plumbing,Electrical,Mechanical, Roofing,Siding,Windows& Doors ❑ Health Department Required for properties with private septic or well Signature/date Comments: ❑ WPCA, Administrative Required for properties on sewer Signature/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: - ❑ Montville Police Department Required for all permits EXCEPT one and two family residential Signature/date Comments: ❑ Copy of State Dept. of Transportation Certificate 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 Final Inspection Revise d March 23,2015