HomeMy WebLinkAboutElectrical Upgrade from Fuses to Breakers 2004 Town of Montville
Building Department
Field Inspection Notice
Address: 36 Pennsylvania Avenue
Job ue3LiiyAiLil. Electric Senice
Permit Numbers:E2004-0015
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Comments: 1.
Backfill Not Approved: Approved:
Comments:
Framing Not Approved: Approved:
Comments: 1.
Rough Electric Not Approved: Approved:
Comments: 1.
Electrical Service Not Approved: Approved: 2/2/04 JS
Rough HVAC Not Approved: Approved:
Comments: 1.
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Comments: 1.
Gas Line Not Approved: Approved:
Cor—sent: 1.
Fireplace Throat/ Not Approved: Approved:
Chimney Comments: 1.
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Comments: 1. twin uvcu.
Insulation Not Approved: Approved:
Comments: 1.
Certificateof Not Approved: Approved:
Occupancy Comments: 1.
iVUA ntr�iuvcu. Approved:
Comments: 1.
Not Approved: Approved:
Comments:
Not Approved: Approved:
Comments: 1.
Comments:
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ft Town of Montville
BUILDING DEPARTMENT
310 Norwich-New London Turnpike
Uncasville,CT 06382
(860)848-3030,Ext. 382
Electrical Permit
Permit Number: E2004-0015 Date: 09-Feb-04 Map/Lot: 092/158-000 Owner ID 115512
Job Location: 36 PENNSYLVANIA AVENUE Unit
Job Description: Electric Service
Owner: Contractor:
Joe N and Patricia A Childs Walski Electric
31 St. Regis Avenue
36 Penn Ave Norwich Ct. 06360-
Oakdale CT 06370 Telephone: (860)885-0059
Lic/Reg Type/No. El 189139 Exp Date: 30-Sep-04
Tenant:
Self
Telephone:
Construction Values Permit Fees Construction Information
Building Value: $0.00 Building Fee: $0.00 Use Group: R4
Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1995 CABO
Mechanical Value: $0.00 Mechanical Fee: $0.00 Construction Type: 5B
Electrical Value: $1,000.00 Electrical Fee: $10.00 Permit Code: R5
Other Value: $0.00 Other Fee:
$0.00 Comments:
Total Value: $1,000.00 CO Fee: $0.00
Plan Review Fee: $0.00
State Ed Fee: $0.16
Total Fees: $10.16
It is the owners responsibility to schedule the following inspections(minimum 48 hours notice required);
❑ Footing -Prior to pouring concrete ❑ Rough HVAC
❑ Backfill-Footing drains and waterproofing ❑ Fireplace Throat
❑ Concrete Slab-Prior to pouring concrete ❑ Chimney-One flue above thimble
❑ Rough Framing ❑ Firestopping/draftstopping
❑ Rough Electrical ❑ Insulation
El Electrical Service CRS#: 0 ❑ Final Inspection
❑ Rough plumbing and leak test ❑ Certificate of Occupany
❑ Gas piping and test
Building Official's Signature: / -��
Town of Montville
' BuildingDe artment
P Permit /5—
310 Norwich-New London Tpke.
Tel. 848-3030,Ext 82 Uncasville, CT 06382
Fax. 848-7231
One & Two Family Trades Permit Application Form
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Heating (c Jr-2 y
Cotufitioning
PiPing
Qj Other /`//r h .�1'
Job Location 3 . . I/7„ �� = f7f14D rc L
Job Description/Materials C.s.3 S ry, ,;J /60
Owner T0c ( fit(d s Mailing Address 31°
City 0Ctkcert fC
State L7 Zip Tel F.c) I 7 / /_Tv C
Contractor 14/.9(S,c.4 e etc`L Mailing Address 31 Jr re-6,) 61-(C
City Na a w;c l.. State C-K Zip 01- 1 1.4 Tel F64 ma=r
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Contractor's License/Registration Type&Number /.1"/3
Exp.Date 09 / JZU /py
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
Date / /
Construction Value Fee
Building $ $
Plumbing $ $
Mechanical $ / �('jo, of $
Electrical $ f/2
Other $ $
Certificate of Occupancy $
Plan Review Fee $
State Education $
Total $ /daa, $
Town of Montville Building Department Receipt
Date / „2, / 6 L/
No. t. o °
From: -
aw
Job Address: • /
Amount $
-- (Cashls9' Check #
1#1
/ ('arc' one)
Received by i,/r'J 0.. zi _Ap/,- /�i/,i'. Permit # _
ate y C �
STATE OF CONNECTICUT
DEPARTMENT OF CONSUMER PROTECTION
ELECTRICAL UNLIMITED CONTRACTOR
RICHARD L WALSKI JR
31 ST REGIS AVE
• NORWICH,CT 06360
TYPE: El
pi.fmr. ii5f6f55 o1 ! 04
',SIGNED �i�i-�-/�` _ .�✓ ,
r
STATE OF CONNECTICUT
WORKERS' COMPENSATION COMMISSION
Building Permit Affidavit for Property Owners or Sole Proprietors
(Conn. Gen. Stat. § 31-286b)
Property located at: 3 7 eh r.S aUc_
In the town of Ockac.,\t
Name of building permit applicant:
Please check one:
1• I am the owner of the above property.
2. am the sole proprietor of a business.
2A.Name of business: Ai/965 k.4 6/r
2B. Federal Employer Identification Number(FEIN)
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
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. ido not intend to act as a general contractor or principal employer.
[Sign an. op here]
Signature of applicant
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 co
actor,
subcontractor, or other worker before he/she engages in work on the above propertyin 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)