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HomeMy WebLinkAboutVinyl Siding 2003 Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville,CT 06382 (860)848-3030, Ext.382 Electrical Permit Permit Number: B2003-0346 Date: 03-Jul-03 Map/Lot: 092/181-000 Owner ID 115521 Job Location: .60 PENNSYLVANIA AVENUE Unit Job Description: Install Vinyl Siding Owner: Contractor: Michael Hatchett Michael Hatchett 60 Pennsulvania Ave. 60 Pennsulvania Ave. Oakdale,Ct. 06370 Oakdale Ct 06370 Telephone: (860)859-9824 Lic/Reg Type/No. 0 Exp Date: Tenant: na Telephone: Construction Values Permit Fees Construction Information Building Value: $3,000.00 Building Fee: $16.00 Use Group: Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: Mechanical Value: $0.00 Mechanical Fee: $0.00 Construction Type: Electrical Value: $0.00 Electrical Fee: $0.00 Permit Code: Other Value: $0.00 Other Fee: $0.00 Comments: Total Value: $0.00 CO Fee: $0.00 Plan Review Fee: $0.00 State Ed Fee: $0.48 • Total Fees: $16.48 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 ❑ Electrical Service 0 Final Inspection ❑ Rough plumbing and leak test ❑ Certificate of Occupany ❑ Gas piping and test Building Official's Signature: Town of Montville Building Department Permit# 310 Norwich-New London Tpke. Tel. 848-3030,Ext 382 Uncasville, CT 06382 Fax. 848-7231 Application for Commercial Building Permit ❑ New Construction [J Addition 'teration 0 utility Structure ❑Othier Job Location ‘60 f�P.h/I St,/j/.. .:9 4//ei?G/E Paveai/e (T e37?..) ` Job Description/Materials f-' // Owner ckre/ / 44 1 Mailing Address /00 ,.f,1Sy�/4Z/1/47 ,44 City d2rkaQfe State Gr Zip ©637v Tel $ O 1E57/ j'Zf/ Contractor 5ei/1 Mailing Address City State Zip Tel / / Contractor's License/Registration Type &Number Exp. Date / / 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 7, ,,"1 Date 7 / 2- / 03 Construction Value Fee Building $ ° $ / -, '° Plumbing $ $ Mechanical $ $ Electrical $ $ Other $ $ Certificate of Occupancy $ Plan Review Fee $ State Education $ 7t Total $ $ /6 -/-1 Town of Montville Building Department Receipt Date 7 / (.2? / o3 No. ii 2 �, 2 . From: ' / / 7Cfrr77"-- Job Address: ‘b ar/N Av. Amount $ /G . Cas Check Check # / 7.)„, Circle one) Received by _ �.��, .: 'F •,":- Permit #4100 3 3c/C., - - 1�'eNcl/ Nr STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors (Conn. Gen. Stat. § 31-286b) Property located at: AMSW ',/9 ,1/1//y2 ark�l In the town of OQ'f Name of building permit applicant: ,dge, ; T" Please chec 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 § 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 chec one: 1. I do not intend to act as a general contractor or principal employer. [SignVoy, j_7,241 4,117/ Siature of pp 'c + t 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)