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Waterford Electrical Co. LLC. CONTRACTOR INVOICE
CT LIC/ REG. No. 0186480 E-1
P.O. Box 163
Waterford, CT. 06385 0 5 51
sandersmarks @yahoo.com
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LDATE (e) S/1 JOB N
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JOB NAME
C_- ' / ` JOB LOCATION �`.0 _ A"-" e--
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DESCRIPTION OF WORK
DESCRIPTION AMOUNT
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TOTAL CONTRACT SUM U Dv
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CHANGE ORDER SUMMARY CHANGE ORDERS APPROVED IN PREVIOUS MONTHS'CIf sru l (A:/e------e) /oftie
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CHANGE ORDERS APPROVED THIS MONTH t
NUMBER DATE APPROVED ADDITIONS DEDUCTIONS
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SUBTOTAL CHANGE ORDERS APPROVED THIS MONTH : " .
ORIGINAL CONTRACT SUM (co C`7
I HEREBY ACKNOWLEDGE THE SATISFACTORY COMPLETION OF THE ABOVE DESCRIBED WORK.
TOTAL CHANGE ORDERS TO DATE
SIGNATURE /6 t2 'e:L--
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DATE COMPLETED 6 7e.,//6
PAY THIS AMOUNT ( t97 (90
Town of Montville
Building Department
CERTIFICATE OF OCCUPANCY APPROVAL
5L. r Ai 71- ksza_ ctri—
Property Address
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Job Description
Required
Department
Approval p Permit Issuance Approval
111 Planning & Zoning G /p �4:"
- Signat(ire/da
Comments:
n Health Department
Required for all permits except Signature/date
Plumbing,Electrical, Mechanical, Roofing,Siding,Windows&Doors
Comments:
❑ WPCA, Administrative
Required for properties on sewer Signature/date
Comments:
❑ WPCA, Operations
When Required by WPCA Signature/date
Comments:
Fire Marshal
Required for all properties EXCEPT one and two family Signature/date
Comments:
n 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
Revised May 23,2011