HomeMy WebLinkAboutUpgrade Electrical from 60 to 100 AMP 2003 Town of Montville (j
,�- Building Department
Date /Ate✓ / L, Field Inspec i n Notice Permit #6'Qd 3 . q
Job Location
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( pproved Type of Inspection _4 -J� . '
Not Approved - Please call for re-inspection when the following corrections have been completed:
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// Building Official
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Town of Montville
BUILDING DEPARTMENT
310 Norwich-New London Turnpike
Uncasville,CT 06382
(860)848-3030, Ext.382
Electrical Permit
Permit Number: E2003-0064 Date: 31-Mar-03 Map/Lot: 074/040-B00 Owner ID 117509
Job Location: 65 PINK ROW Unit
Job Description: Electric Service
1
1 Owner: Contractor:
Michele Rice John P. Downey
• 22 Courtney Terrace
65 Pink Row Colchester Ct. 86053-7946
Uncasville CT 06382 Telephone: (860)537-9461
Lic/Reg Type/No. El 122322 Exp Date: 30-Sep-03
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: $1,200.00 Electrical Fee: $10.00 Permit Code: R5
Other Value: $0.00 Other Fee: $0.00 Comments:
Total Value: $1,200.00 CO Fee: $0.00
Plan Review Fee: $0.00
State Ed Fee: $0.19
Total Fees: $10.19
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
❑d Electrical Service ❑ Final Inspection
❑ Rough plumbing and leak test ❑Certificate of Occupany
❑ Gas piping and test
Building Official's Signature: Al,
Town of Montville
NorBuilding Department Permit#Cr PS
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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Air Cotuatiotting
❑Offer Gas OPing
Job Location 6 P g Q `'- V-4 v.; N..
Job Description/Materials e h k friyE, fry C- l4= 8 '/ -
Owner I kv"t0✓,5 plik'
Mailing Address /-�
City lr✓i Cq 5 v; I l P State c 7- .
Zip e' -�80? Tel
/ 367/
Contractor • Voli p. odd �
���--�� e y Mailing Address cRa �'�,1)- es ,
City G4-7/Cite T�� State 7: Zip sfp6 9)S` Tel 4€;316° /s-'// 9 /
Contractor's License/Registration Type&Number E a 3 0?a Exp. Date 9 / a / 6°3
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 • ?g Signature
Date 2 / en_.3
Constructs alue Fee
Building $ $
Plumbing $ $
Mechanical
Elect nca $
Other $ $ /6)
Certificate of Occupancy $
Plan Review Fee
State Education Oi^ $
Total $ /n 'Cv $ O ,/
Town of Montville Building De art t Receipt
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Date ,3 / ,,3 / / p 3 No. 0 2 5 b 6
From: 414„-A.,...- P
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Job Address: 65- ,P,,,,..i.....„ ,
Amount $
/d-• Cash • c Check #
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Received by ,►/j
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/..►; .rPermit #�
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STATE OF CONNECTICUT
WORKERS' COMPENSATION COMMISSION
Building Permit Affidavit for Property Owners or Sole Proprietors
(Conn. Gen. Stat. § 31-286b)
Property located at: P° '1�"� 131.-4 J
In the town of ( )/
Name of building permit applicant: SCI k ,
Please check one:
1• I am the owner of the above property.
2. ✓' I am the sole proprietor of a business.
2A. Name of business: T -DO e y 6)e ` L� L C
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 checjc one:
1. ✓ I do not intend to act as a general contractor orrinci al employer.
P P
[Sign and stop here] P
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 insuranc- every contractor,
sub e tor, or other worker before he/she engages in work on the above pro s.-. • in accordance with the
Workers' o ion Act(Chapter 568).
I understand that pursuant to § r .G.S., officers of a c•
. 'on and partners in a partnership may elect
to be excluded from coverage by filing a . ith - ; • •ropriate District Office; and that a sole proprietor
of a business is not required to have coverage unles ', his intent to accept coverage.
Signature of applicant
r �
Subscribed and sworn to befo e this wtct�� � ` 4
,.� y of , 2'00 3
y (Notary Public/Commissioner of the Superior Court)