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Home My WebLink AboutMFH Electrical Field Inspection Notice Town of Montville Building Department December 3, 2007 Address: 76 Pink Row Job Description: Hook Up Mobile Home Electric Service Permit Number(s): E2007-0149 Permit Date: June 22,2007 Not Approved Approval INSPECTION Date: Deficiencies Special Date Conditions Final inspection and 6/22/07 CC certificate approval Rev.Date: 1/18/06 Page 1 of 1 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: E2007-0149 Date: 22-Jun-07 Map/Lot: 074/015-T76 Owner ID: 5502000 Project Location: 76 PINK ROW Unit: Job Description: hook-up electric service for mobile home Owner Name: Catherine Vine Tenant Name: N/A Careof: 18 Bluminthal Dr. Uncasville CT 06382- Telephone: Contractor Name: TIG Electric,Inc. --"-- Telephone: (860)535-2289 DBA: Lic/Reg Type: El Lic/Reg No: 183635 95 Yawbux Valley Rd. Exp Date: 30-Sep-07 North Stonington Ct 06359- 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: 2005 State Building Code Mechanical Value: $0.00 Mechanical Fee: ----- $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 Comments: Plan Review Fee: $0.00 Included on 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 ❑ 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 framing ❑ Electrical Service ❑ CRS No: 0 Framing ❑ R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble ❑ Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation ��l Certificate of Approval ❑ C-•' occ .an. Building Official's Approval: /�� Town of Montville 41i Building DaDartment 310 Norwich-New London Tpke. Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 RESIDENTIAL PERMIT APPLICATION FORM Permit Ne..4j Type of Work Oanc T e New Construction Occu —m ly Per Building Type Addition Single Family ❑Building 0 Alteration ❑Two-Family ❑Plumbing 0 Townhouse ❑Mechanical 0 Accessory Structure ,,Electrical CRS#: Job Address: l oc,J (Number) (Street) Job Description: OIL) � c . ow. co r- (Unit) Owner: P V( tv Address: City: _ State: Telephone: /SOU 0 -- Zip Code: (�/ Contractor: G _ DBA: Address: 95— i C V 1 , State. C\ Zip Code: Telephone: _3539 License Type: ( 8 3C 3 j— Yp License No.: (J4_1_30 �Q Zoor? 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 2005 NEC as the alternative compliance per section E3301.2.1 of the Residential Code, instead of the electrical requirements in chapters 33 through 42 of the Residential Code. Owner/Agent Signature: %/ Date: (fa� � d Construction Value Building Value: Permit Fees Plumbing Value: Building Fee: Mechanical Value: Plumbing Fee: Electrical Value: a2pO,vo Mechanical Fee: Total Value: Electrical Fee: Penalty Fee: C of 0 Fee: Plan Review Fee: State Ed Fee: Total Fee: Rivised Tecem6er31,2c STATE OF CONNECTICUT DEPARTMENT OF CONSUMER PROTECTION ELECTRICAL UNLIMITED CONTRACTOR El GLENN T UMPHLETT 95 YAVyBUX'WALLEY ROAD NORTH STONINV TON,CT 06359 LIC./REG NO. ,FECTIVE 4( EXPIRES �,�30/2�0,7 183635 10/01/2006 0% SIGNED,�� & � _._e_. Town of Montville Building Department 310 Norwich-New London Tpke. Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 CONSTRUCTION PERMIT APPROVAL Ow Property Address 4Ys72 / am //,DOk. (-1:) �� 12(CA-LJ 1 Job Description The applicant is responsible for obtaining all of the required approvals checked off on this form. No building permit will be issued until all of the required signatures have been obtained. Required Approval Department Permit Issuance Approval Tax Collector G `t �c.^-z... c>//9/c 7 Signature/date Comments: ❑ WPCA, Administrative Signature/date • Comments: ❑ WPCA, Operations Signature/date Comments: ❑ Planning &Zoning Signature/date Comments: ❑ Health Department . Signature/date Comments: ❑ Department of Public Works Signature/date Comments: ❑ State Dept. of Transportation (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) Comments: 4111 4 / Signature/date Fire Marshal PA'O (� Comments: l Signature)date WrvisedAugust 5,2005 7A 7B - 7 );� ;�•(' State of Connecticut N - C 1" = Workers' Compensation Commission " ` J DIRECTIONS ��.v� �� DIRECTIONS for FILING FORMS 7A, 7B and 7C lx Building Permit Requirements for Workers's Compensation Section 31-286b of the Workers' Compensation Act requires anyone who requests a building permit to first submit"proof of workers'compensation coverage for all of the employees who are engaged to perform services on the site of the construction project for which the permit was issued." The only exceptions to this law are the sole proprietor or property owner who will not be acting as general contractor or principal employer. What to give to the Building Official to obtain a Building Permit: 1. The General Contractor or Principal Employer must provide a written certificate of workers' compensation insurance for all of the employees on their project.This certificate may not be for liability, disability or any other type of insurance. 2. The Sole Proprietor or Property Owner who will not act as a general contractor or principal employer is not required to have workers'compensation coverage. In order to obtain the building permit, a FORM 7A should be completed and given to the building official. 3. The Sole Proprietor or Property Owner who will act as a general contractor or a principal employer must provide a written certificate of workers'compensation insurance for all of the employees on their project and must file a FORM 7B with the building official—OR he will sign a sworn notarized affidavit on FORM 7B, stating that he will require proof of workers'compensation insurance for all those employed on the job site. • -The General Contractor or Ptincipal Emproyer wtio has properly excl de himself from coverage using the appropriate WCC form(see NOTE below)must file the F RM 7 with the building official.This form certifies that they have properly excluded themselves, and attests that they will require proof of workers'compensation insurance from every employee that works on the designated job site. NOTE: The general contractor or principal employer may exclude himself from workers'compensation coverage by filing one of the following forms with the appropriate Workers'Compensation Commission district office: Form 6B for employees who are Officers of a Corporation or Managers/Members of an LLC Form 6B-1 for employees who are Members of a Partnership