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Home My WebLink AboutSFR Plumbing TOWN OF NiONTVILLE Building Department 310 NORWICH-NEW LONDON TURNPIKE UNCASVILLE, CT 06382-2599 TEL. (860) 848-3030 X382 FAX. (860) 848-7231 PLUMBING PERMIT Permit Number: P2005-0096 Date: 24-Oct-05 Map/Lot: 039/098-003 Owner ID: 5518000 Project Location: 49 PIRES DRIVE Unit: Job Description: Plumbing for new SFR Owner Name: P&H Construction, LLC Tenant Name: N/A Careof: 410 Maple Avenue, Box 164 Uncasville CT 06382- Telephone: Contractor Name: Dziengiel Plumbing Telephone: (860)887-7238 DBA: Lic/Reg Type: P1 Lic/Reg No: 279568 12 Monroe St. Exp Date: 31-Oct-05 Norwich Ct 06360- Construction Value Permit Fees Construction Information Building Value: $0.00 Building Fee: $0.00 Use Group: R-4 Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1999 State Building Code Mechanical Value: $0.00 Mechanical Fee: $0.00 w/2004 Amendment Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type: 5B 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: $0.00 It shall be the owners repsonsibility to schedule the following inspections a minimum of 2 business days in advance: Field set of approved construction documents shall be available onsite during all inspections. BUILDING PERMIT INSPECTIONS PLUMBING, MECHANICAL, ELECTRICAL PERMIT INSPECTIONS ❑ Footing-Prior to pouring concrete R Plumbing and leak test ❑ Deck Piers ❑ R Electrical ❑ Backfill-Footing drains and waterproofing ❑ Elec Trench-with conduit installed ❑ Concrete Slab-Prior to pouring concrete ❑ Pool Bonding ❑ Anchor Bolts-with sill plate and prior to floor framing ❑ Electrical Service CRS No: 0 ❑ Framing ❑ R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble ❑ Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation ❑ Certifica - of Approval .'cate of Occupancy i Building Official's Approval: Town of Montville 4 Building Department 310 Norwich-New London Tpke. Tel. 848-3030,Ext 382 Uncasville,CT 06382 Fax. 848-7231 Application for Commercial Trades Permit Permit# , � J`•-�o 9r .;'`� cPtumbing LcEfectrica( Eiflechanicat URS # J-feating Air Conditioning Gas Piping ['Other Job Address P/i'e S b • (Number) (Street) (Unit) • Job Description J 2ct.) Colts` v / /0 n/bf ii Owner (of7�rvc$f0x Mailing Address UI1C.41S U,/4 <� City (Jrl(4� Li,J/ Cr State c Zip Tel Tenant Mailing Address City State Zip Tel Contractor Dztenj t ]r b*'4 Mailing Address �� /f0///Ute Sf City�OtWiCi O State cD Zip C96360 Telly /,j7 Contractor's License Type&Number Jul (p___) ,s4 - Exp.Date /0 /3/ /o2ca2r 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. f � Owner/Agent Signature - ,/ Date/0 Apt/ /0S Construction Value Fee Plumbing ..T-OCA.OC $ Mechanical $ $ Electrical $ $ Plan Review Fee $ State Education $ Total $ $ 4eviseiNovem6erl,2004 Town of Montville Building Department 848-3030, Ext 382 COMMERCIAL PERMIT SIGN-OFF SHEET CONSTUCTION PERMIT APPROVAL y? / cs D, Property Address 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 Department Permit Issuance Approval Approval Tax Collector o� k u\a‘`os Sial:atui date ❑ WPCA Signature/date ❑ Planning&Zoning Signature/date ❑ Health Department Signature/date ❑ Department of Public Works Signature/date ❑ State Dept. of Transportation Signature/date ❑ Fire Marshal Signature/date Comments/Conditions: 4Wised ovem6er1,2004 vow State of Connecticut N 7A - 7 B - 7C it Workers' Compensation Commission J DIRECTIONS DIRECTIONS for FILING FORMS 7A,7B and 7C tizoirtSJ51Mtt Building Permit Requirements for Workers' 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. 4. The General Contractor or Principal Employer who has properly excluded himself from coverage using the appropriate WCC form (see NOTE below) must file the FORM 7C 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 STATE OF CONNECTICUT DEPARTMENT OF CONSUMER PROTECTION PLUMBING&PIPING 040107%..D CONTRACTOR ,-' -;:.:41‘‘5•:!.., ',';:.\ ea JOH-14.SoZIENOEL p *RoE Si*:.; NOltwitH,CT 06* _ LIC./REG NO. ,....1-,:gffEcTivVEXPIRES 279568 10/31/2005 10/31/2005 / ......a I SIGNED • • •