HomeMy WebLinkAboutRemodel First Floor Plumbing Town of Montville
BUILDING DEPARTMENT
310 Norwich-New London Turnpike
Uncasville,CT 06382
(860)848-3030, Ext.382
Plumbing Permit
Permit Number: P2003-0015 Date: 04-Mar-03 Map/Lot: 075/014-000 Owner ID
Job Location: � POINT
9 119513
BRE 7E ROAD
Job Description: plumbin. for one bathroom Unit
Owner:
Contractor:
Harold S Jr+ Harold S and Paula H Schwenk
Norman P. Brulotte
80 Orchard Rd 40 Club House Road
Weston Lisbon Ct. 06351-
MA 02493-2279 Telephone: (860)886 2164
Lic/Reg Type/No. P1 203424 Exp Date: 31-Oct-03
Tenant:
Self
Telephone: —-----
Construction Values
Permit Fees Construction Information
Building Value: $0.00 Building Fee:
Plumbing Value: $0.00 Use Group: R4
$0.00 Plumbing Fee: $0.00 Code:
Mechanical Value: 1995 CABG
$0.00 Mechanical Fee:
$0.00 Construction Type: 5B
Electrical Value: $0.00 Electrical Fee:
Other Value: $0.00 Permit Code: R5
$0.00 Other Fee:
Total Value: $0.00 Comments:
$0.00 CO Fee: $0.00 Included on Building Permit
Plan Review Fee: $0.00
State Ed Fee: $0.00
Total Fees: $0.00
1- • , 1• - ••• ••• • • 1-. -
❑ 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
❑ Final Inspection
Rough plumbing and leak test
❑ Certificate of Occupany
❑ Gas piping and test
Building Official's Signature: 11
' Town of Montville
,•••, Building Department Permit#g,v____42_,.0 . 6
310 Norwich-New London Tpke. ---- J
Tel. 848-3030,Ext 82 Uncasville, CT 06382
Fax. 848-7231
Application for Commercial Trades Permit
1'lum6ing [] Electrical- S 1ecIzanica(
J{eating
Air Conditioning
❑Other
Job Location 6 ' o i j Lr, Z
Job Description/Materials P • I g t
QVC w f w T�� .o'.1n
Owner .zLk Mailing Address o
City ( �G 5!on State Ina, Zip 0 -21 Tel
Contractor /�of,,,x,, e_c / / Mailing Address v C
City /. State C?• Zip .04211 Tel kby
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Contractor's License/Registration Type&Number ?/ o?
Exp.Date /v
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 /-,Adi4: %
/l � :� Date 3 / 3 / .c:1)
Construction Value Fee
Building
Plumbing $ $
Mechanical $ .0,0o —
$
Electrical $
Other $ $
Certificate of Occupancy $ $
Plan Review Fee $
State Education $
Total $ $
STATE OF CONNECTICUT
DEPARTMENT OF CONSUMER PROTECTION
PLUMBING&PIPING UNLIMITED CONTRACTOR
NORMAN P BRULOTTE
40 CLUB HOUSE RD
LISBON,CT 06351
TYPE: P1
LIC./REG NO. I EFFECTIVE EXPIRES
203424 I 11/01/2002 10/31/2003
SIGNED/Z-11..„44-._/
STATE OF CONNECTICUT
WORK RS'COMPENSATION COMMISSION
Buildin: permit Affidavit for Pro.e
Owners or Sole Pro I rietors
(Conn. Gen. Stat. §31-286b)
Property located at "
� rj J - Ufa/
In the town of
Name of building permit applicant: /IID
Please check one:
1. I am the owner of the abovero
2.C-Iam the sole proprietor P arty
P prietor of a business.
-2A.Name of business � /7
2B.Federal Employes Id
Pursuant to §3 I-286b "a................Identification Number(IF� .. `. b GS t�
' P or -
sole prietor
contractor ce or a risco notarized mayrovide either a cwt,o ftends workers'co as ea g --•
compensation i affidavit... statingcompensation
'
insurance for all those employed that he���proof of worker'
P yea on the job site in accordance with this chapter
Please checkon�e-"
1•L"ti-do not intend to act
as
[Sign and stop hen a general contractor or principal employer.
tativ-
Signature of applicant
2. I intend to act as a
provided ace general contractor or prince
certificate of workers'compensation 1 employer.Applicant
pensation • must either
below. insurance or sign the affidavit
..............
.................
I Affidavit •---......
hereby swear and attest that I will
contractor,subcontractor,or other l require
r proof of workers'compensation
accordance ubh before he/she engagesin work insurance abo a for perry
the Workers'Com 6on the above pro
Compensation Act(Chapter 568). property in
I understand that pursuant to
paI and rstan ay electtot §31-275 C.G.S., officers of a
rtner Office; excluded from coverage by corporation and partners inp a
District
st his intent to d that a sole proprietor of a business is not a waiver to have the ve appropriate
accept coverage_ required prate
coverage unless he
Signature ofappticant
Subscribed and sworn to before me this
day of
200 .
(Notary Public!Commissioner of the Superior Court)