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Home My WebLink About2003 - Electrical Upgrade 100 to 200 AMP 00,46. 4? Town of Montville Building Department Sii Date: /74 / /a �— ec Field Inspection Notice Permit#: Address: C) pdC , , c ./Not Comments/Corrections Required—re-inspection required: Inspection Approved Approved ❑ Footing 0 ❑ Backfill 0 0 ❑ Concrete Slab ❑ Framing 0 0 Rough Elec 0 Elec Service L, ❑ Rough HVAC `0', ❑ Rough Plumbing 0 ❑ ❑ Gas Line 0 0 ❑ Fireplace Throat 0 0 )\.. ,-)\ 41) ❑ Chimney 0 0 ❑ Fire/Draftstopping 0 0 0 ❑ Insulation 0 ❑ Final Inspection 0 0 ❑C of O \1;If ❑ 1:3 , N 1 Ad4 Inspector's Signature / Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville,CT 06382 (860)848-3030, Ext. 382 Electrical Permit Permit Number: E2003-0318 Date: 16-Oct-03 Map/Lot: 103/049-000 Owner ID 120024 Job Location: 60 POLLYS LANE Unit Job Description: Electric Service Owner: Contractor: Donald R Jr Mallon John MacNeil 424 Cherry Lane 60 Pollys Lane Oakdale Ct. 06370- Uncasville CT 06382 Telephone: (860)848-1121 Lic/Reg Type/No. El 104051 Exp Date: 30-Sep-04 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: $1,000.00 Electrical Fee: $10.00 Permit Code: R5 Other Value: $0.00 Other Fee: $0.00 Comments: Total Value: $1,000.00 CO Fee: $0.00 Plan Review Fee: $0.00 State Ed Fee: $0.16 Total Fees: $10.16 It is the owners responsibility to schedule the following inspections(minimum 48 hours notice reauired): ❑ 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 ❑I] Electrical Service ❑ Final Inspection ❑ Rough plumbing and leak test ❑ Certificate of Occupany ❑ Gas piping and test Building Official's Signature. t • Town of Montville Buildin a Department Permit# 310 Norwich-News London Tpke. Tel. 848-3030,Ext 82 Uncasville, CT 06382 Fax. 848-7231 One & Two Family Trades Permit Application Form DPlumding 1 etrical []Mechanical Skating .fir Conditioning (]Other _Gas Piping Job Location “7 Pa /45 Z.-^ Job Description/Materials O' le l` 0(J ti 004 — 2o04 C f- 9s 8 5 3 Owner BONA Y v l AA(.t') Mailing Address 60 ? (1 LJS Low u 11 City V A�'G S `l �' State t Zip 063 ? L Tel c' O / YF q— Contractor 3t �1teS t [ _ 33 Mailing Address 7 Z� ��'/'� �-o�• City nen p A k L� cX3 p State � Zip � Tel ��/ ��d / 1 Contractor's License/Registration Type&Number 6:7( /p (K0 S( Exp. Date o7 /3D / (5 Li - 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 an. • .• ter attest that the proposed work is authorized by the owner in fee and that I am authorized to make application f, a permit or such work as described above. Ovine /Ageriign• j Date n) / 2 / O� Construction Value Fee Building $ $ Plumbing $ $ Mechanical $ $ Electrical $ /Qv V.U 0 $ / Other $ Certificate of Occupancy $ Plan Review Fee State Education $ Total $ $ /6) 1./ 0 .tt1 • STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors (Conn. Gen. Stat. § 31-286b) Property located at: � v Pe,//7 C.-4A- In the town of /DA,J vi �� Name of building permit applicant: a 1 f}` U F 7L— Please LPlease check one: • 1. I am the owner of the above property. 2. yN I am the sole proprietor of a business. 2A. Name of business: 144,9c.Al 1 2B. Federal Employer Identification Number(FUN) 501W- 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 c ck one: 1• ' o not intend to act as - gener.i c o ntracto r princip mployer. [Sign and stop 4 Signature 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 insurance for every contractor, subcontractor, or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to § 31-275 C.G.S., officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office; and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. Signature of applicant Subscribed and sworn to before me this day of , 200_. (Notary Public/Commissioner of the Superior Court) Town of Montville Building Department Receipt Date ,,ZO /7 / 43 No. 03234 From: a # 2( 1 Job Address: O / r / Al./ /12 . Amount $ ` • Cash - Check # -7-:./& „,(Circle one) Received by / r 1,i/.. i ,./��J, �► Permit # � �0 ' O o °� o y o o C .CD CD y 0-t CD �. fa. :NNN d 0 o o. fa. n a. b • z y n �' - C7 C et rrri r cD eCi a. ¢' C7 y o o� \ � et N 0 . a, 0 z o \ ' .l CD 0 b o up et et r CL `"J A • ° to CD Cj g net, UQ O O � .y Gy C Q ° H et ,.. et o C to oi. et a. tic) O na o C et CD O o "* O � rt CD C4 `6. < P. CA On 0 o tZ iv cn CM R 0 ' o N �, N N O" = NO O CD CD 0 Town of Montville Building Department 848-3030, Ext 82 ONE &TWO FAMILY CERTIFICATE OF OCCUPANCY SIGN-OFF SHEET • Property Address •. 4 Job Description: I� The owner/agent shall be responsible for the completion of the form, no certificate of occupancy signatures below have been obtained. P y will be issued until all HEAL, : DISTRICT 848-3030-882 Approved Septic stem 0 Permit#• Not' Applicable Date Approved Private Well ❑ Permit#: Not Applicable WPCA DEPARTMENT Date 848-3030 Ext 881 Approved Municipal Sewer 0 Permit#: jR. Not Applicable Date Approved Munich al Water 0 Permit# Not Applicable DEPARTMENT OF PUBLIC WORKS Date 848-7473 Approved Director ❑ Permit#: ( Not Applicable PLANNING&ZONIN DEPARTMENT Date 848-3030 Ext.81 /sZ In-Compliance 40 Zonin Permit g Date D Not Applicable In-Compliance Inland Wetlands 0 Permit#: [] Not Applicable Date