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Home My WebLink About2004 - Sunroom Expansion - Electrical 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: E2004-0326 Date: 08-Nov-04 Map/Lot: 096/101-000 Owner ID: 118000 Project Location: 28 BALDWIN COURT Unit: Job Description: wiring for addition Owner Name: Linda M Sposato Tenant Name: N/A Careof: 303 Mohegan Park Road, Lot #20 Norwich CT 06360- Telephone: Contractor Name: Electrical Unlimited Telephone: (860)886-6073 DBA: Lic/Reg Type: El Lic/Reg No: 190384 16 Bliss Place Exp Date: 30-Sep-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: $8.00 Code: 1999 State Building Code w/2004 Amendment Mechanical Value: $0.00 Mechanical Fee: $0.00 Electrical Value: $1,000.00 Electrical Fee: $8.00 Construction Type: 5B - otaNFaiae: 00 0-----Perralty-Fe~. $0 00----Pent C-ode R5 C of O Fee: $0.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $0.16 Total Fee: $8.16 It shall be the owners rel2sonsibility 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. ❑ Footing - Prior to pouring concrete ❑ R Plumbing and leak test ❑ Backfill - Footing drains and waterproofing ❑d R Electrical ❑ Concrete Slab - Prior to pouring concrete ❑ Elec Trench - with conduit installed ❑ Framing ❑ Electrical Service CRS No: 0 ❑ Fireplace Throat - One flue above throat ❑ R HVAC ❑ Chimney - One flue above thimble ❑ Gas Piping and leak test ❑ Firestop Draftstopping ❑ Final Inspection ❑ Insulation ❑ Certificate of Occupancy Building Official's Approval: Town of Montville Building Department 310 Norwich-New London Tpke. Tel. 848-3030, Ext 382 Uncasville, CT 06382 Fax. 848-7231 Residential Trades Permit Application Form Permit # 0Zy v0 „03 z-6 ❑ [umbing ~ECectricaf ❑9dechanical CR5 # Yfeating Air Conditioning Gas 'Piping Single Tami y ❑ Two-Tami(y ❑ Townhouse Job Address --Z 9) F.) a 1 LL) ",~n C4 (Number) (Street) (Unit) Job Description d Owner (.bflc Mailing Addressi htQ,~ city v,_t C-- State _ Zip Tel B66 / - Contractor E: (2 i C' a \ QIA 1 c iM i ailing Address ~r e City -C 1 i C State _ Zip Tel / Exp. Date/ / Contractor's License Type & Number- q0 57 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 authorizAtomake appl' atio r ernnit for such work as described above. Owner /Agent SignatuDate Construction Value Fee Plumbing $ $ Mechanical $ $ Electrical $ 1 Q~~ ° $ Plan Review Fee $ State Education $ Total $ $ (Complete reverse side) 4Zpvised'Septem6er9, 2004 Town of Montville Building Department Receipt No. C D Ole 4 J Date j c l From: Job Address: Check Check # 0' as Amount (,ircle one) permit # Received by I ELECTRICAL UNLIMITED CQNTRACTOR BRANDON H R GIRARD 7 JULIAN -M itRAcE NORWICH, Gr 06360 u~1~t~4NO 1~OF/~~t%~~~104 SIGNED_ State of Connecticut Workers' Compensation Commission - Please TYPE or PRINT IN INK 04/ JS~N~t TN'AMST//[/~ Proof of Workers' Compensation Coverage when Applying for a Building Permit for the Sole Proprietor or Property Owner "who WILL NOT act as General Contractor or Principal Employer Permit Building Applicant for Name of Applicant for Building Permit 1 l~~r- l 2~ 1 e Property located at in the City / Town of l^ l If you are the owner of the above-named property or the sole proprietor of a business doing work on the site of the construction project at the above-named property and you WILL NOT act as the general contractor or principal employer, you are not required to have workers' compensation insurance coverage. CHECK ONE (1) BOX ONLY and complete the following: ❑ I am the OWNER of the above-named property. I WILL NOT act as the general contractor or principal employer. Signature of OWNER Applicant I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I am the SOLE PROPRIETOR of a business doing work at the above-named property. I WILL NOT act as the general contractor or principal employer. Name of Business \ CC- IA \41 L Federal Employer ID# (FEIN) Signature of SOLE PROPRIETOR Applicant Town of Montville Building Department 310 Norwich-New London Tpke. Uncasville, CT 06382 Tel. 860-848-3030, Ext. 382 Fax. 860-848-7231 CONSTRUCTION PERMIT APPROVAL .295 Bal&,olh CT Property Address JjA 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 k k k l u,4 WPCA { ❑ Planning & Zoning Sigiiatijrc/ date ❑ Health Department ❑ Department of Public Works ❑ State Dept. of Transportation F-1 d -e. -ate ❑ Fire Marshal Sigiiawre, date Comments/Conditions: g4 i edseptem6er9, 2004