HomeMy WebLinkAbout2017 - SFR 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: E2017-0202 Date: 11-Aug-17 Map/Lot: 024/001-00C Owner ID: 1168900
Project Location: 74 CRANDALL HILL ROAD Unit:
Job Description: Electric Service
Owner Nam John&Beth Giddings Tenant Name N/A
Careof:
169 Park Avenue Ext.
Uncasville C'T 06382- Telephone: (860)227-6061
Applicant Name Property Owner Telephone:
DBA: Lic/Reg Type
Lic/Reg N 0
Exp Date:
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: 2016 State Building Code
Mechanical Valu $0.00 Mechanical Fe $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 Comment
Plan Review Fe $0.00 Fees Included with 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 frami ❑.r Electrical Service CRS No: 2618281
❑ Framing ❑ R HVAC
❑ Masonry Fireplace Throat or Chimney Thimble ❑ Gas Piping and leak test
❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION
❑ Insulation ❑d Certificate of Approval
❑ Certificate of Occupancy
Building Official's Approval: o�9 '"K;;"7"---
Town of Montville
Building Department
310 Norwich-New London Tpke.
Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231
RESIDENTIAL PERMIT APPLICATION FORM Permit No.: L 17–DaO�
Type of Work Occupancy Type Permit Type
El New Construction ❑Single Family 0 Building
❑Addition ❑Two-Family El Plumbing
❑Alteration ❑Townhouse ❑Mechanical
�^--�El Structure ❑ Electrical CRS#:4 2
Property Address:—1 CO-A L)b-A lA \2C_Ark
(Number) (Street) (Unit)
Job Description: 4 iT(24C Sl'"--k2-•D t QCT\.S- le-LA LTI (5 \
-
Owner:3C) L) 5C gX R U‘ 3c
Address: 169
^ ee 2-2-7 6,0 r
City: t�Ze-t7 t``Q State:C k Zip Codetx43e)L Telephone'C:° ) 7/O - b y FS
Applicant: �1
DBA:
Address:
City: State: Zip Code: Telephone( )
Contractors - Complete the Following:
License Type: License No.: 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.
El By checking this box, I will follow the requirements of the 2014 NEC as the alternative compliance per section E3401.1 of the Residential Code,
instead of the electrical requirem-nts in chapters 34 th . .. 43 of the Residential Code.
Owner/Agent Signature: .:` 1 � 41111 Date: I 1 V 2�1
Construc ion Value Permit Fees
Building Value: Building Fee:
Plumbing Value: Plumbing Fee:
Mechanical Value: Mechanical Fee:
Electrical Value:
Electrical Fee:
Total Value: Penalty Fee:
C of O Fee:
Plan Review Fe--
State Ed -:
To ee:
Revived:August 23,2007
VV
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State of Connecticut N 7A
:.
.) Workers' Compensation Commission
��"�./�� Please TYPE or PRINT IN INK ce
itZazazv
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
APPLICANT FOR BUILDING PERMIT l ,
Name ofApplicant for Building Permit ,.....\j1 IV1 �\ ~3 f'—''1 -"(
Property located at I C \ N k•` A
in the City/Town of X-71-\Cnk\0 X\\.52..., ei$ -
ATTEST
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 VNLL NOT act as the general contractor or principal employer.
2... :LSignature of OWNER Applicant-.- �.C(-----1_ {
5
❑ 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
Federal Employer I D#(FEIN)
Signature of SOLE PROPRIETOR Applicant