HomeMy WebLinkAboutFurnace Replacement 2017 TOWN OF MONTVILLE
Building Department
310 NORWICH-NEW LONDON TURNPIKE
UNCASVILLE, CT 06382-2599
TEL. (860) 848-3030 X382 FAX. (860) 848-7231
MECHANICAL PERMIT
Permit Number: M2017-0139 Date: 15-Aug-17 Map/Lot: 021/006-T15 Owner ID: 710000
Project Location: 350 CHESTERFIELD ROAD Unit: 15
Job Description: Replace Existing Propane Furnace
Owner Nam Donald Wilkins Tenant Name N/A
Careof:
261 C Route 163
Montville _T 06353- Telephone: (860)884-2182
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 ❑ Electrical Service CRS No: o
❑ Framing ❑ R HVAC
❑ Masonry Fireplace Throat or Chimney Thimble CI Gas Piping and leak test
❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION
❑ Insulation 111 Certificate of Approval
❑ Certificate of Occupancy
Building Official's Approval:
i
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.:(ya –p(35
Type of Work Occupancy Type Permit Type
❑ New Construction ❑Single Family ❑ Building
❑Addition ❑Two-Family ❑Plumbing
❑Alteration ❑Townhouse k Mechanical
❑Accessory Structure Electrical CRS#:
Property Address: 3-5 0 (1.5rS),'ki 6-0/
(Number) (Street) / (Unit)
- Job Description: �P�J1CtC� EY.....-13K.ic male`— (froecv1e)
Owner J 9/(I
Address: a 1U7163
City: (1 A){Cr Oe State:C 7" Zip Code:Ut-,3s� Telephone( U ) - )/ -2
Applicant: Crc er/ f Q tcJ.2t
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.
❑ 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 requirements in chapters 34 through 43 of the Residential Code.
fit Owner/Agent Signature: Date: ,S)-//
Construction 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 0 Fee:
Plan Review Fee:
State Ed Fee:
Total Fee:
Revised August 23,2007
r
State of Connecticut
Workers' Compensation Commission
7A
•
cam:�i � Please TYPE or PRINT IN INK
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
�1
Name of Applicant for Building Permit an'''../CA.t wrtr..l
Property located at 3SC)Ch P_(CT pa 4 3
in theCity/Townof `in cc 0 v t .\ c_ (_: Cjl4130
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:
YLI am the OWNER of the above-named property.I WILL NOT act as the general contractor or principal employer.
Signature of OWNER Applicant- _ ZZ_
LI 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 ID#(FEIN)
Signature of SOLE PROPRIETOR Applicant
Town of Montville
Building Department
CONSTRUCTION PERMIT APPROVAL
3ChesicrRet Lo t- #15
Property Address
60,4- -r- P-cmod.c_f J-1-1-fr_ri v c z)-is nido I t-fz)4'1
Job Description
Required Department Permit Issuance Approval
Approval
® V Tax Collector s/i, / 7
Signature/date
Comments:
® � Fire Marshal / 7
Si/ { gflature/dateh /
Comments:
❑ Planning & Zoning
Required for all permits except Signature/date
Plumbing,Electrical,Mechanical, Roofing,Siding,Windows&Doors
❑ Health Department
Required for properties with private septic or well Signature/date
Comments:
❑ WPCA, Administrative
Required for properties on sewer Signature/date
Comments:
❑ WPCA, Operations
When Required by WPCA Signature/date
Comments:
❑ Department of Public Works
Required when project includes driveway work or certain drainage requirements Signature/date
Comments: -
❑ Montville Police Department
Required for all permits EXCEPT one and two family residential Signature/date
Comments:
❑ Copy of State Dept. of Transportation Certificate
Required for Structures over 100,000 sq.ft.or with more than 200 parking spaces-Official copy of STC Certificate of Operation required—per
CGS 14-311
Signature/date
Building Department Final Inspection
Revised March 23,2015