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MFH, Deck and Carport 2003 M 0 +r c3 N O +' V 5 O +� WCcl %� c0 amc) N > 0 V © .0 0 o aa y 0 U �, c a, a 1 C .... V 1 c9 C) G 0 A W 4, ) ¢, �) ow E Ogg 0 O A s, N = • 0 a `EA gi 0 .. O U r"..., �. V V O Q H L. C g ? y N H d e0 c1.-o U V O ed V -� U O "'it' �; O d o O U o N — o w bn 0 0, 0 • `t M F UI• 0 cn A b c o a4 ti a A 0 (., „,,, . ,:, •...• ... Q , F,L, p4 2 0 O a O .� ° Na c7 EA E• -2 ?) . 0 0 E. (/) o w4 ....) C.) 0 CLT `„_ ________ Q t 41 y M Town:of 4Montville • Building Department Date_zZi/?iField Inspection Notice Permit# " 3 Job Location - ► A s' . A /411 _ "J:710 Approved Type of Inspection Not Approved - Please call for re-inspection when the following corrections have been completed: 4170 Buildin_ : isci�al I j Town of Montville Building Department Date / /_‘2 Field Inspection Notice Permit # )1/074Q3 —/3/ Job Location le p< 1(62- ) /Vho6c) r"• • Approved Type of Inspection - _ U !f Not Approved - Please call for re-inspection when the following corrections have been completed: �o Pre- f Building Official Toiwn,of Montville 0 Buildjng Department Date 7 //S / 07 Field Inspection Notice Permit # Job Location 2 �.A/1.ri3oti Approved Type of Inspection ( L5 7 4-(7 Not Approved - Please call for re-inspection when the following corrections have been completed: _1a ? �11-#0s°-C / Liu .r. 4-j ,,, "Or , Building Official Town of Montville Building Department low 848-3030,Ext 82 ONE&TWO FAMILY CERTIFICATE OF OCCUPANCY SIGN-OFF SHEET c-l/t D Gei i V� Property • ddress Job Description: /(5. The owner/agent shall be responsible for the com tion of the form, no certificate of occupancy will be issued until all signatures below have been obtained. HEALTH DISTRICT 848-3030-339 Approved 0 Permit#: ❑ Not Applicable Septic System Date Approved ❑ Permit#: ❑ Not Applicable Private Well Date WPCA DEPARTMENT 848-3030,Ext.376 Approved Op,* `, o� 3 ❑ Permit#: 0 Not Applicable Municipal Sewer Date House Trap ❑ Outside ❑ Inside Approved ❑ Permit# ❑ Not Applicable Municipal Water Date DEPARTMENT OF PUBLIC WORKS 848-7473 Approved 0 Permit#: 0 Not Applicable Director Date PLANNING & ZONING DEPARTMENT 848-3030.Ext.379 7.,416A4 21140621f/ / /C53 In-Compliance ZN. Permit#: 7O -/Z( ❑ Not Applicable Zoning r, Date In-Compliance 0 Permit#: ❑ Not Applicable Inland-Wetlands Date *visa 6/28/2002 Permit Fee Calculation Spreadsheet RESIDENTIAL PERMIT CALCULATION (MANUFACTURED) QTY $/UNIT TOTAL Site Work Slab on Grade 1105.5 SF $ 6.99 $ 7,727.45 Foundation SF $ 29.70 $ Anchors SF $ 6.69 $ - Garages Attached, 1 car EA $ 8,885.10 $ - Attached,2 car EA $ 15,113.70 $ - Attached,3 car EA $ 20,913.90 $ - Detached, 1 car EA $ 11,657.10 $ - Detached,2 car EA $ 17,456.25 $ - Detached,3 car EA $ 23,256.45 $ - Breezeway/Decks Open 176 SF $ 15.59 $ 2,743.84 Enclosed SF $ 94.76 $ - Porches Open SF $ 62.69 $ Enclosed SF $ 123.90 $ Carport 308 SF $ 9.85 $ 3,033.49 Sheds SF $ 26.25 $ TOTAL BUILDING $ 13,504.78 Electrical New Service EA $ 1,519.19 $ Tie-in 1 EA $ 210.00 $ 210.00 Misc.Electrical 0 SF $ 1.24 $ Plumbing New Sewer EA $ 1,250.00 $ - Sewer Tie-in 1 EA $ 210.00 $ 210.00 New Domestic EA $ 1,200.00 $ - Domestic Tie-in 1 EA $ 210.00 $ 210.00 Mechanical Oil Heat EA $ 579.76 $ LP-Gas EA $ 450.00 $ Y Its air conditioning included(Y/N)? $ 5,107 PERMIT FEE Building $ 13,505 $ 82.00 Y Plumbing $ 420 $ 10.00 Y Mechanical $ 5,107 $ 34.00 Y Electrical S 210 $ 10.00 Other $ - CO Fee $ 10.00 Plan Review $ 8.20 State Ed Fee $ 19,242 $ 3.08 Total Fees $ 157.28 Based on 2003 RS Means Residential Cost Data 5/19/03 1 ..1..i..--.!,, ,,' - s t+f: rb P ,t Y ,. P y S $ j p, 1`^i'b."?e ti> „ r k y {t, yam. J e s,syt..t N E `1 IS I ® y I 1';' �c st"'•a 1(j1 'E i --- g qq 1�1 ..',".1-," ,.,...,=';.1.;•,'iCn 4 -X l l�k "_., q/ �-1 br,, -.cs.i -,",11.... ".::-...„f'; If° , rr::1 k fir C , �,q .�., Q- rl n rl {� , '�`; 'J - ,r/ _QC-3 ;".1,''',.:,1' rte' ..1 � � -.'...:4 1" f t" k J F! J - 3+1 Fr µ` ."7-- ,.,. .. Z? i'?9, :V :'t4i'��s ei a :' y f / .,.11:.:..f.,.,, [r,h� ..., _'JJ a y.. N > .> 4� � � � Q P Yfw rRY FS P3>j qQ^P [ 'E '�y, ..�"� '�' yny 1 � iri ;.�T�.p `�S�yx .b-yF�AY'�- 4 { h '� ,rte R� shy r r4 _4-1%,-,"; '"-,w ,; U ^� r �":'' O e, --M1- U c:7;;;;;;.- iW - - f\ U .Z:,'C- '� Z r :$..=.)..,",---; AOS j! ''` 1' t ae'I' ____ ___ __ 4:"..., ACORD„ CERTIFICATE OF LIABILITY INSURANC , OP ID Nuc DATEi(MWDDr7Y1 NSE-2 03/17/03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Mathog .S Moniello Cos. , Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 433 South Main Street Ste 116 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. West Hartford CT 06110-2815 INSURERS AFFORDING COVERAGE phone: 860-313-2000 Fax:860-561-2882 _ _ __• . •-. --- INSURCD ' INsLn R A' Pennsylvania Manufacturer's _-.. ...___ INSURER B: •_. — Jensen's, Inc. INSURER C. -_— ---_.. . _ — AlAn Krieger - —! 246 gedstone St.-Pp Box 608 INSURER D. _- _� Southington CT 06489 INSuR6RE I COVERAGES .. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.No grHSTANDING ANY REQUIREMENT,TERM OR CONDITION DF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIPICtiTE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POUCES AGGREGATE LIMITS SHOWN MAY HAVE BERN REDUCED BY PAID CLAIMS. p�( (CFFECTIVC PaCfi PEStGIRATRSF! IId3R POLICY NUMDER DATE(MM/DON) DATE(MMIDDE YI LIMITS LTA TYPi?OF INSURANCE EACH OCCURRENCE $ _..._ GENERAL LIABILITY FIRE DAMAGE IAnY ono fir?) 3 COMMERCIAL GENERAL LIABILITY -•- 1 CLAIMS MADE L._j OCCUR MED EXP(Any ono porson) 3 PERSONAL&ADV INJURY S GENERAL AGGREGATE S I .... . ---.—_-- PRODUCTS•COMP/OP AGG $ __ QEN'L AGGREGATE LIMIT APPLIES PER: POLICY JE Of ri LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S •_ (ELI occident) ANY AUTO ....._ .. . ALL OWNED AUTOS BODILY INJIJRY (Pur pardon) SCHEDULED AUTOS - BODILY INJURY g • _ HIRED AUTOS (Par occident) NON.OWNEG AUTOS — -• -- -_— PROPERTY DAMAGE y AUTO ONLY•EA ACCIDENT $ _ GARAGE LIABII.lYY to ACC $ - OTHER THAN _ _ . .. ._- • jANT AUTO OTHER ONLY' AGG $ - EACH OCCURRENCE $ ExCl=S6 LIABIUTT AGGREGATE_ S 1 OCCUR [_l CLAIMS MADE S.._ -" -_DEDUCTIBLE .. -.-_..._-__,.._--- _ 3 RETENTION $ - VJC SIAIU-_ UIH- X( TORY LIMITS Ek WORKERS COMPENSATION AND EMPLOYERS'LIABILITY 200300-41-79-040A 01/01/03 01/01/04 el.EACHAcGIDENT 3500000 A E.L.DISEASE•EA EMPLOYEE 3 500000 E.L.DISEASE-POLICY LIMIT 3 500000 - OTHER DESCRIPTION OF OPERATIONS/LOCATIONS NEHICLESJEXCLUSIONS ADDED BY CNDORSeMHNT/SPECIAL PROVISIONS CERTIFICATE HOLDER N ADDITIONAL.INSURED;INSURER LETTER:_ CANCELLATION MONTVIL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES Be CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL .1Q.._.DAYS WRITTEN NOTICE TO THE CERT1FICATE HOLDER NAMED TO THE LEFT,IIUT FAILURE TO DO SO SHALL Town of Montville IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Building Dept. REPRESENTaTIVtS, 310 Norwich-Neu London Tpke. AUEPRESE 7A7ID 5ESENTATlvB Uncasville CT 06382 Kathy A. Bellemare ©ACORD CORPORATION 1988 ACORD 25-S(7/97) Town of Montville vat Building Department 848-3030, Ext 82 ONE & TWO FAMILY CONSTRUCTION PER ItT -- _ r."'1 SIGN-OFF SHEET ii .. -. Cry Pci_ heat 3 (OC Property Address ....... Job Description: 4 F Q /I t2 o—) A-P G k( ��6._At-yipv--f The owner/agent shall be responsible for the completion of the form, no constructionermi will t be issued until all signatures below have been obtained. HEALTH DISTRICT 848-3030-882 ❑ Permit#: ❑ Not Applicable Septic System Date ❑ Permit#: ❑ Not Applicable Private Well Date WPCA DEP%'TMENT 848-3030,Ext. 881 iL;I/.° A. uJah i C c Permit#: ❑ Not Applicable Municipal Sew 4 Date ❑ Permit# ❑ Not Applicable Municipal Water Date DEPARTMENT OF PUBLIC WORKS 848-7473 ❑ Permit#: ❑ Not Applicable Director Date PLANNING&ZONING DEPARTMENT 848-3030,Ext. 81 C;(62-e-iie7.---1-1--- � cf/ -(/d.3C in----Permit'ermit#:a6 3 EI102(, Not Applicable Zoni �� Date 016(2-,-, ,x--J‘---'i S//�� ❑ Permit#: CAD' N pAo licable Inland- ands Date Town of Montville itirw Plan Review Form Date: Y' /9, zc03 Street Address: e 2- R A/tiJ 6.' 7jZ1 y L Job Description: We have received a building permit application for the above referenced property. In accordance with Connecticut General Statute 29-263,your application is being rejected for the following reason(s)that are checked-off or commented on: • Supporting Documentation Plans are to be drawn to scale including dimensions of rooms and spaces and all framing information Building permit application not completed,signed,dated '( Permit fee$/.67.2_6 Worker's comp.Affidavit or worker'comp.Insurance Copy Contractor's registration or license Construction permit sign-off sheet Street address of project on all drawings and documents Comments: :. 4ffi 'al 1110 Town of Montville (-4) Building Department Date 7 / /G/ 63 Field Inspection Notice Permit # Job Location G a kAi/Aigoc,c) roved ppType of Inspection P INot Approved - Please call for re-inspection when the following corrections have been completed: Building i' 0 p Town of Montville 0 Building Department Date 7 /,,,za/ 03 Field Inspection Notice Permit # 170a3 21/ / CQ Job Location leo_ / /00 w Dr- -N Approved Type of Inspection � t C 5.ev- V ll' e II Not Approved - Please call for re-inspection when the following corrections have been completed: p eted: Building Official Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville, CT 06382 (860)848-3030, Ext. 382 Mechanical Permit Permit Number: M2003-0131 Date: 31-Jul-03 Map/Lot: 016/T29-T62 Owner ID 122527 Job Location: 62 RAINBOW DRIVE Unit Job Description: set tank&run gas line Owner: Contractor: Jensen's Inc. Spicer Gas 36 Thames Street P.0. Box 608 Groton Ct. 06340- Southington CT 06409 Telephone: (860)445-2436 Lic/Reg Type/No. G1 308503 Exp Date: 31-Aug-03 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: $500.00 Mechanical Fee: $10.00 Construction Type: 5B Electrical Value: $0.00 Electrical Fee: $0.00 Permit Code: R5 Other Value: $0.00 Other Fee: $0.00 Comments: Total Value: $500.00 CO Fee: $0.00 Plan Review Fee: $0.00 State Ed Fee: $0.08 Total Fees: $10.08 It is the owners responsibility to schedule the following inspections(minimum 48 hours notice required): ❑ 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 E Certificate of Occupany ❑ Gas piping and test Building Official's Signature: r'' Town of Montville Building Department Permit #Jilib 'c.i '13 310 Norwich-New London Tpke. Tel. 848-7166, Ext 82 Uncasville, CT 06382 Fax. 848-7231 One & Two Family LP-Gas Permit Application Form Job Location ( )-- 720.;9..-100 w ►". 1 U-LA-C.a.SV ( (.2 i C ... c Job Description/Materials I L i- J( _(- ;o� 0 C i_/ D jai in 4- t,k f 1.,....e� , .e I(b Ce t a ( aI�z�. : 4- Owner l2tti Se c... 'S Mailing Address ;4-go T 4 1.27e •.-e City SO c,c,4-'lA.t tti �c� ,.-\_ State . Zip De)Gm Tel Sef;0 /7i © Z ri Contractor 5-p,C.247 6(4.5 Mailing Address -3‘, T A...a -S.1 . City 0q1,104(,--1,104t,- State , Zip 0(33gQ Tel V6 4/tic/ .)'(1 Contractor's License/Registration Type& Number / / 0036�(�(j3 Exp. Date / 3l / 63 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 ----444-1.1-4. ignature9 O Date 7 / )—q/ Construction Value Fee Building $ $ Plumbing $ $ Mechanical $ S)D mo $ /d Electrical $ $ Other $ $ Certificate of Occupancy $ Plan Review Fee $ State Education Total $ $G uGUR_7C J .1111 rdX•1LWo(O11C00 Jdfl L( UJ 1L•DU r. Vl CSR JG DATt.poYDorYY1 AcoRv CERTIFICATE OF LIA iLITY INSURANCE =_2 01/• 27/03 `NWVVC t • THIS CERTIFICATE I3 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CER71FICATE George J. Smith & Son ins. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR :47 Broad Street ALTER THE COVERAGE AFFORDED SY THE POLICIES snow. :iilford CT 06460 Phone:203-878-4641 Tax:203-876-9886 INSURERS AFFORDING COVERAGE INSURED ;URERA Natl. Council on COD2pe • a NSURER ft Spicer Plus, Inc. ETA Toan Chas er INSURER G: PO Box 903 36 Thames St t4SURER0; Groton CT 06340 - JAN 2 7 2903 I INSURER E: cHEP0(JCES �AGES LDING OCPARI ftE JT THE POLICES OF WSURAHCE LISTED BELOW HAVE BEEN ISSUED TO THE It 1RED NAMED AADbE FOR TIE POLICY PER100 NJICATED.NOTWITHSTA ANY RE0 IRM NT,TERM OR coNDm0N Or AMY CONTRACT OR OTHER OOCUMUNT WTT-1 RESPECT TO WHICH THIS CERTFICATE.WAY BE Wow FORD,CONNECTICUT MAY PERTAIN.THE INSURANCEMRORDEO BY me POLICIES DESCRIBED HERcW is SLSJECTTD All THE TERMS,eXCLUSIONS AND CONO,TONS CF SUa+ EDUCES AGGREGATE 1MITS SHOWN MAY HAVE BEEN REOUCED BY PAD CLAIMS LTR I TYPE Cl BLSURA I 5E PCUCY MJIdR , DAT/ 'DD YpY1 1 Are NaloD I�` UW E 1 G[Nr1 AL LIAEIIJTY EACH OCCURRENCE S I COMMIRCtAI GENERAL LIABILITY I FERE DAMAGE(Ary one fire) $ � souses MADE _OCCUR Oft WW1)!MEC EXP(Any O1) $ PEPSOKAL b ADV INJURY .$ H `GCNBtAL AOOREQAYE S GEN/AGGREGATE LW APPLIES PER' PROCUCTS COMPJOP AGG S POLICY 1 E `-1 IOC • , A IJTOAlOE1.E LIABILITYi COMBINES SINGLE UNIT S ANY AUTO i MA -- , --- ALL OWNED AUTOS _BODILY INJURY 6CFEOIJC. 0AUTOS '� ) _ HIREDAUTOS BODILY INJURY ftro NON 0% tEO AUTOS 1 ecode'W ,J cci tt GJ�dAGE $ I3ARA6a:LIADRtTY i ALJTC ONLY-EA ACCIDENT 1 3 ANY AUTO I OTHER THAN ACG S t AUTO ONLY: AGOS I EXCESS LIABglTY EACH OCCU AENCE E s OCCUR l t CLAIMS MADE I AGGREGATE S 3 1�DEOL*TILE 3 RETENTION S rs WORKERS COIAPSHSATPON AND x 1 TORY.e rr5 r 13- A a`PtOYekr � TO BE ASSIGNED 12/31/02 12/31!03 E.L EACHACCIDENT S100000 EMP L CISEASE-EA ELOYE S 100000 . 1 El_CIsEASE-POLCYLIrwr 3500000 OTHER i I _ OEscRIPTtON Of OPERATWNSA_OCAT7oNSJVQpCS.ISIEXCLUS10Ns ADDED BY ENOc1LSEYENTLSPEGA1 PRONSIONS . CERTIFICATE HOLDER ;N 1-ADO(T10NAL INSURED;INSURER LETTER: CANCELLATION Gt3/L.TOR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES se CANCELLED BEFORE THE EXPIRATION Guilford Town Hall DATE T}iRHOi,THE LSwUHG N6URFR VIII-L.ENDEAVOR TO MAIL 1.()_DAYS WRITTEN Vex 203-453-8034 Noes TO THE CERDSCAT1 MO1 DI R MAMBO TO TEE LIFT,RUT FAIw*f TO DO30 SMALL Building Department 50 Boston Street IMPOSE Mo OSUI3AT1OR OR Lu a+Lm Of AMY roM UPON TRE MMES.rra AOGWTSOR Guilford CT 06430 REPRESENTATIVES ALITNORQ*D IL RIs$ITATNF I Georg_J_ Smith & Son Ins. Annan 31 man eheN^nAnI`nRPnRA.IAAI141!, Jul 29 03 01 : O4p SPICER PLUS 8604452313 p, 1 r4 wr1 i 4,45 36 Thames Street, &rotor, CT 06340 ' 60) 445-2436. 800-448-2028 Fax (860) 445-2313 Date: 7/D-15/03 C ity/Townll3orough: (,u�a-s v ; ( (e, . Address: 24 (,) c?_S v( 1 (e This letter authorizes Robert Mitchell to obtain a permit, on my behalf, for: Property Owner: J,t.s e s Address: D-4 se,A 1 e , Sec-t_44 ( /10 r c 66q� Harold E. Everett-LP Gas Technician Division of Spicer Plus, Inc. • CT Lic. # 00308503 • RI Lic. # 00006311 - —+.._. . .. e...ti,.....++'.-----.vac..-. .... .— ....—. .....-. . . ..•..v.rr,"w"yt'.'-IT.� .- . ti • • IS-I \ 1�1•. 01 ( t)N\y'A t M• t,;Pitet It) %; ,, ,,%st '•1111 rfiilI 1113\ HEATING.PIPING&COOLING LOWED CONTRACTOR HAROLD E EVERT fl JR . SO GEORGIA ROAD OAK .E,CI'06370 Gi LIC.I REG NO. I i~`F..FEC11HE- EXPIRES 308503 a, 09/01/Z702, . ' 8$131/26V3 • SiGNE0 t • .d CICZSH,o9e Sflld d30IdS d SO � ICI �'fl n7 rnr Town of Montville Building Department Receipt Date 7 / so / o7 No. 03024 From: 5//Cg67--- 68- Job 8Job Address: 2 JZ/�, �� i vt� Amount $ /p , off{ Cash Check Check # (Circle one) Received by Permit # a o3--o I I'lZ 3� Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville,CT 06382 (860)848-3030, Ext. 382 Plumbing Permit Permit Number: P2003-0076 Date: 16-Jul-03 Map/Lot: 016/T29 T62 Owner ID 122527 Job Location: 62 Rer�e� ••• -VE Job Description: Plumbin. Unit _ Owner: Jensen's Inc. Contractor: Cris Kerfus/Efficient Plumbing P. O. Box 608 P.O. Box 68 Southington Montville Ct. 06353- CT 06409 Telephone: (860)464-6678 Lic/Reg Type204880 Exp Date: 303 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: Mechanical Value: 1995 CABG $0.00 Mechanical Fee: Electrical Value: $0.00 Construction Type: 5B $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 I. . I a .1! •I I•ICI I II•I-II . II • : I, 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 0 Rough plumbing and leak test ❑ Certificate of Occupany ❑Gas piping and test 44, Building Official's Signature: ...Z. // 7 4 Town,of Montville Building Department Permit# 76 310 Norwich-New London Tpke. Tel. 848-3030,Ext 82 Uncasville,CT 06382 Fax. 848-7231 One&Two Family Trades Permit Application Form 13 'funding ❑Efectricaf []Mechanical .bleating Air Conditioning ❑Other Gas Pcpncg Job Location Gcsa ( \*J O%,--) Job Description/Materials TY, L co CD ,✓ A l S Owner 9 0-1, s6-r., Mailing Address �Co OS�p..�e ��- 3 City 5 v.�-h-t\ , , ,�. State CT- Zip O� 'l�� Tel / ct- / V2�� Contractor / Mailing Address P O , City 1(. 1fl State C-Y Zip 3 Tel S‘ / 90-// Co�1 Contractor's License/Registration Type&Number P. ( .)o`-{ (s'S c7 Exp. Date I O / / 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 �� Date Construction Value gee Building $ $ Plumbing $ $ Mechanical $ $ Electrical $ $ Other $ $ Certificate of Occupancy $ _ Plan Review Fee $ State Education • $ Total $ $ • STATE OF CONNECTICUT DEPARTMENT OF CONSUMER PROTECTION PLUMBING&PIPING UNLIMITED CONTRACTOR CRIS F KERFUS PO BOX 402 [ MONTVILLE,CT 06353 TYPE: P1 LICJREG NO. EFFECTIVE EXPIRES -204880 11/01/2002 10/31/2003 SIGNED �\CL4/2'I \ rV !I ~.'•—_ " ` — ^� L °� l ` JOB L' ,` ��^�~� ��w*' ��!^^, ` JEN����. �N�. ~^ 246 Redstone Street SHEET NO OF P.O. Box 608 SOUTHINGTON, CONNECTICUT 06489 CALCULATED BY DATE (860) 793'028I FAX (860) 793-6909 CHECKED BY DATE ^' * � ��� SCALE ^ � | ' . � . . | ' � i � | —_� __'__�� | � _ - i _| | _L__� � ------� ! i � | | � ' / | | � | | � �� __�--� � ___� . ' / | | --�_-L L � � ' � ' � ( ' { ' -----' -------'-----� --'---- . . ' . . ' � i Joe �^ V` e,�,, I� r..`r t JENSENS, INC. — — 246 Redstone Street - SHEET No. OF P.O. Box 608 CALCULATED BY DATE • SOUTHINGTON, CONNECTICUT 06489 (860) 793-0281 ' FAX (860) 793-6909 CHECKED BY DATE SCALE • PJM •' • 3 ..02 00 . cosi-.:OnICT o� 144149.&:E 5 744X10TPeA'IL > ---- i axe Pr- Apron axa.Pr- lusiers 33/4 5 PACE /.... 5,)4 X1.p j�' ._ .� a)e g' Jo'sr axe • • . .,70(*)". 42 CaNc.,re.4c, P\q:v-) Ce.fog a-• ex+e s, e�f . . 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'. :.. :• ' • • — .. . . . t, ..., . ••Iir -...?- • Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville, CT 06382 (860)848-3030, Ext. 382 Building Permit Permit Number: B2003-0253 Date: 18-Jun-03 Map/Lot: 016/T29-000 Owner ID Job Location: 62 t 1 22527 RATNRM�i Job Description: Manufactured Home, Deck&Carport Unl Owner: Jensen's Inc. Contractor: Jensen's Inc. P. 0. Box 608 P. O. Box 608 Southington Southington Ct. CT 06409 Telephone: (860)793-0281 06409 Lic/Reg Type/No. NHC 149 Exp Date: 30-Sep-03 Tenant: Self Telephone: —--- Construction Values Permit Fees Construction Information Building Value: $13,505.00 Building Fee: $82.00 Use Group: R4 Plumbing Value: $420.00g Plumbin Fee: $10.00 Code: 1995 CABG Mechanical Value: $5,107.00 Mechanical Fee: Electrical Value: $34.00 Construction Type: 5B $210.00 Electrical Fee: Other Value: $10.00 Permit Code: R6 $0.00 Other Fee: $0.00 Comments: Total Value: $19,242.00 CO Fee: $10�0 Plan Review Fee: $8.20 State Ed Fee: $3.08 Total Fees: $157.28 n 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 11 Rough Framing ❑ Firestopping/draftstopping ❑ Rough Electrical ❑ Insulation ❑ Electrical Service ❑ Final Inspection ❑ Rough plumbing and leak test Certificate of Occupany Ej Gas piping and test Building Official's Signature: i Town of l'Thntville Buildingp tmenj Receipt New De ar Date _____1_/_a___21/_.(2_________ j No. 02756 From: Job Address: A /A I i r 4 .464a... _ lik a Amount g -- Cash it0 1010 Check #_il1'L7s7 Circ c one) Received by _ere...,".0. /.; ' .;r1.L.:...,.;[,! Permit Town of Montville . (4400 Building Department Tel. 848-3030, Ext 82 310 Norwich New London Tpke. Permit# sepp r c3 Uncasville, CT 06382 Fax. 848-7231 One & Two Family Building Permit Application Form 0 New Construction []Addztion n 0 AlterationAccessory Structure I ['Other ge-' I&4L4i4VV V t g Job Location w ` Job Description/Materials , /�r/ 7�a� vecc}tiled otiote_ i Owner .....)Q,,,�A./•-5 Mailing Address ��'►,;.. P'y 'O ..city S State Zip 06'18-f Contractor Tel �S�G / j/ 0aal Mailing Address PG, g City ,^, re d ea - City Cr Zip CW‘&9 Contractor's License/Registration Type Tel c�tali /�/��� YP &Number/Y4c_n L ,1� .. AE's iy `r",� I� Exp. Date_/3G / O'3 I hereby certify that the proposed work will conform to the Basic Building State of Connecticut and the Town of Montville and further attest that the proposed and that of I m aauthorized toe application fore a further forrsuch work Coded and all otheruthcodes as adopted by ftee p posbd work is authorized by the owner in fee as described above. Owner/Agent Signature Or P Date S/ /7-/ 0-3 Cons. ction Value Building Fee Plumbing $ Mechanical $ $ $ $ $ $ Electrical Other Certificate of Occupancy $ $ Plan Review Fee $ State Education $ Total $ $ $ $ Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville, CT 06382 (860)848-3030, Ext. 382 Electrical Permit Permit Number: E2003-0211 Date: 11-Jul-03 Map/Lot: 016/T29-000 Owner ID Job Location: 62 t 122527 Job Description: INSTALL 200 AMP SERVICE Unit Owner: Jensen's Inc. Contractor: JOHN MORTON P.0. Box 608 85 GREEN HILL RD CT Southington MADISON CT 06409 Telephone: (203)245-3644 06443 Lic/Reg Type101835 Exp Date: 3 3 Tenant: N/A Telephone: ---- Construction Values Permit Fees Construction Information Building Value: $0.00g Buildin Fee: Plumbing Value: $0.00 Use Group: R-4 $0.00 Plumbing Fee: Mechanical Value: $0.00 Code: 1995 CABO $0.00 Mechanical Fee: Electrical Value: $0.00 Construction Type: 56 $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 Plan Review Fee: $0.00 State Ed Fee: $0.00_ Total Fees: _ $0.00 ii- . . , '11 '1 .-y'.• u'•-u . n ' : 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 0 Electrical Service ❑ Final Inspection ❑ Rough plumbing and leak test ❑ Certificate of Occupany ❑ Gas piping and test Building Official's Signature:i ' Town of Montville r Building Tel. 848-3030 310 Norwi h New �ent Pen Ext 82 London Tpke. lit# G'2aoo z// Uncasville, CT 06382 One & Two Family Trades Pe rmit AFax. 848-7231 Application Form ❑Plumbing Vig l ClAfecrtanical 5leatcng CC-S O Air Conrfitiorcing 7 ,2 6--c�c) Mier — Gas Piping Job Location G Job Description/Materials rR o c eo Owner - , S_ �, C Mallin City .j I., g Address 6 State C r Zip DG Tel / Contractor , City • '/+? 0'/l, Mailing Address r, er. State C Contractor's License/Registration ___ Zip D 67 y--, Tel ZO� Z 11 e/Registration Type&Number E/ --- 3 / YY /O/ i,�.�' Exp. Date I hereby /�/ a3 certify that the of Co proposed work will conform to Connecticut that and the Town of Montville and the Basic BuildingCode and State of I am authorized to make application further attest that the and all aotheruthorized codes bys ado t fora proposed work is au Ped by the permit for such work as described above. �Onzed the owner in fee Owner/Agent Signature / Date /tea Construction Value �1 3uilding 'lumbing $ Fee Plumbing lechaical $ $ lectrical $ $ they $._________________ $ rtificate of Occupancy $ $ an Review Fee $ ite Education $ Ital $ STATE OF CONNECTICUT . DEPARTMENT OF C.O:V SU JL'R PROTECTION ELECTRICAL UNLIMITED CONTRACTOR JOHN W MORTON 85 GREEN HILL RD MADISON,CT 06443 • TYPE: El LICJREG NO. 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