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Home My WebLink AboutGas Line 2006 Field Inspection Notice Town of Montville Building Department October 10, 2006 Address: 260 Raymond Hill Rd., Lot 7 Job Description: Gas line Permit Number(s): M2006-0145 Permit Date: 9/27/06 INSPECTION Not Approved Approval Date: Deficiencies Special Date Conditions Certificate of • Approval • 10/10/06 JS • Rev.Date: 1/18/06 Page 1 of 1 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: M2006-0145 Date: 27-Sep-06 Map/Lot: 087/002-T07 Owner ID: 5815000 Project Location: 260 RAYMOND HILL ROAD Unit: 7 Job Description: Gas line for stove only Owner Name: Ronald E. Dombrowski Tenant Name: N/A Careof: 260 Raymond Hill Rd.,Lot 7 Uncasville Ct 06382- Telephone: Contractor Name: Property Owner __.. Telephone: (860)367-9259 DBA: Uc/Reg Type: Lic/Reg No: 0 Exp Date: Con- ru cUon 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: 2005 State Building Code Mechanical Value: $60.00 Mechanical Fee: $8.00 Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type: IRC Total Value: $60.00 Penalty Fee: $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $0.01 Total Fee Paid: $8.01 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 framing ❑ E• lectrical Service CRS No: 0 ___ Framing ❑ R• HVAC .,�_________ ., _.....__ ❑ Masonry Fireplace Throat or Chimney Thimble E Gas Piping and leak test ❑ Fireblocking_Draftstopping IN PE I• RE•UIRED UPON COMPLETION ❑ Insulation 13- - to o •pproval /■ - - e of Occupancy Building Official's Approval A 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.: _0_2V5- Type of Work Occt ancy Type Permit Type g-New Construction [Single Family 0 Building ❑Addition 0 Two-Family L-__] ❑Alteration 0 Townhouse Robing echanical 0 Accessory Structure 0 Electrical CRS#: Job Address: g 6 0 1241y(41 e k (Number) (Street) (Unit) Job Description: c'Tou c: t Al tz OA.L/ Owner: f2(1ri1,- L ntl b Art, sk Address: a-(00 l/i C/AAV Z/ ti-L t ! % 7 City: U 4/04/YU/L(_(,- / State: C....7-` Zip Code: o 6 2P.)- Telephone: 3 c — f4--F Contractor: -4-*c (� DBA: Address: City: State: Zip Code: Telephone: 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. 0 By checking this box, I will follow the requirements of the 2005 NEC as the alternative compliance per section E3301.2.1 of the Residential Code, instead of the electrical requirements in chapters 33 through 42 of the Residential Code. (-7L Owner/Agent Signature: / Date: %/2-4 473 Construction Valu Permit Fees Building Value: d, 0 Building Fee: Plumbing Value: Plumbing Fee: Mechanical Value: Mechanical Fee: Q, Ov Electrical Value: Electrical Fee: Total Value: Penalty Fee: C of 0 Fee: Plan Review Fee: State Ed Fee: Total Fee: B DI &tnra'Decem6er31,2005 Town of Montville Building Department File Receipt Date: 26-Sep-06 Receipt No: 1713 Received From: Ronald E. Dombrowski Job Address: 260 Raymond Hill Rd. Fees Collected State Educational Training Fee Cash: $8.01 Cash: $0.01 Check: $0.00 Check: $0.00 Check No: 0 Short/Over: $0.00 Construction Value: $60.00 Demolition Value: $0.00 Received By David M M Jens ,e3 1, _....e„.„2„...___, C State of Connecticut-• cticut Workers' Compensation Commission Please TYPE or PRINT IN INK Proof of Workers' Compensation Coverage when Applying ngfor a Building Permit for the Sole or PropertyOwner who WILL NOT act as General Contractor or Principal Employer Applicant for Building Permit Name of Applicant for Building Permit £ Property located at • • G`` L OA' In the City/Town of 1i' L f " • L 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: the OWNER of the above-named property.I WILL NOT act as the general contractor or principal employer Signature of OWNER Ap.licant (2/4"--0-1/ Air ❑ I am the SOLE PROPRIETOR of a business doing work at the above-named property.I WILL NOT act as theeneral contractor ntractor or principal employer. Name of Business Federal Employer ID#(FEIN) Signature of SOLE PROPRIETOR Applicant ir, Town of Montville Building Department 310 Norwich-New London Tpke. Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 CONSTRUCTION PERMIT APPROVAL 060 2J'404/L2 i41 Li ied 7 Property Address T41- ,_,,.0 L- T 2 S-rO u OAJ Ly Job De cription 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 Approval Department Permit Issuance Approval III Tax Collector ...........E5,9„66.,y ��,L_ 9/.1.GI o Co Comments: O WPCA, Administrative Comments: O WPCA, Operations '.; 1.1.1r-i, t Comments: ❑ Planning &Zoning Comments: ❑ Health Department Comments: ❑ Department of Public Works Comments: O State Dept. of Transportation (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,/ yrs_ Comments: ma I Fire Marshal CI 19 ,(&) Comments: 1 / \i Rpvisr1August 5,2005