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TOWN OF MOrNTVILLE
Building Department
310 NORWICH-NEW LONDON TURNPIKE
UNCASVILLE, CT 06382-2599
TEL. (860) 848-3030 X382 FAX. (860) 848-7231
ELECTRICAL PERMIT
Permit Number: E2005-0217 Date: 21-Sep-05 Map/Lot: 035/008-000 Owner ID: 53000
Project Location: 6 ALLISON'S WAY Unit:
Job Description: Electrical & Electric Serviice for New SFR
Owner Name: Joseph M & Tracy S Solesky Tenant Name: N/A
Careof.
184 West Main Street
Niantic CT 06357- Telephone:
Contractor Name: B. P. Electric Telephone: (860)642-9960
DBA: Lic/Reg Type: El
Lic/Reg No: 190315
497 Trumbull Highway Exp Date: 30-Sep-05
Lebanon Ct 06249-
Construction Value Permit Fees Construction Information
Building Value: $0.00 Building Fee: $0.00 Use Group: R-4
Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1999 State Building Code
Mechanical Value: $0.00 Mechanical Fee: $0.00 w/2004 Amendment
Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type: 5B
Total Value: $0.00 Penalty Fee: $0.00 Permit Code: R5
C of 0 Fee: $0.00 Comments:
Plan Review Fee: $0.00 Included onBuilding Permit
State Ed Fee: $0.00
Total Fee: $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 W/ 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 d❑ Electrical Service CRS No: 0
❑ Framing ❑ R HVAC
❑ Masonry Fireplace Throat or Chimney Thimble ❑ Gas Piping and leak test
❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION
❑ Insulation ❑ Ce ficate of Approval
ertificate of Occupancy
Building Official's Approval:
R
Town of Montvil,
Building hepartmel
310 Norwich-New Londoi
Tel. 848-3030, Ext 382 Uncasville, CT 06382 &00 231
Residential Trades Permit Ap
Permit 0,52,17 F-]2'lumbing F-]Electrical E]Yechar,
i
CU#
Single Family F-I Two-Eamily F-I Townhouse
Job Address c.•. L^J
(Number) (Street) (Unit) r
Job Description fem. 9-le r vl ee %"A,;
Owner ae ~ t-05~~ Mailing Address_ ~2 ~ t' e S ~•rs els.
City; " - 4 114 q Stated Zip 63 ~ ✓ J Tel
Contractor X /It:-1e C- 7~", - Mailing Address ~'y 7 f ro ym~-Wd h~j-y
city h~ Stater Zip 0 ~ Tel 13 CI
Contractor's License Type & Number Exp. Date_~/ - 0
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.
.r ~
Owner /Agent Signature s GAG Date 0
Construction Value Fee
Plumbing $ $
Mechanical $ $
Electrical $ $
Work commencing before the issuance of a permit $
Plan Review $
State Education $
Total $ $
Rgv4ed%ovem1vr1, 2004
State of Connecticut
Workers' Compensation Commission -
Please TYPE or PRINT IN INK
ours^f
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 .Permit
of Applicant for Building Permit '
Property located at &"L/
in the City1 Town of
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
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ; . . . . . . . .
1 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 I- fra e- 6-. Federal Employer ID# (FEIN)
P~ oo, d
Signature of SOLE PROPRIETOR Applicant
t
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
Ae c'
Property Address
Job 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 0
Signature, date
Comments:
❑ WPCA, Administrative
Signature/' date.
Comments:
❑ WPCA, Technical
gig paLture!' date
Comments:
❑ Planning & Zoning
Sigizature date:
Comments:
❑ Health Department
Signature/ date
Comments:
❑ Department of Public Works
Signature/ date
Comments:
❑ State Dept. of Transportation
Sigllai: lre/ date;.
Comments:
❑ Fire Marshal
Signature; data.
Comments:
~Ri ed,?ugust 5, 2005