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Home My WebLink AboutElectric/Electric Service for SFR 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: E2005-0047 Date: 28-Mar-05 Map/Lot: 035/009-023 Owner ID: 55000 Project Location: 8 ALLISON'S WAY Unit: Job Description: Electrical & electric Service Owner Name: RTT Development Tenant Name: N/A Careof: 35 Blais Road Uncasville CT 06382- Telephone: Contractor Name: Millovitsch electric Telephone: (860)376-2153 DBA: Lic/Reg Type: El Lic/Reg No: 104995 43 Lisbon Heights Exp Date: 30-Sep-05 Lisbon Ct 06351- 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 w/2000 Amendment Mechanical Value: $0.00 Mechanical Fee: $0.00 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 on Building 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 ❑d R Electrical ❑ Backfill - Footing drains and waterproofing FV~ Elec Trench - with conduit installed ❑ Concrete Slab - Prior to pouring concrete ❑ Pool Bonding ❑ Anchor Bolts - with sill plate and prior to floor framing F%--*] Electrical Service CRS No: 508287 ❑ Framing ❑ R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble ❑ Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation ❑ Certificate of Approval ❑ Certificate of Occupancy Building Official's Approval: Town ,,,)f Montville Building bepartment 310 Norwich-New London Tpke. Tel. 848-3030, Ext 382 Uncasville, CT 06382 Fax. 848-7231 Residential Trades Permit Application Form Permit # C3 RIPIUmding ['Electrical DWechanical clu # SOS °2.,R ~I 9feating _-Air conditioning Gas 'Piping U Single T'amily El Two-Tamily F] Townhouse Job Address (Number) (street) (Unit) Job Description C;d Owner ' plc ~ Mailing Address C City-- State ~ `C - - Zip C f~3 9 2 --le-1-3-6n I`R.' Contractor Oaw. Mailing Address Q( City LC3 iJ v~ Statei Zip Tel Contractor's License Type & Number Exp. Date/ SO / 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 C nstruction Value Fee Plumbing $ $ Mechanical $ $ Electrical $ $ Plan Review Fee $ State Education $ Total $ $ (Complete reverse side) STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Pro rietors (Conn. Gen. Stat. § 31-286b) Property located at: In the town of Name of building permit applicant: Please check one: 1. I am the owner of the above property. 2. / I am the sole proprietor of a business. 2A. Name of business: 2B. Federal Employer Identification Number (FEN nS 'i ~1 Pursuant t o§ 31-286b, "a p roperty o wrier o r s ole p roprietor [ who] i ntends t o a ct a s a g eneral c ontractor o r principal employer" may provide either a certificate of workers' compensation insurance or, a "sworn affidavit... stating that he will require proof of workers' compensation insurance for all those employed on the job site in accordance with this chapter." Please chec ne: 1. T do not intend to act as general contractor or principal employer. [Sign and stop here] Signature of applic t 2. I intend to act as a e al contracto or principal employer. Applicant must either provide a certificate of workers' comp sation insurance or sign the affidavit below. Affidavit I hereby swear and a ttest t hat I w ill r equire p roof o f w orkers' c ompensation i nsurance for e very c ontractor, subcontractor, o r o ther w orker b efore h e/she a ngages i n work on the above property in accordance with. the Workers' Compensation Act (Chapter 568). I understand that pursuant to § 31-275 C.G.S., officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office; and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. Signature of applicant Subscribed and sworn to before me this day of , 200. (Notary Public/Commissioner of the Superior Court) t I I , I 1 1 1, ECTRICAi LrNLII~iiTED CONTRACTOR El JOSEPH N MILLOVITSCH JR I' 43 LISBON HEIGHTS LISBON, C'r 06351 U SIGNED F~ ' Town c Montville Building Department 310 Norwich-New London Tpke. Uncasville, CT 06382 Tel. 860-848-3030, Ext. 382 Fax. 860-848-7231 CONSTRUCTION PERMIT APPROVAL Property Address S C.S\ v~ c 1 Job Description 4-S 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 sigrKwal-c/ date ❑ WPCA Si(t Tt'tl LWC/ elate ❑ Planning & Zoning Signature/ date ❑ Health Department 6 igr.i.atui-e/ Clete; ❑ Department of Public Works ❑ State Dept. of Transportation Si.gnawre/ date ❑ Fire Marshal ;ignaiwre/ date Comments/Conditions: 2evisedSeptember9, 2004