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Home My WebLink AboutAddition - Electrical 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: E2006-0M Date: 27-Jul-06 Map/Lot: 131/042-000 Owner ID: 80000 Project Location: 20 ANDERSEN LANE Unit: Job Description: wiring for addition Owner Name: Jill R Hamel and John David Wile Tenant Name: N/A Careof: 20 Andersen Lane Oakdale CT 06370- Telephone: Contractor Name: Paul Dubois Telephone: (860)444-8847 DBA: Lic/Reg Type: El Lic/Reg No: 184071 519 Ocean Ave. Exp Date: 30-Sep-06 New London Ct 06320- Construction Value Permit Fees Construction Information Building Value: MT Mrtµ m $0.00 Building Fee: $0.00..- Use Group: IRC Plumbing Value: ____$0.00 Plumbing Fee: $0.00 Code: 2005 State Building Code Mechanical Value: _ $0.00 Mechanical Fee: $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 ofO Fee: $0.00+- Comments: Plan Review Fee: $0.00 Included on 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 framing ❑ 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 rtific of Approval ❑ ficate of Occupancy Building Official's Approval: Town of Montville Buildina'Department 310 Norwidh-New London Tpke. Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 RESIDENTIAL PERMIT APPLICATION FORM Permit No.: ° B' Type of Work Occupancy Type Permit Type ❑ New Construction X Single Family ❑ Building ® Addition ❑ Two-Family ❑ Plumbing ❑ Alteration ❑ Townhouse ❑ Mechanical ❑ Accessory Structure 91 Electrical CRS#:_ Job Address: 19 All) 6' R A-1 ~ 4AI,5- (Number) (Street) (Unit) Job Description: W1.0? 4E _A D Z2) 77e,-9 IV Owner: >y L~ aQo AIA141, --G :T4)/-/ov VAL14Z-2 W14 Address: 410 VS Tc~JA-/ City: A 22e!~ L C State: Zip Code: ~~37 Telephone: Contractor: z:)Umg~5-1/ S' DBA: e-- Address: City: A" EGi/ State: G f & Zip Code: G3 Telephone: License Type: 4~:-/ 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 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. Owner /Agent Signature: Date: ~ C~ 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 O Fee: Plan Review Fee: State Ed Fee: Total Fee: qZ v ed Decem6er31, 2005 r STATE OF CONNECTICUT h: DEPARTAMNT OF CONSUVER PROTECTION i ELECTRICAL vNLm#o CQNTRACTOR E1 PAUL j DUP01S g19 OCEAN AVE. NEW I ONDON, CT 06320 LIC. / REG NQa EFFECTIvF EXPIRES 184071.- 10101/2005 : 09/30/2006 i State of Connecticut Workers' Compensation Commission - Please TYPE or PRINT IN INK Proof of Workers' Compensation Cover-age when Applying for a Building Permit for the Sole Proprietor or Property Owner who WILL NOT act as General Contractor or Principal Employer Applicant . Building Permit S' Name of Applicant for Building Permit t~i9U~ t~ 27~ Property located at in the City /Town of zz" Z_ 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 a Town of Viontville Building Department 310 Norwich-New London Tpke. Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 CONSTRUCTION PERMIT APPROVAL Property Address tiz 41 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 Signature/ date Comments: WPCA, Administrative 2-0 ~11 Sianatur 1, Comments: ❑ WPCA, Operations Signature/ date Comments: ❑ Planning & Zoning Signature/ date Comments: ❑ Health Department Signature/ date Comments: ❑ Department of Public Works Signature/ date Comments: ❑ State Dept. of Transportation Signature/ date Comments: Fire Marshal o 0"6 Signature/ date Comments: I` &visedAugusc 5, 2005