HomeMy WebLinkAboutSFR - Plumbing
Town of Montville
BUILDING DEPARTMENT
310 Norwich-New London Turnpike
Uncasville, CT 06382
(860) 848-3030, Ext. 382
Plumbing Permit
Permit Number: P2003-0021 Date: 27-Mar-03 Map/Lot: 037/002-051 Owner ID 2513
Job Location: 31 ANDERS iy 19,NE Unit
Job Description: Plumbing
Owner: Contractor:
Salvatore Mazzarella Winslow Plumbing LLC
8 Norton Avenue
238 Browning Road Guilford Ct. 06437-
Norwich CT 06360 Telephone: (203) 758-6797
Lic/Reg Type/No.P1 204663 Exp Date: 31-Oct-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: $0.00 Mechanical Fee: $0.00 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: $0.00 CO Fee: $0.00 Included on Building Permit
Plan Review Fee: $0.00
State Ed Fee: $0.00
Total Fees: $0.00
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
W Rough plumbing and leak test ❑ Certificate of Occupany
❑ Gas piping and test
Building Official's Signature:
y,
Town of Montville
r, Building Department Permit # fS 021
310 Norwich-New London Tpke.
Tel. 848-3030, Ext 82 Uncasville, CT 06382 Fax. 848-7231
One & Two Family Trades Permit Application Form
Pfumding [JEfectrical FjMechanicaf
Heating
Air Conditioning
GaS OPing
Other
Job Location
Job Description/Materials d--
Owner Mailing Address
City State Zip Tel
Contractor Mailing Address
City ( UAL State5~-J Zip dC~~ Telll
Contractor's License/Registration Type & Number Exp. Date A,
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 Fee
Building $
Plumbing $ $
Mechanical $ $
Electrical $ $
Other $ $
Certificate of Occupancy $
Plan Review Fee $
State Education , $
Total $
a
7
a / /
DEPARTMENT OF CONSUMER PROTE CTION
PLUMBING R PIPING UNLIMITED CONTRACTOR
RONALD R V,'Ii',TSLOW JR
8 NORTON AVE
GUILFORD, CT 06437
TYPE: P1
LIC.JREG NO. EFFECTIVE EXPIRES
204663. 1.1/0-1/2002 4/2003
i
`SIGNED
STATE OF CONNECI?CUT
WORKERS' 00beE ISAMON 0014 &SSION
BuiePerinit Affidavit for property Owners
or Sole Probrretors
(Co Gen. St at § 31-286b}
Property -located -at ezl
In dw tows; of
Name of building permit applicant: Cis
Please check one:
1- I am the wucr of the, above property.
2. am the sole. proprietor of a business. -
-2A. Name of business
2B. Federal EmpIoy=IdentificationNumbe r. G
Pursuant to 31--2866, "a pro" owner or sole
proprietor principal om I .who •
general
'Con ra tractor
ra " P oy may provide either a ccrtWwate omfwworke& com a
sworn notarizod affidavit.., stating that he wdt Pkoa
Compensation insurance for all those employed on the job site inac ordproof ofworkcre
na
ance with this chapter
Please check Mo 1. not i
ntend to act as a general contractor or principal employer.
[Sign and sto j
Signa of applicant
2. I int d to act as a general contractor or principal
provide. a catifrcate of workers com employer. Applicant must either
pensation insumee-or sign the affidavit
N.............•.............................._
A~1Tfdayit
I l4oreby Swear artd.attest that I *ig.require proof of workers' compensation
contractor, subcontractor, or other worker before hefshe engages in ork o insurance for. eYay
~acoordance with the Worke& work on the above property is
Compensation Act (Chapter 568). .
I understand that pursuantto § 3I>275 C.G.S., officers of a
. partrterslrip may eloc;t to-be cxekrdod from covers Qaporatt°n and partners in a
go Dsliiet O~ by g a waiver with the appropriate
ce► an ~ la petor of a business u notuiral.to have cover unless he
files his.intcnt vi accept m$G
Sigaatum ofapplic~nt
Subscribed and sworn to befom ma this
dv of
.200
fttuy Pub&J CommWoner-of tho Superior C )