HomeMy WebLinkAbout2007 - Central Air Conditioning
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: M2007-0093 Date: 12-Jul-07 Map/Lot: 030/051-000 Owner ID: 136000
Project Location: 19 BAYBERRY LANE Unit:
Job Description: Central A/C
Owner Name: Herbert W and April K Camp Tenant Name: N/A
Careof:
19 Bayberry Lane -
Uncasville CT 06382- Telephone:
Contractor Name: Cool Time Ref. Inc. Telephone: (860❑546 6899
DBA: Lic/Reg Type: DI
Lic/Reg No: 307191
132 Kenwood Exp Date: 31-Aug-07
Griswold CT 06351-
_Cgnsi ruStion Value Permit Fees Construction Information
Building Value: $5~,~000.00 Building Fee: $45.00 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 Electrical Fee: $0.00 Construction Type: IRC
Total Value: _ $5,000.00 Penalty Fee: $0.00 Permit Code: R5
C of 0 Fee: $0.00 Comments:
Plan Review Fee: $0.00
State Ed Fee: $0.80
Total Fee Paid: $45.80
It shall be the owners repsonsibility to schedule the following inspections a minimum of 2 business davs 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 0 R HVAC
❑ Masonry Fireplace Throat or Chimney Thimble ❑ Gas Piping and leak test
❑ Fireblocking _Draftstopping INSPECTION REQUIRED UPON COMPLETION
❑ Insulation Certificate pprova'
f e of Occupancy
4
Building Official's Approval: -
;i
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.: ~giappZ Dt743
Type of Work Occupancy Type Permit Type
❑ New Construction ❑ Single Family ❑ Building
❑ Addition ❑ Two-Family ❑ Plumbing
❑ Alteration ❑ Townhouse ❑ Mechanical
❑ Accessory Structure ❑ Electrical CRS#:
Job Address: Z,f
(Number) (Street) (Unit)
Job Description:
Owner:
Address:
City: State: Zip Code:
Telephone:
Contractor: ~004- Z- ,
DBA:
Address
City: ( ;el5 Ae--~ State: Zip Code:
Telephone: License Type: License No.:Expiration Date: 47 ;7
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.
c
Owner /Agent Signature,, Date:
Construction Value Permit Fees
Building Value: Building Fee:
Plumbing Value: Plumbing Fee:
Mechanical Value: T'006.21 Mechanical Fee:
I`
Electrical Value: Electrical Fee:
Total Value: Penalty Fee:
C of 0 Fee:
Plan Review Fee:
State Ed Fee:
Total Fee:
Pwiced. oe=6es31, Zoos
1-
Town of Montville
Building Department
File Receipt
2520
Receipt No:
Date: 10-3ul-07
Received From: Cool Time Refrigeration Inc.
Job Address: 19 Bd her Dr.
State Educational Training Fee
Fees Collected $0.00
$0.00 Cash:
Cash: Check: $0.80
Check: $45.80
0
Check No:
$0.00
$5,000.00
Short/Over:
Construction Value:
$0.00
Demolition Value:
Received By David Jensen
STATE OF CONNECTICUT -7
DEPARTMENT OF CONSUMER PROTECTION
HEATING, PIPING & COOLING LIMITED CONTRACTOR
i D1
j KEVIN E BURNS
13Z KENWOOD EST:.
GRISWOLD, CT 06351
EIC. / REG NEFFE TIVE EXPIRES
307191 09/01/2006.08/31/2007
f SIGNED
a
State of Connecticut 1
Workers' Compensation Commission
Please TYPE or PRINT IN INK
ors •
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
Building Applicant for
Permit
Name of Applicant for Building Permit ~O
Property located at
In the City ! 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 properly. I WILL NOT act as the general contractor or principal employer.
Signature of OWNER Applicant
6_1 am the SOLE PROPRIETOR of a business doing work at the above-named property. I WILL NOT act as the general c
ontractor or principal employer.
Name of Business
Federal Employer ID# (FEIN)
Signature of SOLE PROPRIETOR Applicant
Q
Town of Montville
Building Department
310 Norwich-New London Tpke. Fax. 860-848-7231
Tel. 860-848-3030, Ext 382 Uncasville, CT 06382
CONSTRUCTION PERMIT APPROVAL
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
Comments:
WPCA, Administrative 0
a r ? date
Comments:
WPCA, Operations
Comments:
❑ Planning & Zoning Comments:
❑ Health Department
tr
Comments:
❑ Department of Public Works
trl date
Comments:
❑ State Dept. of Transportation
(Structures over 100,000 sq. ft. or with more than 200 parking sp s -Official copy of STC Certificate of Operation required -per CGS 14-311)
ignaturF
Comments:
Fire Marshal
L, ' hire/ dale
Comments.
14i edAugust 5, 2005