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Home My WebLink About2001 - Hot Tub - Electrical ToWn f Montville ! Building Department Date Field Inspection Notice Permit # Job Location Approved Type of Inspection a-le V ❑ Not Approved - Please call for re-inspection when the following corrections have been completed: 1 _ t. Building Official Town of Montville .f ulding Department field Inspection Notice Permit # 4LWf°0 Date Job Location Approved Type of Inspection Not A roved - Please call for re-inspection when the following corrections have been completed: ❑ pp k i m Official ~ Budd. g Town of Montville Building Department Phone: 848-7166 310 Norwich New London Tpke Fax: 848-7231 Building I Trades Permit Permit Number EL2001-250 Permit Date 11/13/01 Permit Type Electrical Permit Code R5 Job Street # 16 Job Location BEECHWOOD ROAD Map/Lot 076/057-000 Job Description Electrical & Electrical Service Owner Contractor Georgina Chongo Niantic Electric Address 16 Beechwood Road Address 35 Forest Road City Oakdale State Ct. City Niantic State Ct. Telephone 848-2493 Zip 06357 Telephone 739-3797 Zip 06370 Lic/Reg Number 125286 Lic/Reg Type E1 Exp Date: 9/30/01 Use Group R4 Code 1995 CABO Type Construction 5B Building Value $0.00 Building Fee $0.00 Plumbing Value $0.00 Plumbing Fee _ $0.00 Mechanical Value $0.00 Mechanical Fee $0.00 Electrical Value $1,800.00 Electrical Fee $10.00 Other Value $0.00 Other Fee $0.00 Total Values $1,800.00 C/O Fee $0.00 Comments: Plan Review Fee $0.00 State Ed Fee $0.29 Total Fees $10.29 Building Official's Signature Date l2l<_ It is the owners res on ' i o schedule the followin re uired inspections minimum 24 hours notice required): ❑ Footings - prior to pouri concrete ❑ Backfill - footing drains and waterproofing ❑ Fireplace Throat ❑Concrete Slab, prior to pouring ❑ Fireplace Final ❑ Rough Framing ❑ Chimney - one flue above thimble 66 Rough Electrical ❑ Firestopping/draftstopping ®Electrical Service ❑ Insulation ❑Rough Plumbing and leak test ❑ Pool bonding ❑ Gas piping - pressure test and installation ❑ Final Inspection ❑ Rough HVAC ❑ Certificate of Occupancy - PRIOR to use or occupanc a Town of Montville permit #"L Building Department 310 Norwich-New London Tpke. Tel. 848-7166 Uncasville, CT 06382 Fax. 848-7231 Application for Building or Trades Permit Building Permit Trades Permit New ❑ onstmction [:].Ac=ory tion &uaure Ad&tion era ❑ tron pother E~ ❑ xeat* Au --Air Conditioning -Gas TjOiV Job Location Job Description/Materials f f "f f Owner Mailing Address / e o ID tis City iA FI lz State CT- -Zip c~ ~r 7C, Tel Contractor,///z/ / C i~ Mailing Address S . ~ ✓2 i2F s State ~ pC)~<LL4 Tel 7 7 7 Contractor's License/Registration Type & Number_ /La~ Exp. Date j New Home Construction Contractors; Have you entered into a contract with a consumer for the proposed new home? ❑ Yes [~to 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, ~jr~ Construction Value Fee Building $ $ Plumbing $ $ Mechanical $ $ Electrical $ Other $ C~ Certificate of Occupancy $ Plan Review Fee $ State Education $ Total $ Town OUMontville Building Departwr nt Receipt Date No. 0 12791 g .From: Job Address: ash-.) Check Check # Amount r (c;rdc ono ' j L a k~~;'.¢: Permit Rccci ed by STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors (Conn. Gen. Stat. § 31-2866) Property located at/ 6 In the town of 4 L Name of building permit applicant:1,V Please check one: 1. _ I am the owner of the above property. , ir- 2. I am the sole proprietor of a business. ..2A. Name of business 2B. Federal Employer Identification Number (FEIN) Pursuant to § 31-286b, "a property owner or sole proprietor [who] intends to act as a general contractor or principal employer" may provide either a certificate of workers' compensation insurance or a "sworn notarized 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 check one: 1 k,f~- I do not intend to act as a general contractor or principal employer. [Sign and stop here] L---Signature of ap licant 2. _ I intend to act as a general contractor or principal employer. Applicant must either provide a certificate of workers' compensation insurance or sign the affidavit below. Affidavit I hereby swear and attest that I will require proof of workers' compensation insurance for every contractor, subcontractor, or other worker before he/she engages in 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)