HomeMy WebLinkAboutBoiler Replacement 2009 Field Inspection Notice
Town of Montville
Building Department
Address: 119 Park Avenue Ext.
Job Description: Replace Boiler
Permit Number(s) B2009-0134 Permit Date: September 21,2009
Not Approved Approval
INSPECTION Date: Deficiencies ,pecial Date
.onditions
Flue connection • 10/09/09 DJ
Fuel line
10/09/09 DJ
Backflow prevention 10/09/09 DJ
Low water cutoff ••
device 10/09/09 DJ
Final inspection and • •
certificate of approval 10/09/09 DJ
Rev.Date: 1/18/06
Page 1 of I
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: M2009-0134 Date: 21-Sep-09 Map/Lot: 096/019-000 Owner ID: 5326000
Project Location: 119 PARK AVENUE EXTENSION Unit:
Job Description: Replace Boiler
Owner Name: Barbara A Thompson Tenant Name: N/A
Careof:
119 Park Ave Ext
Uncasville CT 06382- Telephone: (860)848-3370
Contractor Name: Home Owner Telephone:
DBA: Lic/Reg Type:
Lic/Reg No: 0
Exp Date:
Construction Value Permit Fees Construction Information
Building Value: $0.00 Building Fee: $0.00 Use Group: IRC
Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 2005 State Building Code
Mechanical Value: $3,900.00 Mechanical Fee: $32.00
Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type: IRC
Total Value: $3,900.00 Penalty Fee: $0.00 Permit Code: R5
C of 0 Fee: $0.00 Comments:
Plan Review Fee: $0.00
State Ed Fee: $0.86
Total Fee Paid: $32.86
It shall be the owners repsonsibility to schedule the following inspections a minimum of 2 business dans 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 -dficat- of Approv-
'ertifi - - '-f! cupancy
Buildin. Official's Ap.roval: - ---
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.: D(`3F-(r--D\cj`1
Type of Work Occupancy Type Permit Type
❑New Construction ❑Single Family ❑Building
❑Addition ❑Two-Family ❑ Plumbing
0 Alteration ❑Townhouse ❑Mechanical
❑Accessory Structure 0 Electrical CRS#: �n
Property Address: l I l � c i f-_ — UAt .4-(S tt) D4
(Number) r (Street) (Unit)
Job Description: ��A lDn r
Owner: tte .�Address: j I 1 & t
City: IA l State: (0 Zip Code: /X 34 1 Telephone( ) ) - .S3 7 7)
Applicant: ' -° ra .J27
DBA:
Address:
City: State: Zip Code: Telephone( )
Contractors-Complete the Following:
License Type: 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,l 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: "J7: 4„.___ Date: ') —I/ c 2
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 0 Fee:
Plan Review Fee:
State Ed Fee:
Total Fee:
5j'ised August 23,2007
Town of Montville
Building Department
File Receipt
Date: 11-Sep-09 Receipt No: 4872
Received From: Barbara Thompson
Job Address: 119 Park Avenue Ext.
Fees Collected State Educational Training Fee
Cash: $32.86 Cash: $0.86
Check: $0.00 Check: $0.00
Check No: 0
Short/Over: $0.00
Construction Value: $3,900.00
Demolition Value: $0.00
Received By Carmen Roberts Clannt14/1 , 2i1aQ'1SzD
Address: 119 Park Avenue Ext.
ITEM CITY 5/UNIT TOTAL
Building Plumbing Mechanical Electrical
BUILDING AREA
New Construction 0 SF $ 113.03 $ - $ -
Basement,Finished SF $ 22.96 $ - $ -
Basement,Unfinished 0 SF $ 12.40 $ - $ -
Crawl Sapce SF $ 9.30 $ -
Interior Renovations SF $ 35.09 $ - $ - $ -
MANUFACTURED HOMES
Ground Anchors SF $ 6.45 $ - $ - $ -
Basement SF $ 12.41 $ - $ - $ -
Crawl Space SF $ 9.31 $ - $
AMENITIES
Kitchen 0 EA $ - $ - $ -
Full Bathroom 0 EA -
Half-Bathroom 0 EA
GARAGE
Attached SF $ 54.35 $ - $ -
Detached - SF $ 69.53 $ - $ -
Under SF $ 10.03 $ - $ -
Carport SF $ 19.89 $
MECHANICAL
Warm-Air Y/N $ -
Hot Water n- Y/N $ -
Electric n- Y/N $ -
Air Conditioning n Y/N $ -
ELECTRICAL SERVICE
Upgrade Amps $ -
Overhead,new -Amps $ -
Underground,new 0 Amps $ -
Subpanel EA $ 599.50 $ -
Gen Set - EA $ 3,850.00 $ -
SOLID FUEL BURNING APPLIANCES
Prefab Metal Fireplace EA $ 6,497.70 $
Masonrywllfireplace EA $ 7,096.65 $ -
Masonry w12fireplaces EA $ 11,095.70 $ -
Wood Stove,free standing EA $ 2,692.25 $
Wood stove insert EA $ 1,859.77 $ -
DECKS,PORCHES,SUNROOMS
Deck 0 SF $ 43.07 $
Porch - SF $ 149.38 $ -
Sunroom - SF $ 176.90 $
POOLS&HOT TUBS
Hot Tub EA $ 8,016.25 $ - $ -
Irground Pool EA $ 21,373.44 $ - $
Above Ground Round - EA $ 5,099.46 $ - $ -
Above Ground Oval EA $ 6,019.75 $ - $ -
Pool Heater - EA $ 8,984.25 $ -
Inflatable Type Pool - EA $ 1,550.00 $
SHEDS
w/o electrical SF $ 20.35 $ -
w/electrical - SF $ 20.35 $
RENOVATIONS
Roofing,Overlay SF $ 300 $ -
Roofing,Strip&reroof SF $ 4.00 $ -
Roof Sheathing SF $ 1.31 $ -
Siding - SF $ 5.50 $ -
Windows - EA $ 500.00 $ -
Skylights - EA $ 1,051.10 $ -
Doors,Exterior EA $ 601.50 $ -
Oil Tank,275 Gallon - EA $ -
Oil Tank,550 Gallon EA $ -
MISCELLANEOUS CALCULATIONS $ 3,900.00
TOTALS 5 - $ • $ 3,900.00 $ -
PERMIT FEE CALCULATIONS
Construction Value Fee
Building
Plumbing
Mechanical y $ 3,900.00 $ 32.00
Electrical
Working before Permit Issuance $ -
Certificate of Occupancy Fee $ -
Plan Review Fee $ -
State Education Fee $ 0.86
TOTALS $ 3,900.00 $ 32.86
Figures are based on the 2006 RS Means Residential Cost Data
�A: State of Connecticut ii
vv
7A
ti,+ , Workers' Compensation Commission
ce
.3rz"� le � Please TYPE or PRINT IN INK
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
APPLICANT FOR BUILDING PERMIT I f
Name of Applicant for Building Permit -r YJ�z -- b r7�,$bks
Property located at 11 q er 1, 1- Eijc'1 U
in the City/Town of U In C-G_s vu..UW} Cr 6,6 3 r Z
ATTEST
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 042.4-(,:•-6,.....—r...., I
❑ I 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
Town of Montville
Building Department
310 Norwich-New London Tpke.
Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231
CONSTRUCTION PERMIT APPROVAL
Applicant is responsible for obtaining all of the required approvals. No permit will be issued until all the required signatures are obtained.
c1 Pck( 1�
Property Address
epkacR1e(
Job Description
® - Required for all permits ® - At least one required for all permits ❑ - Required as indicated below
Required Department Permit Issuance Approval
Approval
J ® Tax Collector (////0 9
Signature/date
Comments:
/11 Planning & Zoning iL�� � 7////C 9
Signature/date
Comments: GQ-2/4
J ® Fire Marshal
Signature/date
Comments:
® Health Department
Required for properties with septic systems—Not required for Plumbing, Electrical,Mechanical,Roofing,Siding,Windows&Doors
Signature/date
Comments:
J a WPCA, Administrative
Required for properties on sewer i
ignature/date
Comments:
WPCA, Operations
When Required by WPCA Signature!date
Comments:
Department of Public Works
Required when project includes driveway work or certain drainage requirements Signature/date
Comments:
❑ State Dept. of Transportation
Required for Structures over 100,000 sq. ft. or with more than 200 parking spaces-Official copy of STC Certificate of Operation required—per
CGS 14-311
Signature/date
Building Department Review Complete
Signature!date
,Fvisediv"avem6cr5,2008