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Home My WebLink About8x12 Shed 2002 Town of Montville BUILDING DEPARTMENT 310 Norwich-New London°ilurnpike Uncasville,FT 06382 860-848-3030, Ex.t 82 Building Permit Permit Number: B2002-185 Permit Date: 03-May-02 Permit Code R9 Job Location: 11 PARTRIDGE HOLLOW UNIT: MAP/LOT: 028/005-017 Job Description: shed Owner Contractor JOHN C+ DEBORAH L ULLRICH John Ullrich 11 Partridge Hollow 11 PARTRIDGE HOLLOW Unit: Oakdale,Ct. 06370 OAKDALE CT 06370 Telephone: 848-0810 Lic/Reg Type: Use Group R4 Lic/Reg Number: 0 Code 1995 CABO Exp Date: Construction Type 5B Construction Values Permit Fees Building Value: $2,400.00 Building Fee: $16.00 Plumbing Value: $0.00 Plumbing Fee: $0.00 Mechanical Value: $0.00 Mechanical Fee: $0.00 Electrical Value: $0.00 Electrical Fee: $0.00 Other Value: $0.00 Other Fee: $0.00 Total Value: $2,400.00 C/O Fee: $10.00 Comments: Plan Review Fee: $1.60 State Ed Fee: $0.38 Total Fees: $27.98 jt is the owners responsibility to schedule the following required inspections(minimum 48 hours notice requested): ❑ Footing-Prior to pouring concrete ❑ Rough HVAC ❑ Backfill-Footing drains and waterproofing ❑ Fireplace Throat ❑ Concrete Slab-Prior to pouring ❑ Fireplace Final ❑ Rough Framing ❑ Chimney-One flue above thimble ❑ Rough Electrical ❑ Firestopping/draftstopping ❑ Electrical Service ❑ Insulation ❑ Rough Plumbing and Leak Test ❑ Final Inspection ❑ Gas Piping and Pressure Test ❑d 'ic- - of Occupancy-Prior to use or occupancy Building Official's Signature: Town of Montville Building Department Permit# 310 Norwich-New London Tpke. Tel. 848-3030, Ext 82 Uncasville, CT 06382 Fax. 848-7231 One & Two Family Building Permit Application Form New Construction 0 Addition fl Alteration KAccessoly Structure DOther Job Location (;{�t 116\c L ,J Job Description/Materials cjA-?_ \e Owner �,n C . �l`�,� LA.-% Mailing Address 1 ?CAS-V(' %dole City State CA . Zip £'667o Tel 15E0 /53.9( / Cg/O Contractor ✓t- Mailing Address City State Zip Tel Contractor's License/Registration Type&Number Exp. Date 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 AinC- 0111,10 Date y Construction Value Fee Building $ $ Plumbing $ $ Mechanical $ $ Electrical $ $ Other $ $ Certificate of Occupancy $ Plan Review Fee $ State Education $ Total $ $ STATE OF CONNECTICUT WORK ' COMPENSATION COMMISSION Buildin: Permit Affidavit for Prose Owners or Sole Pro.rietors (Conn. Gen. Stat §31-2861) Property located at 1 In the town of L Name of building permit applicant II a L • Please check one: I. am the owner of the above 2. I am the sole property. proprietor of a business_ 2A.Name of business 2B.Federal Employer Identification Number Pursuant.. §3I-2861 Ka --------------------------- contra nt to or property owner or soleproprietor .. ct as _..----.-._ coatrancc ora�cipal employer"may provide eitha [who] intends to act as general sworn notarized affidavit... g certificateof workers' f workers' compensation insurance for all those employed on the job he i�proof of w site in accordance with this PIcase check one: chapter?' 1. ' I do not intend to act as a gcncraI contractor or principal employer_ [Sign •n+ stop here] #1 I/1 �� 1144S•eatur,c of aPPIi `" " 2. I to act as a general con intend provideacontractor or principal employer.Applicant certificate of workers`compensation PP cant mai either bcIow_ insurance or sign the affidavit Affidavit I hereby swear and attest that I will - ------~--- contractor,subcontractor,or other require beforehe/sheoworkers'compensation Patton insurance for perry the Workers'Com gages in work on the above understand Pa�ation Ad(Chaptcr.568). PAY� I azhr mayat pursuant to§31-275 C.G.S cors of a P elect to be excluded ~ off corporation and partner Office; and that tt a sole from coverage by filinga Pers in a files his intent to accept coverage.prprietor of a business is nowaiver with the ve appropriate unless required to have coverage unless he Signature ofapplipnt Subscribed and sworn to before me this day of ,200 (Notary Public/Commissioner of the Superior(`,..rtl Town of Montville Building Department 848-3030, Ext 82 ONE & TWO FAMILY CONSTRUCTION PERMIT SIGN-OFF SHEET I CS ► '/ct -Kb Property Address Job Description: Gi X )(-� o/9 d The owner/agent shall be responsible for the completion of the form, no construction permit will be issued until all signatures below have been obtained. HEALTH DISTRICT 848-3030-882 Septic System Date Permit#: ` , Not Applicable J ❑ Permit#: Not Applicable Private Well Date WPCA DEP MENT 848-3030,Ext.881 ❑ Permit#: Not Applicable unicipal Se -r Date ❑ Permit# ❑ Not Applicable Municipal Water Date DEPARTMENT OF PUBLIC WORKS 848-7473 fak4Director ❑ Permit#: Not Applicable Date PLANNING&Z e NING DEPART 4- NT 848-3030,Ext.81 2G ZU Zoning rZ Permit#: � Not Applicable Date 544- Z ❑ Permit#: Inland-Wetlands Not Applicable Date Town of Montville Building Department Receipt Date No. 1 b b 5 From: .(7)n ��L P l N - Job Address: _jj____P_A� 7"n i z;;.- Amount $ — � Cash (dip Check #� one) Received by ------_ Permit I$-- • Permit Fee Calculation Spreadsheet , MISCELLANEOUS PERMIT CALCULATION Pools&Spas Above Ground Round EA S 3,000.00 $ _ Above Ground Oval EA $ 5,000.00 $ - In-Ground EA $ 18,000.00 $ - Heater EA $ 3,300.00 $ Hot Tub EA $ 5.000.00 $ - Roofing Strip&Reroof SQ $ 210.00 $ Overlay SQ $ 175.00 $ - Sheds With Electric SF $ 25.00 $ No Electric 96 SF $ 25.00 $ 2,400.00 Deck SF $ 15.00 $ Porch SF $ 23.00 $ - TOTAL BUILDING CONSTRUCTION COST $ 2,400.00 I PERMIT FEE Building $ 2,400 $ 16.00 • Mechanical $ - $ Electrical $ - $ $ - CO Fee $ 10.00 $ Plan Review $ 11.60 State Ed Fee $ 2,400 $ 0.38 Total Fees $ 27.98 Based on 2000 Average Construction Cost 4/26/02