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Home My WebLink About10x16 Shed 2003 Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville,CT 06382 (860) 848-3030, Ext. 382 Building Permit Permit Number: B2003-0487 Date: 05-Sep-03 Map/Lot: 028/005-075 Owner ID 114510 Job Location: 26 PARTRIDGE HOLLOW Unit Job Description: Shed Owner: Contractor: Bruce A and Ruth Ann Posner Bruce Posner 26 Partridge Hollow 26 Partridge Hollow Oakdale Ct. 06370- Oakdale CT 06370 Telephone: (860)848-1731 Lic/Reg Type/No. 0 Exp Date: Tenant: Self Telephone: Construction Values Permit Fees Construction Information Building Value: $4,200.00 Building Fee: $28.00 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: R9 Other Value: $0.00 Other Fee: $0.00 Comments: Total Value: $4,200.00 CO Fee: $10.00 Plan Review Fee: $2.80 State Ed Fee: $0.67 Total Fees: $41.47 It is the owners responsibility to schedule the following inspections(minimum 48 hours notice requires(): ❑ Footing-Prior to pouring concrete Cl 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 ❑ Rough plumbing and leak test ❑d Certificate of Occupany ❑ Gas piping and test Building Official's Signature: fi Town of Montville Building Department Permit IttetzazW 7 310 Norwich-New London Tpke. Tel. 848-3030,Ext 382 Uncasville, CT 06382 Fax. 848-7231 One & Two Family Building Permit Application Form Elew Construction � El Addi:tion []Alteration N accessory Structure— 5;9E:6 DOther Job Location - / Job Description/Materials OwnerI -T,f'4, ,4wv/s--t Mailing Address-?(a .4,,,e/7e/A6-e- , i City�g. r— State C,' Zip 3 7D Tel SZ 6 /d''Vfi/73/ Contractor 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 / Date Construction Value Fee Building $ $ Plumbing $ $ Mechanical $ $ Electrical $ $ Other $ $ Certificate of Occupancy $ Plan Review Fee $ State Education Total $ $ $ (See Reverse side for additional requirements) STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors (Conn. Gen. Stat. § 31-286b) Property located at: c• 6T;€r� In the town of ' 9;/::/\4-4 Name of building permit applicant: "„ �, / Please check one: 1. t/---1 am the owner of the above property. 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 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. ✓I do not intend to act as a general contractor or principal employer. [Sign and stop here Signature of applicant 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) Town of Montville Building Department Receipt Date -�- I 7 / 27 / 03 No. U3i00 From: g 1 /1 Job Address: 2-4 Pcc.rkr;J&-, Ll6w i Amount $ i// . y-? Cash 411M1110. Check # 1792,_ (Circle one) I Received by 4.-":Jh•-.r,r..-•IN Permit # Permit Fee Calculation Spreadsheet MISCELLANEOUS PERMIT CALCULATION Pools&Spas Above Ground Round EA $ 3.150.00 $ - Above Ground Oval EA $ 5,250.00 $ - In-Ground EA $ 18.900.00 $ - Heater EA $ 3.465.00 $ - Hot Tub EA $ 5.250.00 $ - Roofing Strip&Reroof "SQ $ 207.20 $ - Overlay SQ $ 127.05 $ - Plywood SQ $ 101.85 $ - Sheds 160 SF $ 26.25 $ 4.200.00 Electrical Service 100 Amp EA $ 816.43 $ - 200 Amp EA $ 1.519.19 $ - 400 Amp EA $ 6.039.29 $ - Breezeway/Decks Open SF $ 22.31 $ - Enclosed SF $ 94.76 - Porches ....................... Open SF $ 62.69 $ - Enclosed SF $ 123.90 - S TOTAL BUILDING CONSTRUCTION COST $ 4,200.00 PERMIT FEE Building S 4.200 $ 28.00 Electrical S - $ - $ $ - CO Fee $ 10.00 Plan Review $ 0.67 State Ed Fee S 4.200 $ 0.67 Total Fees $ 41.47 Based on 2003 RS Means Residential Cost Data 8/27/03 I 1. Town of Montville Building Department 848-3050, Ext 382 ONE&TWO FAMILY CONSTRUCTION PERMIT SIGN-OFF SHEET a TAR-Tra) 4 h/6LGc, Property Address Job Description: /o 71/6 ��gc7 The owner/agent shall be responsible for the completion of the form, no certificate of occupancy will be issued until all signatures below have been obtained. HEALTH DISTRICT 848-3030-339 Approved Not Permit ❑ Permit#: ❑ Required Septic System Date Approved Not Permit ❑ Permit#: ❑ Required Private Well Date c:7 DEPARTMEN 848-3030,Ext 376 fit dy 703APproved Not Permit : ❑ Permit#: ❑ Required Municipal Sewer Date House Trap ❑ Outside ❑ Inside Approved Not Permit ❑ Permit# ❑ Required Municipal Water Date DEPARTMENT OF PUBLIC WORKS 848-7473 Approved Not Permit ❑ Permit#: ❑ Required Director Date PLANNING & ZONING DEPARTMENT 848-3030.Ext.379 Ji Z7 PerAppmit#:roved Not Permit � Zoning ate 32S-7 0 Required Approved Not Permit ❑ Permit#: ❑ Required Inland-Wetlands Date