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Home My WebLink About8x12 Shed 2002 Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville,CT 06382 860-848-3030, Ex.t 82 Building Permit Permit Number: B2002-293 Permit Date: 03-Jun-02 Permit Code R9 Job Location: 33 PARTRIDGE HOLLOW UNIT: MAP/LOT: 028/005-068 Job Description: shed Owner Contractor MATTHEW R+ LAURA A TRYON Matthew R.Tryon 33 Partridge Hollow 33 PARTRIDGE HOLLOW Unit: Oakdale,Ct. 06370 OAKDALE CT 06370 • Telephone: 848-4561 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 ;t is the owners resoonsibilitv 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 ■ inal Inspection ❑ Gas Piping and Pressure Test 0 Certi e of• .upa r c - Prior to use or occupancy Building Official's Signature: A Town of Montville Building Department Permit#4Co 46-1?Norwich-New London Tpke. Tel. 848-3030, Ext 82 Uncasville, CT 06382 Fax. 848-7231 One & Two Family Building Permit Application Form 0 New Construction ❑Addition ❑Alteration kAccessory Structure Other Job Location 33 ( ,iy d j( rd law 'Kth( o Job Description/Materials Sr\Pll <). )a Owner r 4- Laltra—MACYA Mailing Address P6...e e HO( Lad City Ca0U. State Of-Zip J 3 N Tel Sio1/ sm i L4s(p / 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 Signatur- `tr ( a____ 1LLQV Date / / Construction Value Fee Building $ ,.A/06) v7 $ /, Plumbing $ $ Mechanical $ $ Electrical $ $ Other $ $ Certificate of Occupancy $ /0 0_ Plan Review Fee $ / 4,0 State Education3r Total $ �Ya� Q% $ yr Town of Montville Building Department Receipt Date 5— / ,2o / o D., No. 01755 t' 4) From: 1 _____L-e/4 77e y 0 A.) _____ Job Address: 33 R90-a/ n64- A [: Amount $ .2._e" Ca:h 4101 Check # �` J7 (('ircle one) +'� Received . OF .,_ Permit 1106, s STATE OF CONNECTICUT WORKERS'COMPENSATION COMMISSION Buildin: Permit Affidavit for Pro.e Owners or Sole Pro.rietors (Conn.Gen. Stat. §31-286b) Property located at tt`' AN!/ to }�,' 1. In the town of ' S NCI Name of building permit applicant: aLAt PIease checlOpg: 1!,,,/ I 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) ...................... '� Pt to §3I-2866,"aproperty """"""'............. owner or sole proprietor -.... c . may [who] intends to act as a general contractor or principal employer" provide either a certificate of workers'compensation insurance or a"sworn notarized affidavit... ge Pkerstion compensation insurance for all those employed on the job site inwill��proof of workerc accordance with this chapter." Please check one: 1..X I do not intend to act as a general contractor or principal employer. [Sign and stop here] AM" Si? a o 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'com contractor,subcontractor,or other worker before he/she engagesn wo kon thensurance for every i accordance with the Workers'Compensation Actn work on the above property in (Chapter 568). I understand that pursuant to §31-275 C.G.S.,officers of a co partnership may elect to be excluded from coverage by filingtion and appropriate partners in a District Office;and that a sole proprietor of a business is not waiveruidto haveith the appropriate files his intent to accept coverage• required coverage unless he Signature of applicant Subscribed and sworn to before me this day of 200 (Notary Public!Commissioner of the Superior Court) r Town of Montville t Building Department 848-3030, Ext 82 ONE & TWO FAMILY CONSTRUCTION PERMIT SIGN-OFF SHEET a3 L* L11 • Kda,( Prope ddress Job Description: \olc‘ 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 0 Permit#: ❑ Not Applicable Se. ' S to Date 0 Permit#: ❑ Not Applicable Private Well Date WPCA 1 EPARTMENT 848-3030,Ext. 881 1 i4OF 1 i/ i h ,10 4f%J V d 0 Permit#: Not Applicable f i' Dae Muni ffi'i% ••., ❑ Permit# ❑ Not Applicable Municipal Water Date DEPARTMENT OF PUBLI RKS 848-7473 0 Permit#: 0 Not Applicable ire or Date PLANNING ZO G i PARTMENT 848-3030,Ext.81 J 1p /' . '• •do-eee ie / V29/GZ— ❑ Permit#: – 6- ❑ Not Applicable Zoning Date 7 0 Permit#: .42 Not Applicable Inland-Wetlands Date