HomeMy WebLinkAboutGarage Conversion 2003 Town of Montville
BUILDING DEPARTMENT
310 Norwich-New London Turnpike
Uncasville,CT 06382
(860)848-3030, Ext. 382
Building Permit
Permit Number: B2003-0579 Date: 16-Oct-03 Map/Lot: 028/005-069 Owner ID 114515
Job Location: 37 PARTRIDGE Ho i OW Unit
Job Description: convert garage to workshop
Owner: Contractor:
Joseph J and Wendy L Summers Joseph Summers
37 Partridge Hollow
37 Partridge Hollow Oakdale Ct. 06370-
Oakdale CT 06370 Telephone: (860)848-3425
Lic/Reg Type/No. 0 Exp Date:
Tenant:
Self
Telephone:
Construction Values Permit Fees Construction Information
Building Value: $1,200.00 Building Fee: $10.00 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: R4
Other Value: $0.00 Other Fee:
$0.00 Comments:
Total Value: $1,200.00 CO Fee: $10.00
Plan Review Fee: $1.00
State Ed Fee: $0.19
Total Fees: $21.19
It is the owners responsibility to schedule the following inspections(minimum 48 hours notice required):
❑ Footing - Prior to pouring concrete ❑ Rough HVAC
❑ Backfill-Footing drains and waterproofing ❑ Fireplace Throat
❑ Concrete Slab- Prior to pouring concrete ❑ Chimney-One flue above thimble
10 Rough Framing Firestopping/draftstopping
❑ Rough Electrical ❑d Insulation
El Electrical Service ❑ Final Inspection
❑ Rough plumbing and leak test J Certificate of Occupany
❑ Gas piping and test
Building Official's Signature:
Town of Montville
Building Department Permit#
310 Norwich-New London Tpke.
Tel. 848-3030,Ext 382 Uncasville, CT 06382 Fax. 848-7231
One & Two Family Building Permit Application Form
New Construction []ilrldition 14$fteration Accessory Structure
Other
Job Location 3 '7 f,42T!Z/L74 C; 0LL,(,-J
Job Description/Materials .. - . �_ _ - C „ _.
i n LL L✓,12:*L I6", 2_ 5 l-.�'‹,(-/ac{t
Owner o c-�L �vm„-crs Mailing Address 37 p` ,r-i-f,�s-c ,7S41-e/c.,
City State (f Zip Tel w.° /T6 /3uf 3S
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 ermit for such work as described above.
Owner/Agent Signatur: Date 2& / / 03
Construction Value Fee
Building $ /2
Plumbing $ $
Mechanical $ $
Electrical $ $
Other $ $
Certificate of Occupancy $ /0 -%
Plan Review Fee $ / d'
State Education $ /9
Total $ /zn _ $ s9/ig
(See Reverse side for additional requirements)
Town of Montville Building Department Receipt 1
1
Date //) / 9 / �- 3 No. 03240
From: ,:;►ae ' :/�i.g .
Job Address: NT -r , �
Amount $ / . / / Cash Check # \ J V2
,.•
�Circic one
Received ‘ �"� - �•�'
b �/�.E!/i Iii.�ii1�'' Permit #6351, OO "--057 >
•
STATE OF CONNECTICUT
WORKERS' COMPENSATION COMMISSION
Building Permit Affidavit for Property Owners or Sole Proprietors
(Conn. Gen. Stat. § 31-286b)
Property located at: 7 Pc.„{-4-- ,c)2,- ,/I c'—
In the town of fl'i--ev;Ll
Name of building permit applicant: asp,),
Please check one:
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)
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 inten• to act .. a general con • - . or principal employer.
[Sig . d s • • r�
erlfur- of applic•4111111."-
2.
•+s'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
848-3030,Ext 382
ONE&TWO FAMILY
CONSTRUCTION PERMIT
SIGN-OFF SHEET
7 PAL B . O . 0C,./
Property Address
Job Description: c- n t--)e.irksJ- fe.-rou<_ c)odrs 8-
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 No Permit
❑ Permit#: ❑ Required
Septic System Date
Approved No Permit
❑ Permit#: ❑ Required
Private Well Date
WPCA DEPARTMENT 848-3030,Ext 376
Approved No Permit
/O /0_3 111Permit#: ❑ Required
Munici al Sewer Date
House Trap ❑ Outside ❑ Inside
Approved No Permit
❑ Permit# ❑ Required
Municipal Water Date
DEPARTMENT OF PUBLIC WORKS 848-7473
Approved No Permit
❑ Permit#: ❑ Required
Director Date
PLANNING &ZONING DEPARTMENT 848-3030.Ext.379
Approved No Permit
/0/S 0 3 ❑ Permit#: Required
Zoning ate
Approved No Permit
❑ Permit#: ❑ Required
Inland-Wetlands Date