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Home My WebLink About12x16 Shed 2004 TOWN OF MONTVILLE Building Department 310 NORWICH-NEW LONDON TURNPIKE UNCASVILLE, CT 06382-2599 TEL. (860) 848-3030 X382 FAX. (860) 848-7231 BUILDING PERMIT Permit Number: B2004-0362 Date: 12-Jul-2004 Map/Lot: 028/005-069 Owner ID: 5373000 Project Location: 37 PARTRIDGE HOLLOW Unit: Job Description: 12x16 shed Owner Name: Joseph J and Wendy L Summers Tenant Name: N/A Careof: 37 Partridge Hollow Oakdale CT 06370- Telephone: Contractor Name: Property Owner Telephone: DBA: Lic/Reg Type: Lic/Reg No: 0 Exp Date: Construction Value Permit Fees Construction Information Building Value: $5,040.00 Building Fee: $48.00 Use Group: R-4 Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1999 State Building Code Mechanical Value: $0.00 Mechanical Fee: $0.00 w/2000 Amendment Electrical Value: $252.00 Electrical Fee: $8.00 Construction Type: 5B Total Value: $5,292.00 Penalty Fee: $0.00 Permit Code: R9 C of 0 Fee: $10.00 Comments: Plan Review Fee: $5.60 State Ed Fee: $0.85 Total Fee: $72.45 It shall be the owners repsonsibility to schedule the following inspections a minimum of 2 business days in advance: Field set of approved construction documents shall be available onsite during all inspections. ❑ Footing-Prior to pouring concrete ❑ R Plumbing and leak test ❑ Backfill-Footing drains and waterproofing ❑ R Electrical ❑ Concrete Slab-Prior to pouring concrete ❑ Elec Trench-with conduit installed El Framing ❑ Electrical Service CRS No: 0 ❑ Fireplace Throat-One flue above throat ❑ R HVAC ❑ Chimney-One flue above thimble ❑ Gas Piping and leak test ❑ Firestop Draftstopping ❑ Final Inspection ❑ Insulation El Certificate of Occupancy Building Official's Approval: -1�� Town of Montville { Building Department 310 Norwich-New London Tpke. Tel.848-3030,Ext 382 Uncasville, CT 06382 Fax. 848-7231 Residential Building Permit Application Form Permit# New Construction 0 Addition []Alteration NAccessory Structure ❑Single Family [] (Two-Family Q Townhouse Job Address 37 Y4rz_9^72_,)17/E_ , o (Number) (Street) (Unit) Job Description /Z)c IC. _ -41X'2 Owner ..N cdeek .,(,f ,,,k �y,-,r,,), Mailing Address g 7 9�,,,,Gt 6- ,4?'GLO 4J City E,AILD A►Le' State Cr Zip 04'"Do Tel 76 ,' / rilic/ 3yai Contractor �f��jL- 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 p- i• for such work as described above. Separate applications are require. .r e c. .• .11,,p in_ •- anical, etc. Owner/Agent Signature Date / $/ O Construction Value Fee Building $ $ Plumbing $ $ Mechanical $ $ Electrical $ $ Certificate of Occupancy $ Plan Review Fee $ State Education $ Total $ $ (See averse side for addition(requirements) i Town of Montville Building Department Receipt P Date 4 i_21-1-/ � y No. 6 3 9 ri ;: From: U d y. Job Address: 3 9 4 gT Pc. /-10( L Amount $ � C. .. � e Check # C (circle one) Received by ,.A ,,,,4/ Permit #/�4900V— 3(, 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 $ 225.00 $ Overlay SQ $ 130.00 $ Plywood SQ $ 105.00 $ Plumbing Full Bath EA $ 4,230.00 $ Half Bath EA $ 2,690.00 $ Garages Attached, 1 car EA $ 8,885.00 $ Attached, 2 car EA $ 15,114.00 $ Attached, 3 car EA $ 20,914.00 $ Detached, 1 car EA $ 11,657.00 $ Detached, 2 car EA $ 17,456.00 $ Detached, 3 car EA $ 23,256.00 $ Sheds SF $ 26.25 $ - Sheds with Electrical 192 SF $ 26.25 $ 5,040.00 Electrical Service 100 Amp EA $ 825.00 $ 200 Amp EA $ 1,500.00 $ Siding $ - Windows & Doors $ Decks/Porches/Sunrooms Open SF $ 22.31 $ Covered SF $ 62.69 $ Enclosed SF $ 123.90 $ TOTAL BUILDING CONSTRUCTION COST $ 5,040.00 PERMIT FEE CALCULATIONS Fee Building $ 5,040 $ 48.00 Plumbing $ _ $ _ Mechanical $ - $ _ Electrical $ 252 $ 8.00 Work Commenced before permit issuance $ _ CO Fee $ 10.00 Plan Review $ 5.60 State Ed Fee $ 5,292 0.85 Total Fees $ 72.45 Based on 2003 RS Means Residential Cost Data 6/15/2004 STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors (Conn. Gen. Stat. § 31-286b) Property located at: 7 ?/Ag- Eol-L In the town of /..16,rJ71/ LIG- Name of building permit applicant: �c75-0-671-1- v m 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.,c) I do not i• n. o act_;..-.-. general�.•�or or principal employer. [S'.: an. to. -0� ' icant 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) 7. Town of Montville Building Department 848-3030,Ext 382 RESIDENTIAL CONSTRUCTION PERMIT SIGN-OFF SHEET 3? PAR--.T2-/ G, �oLLoW Property Address Job Description: /Z,x/6 5,/1Efl The applicant is responsible for the completion of the form,no permit will be issued until all signatures below have been obtained. HEALTH DISTRICT 848-3030,Ext.339 Approved No Permit ❑ Permit#: 0 Required Septic System Date Approved No Permit 0 Permit#: ❑ Required Private Well Date WPCA DEPARTMENT 848-3030,Ext 376 / x Approved No Permit ,/ 4 ;o ❑ Permit#: 4 Required •unicipal Sewer Dae Building Trap 0 Outside [❑ Inside Approved No Permit ❑ Permit# 0 Required Municipal Water Date DEPARTMENT OF PUBLIC WORKS 848-7473 Approved No Permit Director ❑ Permit#: 0 Required Date PLANNING& ZONING I EPARTMENT 848-3030,Ext.379 ueiVJ C) I Approved No Permit / 6 Z Y 6y Zoning ate Permit#. .fid 3 i ❑ Required "� a_ Approved No Permit ' CC ❑ Permit#: Required Inland-Wetlands Date pg- 821113'118 ~ N 11K JI 3.LY,9S.90N ,9f-al o ,3.14,9S.90S Sf'9YI N h I N n �W 111 • I CI- Hwy m., g ;�:4 y I6 cs• Z \ .s / 8 '\ ,.'1 •1 I ,lS'L9=1 r,.14 I 6 \ N A N alrl \ N. :•• ' \\ I I • . • I • 1; . .0-,fl N ------7 1 \1 ,91 (7--- • • I / I / ,0-,91 :2 ..._ • 3 n • • 1 R /-- a3iif18 S0NVl13M 1!OS N N /f VI ...> O W 1 t W oN OlhA 2 / - / ,0-,Z1 / �r-o ~c 1, • "�1 Ocg af ,�m m I N / n i V ZS • • • • • • • • •• • • ' • 09•5A•5•1• • • • 133.36 ,rL o /6. 1.111Immilt.11-. 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