HomeMy WebLinkAboutStrip and Re-Roof 2003 Town of Montville
BUILDING DEPARTMENT
310 Norwich-New London Turnpike
Uncasville,CT 06382
(860)848-3030,Ext.382
Building Permit
Permit Number: B2003-0201 Date: 23-May-03 Map/Lot: 093/009-000 Owner ID 115507
Job Location: 24 PENNSYLVANIA AVENUE Unit
Job Description: Strip&re-roof
Owner: Contractor:
Jeffrey J and Anita M Dugan James Chusse
2 Old Shetucket Tpke.
24 Penn Ave Hanover Ct. 06350
Oakdale CT 06370 Telephone: (860)376-8331
Lic/Reg Type/No. HIC 576541 Exp Date: 30-Nov-03
Tenant:
Self
Telephone:
Construction Values Permit Fees Construction Information
Building Value: $2,279.00 Building Fee: $16.00 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: $2,279.00 CO Fee: $10.00
Plan Review Fee: $0.00
State Ed Fee: $0.36
Total Fees: $26.36
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
❑ Rough Framing ❑ Firestopping/draftstopping
❑ Rough Electrical ❑ Insulation
❑ Electrical Service ❑d Final Inspection
❑ Rough plumbing and leak test ❑ Certificate of Occupany
❑ Gas piping and test
Building Official's Signature: �� �
,�, Town of Montville
�" Building Department Permit 4tD(x3.6?o/
310 Norwich-New London Tpke.
Tel. 848-3030,Ext 382 Uncasville,CT 06382 Fax. 848-7231
One&Two Family Building Permit Application Form
096w Construction 0 Airation 0 alteration 0 Accessory Structure
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Job Location 2 Li Ve nn s v CA A % `k -v T
Job D
escription/Materials Q P 0 a(t' f I,i c I tP S
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Owner F`t \ ..� c� N� Mailing Address . 1 f'te V1 1 V ct o( l/`S �
City State e-T Zip 06. 70 Tel .F4 / -i/2'9 I
Contractor N\°i'"'I'! C11-s"� MailingAddress 2 S� '
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City State C [ Zip C Tel 860 /376 / 833 1
Contractor's License/Registration Type&Number Exp.Date 11 /3 /OZ
L-10r-7 e ro ue.-►r-P (en-1-Cq c-6c 5-76sy I
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.
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Owner/Agent SignatureDate S /0 7 /Q
/ Construction Value
Fee
Building $ c 7 7 $ /6
Plumbing $ lam` $
Mechanical $ $
Electrical $ $
Other $ $ mer- ,
Certificate of Occupancy $ rf 6'
Plan Review Fee 02 02_7 9 $
State Education l' $
Total $ $ r 3
(See*verse situ for aidxtional requirements)
Town of Montville Building Department Receipt
Date ,,5' / / Q �� No. 02728
From:
Job Address: li i _..
Amount $
C'f‘ 42 Check Check #
Iti'ircle one)
Receivedby ,r or. ,'' Permit # ,; cQ0 a 3— PU (
fr 41
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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 11 SQ $ 207.20 $ 2,279.20
Overlay SQ $ 127.05 $ -
Plywood SQ $ 101.85 $ -
Sheds SF $ 26.25 $ -
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 $ -
TOTAL BUILDING CONSTRUCTION COST $ 2,279.20
PERMIT FEE
Building $ 2,279 $ 16.00
Electrical $ - $ -
$ -
$ -
CO Fee $ 10.00
Plan Review $ -
State Ed Fee $ 2,279 $ 0.36
Total Fees $ 26.36
Based on 2003 RS Means Residential Cost Data
5/8/03
I
STATE OF CONNECTICUT
WORKERS' COMPENSATION COMMISSION
Building Permit Affidavit for Property Owners or Sole Proprietors
(Conn. Gen. Stat. § 31-286b)
Property located at: 2 LI V-epi n Sy [v CA Qcl 1 e c 370
In the town of (9Gt a cc3\�_
Name of building permit applicant:
QS u S S�
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 chec ne:
1. I do not intend to act as a _eneral contract° sr principal employer.
[Sign and stop here] /
Signature of applic"
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)