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HomeMy WebLinkAboutStrip and Re-Roof 2002 Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville,CT 06382 860-848-3030, Ext.82 Building Permit Permit Number: B2002-328 Permit Date: 11-Jul-02 Permit Code R4 Job Location 29 PENNSYLVANIA AVENUE UNIT: MAP/LOT: 092/154-000 Job Description: strip&re-roof Owner Contractor DONNA L+ROY E SHAFER Roy E. Shafer 29 Pennsylvania Avenue 29 PENN AVE Unit: Oakdale,Ct.06370 OAKDALE CT 06370 Telephone: 859-3466 Lic/Reg Type: Use Group R4 Lic/Reg Number: 0 Code 1995 CABO Exp Date: Construction Type 5B Construction Values Permit Fees Building Value: $2,940.,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: $2,940.00 C/O Fee: $10.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $0.47 Total Fees: $26.47 It is the owners responsibility 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 ® Final Inspection ❑ Gas Piping and Pressure Test ■ - ifi . :of upancy-Prior to use or occupancy Building Official's Signature: - Town of Montville Building Department Permit#40_0 1)(2-,, 310 Norwich-New London Tpke. Tel. 848-3030, Ext 82 Uncasville, CT 06382 Fax. 848-7231 One & Two Family Building Permit Application Form ❑New Construction ❑Addition ❑Alteration ❑Accessory Structure ❑Other ,),, Job Location ) PennS /U, i'R /Hr1bell(", aak CT Job Description/Materials /9 SXYGb4[e. 111,9 ie-g Owner poy G, ij akl,VA I.. J nfi ,� Mailing Address g A0,41,04 %4,91 ',g1 City DllkiA�� State Of Zip Tel Tel 860 18,571 g/ > Contractor 36"c..l= 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 ap. • ation for a permit for such work as described above. lo 4 Owner/Agent Signature i Dat //9 / ©N Construction Value Fee Building $ 0 9 P $ Plumbing $ $ Mechanical $ $ Electrical $ $ Other $ $ Certificate of Occupancy $ Plan Review Fee $ State Education $ Total $ $ c Y� ,D� Town of Montville Building Department Receipt Date 4 / / oZ. No. 01850 From: L/ 9 Job Address: 29 pe.x.).YLVAie. I\y 11;) Amount $ - 1- 7 Cash Check Check # 2.6 S (circle one) Received by e>� Permit 1132-o 0 Z �'Z� Permit Fee Calculation Spreadsheet MISCELLANEOUS PERMIT CALCULATION Pools&Spas Above Ground Round EA $ 3,000.00 Above Ground Oval EA $ 5,000.00 In-Ground EA $ 18,000.00 Heater EA $ 3,300.00 Hot Tub EA $ 5,000.00 Roofing Strip&Reroof 14 SQ $ 210.00 Overlay SQ $ 175.00 Sheds With Electric SF $ 25.00 No Electric SF $ 25.00 $ Deck SF $ 15.00 $ Porch SF $ 23.00 $ TOTAL BUILDING CONSTRUCTION COST $ 2,940.00 PERMIT FEE Building $ 2,940 $ 16.00 Mechanical $ - $ - Electrical $ - $ - $ - $ - CO Fee $ 10.00 Plan Review $ - State Ed Fee $ 2,940 $ 0.47 Total Fees $ 26.47 Based on 2000 Average Construction Cost 6/19/02 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 .'i/ l Alb In the town of 1/ (` Name of building permit applicant d Please check one: 1• k 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 ere of workers insurance or a"sworn notarized affidavit... statingthat he compproof of knration compensation insurance for all those employed on the job site in accordance with this chapter." Please check one: 1/X I do not•. n% to act as a :eneral contractor or principal employer. [Si• n• oD irC /1 ,, Signa • of applicanie 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 orkers'compensation contractor, subcontractor,or other worker before he/she engagesworkin the ao a for perry in work accordance with the Workers'Compensation Act(Chapteron above property in 568). I understand that pursuant to§31-275 C.G.S.,officers of a corporation partnership may elect to be excluded from coverage by filing eand partners in a iate District Office; and that a sole proprietor of a business is not watvdr to haveith the coverage unless files his intent to accept coverage. coverage unless he Signature of applicant Subscribed and sworn to before me this day of •200 . (Notary Public/Commissioner of the Superior Court)