HomeMy WebLinkAboutBathroom Permit Closeout 2016 I L
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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: B2016-0392 Date: 13-Oct-16 Map/Lot: 092/154-000 Owner ID: 5399000
Project Location: 29 PENNSYLVANIA AVENUE Unit:
Job Description: Close out 1985 Bathroom permit
Owner Nam Donna L and Roy E Shafer Tenant Name N/A
Careof:
29 Penn Ave
Oakdale CT 06370- Telephone:
Applicant Name Roy E Shafer Telephone:
DBA: Lic/Reg Type
Lic/Reg N 0
Exp Date:
Construction Value Permit Fees Construction Information
Building Value: $0.00 Building Fee: $0.00 Use Group: R-3
Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 2005 State Building Code
Mechanical Valu $0.00 Mechanical Fe $0.00
Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type IRC
Total Value: $0.00 Penalty Fee: $0.00 Permit Code: C3
C of 0 Fee: $0.00 Comment
Plan Review Fe $0.00
State Ed Fee: $0.00
Total Fee Paid: $0.00
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.
BUILDING PERMIT INSPECTIONS PLUMBING.MECHANICAL,ELECTRICAL PERMIT INSPECTIONS
❑ Footing-Prior to pouring concrete R Plumbing and leak test
❑ Deck Piers R Electrical
❑ Backfill-Footing drains and waterproofing ❑ Elec Trench-with conduit installed
❑ Concrete Slab-Prior to pouring concrete __! Pool Bonding
❑ Anchor Bolts-with sill plate and prior to floor frami Electrical Service CRS No: 0
❑ Framing R HVAC
Masonry Fireplace Throat or Chimney Thimble ❑ Gas Piping and leak test
• Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION
Insulation r Certificate • •prove
r ert'' at cupancy
Building Official's Approval:
Town of Montville
Building Department
310 Norwich-New London Tpke.
Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231
RESIDENTIAL PERMIT APPLICATION FORM Permit No.: 82°1'-°Sea
Type of Work Qcfeupancy Type ermit T e
❑New Construction Single Family uilding
Xddition 0 Two-Family g
Iteration 0 Townhouse ❑Mechanical
0 Accessory Structure
XIANICIdna CRS#:
Property Address: 2-1 f �-11-- I l—\/ (tV 1 t. kjaiLk- '
//(N►►
(Number) (Street(S / 4/,‘„,-,0/ (Unit)
Job Description: C e e'ti� �J� i Oorn
k ' SIOwner: � ` a/-
Address: , • )2.910/11" A
CA
Of° i
?T- <57.1rr‘
City: ile / State: Zip Code://.;( 71"
a Telephone Li ((
Applicant: _94 '12-e, ,V,j 19it 2J
DBA:
Address:
City: State: Zip Code: Telephone( ) -
Contractors- Complete the Following:
License Type: --. License No.: Expiration Date:
I hereby certify that the proposed work will conform to the State 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.
❑ By checking this box, I will follow the • emen i of the 2005 NEC as the alternative compliance per section E3301.2.1 of the Residential Code,
instead of the electrical requirem-• aptgrs/ hro h 42 of the Residential Code.
/D �/
Owner/Agent Signature: , Z A Date:
//‘
Constru ton Value Permit Fees
Building Value: Building Fee:
Plumbing Value: Plumbing Fee:
Mechanical Value: Mechanical Fee:
Electrical Value: Electrical Fee:
Total Value: Penalty Fee:
C of 0 Fee:
Plan Review Fee:
State Ed Fee:
Total Fee:
Qevise k August 23,2007
vw
State of Connecticut7A
0 Workers' Compensation Commission
C 11
'VIMtzs: r Please TYPE or PRINT IN INK ce
z.
Proof of Workers' Compensation Coverage when Applying
for a Building Permit for the Sole Proprietor or Property Owner
who WILL NOT act as General Contractor or Principal Employer
APPLICANT FOR BUILJai
DING PERMIT
Name of Applicant for Building Permit V --4 E
�, /;(' �/ �
Property located at , /11 / / L /r
in the City/Town of
ATTEST
If you are the owner of the above-named property or the sole proprietor of a business doing work on the site of the construction project at the above-named
property and you WILL NOT act as the general contractor or principal employer,you are not required to have workers'compensation insurance coverage.
CHECK ONE(1) BOX ONLY and complete the following:
❑ I am the OWNER of the above-named property.I WIL N15T as the general tractor or principal employer.
Signature of OWNER Applicant
❑ I am the SOLE PROPRIETOR of a business doing work at the above-named property.I WILL NOT act as the general contractor or principal employer.
Name of Business
Federal Employer ID#(FEIN)
Signature of SOLE PROPRIETOR Applicant
Town of Montville
Building Department
CONSTRUCTION PERMIT APPROVAL
401 , , ..• ,
• ' 1' /P2(97/A/1/14 XaoaLe
/ 4 4 (I.
...
Property Ad•res
fr' I / ?A5 /. / t!lY•' . , M7/
Job lescription
Required Department Permit Issuance Approval
Approval
II Tax Collector te, , ,'SID- ,--e_. /o 1(, /
Signature/date
Comments: /
® Fire Marshal �'� Yi ��
Signature/date
Comments:
❑ Planning & Zoning
Required for all permits except Signature/date
Plumbing,Electrical,Mechanical,Roofing,Siding,Windows&Doors
❑ Health Department
Required for properties with private septic or well Signature/date
Comments:
Nit
WPCA, Administrative
it tA/ t 1411/(11 A5446
required for properties on sewer Signature/date
Comments:
❑ WPCA, Operations
When Required by WPCA Signature/date
Comments:
❑ Department of Public Works
Required when project includes driveway work or certain drainage requirements Signature/date
Comments: -
❑ Montville Police Department
Required for all permits EXCEPT one and two family residential Signature/date
Comments:
❑ Copy of State Dept. of Transportation Certificate
Required for Structures over 100,000 sq.ft.or with more than 200 parking spaces-Official copy of STC Certificate of Operation required—per
CGS 14-311
Signature/date
Building Department Final Inspection
RevisedMarc.h23,2015