The URL can be used to link to this page

Home My WebLink AboutVinyl Siding 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: B2004-0488 Date: 19-Aug-04 Map/Lot: 103/019-000 Owner ID: 5564000 Project Location: 39 PODURGIEL LANE Unit: Job Description: Vinyl Siding Owner Name: Russell A Est and Claire P Wallen Tenant Name: N/A Careof: 39 Podurgiel Lane Uncasville CT 06382- Telephone: Contractor Name: Jeff Gibson Telephone: (860)460-4669 DBA: Lic/Reg Type: HIC Lic/Reg No: 576420 11 Tamarack Dr. Exp Date: 30-Nov-04 Clinton Ct 06413- Construction Value Permit Fees Construction Information Building Value: $15,000.00 Building Fee: $120.00 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: $0.00 Electrical Fee: $0.00 Construction Type: 5B Total Value: $15,000.00 Penalty Fee: $0.00 Permit Code: R4 C of 0 Fee: $0.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $2.40 Total Fee: $122.40 Jt shall be the owners reosonsibility 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 ❑ 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 ❑d Final Inspection ❑ Insulation ❑ Certificate of Occupancy Building Official's Approv. . 11 Town of rvkintville 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 ['Addition Alteration El Accessory Structure Sing1 Two-Tami[y Townhouse Job Address 21 Podk-r— � e ( Lv (Number) (Street) (Unit) Job Description 0',(AT S/4 /1/c„� o'`-."1 U' Owner 04i, L Mailing Address g`"( el--rq i it LA City (440.5 i I,l State C I Zip )Tel g6Q /6 / Contractor JCa CML co Mailing Address LL /RvvvotrAGlc n,_ City C( +Tye State Cr Zip 0(1/3 Tel 0i0 / f60 / '6C Contractor's License/Registration Type&Number �pr►�le ��,,,p ...��'" Exp. Date I / / 36 / 04 a-4-g-764)-0 #5-764)LD 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. Separate applications are required for electrical,plu g,mechanical, etc. a Owner/Agent Signature ��-� Date 08 / ` / 61 Construction Value Fee Building $ Plumbing Mechanical $ $ Electrical $ $ Certificate of Occupancy $ Plan Review Fee $ State Education $ ,2Z, t�d Total $ �s OPQ $ 16 (See 1 verse side for additional requirements) Town of Montville Bnildirig Department Receipt Date / ' / 'V 'I No. 04132 From: i - 411 # .. Job Address: ss frf0 ,4 A'4 Ci4i ..3-- 2`.-"' Amount $ !/�� . Cash cc Check # y/!f� / (circle one) 411, of Received b // /" Y �I,!'r - is o _. _ .11. '.1 Permit #�a 60 y—, • Permit Fee Calculation Spreadsheet MISCELLANEOUS PERMIT CALCULATION Address: Pools & Spas Above Ground Round EA $ 3,200.00 $ - Above Ground Oval EA $ 6,000.00 $ In-Ground EA $ 18,900.00 $ Heater EA $ 3,465.00 $ - Hot Tub EA $ 5,250.00 $ - Roofing Strip & Reroof SQ $ 300.00 $ - Overlay SQ $ 185.00 $ - Plywood SQ $ 105.00 $ - Plumbing Full Bath EA S 4,230.00 $ - Half Bath EA S 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 SF $ 26.25 $ Electrical Service 100 Amp EA $ 825.00 $ - 200 Amp EA S 1,500.00 $ - Siding $ 15,000.00 Windows & Doors $ - Decks/Porches/Sunrooms Open SF $ 22.31 $ Covered SF $ 62.69 $ - Enclosed SF $ 123.90 $ - TOTAL BUILDING CONSTRUCTION COST $ 15,000.00 PERMIT FEE CALCULATIONS Fee Building 5 15,000 $ 120.00 Plumbing $ - $ - Mechanical $ - $ - Electrical S $ - Work Commenced before permit issuance $ - CO Fee $ - Plan Review $ - State Ed Fee $ 15,000 2.40 Total Fees $ 122.40 Based on 2003 RS Means Residential Cost Data 8/9/04 • STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors (Conn. Gen. Stat. § 31-286b) Property located at: 3 Pok-7,� e� In the town of (./{,Lust �Q Name of building permit applicant: Te6t-i kce Please check one: 1. /1 am the owner of the above property. 2. ,/ I am the sole proprietor of a busine�s ! 2A. Name of business: LX 1L1 �,p�r- Re„.,,4e6�,r► --- V 2B. Federal Employer Identification Number(FEIN) .5S'1�,C 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 one: 1. I do not intend to act as a general contractor or rincipal employer. [Sign and stop here] Signature of appli 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) Tov'n of Montville Building Department 848-3030, Ext 382 RESIDENTIAL CONSTRUCTION PERMIT SIGN-OFF SHEET Property Address Job Description: 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#: ❑ Required Septic System Date Approved No Permit ❑ Permit#: ❑ Required Private Well Date WPCA DEPARTMENT 848-3030,Ext 376 Approved No Permit ❑ Permit#: ❑ Required Municipal Sewer Date Building 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 ❑ Permit#: ❑ Required Zoning Date Approved No Permit ❑ Permit#: ❑ Required Inland-Wetlands Date 4 -,:,,t,.' .:•,S %•' :, yeti I' `, .'•.'� A:t0.1....$00.44:41' 4, ::lil: r• � y ry - • h• .::e ;�;,�,t{. "y :Baa =C• m3•, .y3. ani' s' \ ylf:.:•',W\41";::. Ii:, r,,410. ,�ry;::, r 42'•r. 4,400.00..."0„ f �F .�" ,• ,¢l;;..: �'�1�T, . n, �:tr„ ,.5.,, ,�':n� f1t• r�: ,^r nl�r Q •`:`•Tv ,t'Fi,� ,.1 T:th = I,�: �\" i�. � '\ <+ .. �1 �4 S,` S fi� T� :gg✓�°? �:.•, s''�A, a{� 4;"{{ �i�,t ��+y:��: ! �J�: ��G•s��?.,.�` s•{ ,,,,., ;,� :;:{r�`,t' "�{i �v rs��;:; �,•��,.; s�� i{ssr�� :�G{,�s •sss�?, �s,�? r;:R..,, .fs �.. z' STATE OF CONNECTICUT + DEPARTMENT OF CONSUMER PROTECTION 1 Be it known that `'' JEFFREY S GIBSON 19 \\ESTENDAVE -34IIANT1C,CT 06357 1 -_-4, -•fig has been certified by the Department of Consumer Protection as a registered HOME IMPROVEMENT CONTRACTOR , - DBA: GIBS.ON EX` ; .IOR R MODELING ' i5, • Registaratiot 57 6420 ?---r—v sr {r , 3:.,. c _ Effective: 12/10/2003 !:3,1i� Expires: 11/30 ii 2004 ..' Edwin R. Rodriguez,Commissioner "' =; 4;1, rs �,.�. .:.:I...,..; ' ,.•�''• j .... { � : y s ..e K i f '1111 ;N,t: b% j{ wf 0 i {%„rn : [ - Y,r rys ! a ter.r t t 4Y..` r.,n.i ,,,?.1111.11P,' ,�'. R3�ti su` .:?: . � ,r, ' , ••, /y^;Y V 't' .YtS' P, 4" ' `t v ' 'r qt•� •t %fV•hi^ 1%tt s'{`f \: •ss5 ss� r ✓ t *VAVile?Sfy� t:,::. ik., . ? , iC;n. . � e:�7'• £istivs ,'•r'+ rs -sti ,,, y {yv;; -SrysN:: ' {y .' •: . *0.41. 6:4:11,' lu. 7L: :gKti S> wWw.. ,_� 4`h_ L_: ____