HomeMy WebLinkAboutVoided, Invalid or Expired Documents 2006-08 Town of Montville
Building Department
310 Norwich-New London Tpke.
Uncasville, CT 06382 Fax. 860-848-7231
PPLICATION FORM Permit No.:
Permit Type
❑ Building
❑Plumbing
❑Mechanical
re 0 Electrical CRS#:
'Rd p/- UNC-44 S u , II S Cr
(St -et) (Unit)
Ap� G� ,4CGrkpk = Ai) dS
Ptg, R c
' t..) / tti FS
Owner: n
Address: O 0/ 4W c A i — 04
City: : _ r / State: C . it.) Zip Code: 042/5—
Telephone:
Contractor:
DBA:
Ad. ess:
City: Alk State:
p Code:
Telephone: License Type: License No.: E =ration ,•te:
I hereby certify that the proposed wor • ill conform to the State Building C.•e and all other codes as .:opted by the State of Con -cticut and the Town
of Montville and further attest that t proposed work is authorized by the ow -r in fee and that I -• authorized to make application .r a permit for such
work as described above.
0 By checking this box, , ill follow the requirements of the 2005 NEC as the alt- - e compliance per section E3301.2.1 of the Re-'dential Code,
instead of the elect('-I requirements in chapters 33 through 42 of the Residen'. '.de.
Owner/Agen •ignature: /- f(� I 6D
Date:
Construction 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:
&vises'Decem6er31,2005
Town of Montville
Building Department
310 Norwich-New London Tpke.
Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231
PERMIT APPLICATION FORM Permit No.:
Type-of Work Occupancy Classification Construction Type Permit Type
❑ New Construction ❑A-1 ❑B ❑H-1 ❑I-1 0 R-1 ❑s-i D.Type IA 0 Type HIB 0 Building
❑Addition 0 A-2 ❑B,Medical 0 H-2 ❑1-2 0 R-2 ❑S-2 ,00 Type IB 0 Type N ❑Plumbing
❑Alteration 0 A-3 ❑E 0 1-1-3 ❑1-3 ❑R-3 0 U 7 ❑Type HA ❑Type VA 0 Mechanical
['Change of Use 0 A-4 ❑F-1 ❑ H-4 0 1-4 0 R-4 0 Mixed 0 Type IIB ❑Type VB ❑Electrical
❑A-5 ■ F-2 ❑M / 0 Type IIIA CRS#:
Job Address:
m._r) (Street) (Unit)
Job Description: Allyn ,-/ • �L-c�/vi2 - A ail' I c.)t1J 4- if 1 //e=jr- i)/C ::"L" IL►T/c I/4.-
tr 4wiepi --I_ r 6.17( YL al }- 1iA)/_'�
Owner: vJ (✓)A(ti;l):EIr Tenant:
Address: //DeVbC O� A.•ress:
City/State/Zip: rGi�� r--- "� City/State/Zip:
Telephone: 0 /' Telephone:
cit 1_ /0
Contractor:
I •: \ Z----
Address:
City: State: Zip Code:
Telephone: • cense Type: License No.: -Expiration Date:
I hereby certify that the proposed work wil .nforrn to the State Building Code and all other cod-.: as adopted by the€tate of Connecticut and the Town
of Montville and further attest that th- proposed work is authorized by the owner in fe and that I am authorized to make application for a
permit for such work as described .•ove. /'
Owner/Agent Signature: C/1/1-4Date: (7...._)"
'—L
i
Const ction Value
\\.. Permit Fees
Building Value' 'Building Fee:
Plumbing ue: Plumbing Fee:
Mecha • 1 Value: Mechanical Fee:
Ele rical Value: Electrical Fees.„
Total Value: Penalty Fee:
C of O Fee:
Plan Review Fee:
State Ed Fee:
Total Fee:
9Zrvised August 23,2007
Town of Montville
Building Department
310 Norwich-New London Tpke.
Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231
CONSTRUCTION PERMIT APPROVAL
Property Address
if:2P n1 %Ifk, (41— - Cc , /1 (VI A
Job Description
The applicant is responsible for obtaining'all of the require approvals checked off on this form. No building
permit will be issued until all of the required sis atures hayebeen obtained.
Required
Approval Department Permit Issuance Approval
Tax Collector
Required for all permits
Comments:
WPCA, Administrative 4//2 ) X
Required for properties on sewer
Comments:
❑ WPCA, Qpera ons
When Required by WPCA
Comment .
®
Plan •
g &Zoning s(.P.L),-e;"2
Re.wired for all az its �f'�
ealth Department
Re.uired or.ro.erties with se.tic s stems-Not required for Plumbing,Elect' I, Mechanical, Roofing,Siding,Windows&Doors
Comments:
❑ Department of Public Works
Required when project includes driveway work or certain drainage requirements
Comments:
N
State Dept. of Transportation
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
Comments:
• Fire Marshal VC,e.,. - -
\\C)
Required for all permits
Comments:
Revised-August 5,2005