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Home My WebLink AboutDeck Extension 2004 Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville,CT 06382 (860)848-3030, Ext.382 Building Permit Permit Number: B2004-0348 Date: 23-Jun-04 Map/Lot: 028/005-021 Owner ID 117007 Job Location: 15 PHEASANT RUN Unit Job Description: Deck Extension Owner: Contractor: Timothy E and Paula L McDonough Affordable Projects 39 Oxoboxo Cross Road 15 Pheasant Run Oakdale Ct. 06370- Oakdale CT 06370 Telephone: (860)887-2763 Lic/Reg Type/No. HIC 572055 Exp Date: 30-Nov-04 Tenant: Self Telephone: Construction Values Permit Fees Construction Information Building Value: $3,429.00 Building Fee: $22.00 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: R10 Other Value: $0.00 Other Fee: — $0.00 Comments: Total Value: $3,430.00 CO Fee: $10.00 Plan Review Fee: $2.20 State Ed Fee: $0.55 Total Fees: $34.75 It is the owners responsibility to schedule the following inspections(minimum 48 hours notice required): ❑d 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 El Rough Framing ❑ Firestopping/draftstopping ❑ Rough Electrical ❑ Insulation ❑ Electrical Service CRS #: 0 ❑ Final Inspection ❑ Rough plumbing and leak test ❑d Certificate of Occupany ❑ Gas piping and test Building Official's Signature:Allef /7,P-- Town of Montville Building Department yrA 310 Norwich-New London Tpke. Tel.848-3030,Ext 382 Uncasville,CT 06382 Fax.848-7231 Residential Building Permit Application Form Permit#do206 `Zf D 37 ❑New Construction [A Addition 0 Alteration ❑Accessory Structure ❑Single¶Family ❑ Two-'Family❑ 'Townhouse Job Address 15 `"tC\SP►N 3\10 XYAC ‘`\•7 , n;t ) (Number) (Street) N Job Description WIS., S‘W Owner��'M ‘MtaIlgq,24\ Mailing Address S t .a City ly-y\ A-\j.\VL State a Zip 'O Tel _/ Mailing �`l '610� °. e`r'cS Contractor g4.3(4))6 � �2�5 Address City OKL R State Zip 000j 7 Tel At) S7 ),C55l Contractor's License/Registration Type&NumberWrnt_ krr►?r J e' .* Exp.Date` / / a3a4A 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,plumbing,mechanical, etc. Owner/Agent Signature Date Construction Value Fee Building $ C �� • t�J $ Plumbing $ $ Mechanical $ $ Electrical $ $ Certificate of Occupancy $ Plan Review Fee $ State Education $ Total $ $ (See averse side for additional requirements) Town of Montville Building Department Receipt � � � / 014 No. O c:-;2. > • Date " � `" From: Ar --o R 0BAC 1...E ?07.-0J a-CV Job Address: I S FR 2 A 5A " 'Zv Amount $ 311 • 73 Mill Check Check # (Circle one) Permit # Received by J • v t'�t`+. Permit Fee Calculation Spreadsheet MISCELLANEOUS PERMIT CALCULATION Pools&Spas Above Ground Round EA $ 3,150.00 $ Above Ground Oval EA $ 5,250.00 S In-Ground EA $ 18,900.00 $ Heater EA $ 3,465.00 S Hot Tub EA $ 5,250.00 $ Roofing Strip&Reroof SQ $ 207.20 S Overlay SQ $ 127.05 Plywood SQ $ 101.85 $ Sheds SF $ 26.25 S Electrical Service 100 Amp EA $ 816.43 $ 200 Amp EA $ 1,519.19 $ 400 Amp EA $ 6,039.29 $ Breezeway/Decks Open 220 SF $ 15.59 $ 3,429.80 Enclosed SF $ 94.76 $ - Porches Open SF $ 62.69 $ Enclosed SF $ 123.90 S TOTAL BUILDING CONSTRUCTION COST $ 3,429.80 PERMIT FEE Building $ 22.00 Electrical $ $ - $ - CO Fee $ 10.00 Plan Review $ 2.20 State Ed Fee $ 3,430 $ 0.55 Total Fees $ 34.75 Based on 2003 RS Means Residential Cost Data 6/14/04 r • STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors (Conn. Gen. Stat. § 31-286b) Property located at: 13G SN,it In the town of rCjV.(_. Name of building permit applicant:Arfr2,)-c .. Jt�S Please check one: 1. I am the owner of the above property. 2. )p I am the sole proprietor of a 4Ni4N,ss. 2A. Name of business: �r0p9-,l z. R\-,5 -t_A--5 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 check one: 1. I do not intend to act as a general contractor or principal employer. [Sign and stop here] Signature of applicant 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 b filing a wa. -r with the appropriate District Office; and that a sole proprietor of a business is not requ. a• o . e ov:, .ge . - ess h- his intent to accept coverage. Sign.'�e o applicant 1 Subscribed and sworn to before me this ,1 '7 ‘- day of J�r,�e...._ , 200 ' — </ 2C-ia-IZJ,_ (Notary Public/Commissioner of the Superior Court) MELINDA L. ROBERTS NOTARY PUBLIC t'!`,t COMMISSION EXPIRES OCT.31,2007 Town of Montville Building Department 848-3030, Ext 382 RESIDENTIAL CONSTRUCTION PERMIT SIGN-OFF SHEET / PLA-0 Property Address Job Description: C1(.._ N-___NA-c Ci 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 0 Permit#: ❑ Required Septic System Date Approved No Permit ❑ Permit#: ❑ Required Private Well Date WPCA DEPARTMENT 848-3030,Ext 376 Approved No Permit �... 1 1-1'-61 0 Permit#: ❑ Required Municipal Sewer Date Building Trap ❑ Outside 0 Inside Approved No Permit ❑ Permit# ❑ Required Municipal Water Date DEPARTMENT OF PUBLIC WORKS 848-7473 Approved No Permit Director ❑ Permit#: 0 Required Date PLANNING&ZONING DEPARTMENT 848-3030,Ext.379 btkeivk • /proved No Permit l (9 �Hca_i _permit#: ;,20-1 -O1/442.❑ Required D.40/100Date Approved No ermit 0 Permit#: Re uired Inland-Wetlands Date .-‘v :115 Qgof') 9\f7 . .-".(76" rgIX .3°44. V,›.cats • i4k oar"P 2LA .. ..... it . i i ...1, > o it SA ..a"... \, \ 4/ 4= - - - - Al it 2 7 i r --uxi-: -t / V <!1 to t' e- V =-- `)'6' 9,(5.") ____ ,.- \i' - CO m ch G.) i • • (L.)111 Pz e'04'4!lit 0 Oil. t:..1 •*21 , • . i iikt r_.141::' 8 c: kev-or . 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