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Home My WebLink About2001 - Strip and Re-Roof Town of Montville Building Department Phone: 848-7166 310 Norwich-New London Tpke Fax: 848-7231 Building / Trades Permit Permit Number BP2001-721 Permit Date 12/13/01 Permit Type Building Permit Code R4 Job Street# 5 Job Location PINK ROW Map/Lot 074/047-000_ Job Description Roofing -Strip Owner Contractor Ted Bourez (M. Wucik Building Address 5 Pink Row Address 317 Route 165 City Uncasville State Ct. City Preston State Ct. ..... ..._... Zip 06382 Telephone 848-2889 Zip 06365_ Telephone 887-6000 Lic/Reg Number 544809 Lic/Reg Type HIC Exp Date: 11/30/02 Use Group R4 Code 1995 CABO Type Construction 5B Building Value $5,000.00 Building Fee $28.00 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 Values $5,000.00 CIO Fee $0.00 Comments: Plan Review Fee $0.00 State Ed Fee $0.80 / otal Fees $28.80 Building Official's Signatur: �/�� - Date/i //c//6/ It is the owners res•onsibili to schedule the followin. re•ui gins•ections minimum 48 hours notice re•uested : u Footings -prior to pouring concrete ❑ Backfill -footing drains and waterproofing Ci Fireplace Throat ❑Concrete Slab, prior to pouring ❑ Fireplace Final ❑ Rough Framing ❑ Chimney -one flue above thimble ❑ Rough Electrical Ci Firestopping/draftstopping ['Electrical Service CI Insulation [Rough Plumbing and leak test Cl Pool bonding ❑ Gas piping -pressure test and installation 1/ Final Inspection ❑ Rough HVAC Li Certificate of Occupancy-PRIOR to use or occupanc Town of Montville Permit# Building Department Ez` c 2 I 310 Norwich-New London Tpke. Tel. 848-7166 Uncasville, CT 06382 Fax. 848-7231 Application for Building or Trades Permit Building permit Trades Permit ❑New Construction 0 Accessory Structure ❑Addition ❑cDemofition ❑cPlum6ing ��fec�ianical ❑Alteration Other d �Electrzcal _ 7feating Air Conditioning _ Gas`Piping Job Location pj - ?, r,, V:- Rt, LA Vi C__,AV A1�.- ,_ Job Description/Materials-RBNw,�z -- E2,3 i b/1//,/3 -- /(-VS rfrt LL 'z 5 y;z 514i"-ti 1e g . Owner—re\ c________ _________,-,- Mailing Address City w10-474 ' l Ita- State Cr( Zip ry3-z-. Tel &tom' /&-(8 Contractor s. rel. __tA- t��e ,1 Mailing Address 1 t�S City'�QeS 61.1 State C k , Zip 01031, S- Tel 64.c'/ 547/ 6,00-c. Contractor's License/Registration Type&Number C`t y<c i Exp. Date l l / '30 / Lc c,z�. New Home Construction Contractors: Have you entered into a contract with a consumer for the proposed new home?❑ Ye3No 1) 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. � /Owner/Agent Signature Date It / 2, / Zop/ Construction Value Fee Building Plumbing $ , Wiz_ $ Z� Mechanical $ $ Electrical $ $ Other $ $ Certificate of Occupancy $ $ Plan Review Fee $ State Education $ — Total _ $ O,5? $_ Oce' i Town of t ntville ,Building Departme Receipt p 1 (;) Date _____u__/_/ /V_ - _ No. 01313 From: -a_:M___.- LC,Mr /i Job Address: Yom// - ,at,/ 4; Amount $ ?g_ Cash 411111, Check 1/3355_ (ci Received by -_.___ _ Permit II 200 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 —Pt ^,,, uL,,3 In the town of _ , g..- Name of building permit applicant: Apr LAD x,2-7 t_)- k Please check one: 1. I am the owner of the above property. 2. ,,/ I am the sole proprietor of a business. f 2A.Name of business , '(l k-,C, �� 1 R-, + --s c 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 notarized 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. [Sig•,, -&------- •d stop her•j 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 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) TOWN OF MONTVILLE BUILDING DEPARTMENT 310 NORWICH-NEW LONDON TPKE. UNCASVILLE, CONNECTICUT 06382 Building Permit TeL 860-848-7166 Fax 860-848-7231 Page: 1 Permit Number: BP1999-41 Printed: 3/16/99 Approved: Applicant: MTIC Painting & Construction Zoning: P.O.Box 907 Addition: Uncasville, Ct 06382 Block:074 Lot(s): 047-000 Parcel Number: PARC1999-107 Section: 5 Pink Row Township: Uncasville, Ct 06382 Range: Area: Legal Description: Builder MTIC Painting &Construction 2511 Norwich-New London Tpke. Voice: 860-204-6232 Uncasville, Ct 06382 Fax: Local License: State License: 557850 Fees and Receipts: Number Description Amount FEE1999-241 Building Permit Fee (Auto) $10.00 Fees Total: $10.00 Construction Value: $2,000.00 Structure Use: Residential Start Date: 0/0/00 Purpose: strip & replace roofing End Date: 0/0/00 Floor Areas Impervious Surfaces Living Space: 0.00 Basement/Storage: 0.00 House: 0.00 Porch/Walk: 0.00 Garage: 0.00 Porches: 0.00 Garage: 0.00 Other: 0.00 Decks: 0.00 Other: 0.00 Driveways: 0.00 Total: 0.00 Total Area: 0.00 Site Area: 0.00 Structure Area: 0.00 Percentage of Site: Building Offic' s Signature / Date Mar 11 99 06: 51p MTICPainting&Construction 86 -204-6249 p. 2 11 II TOWN OF MONTVILLE k al Building Department Telephone 860-848-7166 Fax 860-848-7231 APPLICATION FOR BUILDING PERMIT OR TRADES PERMIT ILL 1)1 IS rCTION COMPLETELY . f/Aweer : ,2( � Mailing Address: 5 ARA /e6,6e)- ity: dPeCZKVA4.16State: ei Zip Code - Tel : ob Location: JT /:(-42A 2J-- Map/Block/Lot: V 7f/0 y7 - 04 ontract or : //// /6 P�t9f-e i„1 /Xiiik7 Mailing Address: Q •( 7X ? '? ity: 0176 .5U/ffe State: C:�. Zito Code: 3 Z Tel : .2 ? 3Z *********************************************************************M***** tick Built: Modular Home: Manufactured Home : Commercial : Jdition: Garage : Car Port : Shed: Remodeling : Roofing : X iding: Fireplace: Chimney: Windows: Pool : Demolition : lumbing: Heating: Electrical : Air Conditioning: Gas : itio: Porch: Deck : Retaining Wall : New: Repair/Replacement : )b Discription/Materials used: ity Sewer or Septic System - ze• Type of Heat : Fireplace : .of Stories: No . Rooms: Breezeway : _ Baths : Garage: Use : _ I hereby certify that the proposed work will conform to the Basic ilding Code and all other Codes as adopted by the State of Connecticut_ , and e Town of Montville . ner/Agent Signature : Odwie 41� - Date : 3�l/91 signed by Contractor , type of license/registration & No : QaS; Q ******************* :************************************************* ***** Building Department Use Only rmit # EstimatedFEE Cost __,>46 19-J Building �Q - /�`_' Plan Review C .O . To checkA ,_ 4,441/ Mar 11 99 06: 51p MTICPainting&Construction 6 -204-6249 tt* p. 1 MTIC Painting & Construction, LLC. • • P.O. Box 907 • Uneasville,Ct. 06382 Phone (860) 204-6232 Fax (860)204-6249 facsimile -transmittal To: veAm Fax: 366 .?y S' 7 2 3 1 From: PIP C .i- Date: 3//i/?2 Re: gud y "e Pages: 2.. NOTES: �+n sl74 X 5124, Crud , --toy 5.-/r2-44 MESSAGE: 89i ./ GOJ e pe-1- 614a. ,e-- f�O4 U) al 1` c a(? VSGOIA-A0/9ead) 0047 rde:Pe-Le ,9tea carr is) --