Loading...
HomeMy WebLinkAbout7x17 Shed 2001 Town of Montville Building Department Phone: 848-7166 310 Norwich New London Tpke Fax: 848-7231 Building / Trades Permit Permit Number BP2001-594 Permit Date 10/12/01 Permit Type Building Permit Code R9 Job Street# 46 Job Location PINK ROW Map/Lot 074/039-000 Job Description Shed 7'x 17' Owner Contractor Donna Franklin Donna Franklin Address 46 Pink Row Address 46 Pink Row City Uncasville State Ct. City Uncasville State Ct. Zip 06382 Telephone 848-7652 Zip 06382 Telephone 848-7652 Lic/Reg Number Lic/Reg Type Exp Date: Use Group R4 Code 1995 CABO Type Construction 5B Building Value $3,000.00 Building Fee $16.00 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 $3,000.00 C/O Fee $10.00 Comments: Plan Review Fee $1.60 State Ed Fee $0.48 •tal Fees $28.08 II Building Official's SignatureAr r Date JC)//-5-1-c-9/ It is the owners responsibili to schedule the following requir-inspections (minimum 24 hours notice required): Footings -prior to pouring concrete Backfill -footing drains and waterproofing ❑ Fireplace Throat Concrete Slab, prior to pouring ❑ Fireplace Final ❑ Rough Framing ❑ Chimney -one flue above thimble ❑ Rough Electrical ❑ Firestopping/draftstopping ❑Electrical Service ❑ Insulation [Rough Plumbing and leak test ❑ Pool bonding ❑ Gas piping -pressure test and installation ❑ Final Inspection 0 Rough HVAC © Certificate of Occupancy-PRIOR to use or occupanc Town of Montville Permit#,„00 f -5''q Building Department 310 Norwich-New London Tpke. Tel. 848-7166 Uncasville, CT 06382 Fax. 848-7231 Application for Building or Trades Permit Building Permit Trades Permit ❑ Nein Construction (J Accessory StructurecPlum6i ❑Action ��DemoCztion '�9 ❑�feclranicalNib ❑Alteration rjOt ��lect'Ycal 9feati Air Conditioning Gas q)1Pc'ig Job Location eX6 . Job Description/Materials /J'�c 1< /A/zJ S//e Owner eo",,t/A7 f i;',4” /N Mailing Address 5'6 / r)' !70 .) City GN�"?Sy, /( State Zip Tel / Contractor Mailing Address City State Zip Tel / / Contractor's License/Registration Type&Number Exp. Date New Home Construction Contractors: Have you entered into a contract with a consumer for the proposed new home? ❑ Yes In No 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 c1-•—•--1 o i) Date . c / ,,f / Construction Value Fee Building Plumbing Mechanical $ $ Electrical $ $ Other $ $ Certificate of Occupancy $ Jo,._ Plan Review Fee $ / -Cc/o State Education $ circ - Total $ • V * Town of Montville I3uildin g Department C . . . p rtment Receipt Date ___1()_/ __.--_—/0/ No. 01147 From: %yN Al a Job Address: �/U /n/i� ---_ PUS , ctAmount $ 6k7 US' ',ash Check k # Circle one) Received by 2:10— ...- Permit # /tae /__ 9 C/ STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors (Conn. Gen. Stat. § 31-2866) Property located at Y-64 / " 4 4Q6 In the town of 0,1-'c APS V � //Q, Name of building permit applicant: Ac fc /A/21 'T �G Please check one: 1. T I am the owner of the above property. 2.—I am the sole proprietor of a business. 2A.Name of business 2B. Federal Employer Identification Number(FEIN) Pursuant to § 31-2866, "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. [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 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 848-7166 CONSTRUCTION PERMIT SIGN-OFF SHEET Property Address Map/Lot Job Description: The owner/agent shall be responsible for the completion of the form, no construction permit will be issued until all signatures below have been obtained. HEALTH DISTRICT 823-1189 ❑ Permit#: IK,,Not Applicable Septic System Date ❑ Approved $,Not Applicable Plans for Food Service Establishment Date ❑ Permit#: *Not Applicable Private Well Date WPCA DEPARTMENT 848-7094 ❑ Permit#: '1q Not Applicable Municipal Sewer Date [11 Permit# 1 1' Not Applicable Municipal Water Date DEPARTMENT OF PUBLIC WORKS 848-7473 Director 11] Permit#: Not Applicable Date POLICE DEPARTMENT 848-7510 ❑ Plan Reviewed "Not Applicable Officer in Charge Date PLANNING & ZONING DEPARTMENT 848-8549 11'v`141N0 ✓`attic Lk) ( emit#: -70 _. 2 ''❑ Not Applicable Zoning Date GULP _ :��A'ff/cu, / 01 ?,( 01 ❑ Permit#: ❑ Ap licable Inland etlands Date r FIRE MARSHAL'S OFFICE 848-1175 Plan Review ❑ Approved Not Applicable Fire Marshal Date A y 44a I CII3V133311FJ1 11.,,, \itel .... .......... _.._,� _ . 4:li o% w IN Rt • bah -, x j - _ o5 1111 -4. . ' 11 414 4-1 M/ r f 1 1 I Zy �_ a 141(..— _ � _ A \7.04:$,)it:_2'; ; Al 4V. T tki ‘441,,,, in. C 4 YkJ .� to (11 h aO ...k. CI 40 C CMC444 , Iry 4. �i in 0.Thli C ._., .._. eIC CIP 111. Pr o