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TOWN OF MONTVILLE `" 1
Building Department
310 NORWICH-NEW LONDON TURNPIKE
UNCASVILLE, CT 06382-2599
TEL. (860)848-3030 X382 FAX. (860) 848-7231
BUILDING PERMIT
Permit Number: B2016-0202 Date: 01-Jun-16 Map/Lot: 017/004-0013 Owner ID: 4465000
Project Location: 90 MOXLEY ROAD Unit:
Job Description: Strip&ReRoof
Owner Nam John D.and Mary Clare Skopek Tenant Name N/A
Careof:
90 Moxley Rd
Uncasville CT 06382- Telephone: (860)501-9052
Applicant Name Britt Esterley Telephone: (860)961-3178
DBA: BEE Home Improvement LLC Lic/Reg Type HIC
Lic/Reg N 633886
214 Maple Avenue Exp Date: 30-Nov-16
Uncasville CT 06382-
Construction Value Permit Fees Construction Information
Building Value: $7,200.00 Building Fee: $96.00 Use Group: IRC
Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 2005 State Building Code
Mechanical Valu $0.00 Mechanical Fe $0.00
Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type IRC
Total Value: $7,200.00 Penalty Fee: $0.00 Permit Code: R4
C of 0 Fee: $0.00 Comment
Plan Review Fe $0.00
State Ed Fee: $1.87
Total Fee Paid: $97.87
It shall be the owners repsonsibility to schedule the followinq inspections a minimum of 2 business days in advance:
Field set of approved construction documents shall be available onsite during all inspections.
BUILDING PERMIT INSPECTIONS PLUMBING,MECHANICAL,ELECTRICAL PERMIT INSPECTIONS
❑ Footing-Prior to pouring concrete ❑ R Plumbing and leak test
❑ Deck Piers ❑ R Electrical
❑ Backfill-Footing drains and waterproofing
❑ Elec Trench-with conduit installed
❑ Concrete Slab-Prior to pouring concrete
El Pool Bonding
❑ Anchor Bolts-with sill plate and prior to floor frami
❑ Electrical Service CRS No:
❑ Framing
❑ R HVAC
❑ Masonry Fireplace Throat or Chimney Thimble
❑ Gas Piping and leak test
❑ Fireblocking Draftstopping
❑ Insulation
INSPECTION REQUIRED UPON COMPLETION
i7 Certificate of Appro .I
i erti',;.. - of• cupancy
Building Official's Approval: /
/
•
Town of Montville
Building Department
310 Norwich-New London Tpke.
Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231
RESIDENTIAL PERMIT APPLICATION FORM Permit No.: (3 I -
Type of Work Occupancy Type Permit Type
❑ New Construction ❑ Single Family ❑ Building
❑Addition ['Two-Family ❑ Plumbing
❑Alteration ❑Townhouse ❑ Mechanical
❑Accessory Structure ❑ Electrical CRS#:
Property Address: 90 Mc r:/
(Number) 7
(Street) (Unit)
Job Description: /V(J A a s -C7
Owner: J A,4..-/ ¢f/1 e c- SA c 1,
Address: 56 A /.L/
City: C�/1/�,� Sta�: r Zip Code: l ✓ <'� Telephone( )S0 j
Applicant: 2.%-i Lis¢,r 47
DBA: �f f�JJl/Mr,O/%i ,-, .� _j_ ' —
Address: 11 ( G,.
City: State: C17 Zip Code: (14.1 J u Telephone(11,r, ) YL/. )
7
Contractors - Complete the Following:
License Type: W / l� License No.:�, )05 Expiration Date: l//270 i)4
I hereby certify that the proposed work will conform to the State 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.
❑ By checking this box, I will follow the requirements of the 2005 NEC as the alternative compliance per section E3301.2.1 of the Residential Code,
instead of the electrical requirements in chapters 33 through 42 of the Residential Code.
Owner/Agent Signature: Date: ,j , / i L
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:
ftvised August 23,2007
Town of Montville
Building Department
File Receipt
Date: 31-Mav-16
ReceiptNo: 11373
Received From: Britt Esterlv
Job Address: 90 Morley Road
Town Fees Collected State of Connecticut Fees Collected
Bldg Cash: $97.87 State Cash: S1.87
Bldg Check: $0.00 State Check:
$0.00
Bldg Credit: $0.00 State Credit:
$0.00
Fire Cash: $0.00
Fire Check: $0.00
Construction Value: 57.200.00
Fire Credit: S0.00
Demolition Value: $0.00
CheckNo: 0
Received By: Carmen Kneeland (CV)nt, F---tel/ Q 2c (A
Address: 90 Moxley Road
ITEM CITY $/UNIT TOTAL
Building Plumbing Mechanical Electrical
BUILDING AREA
Basement,Finished SF $ 41.96 $ - $ -
Interior Renovations SF $ 36.09 $ - $ - $
AMENITIES
Kitchen EA $ - $
Full Bathroom EA $ _ $
Half-Bathroom EA $ _ $
GARAGE
Detached SF $ 71.53 $ - $ -
MECHANICAL
Warm-Air n Y/N $ _
Hot Water n Y/N $ -
Electric n Y/N
Air Conditioning n Y/N $ -
ELECTRICAL SERVICE
Upgrade Amps $ -
Subpanel EA $ 699.00 $
Gen Set EA $ 3,850.00 $ -
SOLID FUEL BURNING APPLIANCES
Prefab Metal Fireplace EA $ 6,497.70 $ -
Masonryw/lfireplace EA $ 7,096.65 $ -
Masonry w/2 fireplaces EA $ 11,095.70 $ -
Wood Stove,free standing EA $ 2,692.25 $ -
Wood stove insert - EA $ 1,859.77 $ -
DECKS,PORCHES,SUNROOMS
Deck SF $ 44.07 $ -
Porch - SF $ 149.38 $ -
Sunroom SF $ 176.90 $ - $ -
POOLS&HOT TUBS
Hot Tub EA $ 8,016.25 $ - $ -
Inground Pool EA $ 31,550.00 $ - $
Above Ground Round EA $ 6,299.46 $ - -
Above Ground Oval - EA $
$ 7,019.75 $ - $ -
Pool Heater - EA $ 8,984.25 $ - -
Inflatable Type Pool EA $ 1200.00 $ - $ -
SHEDS
w/o electrical SF $ 25.55 $ -
w/electrical SF $ 26.85 $ - $ -
RENOVATIONS
Roofing,Overlay SF $ 3.50 $ -
Roofing,Strip&reroof 1600 SF $ 4.50 $ 7,200.00
Roof Sheathing SF $ 1.51 $ -
Siding - SF $ 6.75 $ -
Windows - EA $ 550.00 $ -
Skylights EA $ 1,051.10 $ -
Doors,Exterior EA $ 601.50 $ -
Oil Tank,275 Gallon - EA $ -
Oil Tank,550 Gallon EA $ _
MISCELLANEOUS CALCULATIONS
TOTALS $ 7,200.00 $ - $ $ -
PERMIT FEE CALCULATIONS
Construction Value Fee
Building $ 7,200.00 $ 96.00
Plumbing y $ - $
Mechanical y $ - $ _
Electrical y $ - $
Working before Permit Issuance $
Certificate of Occupancy Fee $
Plan Review Fee $
State Education Fee $ 1.87
TOTALS $ 7,200.00 $ 97.87
Figures are based on the 2006 RS Means Residential Cost Data
L._ Niiill
cState of Connecticut N
7A
•, Workers' Compensation Commission
tint%%/,,i�� Please TYPE or PRINT IN INK
Proof of Workers' Compensation Coverage when Applying
for a Building Permit for the Sole Proprietor or Property Owner
who WILL NOT act as General Contractor or Principal Employer
APPLICANT FOR BUILDING PERMIT v
Name of Applicant for Building Permit e{A/ if v A.,,, /si
Property located at 0 /V 01(!7 gJ
J
in the City/Town of U,yw,L G.., 1,I fie.e./ ( i b..4,- 6-i-----
ATTEST LATTEST
If you are the owner of the above-named property or the sole proprietor of a business doing work on the site of the construction project at the above-named
property and you WILL NOT act as the general contractor or principal employer,you are not required to have workers'compensation insurance coverage.
CHECK ONE(1) BOX ONLY and complete the following:
4
❑ I am the OWNER of the above-named property.I WILL NOT act as the general contractor or principal employer.
Signature of OWNER Appfucant - --- - ----
m the SOLE PROPRIETOR of a business doing work at the above-named property.I Will NOT act as the general contractor or principal employer.
Va
.
Name of Business fy£ go»^c f 'i—;L C_--
Federal Employer lD#(FEIN)
_ -
Signature of SOLE PROPRIETOR Applicant 2
Nee
Town of Montville
Buildinq Department
CONSTRUCTION PERMIT APPROVAL
Applicant is responsible for obtaining all of the required approvals. No permit will be issued until all the required signatures are obtained.
5t T7 /<J /'' 1.,//17 �a
Property Address
A.(
Job Description
Required
Department
Approval Permit Issuance Approval
Tax Collector //y/iLc,Signature/date
Comments:
Planning & Zoning
Comments: �,�_
Z.l�� Si. .ture/ ate
Fire Marshal � �I
Signature/date
Comments:
❑ Health Department
Required for properties with private septic or well
Comments:
❑ WPCA, Administrative
Required for properties on sewer Signature/date
Comments:
❑ WPCA, Operations
When Required by WPCA Signature/date
Comments:
❑ Department of Public Works
Required when project includes driveway work or certain drainage requirements Signature/date
Comments:
❑ Montville Police Department
Required for all permits EXCEPT one and two family residential Signature/date
Comments:
❑ 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
Signature/date
Building Department Review Complete
Signature/date
Revised May 23,2011