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Home My WebLink AboutSiding and Windows 2004 TOWN OF MONTVILLE Building Department 310 NORWICH-NEW LONDON TURNPIKE UNCASVILLE, CT 06382-2599 TEL. (860) 848-3030 X382 FAX. (860) 848-7231 BUILDING PERMIT Permit Number: B2004-0492 Date: 19-Aug-04 Map/Lot: 103/057-000 Owner ID: 5612000 Project Location: 35 POLLYS LANE Unit: Job Description: Siding&Windows Owner Name: Elizabeth Tasca and Darius Fellows Tenant Name: N/A Careof: 35 Pollys Lane Uncasville CT 06382- Telephone: Contractor Name: James d. Henderson Telephone: (860)857-7775 DBA: Lic/Reg Type: HIC Lic/Reg No: 564224 P.0. Box 316 Exp Date: 30-Nov-04 Groton Ct 06340- Construction Value Permit Fees Construction Information Building Value: $3,500.00 Building Fee: $64.00 Use Group: R-4 Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1999 State Building Code Mechanical Value: $0.00 Mechanical Fee: $0.00 w/2000 Amendment Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type: 5B Total Value: $3,500.00 Penalty Fee: $0.00 Permit Code: R4 C of 0 Fee: $0.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $0.56 Total Fee: $64.56 It shall be the owners reosonsibility to schedule the following inspections a minimum of 2 business days in advance: Field set of approved construction documents shall be available onsite during all inspections. ❑ Footing-Prior to pouring concrete ❑ R Plumbing and leak test ❑ Backfill-Footing drains and waterproofing ❑ R Electrical ❑ Concrete Slab-Prior to pouring concrete ❑ Elec Trench-with conduit installed ❑ Framing ❑ Electrical Service CRS No: 0 ❑ Fireplace Throat-One flue above throat ❑ R HVAC ❑ Chimney-One flue above thimble ❑ Gas Piping and leak test ❑ Firestop Draftstopping 0 Final Inspection ❑ Insulation ❑ Certificate of Occupancy Building Official's Approv. . Town of Montville v Building Department 310 Norwich-New London Tpke. Tel. 848-3030,Ext 382 Uncasville,CT 06382 Fax.848-7231 Residential Building Permit Application Form Permit#'1e120 -0 7?C O New Construction ['Addition 2 Alteration 0 Accessory Structure O Single EFamily 1=1 Two-Family 0 'Townhouse Job Address 3 c Polly_.5 '4 , (Number) treet) (Unit) Job Description lie. 4 11 S(j , /1 o (A..1 C 0/12 rep/pee/, PA* i/. .1/1 (.✓i..l 0E7G/ Owner 6e` 1 1 ix SCG( Mailing Address 2 gli,S 4 4 City 31/45- p6/1'!S `V1 OCkJiv ((eState ea---- Zip O,38 . Tel / / Contractor 0M eS Z. I`ICAde 1`-roil Mailing Address Pox 3/ (p City Gro TO 4 r State CT- Zip 0 C 3Yo Tel 3 /85 7 / 2?7 S Contractor's License/Registration Type&Number so).). 2 ( Exp.Date /( / 3 0 /0 V 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 require ' .r electrical,plumbing,mechanical, etc. Owner/Agent Signature ,i/ , Date9 ,/0 / 0v .------ Construction Value Fee Building $ 3S°0 °}` 9 Plumbing $ $ � Mechanical $ $ Electrical $ $ Certificate of Occupancy $ Plan Review Fee $ State Education $ , Total $ 3 oda o; $_____44. (See Wf verse side for additional'requirements) Town of Montville Building Department Receipt ceipt Date _4?.._ / _ _ No. 04137 From: Job Address:gitk="11ff., Amount $ "' • -�6 4,1111110 heck Check # / Circle onc) Received by ,...,,,40, i J�� 0 l .......4:11;,',./ Permit # ,r, Permit Fee Calculation Spreadsheet MISCELLANEOUS PERMIT CALCULATION Address: Pools & Spas Above Ground Round EA $ 3,200.00 $ - Above Ground Oval EA $ 6,000.00 $ In-Ground EA $ 18,900.00 $ - Heater EA $ 3,465.00 $ - hot Tub EA $ 5,250.00 $ - Roofing Strip & Reroof SQ $ 300.00 $ Overlay SQ S 185.00 $ - Plywood SQ S 105.00 $ Plumbing Full Bath EA $ 4,230.00 $ - Half Bath EA $ 2,690.00 $ - Garages Attached, 1 car EA $ 8,885.00 $ Attached, 2 car EA $ 15,114.00 $ Attached, 3 car EA $ 20,914.00 $ Detached, 1 car EA $ 11,657.00 $ - Detached, 2 car EA $ 17,456.00 $ Detached, 3 car EA $ 23,256.00 $ Sheds SF $ 26.25 $ Sheds with Electrical SF $ 26.25 $ Electrical Service 100 Amp EA S 825.00 $ - 200 Amp EA S 1,500.00 $ - Siding $ 3,500.00 Windows & Doors $ - Decks/Porches/Sunrooms Open SF $ 22.31 $ - Covered SF $ 62.69 $ - Enclosed SF $ 123.90 $ - TOTAL BUILDING CONSTRUCTION COST $ 3,500.00 PERMIT FEE CALCULATIONS Fee Building $ $ 32.00 Plumbing $ $ - Mechanical $ $ - Electrical $ $ - y Work Commenced before permit issuance $ 32.00 CO Fee $ - Plan Review $ - State Ed Fee $ 3,500 0.56 Total Fees $ 64.56 Based on 2003 RS Means Residential Cost Data 8/10/04 f STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors (Conn. Gen. Stat. § 31-286b) Property located at: 35 o fry 5 In the town of Oil ea 55 '(e Name of building permit applicant: Ate s � 1e4cf tro .� Please check one: 1. I am the owner of the above property. 2. / I am the sole proprietor of a business. 2A. Name of business: PaoY7(C-0fv/`k5 2B. Federal Employer Identification Number(FEIN) O6 • 13 '(7 S ?0 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 .: . : - eral contractor or principal employer. [Sign and stop he e Signature of. ►,.!i:. 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 848-3030, Ext 382 RESIDENTIAL CONSTRUCTION PERMIT SIGN-OFF SHEET Property Address Job Description: 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 ❑ Permit#: ❑ Required Septic System Date Approved No Permit ❑ Permit#: ❑ Required Private Well Date WPCA DEPARTMENT 848-3030,Ext 376 Approved No Permit ❑ Permit#: ❑ Required Municipal Sewer Date Building Trap ❑ Outside ❑ Inside Approved No Permit ❑ Permit# ❑ Required Municipal Water Date DEPARTMENT OF PUBLIC WORKS 848-7473 Approved No Permit 0 Permit#: 0 Required Director Date PLANNING&ZONING DEPARTMENT 848-3030,Ext.379 Approved No Permit 0 Permit#: 0 Required Zoning Date Approved No Permit 0 Permit#: ❑ Required Inland-Wetlands Date