HomeMy WebLinkAboutRoof over Existing Dech 2001 Town of Montville
Building Department
Phone: 848-7166 310 Norwich New London Tpke
Fax: 848-7231
Building / Trades Permit
Permit Number BP2001-566 Permit Date 9/25/01 Permit Type Building Permit Code R4
Job Street# 7 Job Location POLLYS LANE
Map/Lot 103/063-000
Job Description Roofing -Strip
Owner Contractor
Jane H. Roy
— Lathrop Bros.
Address 7 Pollys' Lane Address P. O. Box 248
City Uncasville State Ct. City Uncasville State Ct.
Zip 06382 Telephone 848-8129 Zip 06382 _ Telephone 848-3773
Lic/Reg Number 554264
Lic/Reg Type,HIC Exp Date: 11/30/01
Use Group R4 Code 1995 CABO Type Construction 5B
Building Value ($4,200.00) 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 $4,200.00 C/O Fee
$10.00
Comments: Plan Review Fee $0.00
State Ed Fee $0.67
Total Fees $38.67 i
/'
Building Official's Signature7/ Date'9 /2 / 0)
It is the owners respon 1 ' schedule the following required inspections (minimum 24 hours notice required):
Footings -prior to p r g 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 1," Final Inspection
❑ Rough HVAC Certificate of Occupancy -PRIOR to use or occupanc
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Town of Montville Permit #i�,I,e
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
❑ New Construction ❑Accessory Structure ❑(Plumbing 09Kechanicat
❑Action ❑q)emofztion. ❑E1 ctricat 51-eating
❑Alteration ❑Otfrer 4 C -,,z,i
VAir Conditioning
Gas Tiling
Job Location 7 1e z_ y / 2/ / /(/r y,jC G- C 9r-
Job Description/Materials l' /' / T/`�' ,4e; ,
Owner 7 ,49,&"'" ,c,/ /t 9,7 Mailing Address 7 f c yf 440/
City (f�tQerig)-S'E/'/L,4,, State j.j7 Zip QG,3j Tel Rao /pv7 /,fr"7/ /
Contractor //S2%/ii41/7 0,--r5_5* Mailing Address 1096 a O X' c,2 ci eF
City IA/ /15l 'C-e-e'r State C% Zip 06e312--z Tel Fat? /fell/ 3 > 2 3
Contractor's License/Registration Type&Number ,1":5Y-76.5/.Exp. Date /7 / yo / a
New Home Construction Contractors:
Have you entered into a contract with a consumer for the proposed new home? ❑ Yes ❑ 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 Signal 2 4110/ Date / /
Construction Value Fee
Building $ 9c`Z60 $ ^Z5'
Plumbing $ $ '-;C)
Mechanical $ $
Electrical $ $
Other $ $
Certificate of Occupancy $ /•• '--
Plan Review Review Fee $
State Education $ , 4
Total $ y�0 0 $ O�i& -
Town of Montville Building Departm� -it Receipt
Date y /4 3 / o 1 No. 01-104
From:
r i
22.Car i '1-'4 5 1
Job Address:
' 0
Amount $___ • 7 Cash Check Check # f
/ i (circler one)
Received byt
, ,,:' ..1.r/ Pen-nit #40,1 co! .6'64
Permit Fee Calculation Spreadsheet
MISCELLANEOUS PERMIT CALCULATION
Pools&Spas
Above Ground Round EA $ 3,000.00
Above Ground Oval EA $ 5,000.00
In-Ground EA $ 18,000.00
Heater EA $ 3,300.00
Hot Tub EA $ 5,000.00
Roofing
Strip&Reroof 20 SQ $ 210.00
Overlay SQ 175.00
Sheds
With Electric SF 25.00
No Electric SF 25.00 $
Deck SF $ 15.00
Porch SF $ 23.00 $
TOTAL BUILDING CONSTRUCTION COST
PERMIT FEE
Building 4,200 $ 2800
Mechanical $ -
Electrical $ -
CO Fee $ 10.00
Plan Review $ -
State Ed Fee 4,200 $ 0.67
Total Fees $ 38.67
Based on 2000 Average Construction Cost
9/24/01
4001
STATE OF CONNECTICUT
WORKERS' COMPENSATION COMMISSION
Building Permit Affidavit for Property Owners or Sole Proprietors
(Conn. Gen. Stat. § 31-286b)
„gi%IProperty located at 7 QeL V 1..._„g/47,-4---
In
n the town of o/ve r V/
Name of building permit applicant: e_ 7%//,' /-3i€0`�'
Please check one:
1. I am the owner of the above property.
2. Aj I am the sole proprietor of a business.
2A.Name of business Z.--- ij€d dS
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. y I do not intend to act as a general contractor or principal employer.
[Sign and stop here] �/
gnature of app icant
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)