HomeMy WebLinkAbout2002 - 12x14 Shed Town of Montville
Building Department
Date ") / 22_/ O Z_ Field Inspection Notice
Permit #
Job Location POLz.,YX '1 L�J�
Approved Type of Inspection C�a
II Not Approved - Please call for re-inspection when the followingcorrections
have been completed:
Building Official
Town of Montville
BUILDING DEPARTMENT
310 Norwich-New London Turnpike
Uncasville,CT 06382
860-848-3030, Ex.t 82
Building Permit
Permit Number: B2002-201 Permit Date: 03-May-02 Permit Code R9
Job Location: 60 POLLYS LANE UNIT:
MAP/LOT: 103/049-000
Job Description: SHED
Owner Contractor
DONALD R JR MALLON Donald R. Mallon,Jr.
60 Polly's Lane
60 POLLYS LANE Unit: Uncasville,Ct.06382
UNCASVILLE CT 06382 Telephone: 848-2530
Lic/Reg Type:
Use Group R4
Lic/Reg Number: 0
Code 1995 CABO
Exp Date:
Construction Type 5B
Construction Values Permit Fees
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 Value: $4,200.00 C/O Fee: $10.00
Comments: Plan Review Fee: $2.80
State Ed Fee: $0.67
Total Fees: $41.47
It is the owners responsibility to schedule the following required inspections(minimum 48 hours notice requested):
❑ Footing-Prior to pouring concrete ❑ Rough HVAC
❑ 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
❑ Fir_I Inspection
❑ Gas Piping and Pressure Test Ce ' ate of Occupancy- Prior to use or occupancy
Building Official's Signature:
e 1
Town of Montville
Building Department Permit #67e0(9-670/
310 Norwich-New London Tpke.
Tel. 848-3030, Ext 82 Uncasville, CT 06382
Fax. 848-7231
One & Two Family Building Permit Application Form
0 New Construction 0 Addition (J Alteration 0 Accessory Structure
Other
Job Location CO POLUS Li WicAs,ilt GT `C.Jb�
g3_
Job Description/Materials [I'`EP,1CA-r U-K.4 Ss*E &ket
Owner tJ Lf) I I N-LIC . 3e.._ Mailing Address 613 PaLis LA
City 00CASVIUr State
CT Zip E� Tel � /g'(0 / (:)- 3 O
Contractor Stif Mailing Address
City State Zip Tel / /
Contractor's License/Registration Type&Number Exp. Date / /
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 applicati or a permit for such work as described above.
/
Owner/Agent Signature Date
/ 41 / 30 / eil
Construction Val e Fee
Building $ 70 $
Plumbing $ ' ' $
Mechanical $ $
Electrical i $
Other $ f $
Certificate of Occupancy $ <
Plan Review Fee $ /��, r)
State Education $
Total $ $ 1/4 ,P
/ , 6 /
STATE OF CONNECTICUT
WORKERS' COMPENSATION COMMISSION
Buildin: Permit Affidavit for Pro.e
Owners or Sole Pro.rietors
(Conn. Gen. Stat. §31-28613)
Property located at y P!
In the town of
Name of building permit applicant:
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
2B.Federal Employer Identification Number
Pursuant to §31-28613, ..........................
«aPrpctyownerorsolc proprietor••-.......---_ n .._ -
contractor or principal cmploy�mayP praetor[who]intends to act as a general
contractor
or a"sworn noaffidavit...
provide either a certificateof workers'compensation
insnotarized affidavit..- stating that he will
compensation insurance for all those employed on the job site ink proof of workers'
accordance with this
Please check one:
1 '�
1. I do not intend to act as a general contractor or principal employe
[Sign an. s o. here] r.
A t
/ zi/
Signature of applicant /
2. I intend to act as a gene-a1 contractor or
m principal employer_Applicant must either
provide a certificate of workers'compensation Pcnsation insunante or sign the affidavit
.--........
Affidavit ................
I hereby swear and attest that I will •----_-•__
contractor,subcontractor,or other workerqbeforehe/she of �compensation insurance for every
accordance with the Workers'Compensation Act(Chapter 568).gages in work on the above property in
I understand that pursuant to§31-275 C.G.S.
partnership may elect to be excluded , officers of a corporation and partners in a
District Office;and thato a solexfrom coverage by filing a waiver with the appropriate
files his intent to accept coverage.proprietor of a business is not
required to have coverage unless he
Signature ofapPlicant
Subscribed and sworn to before me this
day of
200_
(Notary Public/Commissioner of the Superior Court)
Permit Fee Calculation Spreadsheet
MISCELLANEOUS PERMIT CALCULATION
Pools&Spas
Above Ground Round EA S 3,000.00 $
Above Ground Oval EA S 5,000.00 $
In-Ground EA $ 18,000.00 $
Heater EA $ 3,300.00 $
Hot Tub EA $ 5,000.00 $
Roofing
Strip&Reroof SQ S 210.00
Overlay SQ $ 175.00 $
Sheds
With Electric SF $ 25.00 $ -
No Electric 168 SF $ 25.00 $ 4,200.00
Deck SF $ 15.00 $
Porch SF $ 23.00 $ _
TOTAL BUILDING CONSTRUCTION COST $ 4,200.00
PERMIT FEE
Building $ 4,200 $ 28.0(
Mechanical $ _ $
Electrical $ _ $
$
$ -
CO Fee $ 10.00
Plan Review $ 2 80
State Ed Fee S 4.200 $ 0.67
Total Fees $ 41.47
Based on 2000 Average Construction Cost
4/30/02
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