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Home My WebLink About12x20 Shed 2004 d- a N Q N Z O Z N O p .1 O 3 .0 m_ E E 4- _ itl � LI O 3 0 C V) l!) la (n i Ql 1- i 4) .0 C v U) 41 (d L] C _C I (� •i o 22 5' ( U) U) U U > le o _ -v 0 0 W Z <" cc•, o o a Q W d , U L o Z a O o a) c F'is N LL W cin c C tO \I: C7 U 7 m N - m JZ p V • cu c3F., o4- � W Crn..1 U. C O O OU Z a C O to O tNI tO H 1011 V Ca CZ U L '� 5 o vfi -flm 0 .c." V a) a_ 73 •- 0.4.4 N in • Q) 2 U X aru 3 fp a) ....1 V1 4) CO _c o c0 M N d- w a + U U r4 t N i co m C j+ m n L 01 O H -p _I 01 E Z' OO p >;' 1 a cQa MU O O Z Ut - io ro E ca I-. rci N ca fl. o E t9 a; .3 a) N 6. a a = U ca F- U 0 Town of Montville Building Department 310 Norwich-New London Tpke. Uncasville, CT 06382 Tel. 860-848-3030, Ext. 382 Fax. 860-848-7231 CERTIFICATE OF OCCUPANCY APPROVAL 0 7, L/v P operty Addfess Job Description The applicant is responsible for obtaining all of the required approvals checked off on this form. No building permit will be issued until all of the required signatures have been obtained. Required Approval Department Certificate of Occupancy Approval ❑ WPCA Signature/date Planning& Zoning Zadu.s,4 CAtz44. y'zhv 20Y-z yl s i gru2tm e ;.1r3t<, ❑ Health Department Signature/date ❑ Department of Public Works Signature/date ❑ State Dept. of Transportation Signature/date ❑ Police Department Signature./date ❑ Fire Marshal Signature./date Comments/Conditions: vrreiSeptem6er9,2004 Town of Montville Building Department Field Inspection Notice Address: 136 POLLY'S LANE Job Description Shed Permit Numbers: Footing Not Approved: Approved: Comments: 1. Backfill Not Approved: Approved: Comments: 1. Framing Not Approved: Approved: Comments: 1. Rough Electric Not Approved: Approved: Comments: 1. Electrical Service Not Approved: Approved: Comments: 1. Rough HVAC Not Approved: Approved: Comments: 1. Rough Plumbing Not Approved: Approved: Comments: 1. Gas Line Not Approved: Approved: Comments: 1. Fireplace Throat/ Not Approved: Approved: Chimney Comments: 1. Fire/Draftstopping Not Approved: Approved: Comments: 1. Insulation Not Approved: Approved: Comments: 1. Certificate of Not Approved: Approved: 9/13/04 JS Occupancy Comments: 1. Not Approved: Approved: Comments: 1. Not Approved: Approved: Comments: 1. Not Approved: Approved: Comments: 1. Comments: Page 1 of 1 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: B2004-0495 Date: 19-Aug-04 Map/Lot: 102/045-000 Owner ID: 5648000 Project Location: 136 POLLYS LANE Unit: Job Description: Shed 12'x 20' Owner Name: William and Barbara Page Tenant Name: N/A Careof: 136 Pollys Lane Uncasville CT 06382- Telephone: Contractor Name: Property Owner Telephone: (860)848-8729 DBA: Lic/Reg Type: Lic/Reg No: 0 Exp Date: Construction Value Permit Fees Construction Information Building Value: $6,300.00 Building Fee: $56.00 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: $6,300.00 Penalty Fee: $0.00 Permit Code: R9 C of 0 Fee: $10.00 Comments: Plan Review Fee: $5.60 State Ed Fee: $1.01 Total Fee: $72.61 It shall be the owners repsonsibilitv 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 ❑ Final Inspection ❑ Insulation ❑d Certificate of Occupancy Building Official's Approval' • Town of Montville ! ' Building Department 310 Norwich-New London Tpke. Tel.848-3030,Ext 382 Uncasville, CT 06382 Fax.848-7231 Residential Building Permit Application Form Permit# � New Construction 0 Addition []Alteration Accessory Structure ❑Single Family El Two-Family Li Townhouse Job Address , b�� (Number) (Street) (Unit) Job Description ' r'r22:-'-Qc//z— , D1.t/6- Owneriry,-6,42ffb sr glefiz6: Mailing Address /7l f LLcf City l�/lac lD!CL State Zip QV Tel Tel D /R'y R'Zag Contractor 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 application for a permit for such work as described above. Separate applications are required or electrical,plumbing,mechanical,etc. Owner/Agent Signature C�O Date / / Construction Value Fee Building dO Plumbing $ $ Mechanical $ $ Electrical $ $ Certificate of Occupancy Plan Review Fee r d State Education ( Total (See averse side for additional requirements) Town of Montville Building Department Receipt I Date / /7 / o 4/ No. 0 414 4 From: J,, �, • ice . ..-Job Address: / ' 4!".. :r ter.. Amount $ `A / Cash Check Check # Circle one) Received by\ /dj ,i 1/,ijs - - ,, Permit d l 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 $ 185.00 $ - Plywood SQ $ 105.00 $ - Plumbing Full Bath EA S 4,230.00 $ Half Bath EA S 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 240 SF $ 26.25 $ 6,300.00 Sheds with Electrical SF $ 26.25 $ - Electrical Service 100 Amp EA $ 825.00 $ - 200 Amp EA S 1,500.00 $ - Siding $ - Windows & Doors $ - Decks/Porches/Sunrooms Open SF $ 22.31 $ - Covered SF $ 62.69 S Enclosed SF $ 123.90 $ - TOTAL BUILDING CONSTRUCTION COST $ 6,300.00 PERMIT FEE CALCULATIONS Fee Building 5 6,300 $ 56.00 Plumbing $ - $ - Mechanical $ - $ - Electrical S - $ - Work Commenced before permit issuance $ - CO Fee $ 10.00 Plan Review $ 5.60 State Ed Fee $ 6,300 1.01 Total Fees S 72.61 Based on 2003 RS Means Residential Cost Data 8/11/04 STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors (Conn. Gen. Stat. § 31-286b) Property located at: i9t//y-r' In the town of ��i✓e'V,/ � c i-7Z 6 ctj C j 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(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 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. L/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 covera e by filing a waiver wi e appropriate District Office; and that a sole proprietor of a business is not rsuir to coy ge 1 s files his intent to accept coverage. Signature of applicant Subscribed and sworrrto b:. .re me this 1, k day of , 200 4. ��AI r' . I - .01111V otary Public/Commissioner of the Superior Court) SHERRI UNDERWOOD NOTARY PUBLIC MY COMMISSION EXPIRES NOV.30,2007 Town of Montville Building Department 848-3030, Ext 382 RESIDENTIAL CONSTRUCTION PERMIT SIGN-OFF SHEET /3c.0 id//y `s CaI4-- Property Address Job Description: f o2 J(,2(: S-/Lr i_e SA ed 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#: p Required Septic System Date Approved No Permit ❑ Permit#: ❑ Required Private Well Date WPCA DEPARTMENT 848-3030,Ext 376 Approved No Permit ❑ Permit#: ❑ Required unicipa Sewer Date Building Trap 0 Outside ❑ Inside Approved No Permit ❑ Permit# 0 Required Municipal Water Date DEPARTMENT OF PUBLIC WORKS 848-7473 Approved No Permit ❑ Permit#: 0 Required Director Date PLANNING&ZONING DEPARTMENT 848-3030,Ext.379 6444' No Permit -'h.• do .i - 02 Permit#: ! lig- 0 Required ping Date Approved No Permit 0 Permit#: 0 Required Inland-Wetlands Date Order Number: 111062 yy-- °'' Page: Page 1 of 1 i MiA Customer P.O.Number: Order Date: 7/27/04 TERI' O/LS Scheduled Delivery Date: 9/9/04 216 West Road(Route 83) Est. Customer Pickup Date: Ellington,CT 06029 Customer Pickup Status: NA 860-871-1048 (Fax)860-871-1117 RO#: Doors On: Driver Side www.kloterfarms.com Due Date: Salesperson: DOUG L. Deliver To: William Page Mailing Address: (If Different) 136 Pollys Lane Uncasville,CT 06382 Phone: (860)848-8729 Ext.Home Phone: (000)000-0000 Ext.0000 Phone: 0-Ext. Qty Description Unit Price Discount Extended Price 1 12x20 Vinyl Cape Storage Building $5,390.00 $970.20 $4,419.80 1 Cream Vinyl Siding 1 White Trim 1 White Vinyl Shutters ' 240 Gray 30 Year Architectural Shingles $0.40 $96.00 2 Upgrade'E'Window(White)24"Wx36"H,Aluminum DH together in the middle $25.00 $50.00 1 Standard Double Door 1'off Left Corner 1 Extra Single Door 1'off right corner • x $155.00 $155.00 3 Arch Glass Door Window in all doors l $95.00 $285.00 1 4'Storage Loft-Left $95.00 $95.00 1 4'P.T.Ramp $65.00 $65.00 I Anchor System-Installed $80.00 $80.00 TOTALS: $970.20 $5,245.80 NOTES: EE J e '' DD 6' i CUSTOMER AGREES WITH THIS ORDER AS WRITTEN AND Delivery Charge $0.00 ASSUMES FULL RESPONSIBILITY FOR THEIR PROPERTY DURING Subtotal $5,245.80 DELIVERY. Sales Tax-CT $314.75 In the event of unusual delivery conditions such as unlevel site, obstructive trees or Customer Letter $0.00 fences, delivery may exceed the normal 30 minutes at site and result in an additional Wide Load Permits $25.00 charge of$80 per hour. A small deposit on custom orders guarantees price and product TOTAL $5,585.55 for up to one year. However,construction of your custom order will begin when a 1/3 Deposit 7/27/2004 VISA-YARD $-2,000.00 deposit has been received and a delivery date has been scheduled. Kloter Farms will issue a credit slip on any canceled order less a re-stocking fee. Balance Due $3,585.55 Deposit **LINE ITEMS MARKED TBD (To Be Determined) MUST BE ADDRESSED Balance Due BEFORE A DELIVERY DATE CAN BE SET. Deposit Balance Due Family Owned & Operated Deposit SATISFACTION GUARANTEED Balance Due SINCE 1980 Deposit CUSTOMER APPROVAL Balance Due OPEN YEAR ROUND MONDAY-SATURDAY WE APPRECIATE YOUR BUSINESS Payment Info: POD Printed on: 7/27/2004 11:33:19AM '"---------- --' -, 1 f- fa' , q Pooh. 7 to '"1 1(p` ?o o L. S p AIRE-A 1 I I . -F-------- 3S — }} : I ,, < G00L ;t x.,.c n fe.--9,o'- T, ePoesask; ! i2 S I-FED — , I aq, i Ii � � c,c H .' • i AILI --J`,)!_L!., _ i ate 3 a ' i 4 (1 , i iv\ �P l oa.. I I l.v-7-- 4S ii Vn+fiRKPJ , L Sc 0 L E z—0-1_ ---_- r --- • - l m o' ----IA i 4= ._n `' LN / -3 Ls) r' a ! � y �