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Home My WebLink AboutStrip and Re-Roof 2004 Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville, CT 06382 (860)848-3030, Ext. 382 Building Permit Permit Number: B2004-0143 Date: 12-Apr-04 Map/Lot: 068/014-000 Owner ID 121011 Job Location: 29 POWERHOUSE ROAD Unit Job Description: Strip&Re-roof Owner: Contractor: Alexander and Marie A Vollaro David Gilmore P.0. Box 93 29 Power House Rd East Lyme Ct. 06333- Uncasville CT 06382 Telephone: (860)984-5099 Lic/Reg Type/No. HIC 562832 Exp Date: 30-Nov-04 Tenant: Self Telephone: Construction Values Permit Fees Construction Information Building Value: $3,315.00 Building Fee: $22.00 Use Group: R4 Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1995 CABO Mechanical Value: $0.00 Mechanical Fee: $0.00 Construction Type: 5B Electrical Value: $0.00 Electrical Fee: $0.00 Permit Code: R4 Other Value: $0.00 Other Fee: $0.00 Comments: Total Value: $3,315.00 CO Fee: $10.00 Plan Review Fee: $0.00 State Ed Fee: $0.53 Total Fees: $32.53 It is the owners responsibility to schedule the following inspections(minimum 48 hours notice required): ❑ Footing -Prior to pouring concrete ❑ Rough HVAC ❑ Backfill-Footing drains and waterproofing ❑ Fireplace Throat ❑ Concrete Slab-Prior to pouring concrete ❑ Chimney-One flue above thimble ❑ Rough Framing ❑ Firestopping/draftstopping ❑ Rough Electrical ❑ Insulation ❑ Electrical Service CRS #: 0 ❑d Final Inspection ❑ Rough plumbing and leak test ❑ Certificate of Occupany ❑ Gas piping and test Building Official's Signature: „47"AeF 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#19e6 —d� ❑ New Construction 0 Addition []Alteration []Accessory Structure Single Family [i Two-Family Li Townfiouse Job Address 1 "Pa w, �oi4� RCC • bl/leA5!// (Number) (Street) n ' (Unit) Job Description 1 V C.w oG P ,' Owner /<U nice 4 r K Mailing Address 9 A w t /2-44x....4-yam._ Rd. City /4 nye Sv://f C r State CT: Zip 6C- ZTel / f 2Z. r (� Contractor Dig-v/ry a(ipvt or1� Mailing Address T O Bo ' 3 City 1-ns-JL e State i' Zip CE3'3 Tel � C 760/ � Contractor's License/Registration Type&Number �/G ��A' 6'43 2 Exp.Date /1 / 3o/ p oa 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 for I al,plumbing, mechanical, etc. Owner/Agent Signature Date l / /21 0 / Construction Value Fee Building $ ('DSO cC) Plumbing $ / $ Mechanical $ $ Electrical $ $ Certificate of Occupancy $ Plan Review Fee State Education $ Total $ $ (See&verse sidefor additional-requirements) Permit Fee Calculation Spreadsheet MISCELLANEOUS PERMIT CALCULATION Pools&Spas Above Ground Round EA $ 3,150.00 S Above Ground Oval EA $ 5,250.00 S In-Ground EA S 18;900.00 $ Heater EA $ 3.465.00 S Hot Tub EA S 5,250.00 $ Roofing Stop&Reroof 16 SQ S 207.20 $ 3,315.20 Overlay SQ $ 127.05 $ Plywood SQ $ 101.85 $ Sheds SF $ 26.25 S Electrical Service 100 Amp EA $ 816.43 $ 200 Amp EA $ 1,519.19 $ 400 Amp EA $ 6,039.29 $ Breezeway/Decks Open SF $ 22.31 S Enclosed SF $ 94.76 $ Porches Open SF $ 62.69 S Enclosed SF $ 123.90 S TOTAL BUILDING CONSTRUCTION COST $ 3,315.20 PERMIT FEE Building 3.315 S 22.00 Electrical _ S - $ - S - CO Fee S 10.00 Plan Review $ State Ed Fee 3,315 $ 0.53 Total Fees $ 32.53 Based on 2003 RS Means Residential Cost Data 4/12/04 Town of Montville Building Department Receipt Date y / / c No. U3. 6 1 From: Job Address: a7 pot., v V-.v' �J< Amount $ 32--, Check Check # (Circle one) Received by Y. ).,,_ Permit # Department of Consumer Protection License Details Page 1 of 1 Verify License Department of Consumer Protection j g1{ c�1 Et l e to F'.._ . �... Close Screen License Details Name: GILMORE, DAVID Business Name: D & E LAWNCARE DAVID GILMORE Address: 205 FLANDERS RD EAST LYME CT 06333 Credential Type: HOME IMPROVEMENT CONTRACTOR Status: ACTIVE Credential Number: HIC.562832 Effective Date: 01/20/2004 Sub Category: Expiration Date: 11/30/2004 To view Complaint or Disciplinary History click button... Disciplines I Complaints'- � STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors (Conn. Gen. Stat. § 31-286b) Property located at: „,2 /G w1-,e- S L ,Qo. In the town of Atr('es,,lie Name of building permit applicant: j)9 v f' 61((HI..y-o— Please check one: 1. I am the owner of the above property. 2. r I am the sole proprietor of a bu iness. 2A. Name of business: ,0-f-CL./.9 /1)C r4 R c GLC f 2B. Federal Employer Identification Number(FEIN) Pursuant t o § 3 1-286b, "a property owner o r s ole proprietor [who] intends t o 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 chec one: 1. I do not inte i dto c general contractor or principal employer. [Sign and 1 op Signat ifs f ap cant 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 t hat I w ill require p roof o f w orkers' compensation insurance for e very c ontractor, subcontractor, o r o ther w orker b efore h e/she engages i n 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)