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TOWN OF MONTVILLE
Building Department
310 NORWICH-NEW LONDON TURNPIKE
UNCASVILLE, CT 06382-2599
TEL. (860) 848-3030 X382 FAX. (860) 848-7231
MECHANICAL PERMIT
Permit Number: M2017-0156 Date: 06-Sep-17 Map/Lot: 000/000-000 Owner ID: 4429001
Project Location: MONTVILLE MANOR Unit:
Job Description: Replace Gas Meters on Connecticut Blvd.,Massachusetts Road,New Hampshire Lane 8.Pennsylvania Avenue
Owner Nam Eversource Energy Tenant Name N/A
Careof:
Telephone:
Applicant Name Mark D.Kempesta Telephone: (860)822-1971
DBA: MDK Mechanical Lic/Reg Type S7
Lic/Reg N 393861
160 Riverside Drive Exp Date: 31-Aug-18
Baltic CT 06330-
Construction Value Permit Fees Construction Information
Building Value: $0.00 Building Fee: $0.00 Use Group: IRC
Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 2016 State Building Code
Mechanical Valu $9,540.00 Mechanical Fe $120.00
Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type IRC
Total Value: $9,540.00 Penalty Fee:
$0.00 Permit Code: R5
C of 0 Fee: $0.00 Comment
Plan Review Fe $0.00
State Ed Fee: $2.48
Total Fee Paid: $122.48
It shall be the owners repsonsibility 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.
BUILDING PERMIT INSPECTIONS PLUMBING,MECHANICAL, ELECTRICAL PERMIT INSPECTIONS
❑ Footing-Prior to pouring concrete ❑ R Plumbing and leak test
❑ Deck Piers ❑ R Electrical
❑ Backfill-Footing drains and waterproofing ❑ Elec Trench-with conduit installed
❑ Concrete Slab-Prior to pouring concrete ❑ Pool Bonding
❑ Anchor Bolts-with sill plate and prior to floor frami ❑ Electrical Service CRS No: 0
❑ Framing ❑ R HVAC
❑ Masonry Fireplace Throat or Chimney Thimble ❑d Gas Piping and leak test
❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION
❑ Insulation &I Certificate of proval
I/ , e- ifi . e of Occupancy
Building Official's Approval: _.., ���- - �� -
M3011-015(p
MONTVILLE
NAME ADDRESS PHONE# WORK WORK ORDER
CONNECTICUT BOULEVARD
DOREENE DWYER 4 CT BLVD 860-859-2866 1MM 81720397
ROBERT GOODY 8 CT BLVD 860-859-7981 1MM 81720399
WILLIAM LITWIN 12 CT BLVD 860-859-1580 1MM 81720401
WENDELL RICHTER JR 16 CT BLVD 860-859-0076 1MM 8L720403
RICHARD FICKEL 22 CT BLVD 860-859-3379 1MM 81720405
DONNA RIVADENDIRA 31 CT BLVD 860-857-7366 1MM 81720407
LINDA NATION 38 CT BLVD 860-822-5556 1MM 81620065
DUANE KELLEY 39 CT BLVD 860-705-6096 1MM 8L720184
THOMAS GINGERELLLA 42 CT BLVD 860-917-3335 1MM 8L720186
EUGENE GIANGRASSO 43 CT BLVD 860-859-3798 1MM 81720188
KAREN LIVERMAN 46 CT BLVD 860-822-5463 1MM 81720190
SUE SULLIVAN 47 CT BLVD 860-859-1665 1MM 8L720192
CRAIG FANNING 50 CT BLVD 860-859-1071 1MM 81720194
SCOTT CLEWEL 51 CT BLVD 860-887-2235 1MM 81720196
ANDREW ELDRIDGE 54 CT BLVD 860-287-3844 1MM 81720198
CHERYL ALISON 55 CT BLVD 860-886-7170 1MM 8L720200
BRANDON FORREST 58 CT BLVD 860-237-0804 1MM 81720202
JASON BIRD 59 CT BLVD 860-857-0979 1MM 81720204
KENNETH SYLVIA 62 CT BLVD 860-859-2945 1MM 81720206
AMY HILLMAN 63 CT BLVD 860-848-2557 1MM 81720215
' ' STEPHANIE SMOLEN 66 CT BLVD 860-608-9015 1MM 81720217
KRISTEN MASIS 67 CT BLVD 860-705-1550 1MM 81720219
ERNEST BOGUE 70 CT BLVD 860-859-1007 1MM 81720221
JOHN MACLEAN 77 CT BLVD 860-883-7088 1MM 81620041
KATHERINE FALLON 82 CT BLVD 860-892-8624 1MM 81720223
MARK OULUNDSEN 85 CT BLVD 860-859-1149 1MM 81720225
JIA GAGLIARDO 89 CT BLVD 860-908-8431 1MM 81720229
MASSACHUSETTS RD
JOHN GREEN 7 MASS RD 860-861-9726 1MM 8L620055
NEW HAMPSHIRE LANE
ELIZABETH FLANIGAN - 8 NEW HAMPSHIRE LANE 860-908-8028 1MM 81620207
CHARLES LEVIS 12 NEW HAMPSHIRE LANE 860-859-3592 1MM 8L620206
GORDON WEBSTER 19 NEW HAMPSHIRE LANE 860-859-2466 1MM 8L620195
MARY ANN REISINGER 20 NEW HAMPSHIRE LANE 860-859-1602 1MM 8L620205
FRANK HOPKINS 23 NEW HAMPSHIRE LANE 860-859-0507 1MM 81620204
ROBERT BUCETTAS 24 NEWHAMPSHIRE LANE 860-859-3278 1MM 81620203
CAROL BURGESS 28 NEW HAMPSHIRE LANE 860-859-3641 1MM 81620201
PENNSYLVANIA AVENUE
THOMAS BIRK 52 PENN AVE 860-860-3352 1MM 81620082
Town of Montville
Building Department
310 Norwich-New London Tpke.
Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231
RESIDENTIAL PERMIT APPLICATION FORM Permit No.: enaol7—ot5(v
Type of Work Occupancy Type Permit Type
El New Construction ❑Single Family 0 Building
El Addition 0 Two-Family El Plumbing
❑Alteration El Townhouse ❑ Mechanical
0 Accessory Structure El Electrical CRS#:
Property Address: MOrI I(e IY\CL,'lOY
(Number) " (Street) (U )
Job Description: V-Q 1 Qc/ G Q -QL- *v p,,�, e v�
ft) u�� Y �eS Fr s ,x — C kw w ct,t1
Owner: EiGrso0,rC�
Address:
City: State: Zip Code: Telephone( )
Applicant: MO Y._ m c 1'V I cCLI
DBA:
Address:pI i{O Qi VGrr i d Or(V�
City: gaol SIGs State:C 1— Zip Code: 4 S30 Telephone( p G 4 ) Cea?- (G) 7 1
Contractors - Complete the Following:
License Type: License No.: Expiration Date:
I hereby certify that the proposed work will conform to the State 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.
❑ By checking this box, I will follow the r ir: ents o he 114 NEC as the alternative compliance per section E3401.1 of the Residential Code,
instead of the electrical requirements in s •rs 34 rough 3 of e Resi.- is .ode.
•
\/,.. / - - 1
Owner/Agent Signature: Date: _ � !I
Construction Value Permit Fees
Building Value: Building Fee:
Plumbing Value: Plumbing Fee:
Mechanical Value: C540 Mechanical Fee: I QC).CY-)
Electrical Value: Electrical Fee:
Total Value: Penalty Fee:
C of 0 Fee:
Plan Review Fee:
State Ed Fee:
Total Fee:
Qevtced August 23,2007
Town of Montville
Building Department
File Receipt
Date: 05-Seo-17 ReceiptNo: 12617
Received From: MDK Mechanical. LLC
Job Address: Montville Manor
Town Fees Collected State of Connecticut Fees Collected
Bldg Cash: $0.00 State Cash: X0.00
Bldg Check: 1172.48 State Check: 82.48
Bldg Credit: $0.00 State Credit: $0.00
Fire Cash: $0.00
Fire Check: gQ_0p
Fire Credit: t0.00 Construction Value: $9.540.00
Demolition Value: 10.00
CheckNo: 6733
Received By: Carmen Kneeland NOM 1v' �C4 irl�
Court Montville Manor
ITEM QTY $/UNIT TOTAL
Building Plumbing Mechanical Electrical
BUILDING AREA
Basement,Finished SF $ 41.96 $ - $
Interior Renovations SF $ 36.09 $ - $ - $ _
AMENITIES
Kitchen EA $ - $ _ $
Full Bathroom EA $ - $
Half-Bathroom EA $ - $ _
GARAGE
Detached SF $ 71.53 $ - $ _
MECHANICAL
Warm-Air n Y/N $ -
Hot Water n Y/N $ -
Electric n Y/N $ _
Air Conditioning n Y/N $ -
ELECTRICAL SERVICE
Upgrade Amps $ _
Subpanel EA $ 699.00 $ _
Gen Set EA $ 3,850.00 $ _
SOLID FUEL BURNING APPLIANCES
Prefab Metal Fireplace EA $ 6,497.70 $ -
Masonry w/lfireplace EA $ 7,096.65 $ -
Masonry w/2 fireplaces EA $ 11,095.70 $ -
Wood Stove,free standing EA $ 2,692.25 $ -
Wood stove insert EA $ 1,859.77 $ -
DECKS,PORCHES,SUNROOMS
Deck SF $ 44.07 $ -
Porch SF $ 149.38 $ -
Sunroom SF $ 176.90 $ - $ -
POOLS&HOT TUBS
Hot Tub EA $ 8,016.25 $ - $ _
Inground Pool EA $ 31,550.00 $ - $ _
Above Ground Round EA $ 6,299.46 $ - $
Above Ground Oval EA $ 7,019.75 $ - $ _
Pool Heater EA $ 8,984.25 $ - $ _
Inflatable Type Pool EA $ 1,200.00 $ - $
SHEDS
w/o electrical SF $ 25.55 $ -
w/electrical SF $ 26.85 $ - $ _
RENOVATIONS
Roofing,Overlay SF $ 3.50 $ -
Roofing,Strip&reroof SF $ 4.50 $ -
Roof Sheathing SF $ 1.51 $ -
Siding SF $ 6.75 $ -
Windows EA $ 550.00 $ -
Skylights EA $ 1,051.10 $ -
Doors,Exterior EA $ 601.50 $ -
Oil Tank,275 Gallon EA $ -
Oil Tank,550 Gallon EA $ -
MISCELLANEOUS CALCULATIONS $ 9,540.00
Solar Install n
TOTALS $ - $ - $ 9,540.00 $ -
PERMIT FEE CALCULATIONS
Construction Value Fee
Building $ _ $ _
Plumbing y $ _ $ _
Mechanical y $ 9,540.00 $ 120.00
Electrical y $ _ $ _
Plan Review Fee y $ _
Certificate of Occupancy Fee $ _
Plan Review Fee $ _
State Education Fee $ 2.48
TOTALS $ 9,540.00 $ 122.48
Figures are based on the 2006 RS Means Residential Cost Data
STATE OF CONNECTICUT
DEPARTMENT OF CONSUMER PROTECTION
HEATING,PIPING&COOLING LIMITED CONTRACTOR
MARK D KEMPESTA
160 RIVERSIDE DR
BALTIC,CT 06330-1433 •
LIC./REG NO. EFFECTIVE EXPIRES
HTG.0393 61 09/01/20/7 8/31.2018
SIGNED
- 1
Town of Montville
Building Department
CONSTRUCTION PERMIT APPROVAL
(ion-+V k te. 14.410 Co nn A. N.1+:, mass.1 PeiaN
(Properry Addres
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V IJob Description v
OLC �Q<J�� toC (a0)
Required Department Permit Issuance Approval
Approval
Tax Collector
Signature/date
Comments:
® I Fire Marshal Ida/
Signature/date
Comments:
❑ Planning & Zoning
Required for all permits except Signature/date
Plumbing,Electrical,Mechanical,Roofing,Siding,Windows&Doors
❑ Health Department
Required for properties with private septic or well Signature/date
Comments:
❑ WPCA, Administrative
Required for properties on sewer Signature/date
Comments:
❑ WPCA, Operations
When Required by WPCA Signature/date
Comments:
❑ Department of Public Works
Required when project includes driveway work or certain drainage requirements Signature/date
Comments: -
❑ Montville Police Department
Required for all permits EXCEPT one and two family residential Signature/date
Comments:
❑ Copy of State Dept. of Transportation Certificate
Required for Structures over 100,000 sq.ft.or with more than 200 parking spaces-Official copy of STC Certificate of Operation required-per
CGS 14-311
Signature/date
Building Department Final Inspection
Revised March 23,2015