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Home My WebLink AboutStrip and Re-Roof 2017 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: B2017-0406 Date: 25-Sep-17 Map/Lot: 037/003-000 Owner ID: 4873000 Project Location: 1104 OLD COLCHESTER ROAD Unit: Job Description: Strip&ReRoof Owner Nam Transformation Assembly of God Inc. Tenant Name N/A Careof: 1 104 Old Colchester Road Oakdale CI 06370- Telephone: (860)884-57.58 Applicant Name Paul J.Skutt Telephone: (860)490-7774 DBA: PJS Building &Remodeling Lic/Reg Type HIC Lic/Reg N 622377 9 Grieb Road Exp Date: 30-Nov-17 Wallingford CT 06492- Construction Value Permit Fees Construction Information Building Value: $15,750.00 Building Fee: $240.00 Use Group: A-3 Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 2016 State Building Code Mechanical Valu $0.00 Mechanical Fe $0.00 Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type 5B Total Value: $15,750.00 Penalty Fee: $0.00 Permit Code: C4 C of 0 Fee: $0.00 Comment Plan Review Fe $0.00 State Ed Fee: $4.10 Total Fee Paid: $244.10 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 ❑ Gas Piping and leak test ❑ Fireblocking Draftstopping INSPECTION REeUIRED UPON COMPLETION ❑ Insulation Certific• - . Ap• •val �❑ Cep cafe . 'iccupancy Building Official's Approval: .4011 Town of Montville Building Department • 310 Norwich-New London Tpke. Tel. 860-848-6782, Ext 782 Uncasville, CT 06382 Fax. 860-848-7231 PERMIT APPLICATION FORM Permit No.: €I7-old" Type of Work Occupancy Classification Construction Type Permit Type ❑New Construction ❑A-1 ❑B ❑H-1 0 I-1 0 R-1 0 S-1 ❑Type IA ❑Type IIIB l►d Building ❑Addition ❑A-2 ❑ B,Medical ❑H-2 0 1-2 0 R-2 ❑S-2 ❑Type IB ❑Type IV 0 Plumbing RAI Alteration Et/A-3 ❑E ❑H-3 0 1-3 0 R-3 ❑ U 0 Type IIA [,Type VA 0 Mechanical ❑Change of Use 0 A-4 0 F-1 0 H-4 ❑ 1-4 0 R-4 ❑Mixed ❑Type IIB E Type VB 0 Electrical ❑A-5 0 F-2 I ❑ M (t__ ❑Type IIIA CRS#: Property Address: 1 pc=4 Qtslid1chis-�cr ra OarsdAt, C'r %.'76 (Num ) (Street) (Unit) l �7 I l + I fL 'isle Job Description: �e' ZOO f s�'rt�J jJ��(' �hv� lel, ►�►�' ��-� ' c,vij Ur ok.L( ,4,,Yr1ehV • w Owner: 11iG.hS ((OrMxi.kovN CiULN Tenant: �eu s,(Niel Q. 0111-S Address: t t 0 W aid. Cotrivsicr PA Address: l 6 L-1 y(ok Colcirsfe C (l City/State/Zip: O GI,K AG..'L C.( 00 70 City/State/ip:: v hk.(A0•I C Cf Os6s'7o Telephone(8(00 ) `l- S l 5 (d 10 Telephone Q ) _- S 7J0 Applicant: pRO t v SK;l i 1 DBA: \ EJ \�jI t(klh� S 14 tl�,et iek5 Address: 61‘e-'10 Q� ' City: (A)�tk th( rD a State: Ci Zip Code: 0 012.12. Telephone(?))4O ) 7-Io - 7 7 7 41 Contractors -Complete the Following: License/Registration Type: It IC License/Registration No.:O ' 'i it Expiration Date: No U aO t 7 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. Owner/Agent Signature: Date: g 2 , - 1 1 Construction Value Permit Fees Building Value: 15-7 -/--) Building Fee: 0 40. Plumbing Value: Plumbing Fee: Mechanical Value: Mechanical Fee: Electrical Value: Electrical Fee: Total Value: Penalty Fee: C of 0 Fee: Plan Review Fee: State Ed Fee: .10 Total Fee: Qyy• 10 P,111 - 6(4-CO Revised August 23,2007 Town of Montville Building Department Credit Card File Receipt Date: 21-Seo-17 Receipt No: 5568 Received From: Paul J. Skutt Job Address: 1104 Old Colchester Road Fees Collected State Educational Trainino Fee Bldg Fees: $244.10 State Fees: $4.10 Fire Fees: $84.00 ConstructionValue: $15.750.00 DemolitionValue: 10.00 Received By Carmen Kneeland CKAA,04_,0_44 M _ 'CAA_ QCT I I I I I CO D "LI -n c Q. = msz " ii <. Fin v CD * 2,3 a = 1= 1 3 = 3 3 = 3 3 = = `< 7 3 —II -i S. v n1 O cn m e E. sv o o o mxim 54 dam = -n m a0 Q < m _ r, � N 7 W o o „ — — ) � � C) 0 0 d � � -o - 7 ID o c 0 rn , 5 m _ con im g ; C, d3 CD 3 = oo / tno m D DrS �'3 Coti 0 - r- '< 0 ali w Li awd -I -1c w 0 i m 11 Pa o cD I O - 0 0 C) cu 3 r W z < m C) @ a. co cD -, r' N co p0j -4 Z7 D 71 '7 o 0 al 0 —i CD N CD CD W S p 0 ci) 0) z 4!040 NN N► 40, 40, 404I0 404040► 400410404/► 4AU)U)U)U) CA) N N IV CO • A A A O • • I IIII M M M I 00 0 0 O 0 O Print Lookup Details Page 1 of 1 't oil w.. 4,�," ,,"a State of Connecticut Lookup Detail View Name and Address Name DBA Address PAUL J SKUTT III PJS BUILDING & REMODELING Registration Information Registration Effective Expiration # Registration Type Date Date Status HIC.0622377 HOME IMPROVEMENT 07/31/2017 11/30/2017 ACTIVE CONTRACTOR Generated on: 9/25/2017 10:47:57 AM https://www.elicense.ct.gov/Lookup/PrintLicenseDetails.aspx?cred=524088&contact=751... 9/25/2017 -,)1, ,e State of Connecticut N 7A Workers' Compensation Commission _"fi, Please TYPE or PRINT IN INK cc tZP: 1§05M11- Proof of Workers' Compensation Coverage when Applying for a Building Permit for the Sole Proprietor or Property Owner who WILL NOT act as General Contractor or Principal Employer APPLICANT FOR BUILDING PERMIT iI Name of Applicant for Building Permit PE,u( ' SIC -Cth Property located at {109 0\43cr,trii P _r- ga in the City/Town of CUM O�Cl 0_2_, f✓\�_ C. - L ATTEST If you are the owner of the above-named property or the sole proprietor of a business doing work on the site of the construction project at the above-named property and you WILL NOT act as the general contractor or principal employer,you are not required to have workers'compensation insurance coverage. CHECK ONE(1) BOX ONLY and complete the following: UI am the OWNER of the above-named property.I WILL NOT act as the general contractor or principal employer. Signature of OWNER Applicant-. ---- - ----- ❑ I am the SOLE PROPRIETOR of a business doing work at the above-named property.I WILL NOT act as the general contractor or principal employer. I 1 1 I Name of Business OTS �V l l 41 hS3 IQ L moa e`{ Y\s F Signature of SOLE PROPRIETOR Applicant - c Town of Montville Building Department CONSTRUCTION PERMIT APPROVAL �1 oq old Colchester a_ Property Address S6' pp T Re Job Description Required Department Permit Issuance Approval Approval ✓ Tax Collector . -4_2,0 A/o-�-►-� A$ �.� t ,J Signature/date Comments: `/ Fire Marshal iPl0! / 7 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 WA% 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: �J 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'51arch23,2015