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Town of Montville
Building Department
310 Norwich-New London Tpke.
Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231
CERTIFICATE OF OCCUPANCY APPROVAL
Zoo RAymo ii 1I,,/ Rom u J c-9,9V i tie QT- 0 6,3?.Z
Property Address
eaj vEIZ--- PO tC uI N'r'o OFF t ajp/3cz
Job Description
No Certificate of Occupancy will be issued until all of the required signatures have been obtained.
Required
Department
ApprovalCertificate of Occupancy Approval
WPCA
Required for all occupancies on sewer
Comments:
Planning &Zoning � 4 � ///z /c 7
��eduired for all occupancies l
Comments: 74Z6 7-c1,3 3
E' Health Departmentco.„2?.„--es ,( 7
"eq. -d for all occupancies with septic systems
Comments:
❑ Department of Public Works
Required when proiect includes driveway work or certain drainage requirements
Comments:
❑ State Dept. of Transportation
Required when STC Certificate of Operation is applicable
Comments:
❑ Police Department
Required for all occupancies-except one&two family
Comments:
❑ Fire Marshal
Required for all occupancies-exceot one 4 two family
Comments:
RoiseiAugu t 5,2005
A
•
Town of Montville
Building Department
310 Norwich-New London Tpke.
Uncasville, CT 06382
Tel. 860-848-3030, Ext. 382 Fax. 860-848-7231
WIND LIMITATIONS
AFFIDAVIT
Address of Property:
Job Description:
Building Permit Number:
I hereby swear and attest that I have installed or caused to be installed, all of the required connections
relating to construction in locations where the basic wind speed equals or exceeds 110 miles per hour,
per section R301.2.1.1 of the Connecticut Building Code, as they appear on the construction documents
approved by the Building Department for the above referenced address.
Signature of Contractor:
Name of Contractor:
Name of Business—if applicable:
Subscribed and sworn to before me this day of 200
Signature of Notary Public/Commissioner of the Superior Court
•
Field Inspection Notice
Town of Montville
Building Department
August 3, 2007
Address: 200 Raymond Hill Road
Job Description: Convert porch to office space
Permit Number(s): B2006-0044—M2006-0035 Gas space heater Permit Date: 3/14/06
INSPECTION Not Approved Approval
Date: Deficiencies Special Conditions Date
ROUGH 3/29/06 JS • Door to receptacle is more than 6 ft,ad or move •
ELECTRICAL receptacle 4/4/06 JS
DRAFTSTOP • 3 spots in top plate
3/29/06 JS
FRAMING 3/29/06 JS
Insulation •
• 3/31/06 W
GAS LINE& •
TEST • 4/4/06 JS
•
CERTIFICATE OF • •
OCCUPANCY #l C C
YQ U (/1 r c -I 6 L D ti--t -e t CN C4. 4. Cf
/ v7 O 5 r -e (. /rod' O t, R �t / I
- , o cifrx. t- ,fsrvd
,/tk `Y ° L
Rev.Date: 1/18/06
Page 1 of 1
Town of Montville
Building Department
310 Norwich-New London Tpke.
Uncasville, CT 06382
Tel. 860-848-3030,Ext. 382 Fax. 860-848-7231
7/24/07
Stacey Terrial+Michael Frank Pittisinger
200 Raymond Hill Road
Uncasville Ct. 06382
Dear Stacey Terrial+Michael Pittisinger
During a resent review of our files it was established that permit#B2006-0044dated March 14 2006 To
convert a porch to office has not been closed out because a certificate of occupancy hasn't been issued
due to the fact that the final inspection hasn't taken place. Please contact our office between 8:00 and 4:30
to schedule an inspection.
Please be informed that the use of this office space without the issuance of a Certificate of occupancy
would constitute a violation under the Connecticut Building Code.
Respectfully yours
Charles Corell
Building Inspector
cc: File
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: 82006-0044 Date: 14-Mar-06 Map/Lot: 087/001-00B Owner ID: 5806000
Project Location: 200 RAYMOND HILL ROAD Unit:
Job Description: Convert porch to office space
Owner Name: Stacey Terrial and Michael Frank Pittisinger Tenant Name: N/A
Careof:
200 Raymond Hill Road
Uncasville CT 06382- Telephone:
Contractor Name: Property Owner Telephone: (860)848-8405
DBA: Lic/Reg Type:
Lic/Reg No: 0
Exp Date:
Construction Value Permit Fees Construction Information
Building Value: $3,000.00 Building Fee: $24.00 Use Group: IRC
Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 2005 State Building Code
Mechanical Value: $0.00 Mechanical Fee: $0.00
Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type: IRC
Total Value: $3,000.00 Penalty Fee: $0.00 Permit Code: R4
C of 0 Fee: $0.00 Comments:
Plan Review Fee: $0.00
State Ed Fee: $0.48
Total Fee Paid: $24.48
It shall be the owners reasonsibility 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 framing ❑ Electrical Service CRS No: 0
0 Framing ❑ R HVAC
❑ Masonry Fireplace Throat or Chimney Thimble ❑ Gas Piping and leak test
Fireblocking Draftstopping INSPECTION REOUIRED UPON COMPLETION
0 Insulation ■ -rtifica - of Approval
elireZ,7
•'irate of Occupancy
Building Official's Approval: s��+
Town of Montville
Building Department
File Receipt
Date: 10-Mar-06
Receipt No: 1084
Received From: Micheal Pittsinger
Job Address: 200 Raymond Hill Road
Fees Collected State Educational Training Fee
Cash: $24.48 Cash:
$0.48
Check: $0.00 Check: $0.00
Check No: 0
Short/Over: $0.00
Construction Value: $3,000.00
Demolition Value: $0.00
Received By David M Jensen0-op„;// e ---
I
Town of Montville
Building Department
310 Norwich-New London Tpke.
•
CONSTRUCTION PERMIT APPROVAL
.cc RAXn,,.31) /1/I/ Rcob ciocAsVie)w? c5 c 2
Property Address
L\1NAl ?beat- /to r 4,,c -2Q
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 Department Permit Issuance Approval
Approval
Tax Collector ��� \��1 o u
Comments:
❑ WPCA, Administrative
Signature/ date
Comments:
WPCA, Operations
Signature!date
Comments: .
g Planning &Zoning a)4442/22-AKO
Comments:
RI Health Department C.-7 L 3 -/ -0(Q
Sgnoture/ date
Comments:
❑ Department of Public Works
Comments:
❑ State Dept. of Transportation
Signature/ date
Comments: /
MI Fire Marshal i (2i2,
`` Signature/ date
Comments: ski(. - — �►.
•
Revised-Augusts;2005
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.47Q "%CO
Type of Work Ocq ipancy Type Permit Type
0 New Construction Single Family uilding
03ddition 0 Two-Family 0 Plumbing
Alteration ❑Townhouse
0 Mechanical
0 Accessory Structure 0 Electrical CRS#:
Job Address: c2.pC0 RRi>hya omp Rc.\ C.11JCAS 1/t 6lr eT o6pasxa
(Number) (Street)
(Unit)
Job Description: CQ,u rkr— pe ci/ ,i ro cPicz. 1/4sp
iacia
Owner: /77/GiAgl_ F Pti-rso.l G#2
Address: e200 �/1�/yy 0402 N,// 1Q�J4 u
City: ()/UCAS V t II State: Zip Code: d6,38
Telephone: S6o - 3•4,1?-- g 905
Contractor:
DBA:
Address:
City: State: Zip Code:
Telephone: 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 escribed above.
By checking this box, I will follow the requirements of the 2005 NEC as the alternative compliance per section E3301.2.1 of the Residential Code,
instead of the electrical requirements in chapters 33 through 42 of the Residential Code.
Owner/Agent Signature: ��� f" Date: /0
Construction Value Permit Fees
Building Value: Building Fee:
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:
Total Fee:
2evised cDecem6er31,2005
•
•
is (- State of Connecticut
,,_ '°} ':,.......
= Workers' Compensation Commission c-: 7A .
,• ._., J
OE Please TYPE or PRINT IN INK rx
Proof of Workers' Compensation Coverage when Applying
Permit for
for a Building the Sole Proprietor or Property Owner
who WILL NOT act as General Contractor or Principal Employer
Applicant for Building Permit
Name of Applicant for Building Permit rn/c/Z9re- F Pt-r-ru.1G4!Z
. Property located at aXli RAI/MO/0.D A///1 t
in theCity/Townof Oat)(AS V/ 110- Cr— 063SA--
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:
Vam the OWNER of the above-named property.I WILL NOT act as the eneral co9 ntractor or principal employee
Signature of OWNER Applicant Ladd
7
❑ 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.
Name of Business
Federal Employer lD#(FEIN)
Signature of SOLE PROPRIETOR Applicant
3o sNED
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