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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-
BUILDING PERMIT
Permit Number: 82004-0794 Date: 28-Dec-04 Map/Lot: 043/009-023 Owner ID: 55000
Project Location: 8 ALLISON'S WAY Unit:
Job Description: Single Family Residence
Owner Name: RTT Development Tenant Name: N/A
Careof:
35 Blais Road
Uncasville CT 06382- Telephone:
Contractor Name: Property Owner Telephone: (860)848-2852
DBA: Lic/Reg Type: NHC
Lic/Reg No: 1795
Exp Date: 30-Sep-04
Construction Value Permit Fees Construction Information
Building Value: $171,637.00 Building Fee: $1,376.00 Use Group: R-4
Plumbing Value: $12,197.00 Plumbing Fee: $104.00 Code: 1999 State Building Code
w/2004 Amendment
Mechanical Value: $13,552.00 Mechanical Fee: $112.00
Electrical Value: $124,876.00 Electrical Fee: $104.00 Construction Type: 5B
Total Value: $209,873.00 Penalty Fee: $0.00 Permit Code: R2
C of 0 Fee: $25.00 Comments:
Plan Review Fee: $169.60
State Ed Fee: $33.58
Total Fee: $1,924.58
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.
RUTLDING PERMIT INSPECTIONS PLUMBING MECHANICAL ELECTRICAL PERMIT INSPECTIONS
Q Footing - Prior to pouring concrete R Plumbing and leak test
Deck Piers R Electrical
F-/~ Backfill - Footing drains and waterproofing Elec Trench - with conduit installed
W Concrete Slab - Prior to pouring concrete ❑ Pool Bonding
91 Anchor Bolts - with sill plate and prior to floor framing ❑Q Electrical Service CRS No: 0
❑d Framing ❑ R HVAC
❑ Masonry Fireplace Throat or Chimney Thimble ❑ Gas Piping and leak test
❑v Fireblocking _Draftstopping INSPECTION REQUIRED UPON COMPLETION
cate of Approval
Fv~ Insulation /er,lii,,,
pancy
ate of Occu
Building Official's Approval:
Town of Montville
Residential Plan Review
Date:
Job Address: 79- u.nK
a
Job Description:
The following information must be included on both sets of plans or accompanying documents (two sets are required) (C.G.S. 29-252a.) This list is offered as a
guideline only. It is not meant to be all-inclusive for every permit application, nor is it meant to take the place of the building code.
Your application is being rejected for the following reason fsl that are checked-off or commented on:
Supporting Documentation Foundation drainage
X Construction documents shall be of sufficient clarity to indicate the Beam pockets - minimum clearances
location, nature and extent of the work proposed (R106.1.1) Cy✓~~taCyv~ Window and door sizes and locations
Construction documents are to match the orientation on the site plan Engineered plans required for retaining wall
reversed plans are not acceptable, a full plan review can not be Engineered foundation plan required
performed with the submitted documentation Crawl space data - clearance to joists, slab thickness (if provided), vapor
Construction documents are incomplete or unclear, a full plan review can barrier
not be performed with the submitted documentation Crawl space ventilation, location, type and size
Building permit application not completed Crawl space access, location and size
Pernrit fee $ / JZ-4. f ,8
Permit fee to 6e calculated Floor plan(s)
Worker's comp. Affidavit or worker' comp. Insurance required Plans required
Copy Contractor's registration or license Basement floor plan required
Construction permit sign-off sheet with approvals required Second floor plan required
Provide all documentation to show compliance with the Energy Dimensions
Conservation Code (www.energycodes.gov) Finish floor elevation
Street address of project on all drawings and documents required Door and window sizes
Field set of approved plans need to be picked up from our office Kitchen layout
Two sets of construction documents required, this includes engineering Bathroom layout space clearances
data, calculations, and other documentation Stair location
Submit supporting data to show conformance with the wind limitations Ceiling heights
(3 second gust @ 115 mph) Attic access location and size
Identify the use of each room
Site plan Emergency escape & rescue opening required in the basement or two
Plans required code compliant stairs (8310.1)
Plan does not match building plans Indicate required light (8% of floor area per room) and ventilation (4% of
Finish floor elevation floor area per room) for each habitable room or space
Property lines not provided Indicate safety glazing in areas required such as: doors, windows, tub &
Distance from property to structure shower enclosures, etc.
Structure dimensions Indicate bedroom egress windows (5.7 sf net clear opening, 24" clear
Driveway opening height, 20" clear opening width)
Topography (existing and proposed) Egress window sill height
Footing drain inverts, outlet and separation
Proposed utilities to be indicated Garage
Delineation of flood hazard areas and design flood elevation required _ Plans required
(8106.1.3) Minimum 5/8" Type X gypsum board separation (on garage side) to all
Private sewage disposal system to be identified on the plan (RI06.2.1) living spaces - all combustible support framing to be covered with
Grading is to slope away from the building, provide more details minimum /8" Tye gypsum board if it supports rp r ed habitable t in
to have a m
O imum
penngs between the gaga and Foundation Plan 13/8" solid wood door, 1 3/8" solid core steel door, 1 3/8" honeycomb
Plans required core steel door, or 20 minute rated door from the garage to the house and
Dimensions its basement or attic
Wall thickness Indicate self-closing devices on all doors from garage to the house and its
Footing sizes basement or attic
Frost protection required Indicate slope for garage floor
Hatchway
Provide engineering data for the piers to resist gravity, lateral, shear and Elevations
uplift loads, stamped and signed by a CT licensed design professional Plans required
Foundation - indicate the assumed soil conditions that the system has Type of siding
been designed for or provide engineering data. If presumptive soil Type of roofing
conditions cannot be met, provide soil bearing engineering data Finish grades
Concrete strength - foundation, floors, exterior porches, walks, slabs Building heights
Vapor barrier between sub-grade and concrete basement floor Dimension height of chimney above roof
Perimeter insulation, if conditioned space Roof pitches
Foundation anchors - type, size, location/spacing Elevations to match site grading
Floor thickness and control joint location
Lally column size, attachment and spacing
Column footings - size
Waterproofing details
Fireplace/chimney base
Concrete piers and anchor details
_ Holddown anchors, location and type r ,,,L
JZ o
,R i erf 11/16/04
Town of Montville
*90
Building Section(s) & Details Provide minimum net ventilation data
Plans required Roof sheathing - type, size, thickness
Floor-to-floor heights Collar ties - size, placement, spacing
Handrails and guardrails - detail, including height and maximum Roof covering - shingles - type, nailing, provide proper underlayment -
opening, handrail cross-section, continuity and required returns show interior horizontal distance of double underlayment at eave, etc.
Riser height, tread depth, and nosing Overhang detail
Show minimum headroom in stairways - measured from nosing plane to Provide engineering data for all roof trusses - (truss drawings must be
lowest point of ceiling signed and sealed by a Connecticut Licensed Professional Engineer)
Stud size and spacing, species and grade (required prior to installation)
Sheathing - size, thickness, type
Siding, material, type, style - underlayment per mfg. Decks/Porches
Flashing detail - windows and doors - type, material Plans required with dimensions
Additional sections and details required Joists - size, span, spacing, direction, species and grade
Fire-resistance rating details required for exterior wall(s) Ledger - show attachment and flashing to house
Fire-resistance rating details required for dwelling unit separations Decking material and size
Window well Beam - design data if required
Beams - size, span, spacing, direction, species and grade
Framing plans Posts - size, material, and height
Plans required Piers - size, material, depth below grade
Bearing partitions Indicate joist hangers at flush framing and ledger
Direction of framing Stair, handrails, and guardrails details
Beam spans, size, species, grade Joists over-spanned
Framed openings Beam over-spanned
Sheathing type and thickness Height of deck above adjacent grade
Window and door header sizes
Joists - species and grade, size, direction, and spacing Chimneys and Fireplaces
Joists over-spanned Indicate clearance of masonry to combustible framing materials and
Headers over-spanned clearance from fireplace opening to finished trim
Joist hangers for flush framing conditions or ledger Show data for mechanical flue sizing
Beams over-spanned Show exterior combustion air source
Provide design data for all unaligned wall and floor bearing points. Flue sizes
Indicate location of all point loads Manufactures data and installation instructions for metal fireplaces
Cantilevered framing less than 18" to grade to be pressure treated or
decay resistant Electrical Plan(s)
Engineering data for steel beams, engineered lumber, or any other Plans required
engineered product or design Panel location(s) with main size
Meter socket location
Ceiling Plan(s) Outlet locations
Ceiling joists - plan required for geometry GFCI outlet locations
Ceiling joists - spacing, span, direction, species and grade Lights and switches
Ceiling joists required to support minimum 30 psf live load Smoke alarms
Ceiling joists over-spanned Load calculations
Roof Plan(s) Mechanical plan(s)
Roof rafters - plan required for geometry Plans required
Rafters -pitch, spacing, span, species, and grade Dryer vent
Provide framing details of trayed/vaulted ceilings Heating, ventilation, and air conditioning plant locations
Provide detail of cathedral ceiling structure and venting Combustion air requirements
Indicate connection of lower chord of roof trusses and ceiling joists to Manufactures data for equipment
the top plates and wall studs. Calculate roof tie-down sizes for wind Heat loss/gain calculations
conditions
Show framing for gables in cathedral ceiling construction Plumbing plan(s)
Roof rafters over-spanned Plans required
Ridge strapping required Building trap location
Ridge beam, rafters are to bear on top of beam or bear on ledger strip Sewer location
Ridge beam supports Domestic water location
Valley rafters - provide engineering data Manufacturers data for whirlpools, comer tubs, & larger tubs
Valley rafter support Water heater size, type, and location
Ventilation - ridge, gable, soffit
Comments:
4d11 /16/04
Town of Montville]
Residential Plan Review
Date: 0 OL'T
Job Address:
Job Description:
The following information must be included on both sets of plans or accompanying documents (two sets are required) (C.G.S. 29-252a.) This list is offered as a
guideline only. It is not meant to be all-inclusive for every permit application, nor is it meant to take the place of the building code.
Your application is being rejected for the following reason(s) that are checkedoff or commented on:
Supporting Documentation Foundation drainage
Construction documents shall be of sufficient clarity to indicate the Beam pockets - minimum clearances
location, nature and extent of the work proposed (R106.1.1) Window and door sizes and locations
Construction documents are to match the orientation on the site plan Engineered plans required for retaining wall
reversed plans are not acceptable, a full plan review can not be Engineered foundation plan required
performed with the submitted documentation Crawl space data - clearance to joists, slab thickness (if provided), vapor
Construction documents are incomplete or unclear, a full plan review can barrier
not be performed with the submitted documentation Crawl space ventilation, location, type and size
Building permit application not completed Crawl space access, location and size
Permit fee $
Permit fee to be calculated " Floor plan(s)
01-X Worker's comp. Affidavit or worker' comp. Insurance required required
Copy Contractor's registration or license ement floor plan required
_ Construction permit sign-off sheet with approvals required Second floor plan required
Provide all documentation to show compliance with the Energy Dimensions
Conservation Code (www.energycodes.gov) Finish floor elevation
Street address of project on all drawings and documents required Door and window sizes
Field set of approved plans need to be picked up from our office Kitchen layout
Two sets of construction documents required, this includes engineering Bathroom layout space clearances
data, calculations, and other documentation Stair location
_ Submit supporting data to show conformance with the wind limitations Ceiling heights
(3 second gust @ 115 mph) Crg.u r a ~arz._c + r>4W6- C Da Attic access location and size
Identify the use of each room
Site plan Emergency escape & rescue opening required in the basement or two
Plans required code compliant stairs (8310.1)
Plan does not match building plans Indicate required light (8% of floor area per room) and ventilation (4% of
Finish floor elevation floor area per room) for each habitable room or space
Property lines not provided Indicate safety glazing in areas required such as: doors, windows, tub &
Distance from property to structure shower enclosures, etc.
Structure dimensions Indicate bedroom egress windows (5.7 sf net clear opening, 24" clear
Driveway opening height, 20" clear opening width)
Topography (existing and proposed) Egress window sill height
ooting drain inverts, outlet and separation
/proposed utilities to be indicated Garage
Delineation of flood hazard areas and design flood elevation required_ Plans required
(R106.1.3) Minimum 5/8" Type X gypsum board separation (on garage side) to all
Private sewage disposal system to be identified on the plan (8106.2.1) living spaces - all combustible support framing to be covered with
Grading is to slope away from the building, provide more details minimum 518" Type X gypsum board if it supports habitable rooms
Openings between the garage and residence required to have a minimum
Foundation Plan 1 3/8" solid wood door, 1 3/8" solid core steel door, 1 3/8" honeycomb
Plans required core steel door, or 20 minute rated door from the garage to the house and
Dimensions its basement or attic
Wall thickness Indicate self-closing devices on all doors from garage to the house and its
Footing sizes basement or attic
Frost protection required Indicate slope for garage floor
Hatchway
Provide engineering data for the piers to resist gravity, lateral, shear and Elevations
uplift loads, stamped and signed by a CT licensed design professional Plans required
Foundation - indicate the assumed soil conditions that the system has Type of siding
been designed for or provide engineering data. If presumptive soil Type of roofing
conditions cannot be met, provide soil bearing engineering data Finish grades
Concrete strength - foundation, floors, exterior porches, walks, slabs Building heights
Vapor barrier between sub-grade and concrete basement floor Dimension height of chimney above roof
Perimeter insulation, if conditioned space Roof pitches
Foundation anchors - type, size, location/spacing Elevations to match site grading
Floor thickness and control joint location
Lally column size, attachment and spacing
Column footings - size
Waterproofing details
Fireplace/chimney base
Concrete piers and anchor details
Holddown anchors, location and type
qZ v ed 11/16/04
r Town of Montville
Building Section(s) & Details Provide minimum net ventilation data
Plans required Roof sheathing - type, size, thickness
Floor-to-floor heights Collar ties - size, placement, spacing.
Handrails and guardrails - detail, including height and maximum Roof covering- shingles - type, nailing, provide proper underlayment -
opening, handrail cross-section, continuity and required returns show interior horizontal distance of double underlayment at eave, etc.
Riser height, tread depth, and nosing Overhang detail
Show minimum headroom in stairways - measured from nosing plane to Provide engineering data for all roof trusses (truss drawings must be
lowest point of ceiling signed and sealed by a Connecticut Licensed Professional Engineer)
Stud size and spacing, species and grade (required prior to installation)
Sheathing - size, thickness, type
Siding, material, type, style - underlayment per mfg. Decks/Porches
Flashing detail - windows and doors type, material Plans required with dimensions
Additional sections and details required Joists - size, span, spacing, direction, species and grade
Fire-resistance raring details required for exterior wall(s) Ledger - show attachment and flashing to house
Fire-resistance rating details required for dwelling unit separations Decking material and size
Window well Beam - design data if required
Beams - size, span, spacing, direction, species and grade
Framing plans Posts - size, material, and height
Plans required Piers - size, material, depth below grade
Bearing partitions Indicate joist hangers at flush framing and ledger
Direction of framing Stair, handrails, and guardrails details
Beam spans, size, species, grade Joists over-spanned
Framed openings Beam over-spanned
Sheathing type and thickness Height of deck above adjacent grade
Window and door header sizes
Joists - species and grade, size, direction, and spacing Chimneys and Fireplaces
Joists over-spanned Indicate clearance of masonry to combustible framing materials and
Headers over-spanned clearance from fireplace opening to finished trim
Joist hangers for flush framing conditions or ledger Show data for mechanical flue sizing
Beams over-spanned Show exterior combustion air source
Provide design data for all unaligned wail and floor bearing points. Flue sizes
Indicate location of all point loads Manufactures data and installation instructions for metal fireplaces
Cantilevered framing less than 18" to grade to be pressure treated or
decayresistant Electrical Plan(s)
Engineering data for steel beams, engineered lumber, or any other Plans required
engineered product or design Panel location(s) with main size
Meter socket location
Ceiling Plan(s) Outlet locations
Ceiling joists - plan required for geometry GFCI outlet locations
Ceiling joists - spacing, span, direction, species and grade Lights and switches
Ceiling joists required to support minimum 30 psf live load Smoke alarms
Ceiling joists over-spanned Load calculations
Roof Plan(s) Mechanical plan(s)
Roof rafters - plan required for geometry Plans required
Rafters - pitch, spacing, span, species, and grade Dryer vent
Provide framing details of trayed/vaulted ceilings Heating, ventilation, and air conditioning plant locations
Provide detail of cathedral ceiling structure and venting Combustion air requirements
Indicate connection of lower chord of roof trusses and ceiling joists to Manufactures data for equipment
the top plates and wall studs. Calculate roof tie-down sizes for wind Heat loss/gain calculations
conditions
Show framing for gables in cathedral ceiling construction Plumbing plan(s)
Roof rafters over-spanned Plans required
Ridge strapping required Building trap location
Ridge beam, rafters are to bear on top of beam or bear on ledger strip Sewer location
Ridge beam supports Domestic water location
Valley rafters - provide engineering data Manufacturers data for whirlpools, corner tubs, & larger tubs
Valley rafter support Water heater size, type, and location
Ventilation - ridge, gable, soffit
Comments:
Pog'z--~ Mu S Y- !3 c'~~a~~s oAF-A e-IJ / 6,A)raL 4?&PK) ✓ 1-10 I~ 6Zcy~Yj
cc" TS cc.~ i i? ~~r~ To HE- T~fc~7_ F7eg~
B 0 is
Rsvrsed 11/16/04
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
Perm' C~
❑ New Construction ❑ Addition ❑ ACteration ❑ Accessory Structure
❑ Singfe Famify ❑ Two-Tamily ❑ Townhouse
Job Address s7
(Number) (Street) (Unit)
Job Description
Owner If r7- U~r - Mailing Address
City ,JC ,,9 s rll State Zip 0 33 s Tel
Contractor d Mailing Address
City State Zip Tel
Contractor's License/Registration Type & Number `7 a Exp. Date O Q U a
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
rrtrthat am au or' cY o ma ppliti~r or a-p~rit for such work as described above.
Separate applications are required for electrical, plumbing, mechanical, etc.
Owner /Agent Signature Date / /
Construction Value Fee
Building $ $
Plumbing $ $
Mechanical $ $
Electrical $ $
Certificate of Occupancy $
Plan Review Fee $
State Education $
Total $ $
(See Rfverse side for additional requiremEnts)
&vicedSeptember9, 2004
Town of Montville
` Residential Permit Requirements
❑ Two (2) complete sets of construction documents (to scale) including site plan are required and shall show the
following information if applicable. This list is not all-inclusive, additional information may be required for your
particular project.
• Supporting Documentation • Building Section(s) & Details
Completed. signed and dated Building Permit Application Floor-to-floor heights
Permit fee - calculated upon completion of plan review Material type, size, and spacing
Completed building permit affidavit for property owners or sole Stair details (rise, run, treads, nosing, width, headroom)
proprietors or copy of workers compensation insurance Handrail details
Copy of Contractor Registration or license Guardrail details
Construction permit sign-off sheet signed by all departments Roof ventilation
Model Energy Code Analysis
Heat loss calculations • Framing plans
Engineering data for steel beams, engineered lumber, roof trusses or any
other engineered products or design Design loads -for floors, ceilings, roofs
Street address of project on all drawings and documents Bearing partitions
Direction of framing
• Site plan Spans, beam
Wood species and grade
Property lines Framed openings
Distance from property to structure Sheathing type and thickness
Structure dimensions Window and door header sizes
Driveway Decking material, size; spacing
Topography (existing and proposed) Note: Unusual structural conditions may require that additional
Footing drain inverts, outlet and separation engineering back up be submitted
Proposed utilities
Wetlands and flood zone limits and elevation • Chimneys and Fireplaces
Signed-by-P-&-7,-Wetlands, Uneas-Health,-VYTCA--
_ earl antes to com~ustilife
• Foundation Plan Manufactures data for metal flues
Exterior fresh air source for fireplaces
Assumed soil bearirfg pressure Flue sizes
Dimensions Manufacturers data and installation instructions for metal fireplaces
Wall thickness
Footing sizes
Anchor bolts, size and spacing ~ • Electrical Plan(s)
Window and door sizes and locations Panel location(s) with main size
Hatchways Meter socket location
Columns GFCI outlet locations
Floor construction data Smoke detector locations
Drainage details Lights and switches
Waterproofing details Stair illumination
Crawl space ventilation
Crawl-space-assess- Mechanical plan(s)-
Concrete strengths Dryer vent `
Bathroom exhaust ventilation (natural or mechanical) type and size
• Floor plan(s) Hood exhaust
Dimensions Type of heat
Door and window sizes, egress window Heatipg, ventilation, and air conditioning plant location
Glazing in hazardous locations Oil tank size, location, and piping
Garage/dwelling opening protection LP-Gas tank location, size, and piping
Garage/dwelling separation Make-air requirements '
Kitchen layout Manufacturers data for equipment
Bathroom layouts, tub sizes in gallons, space clearances
Indicate use of all rooms • Plumbing plan(s)
Stair location Building trap location if on municipal sewer
Attic access location and size - Sewer location
Square footage for each habitable level of the structure Domestic water location
Required light and ventilation for each habitable room Manufacturers data for whirlpools, corner tubs, & larger tubs
Water heater size, type, and location
• Elevations - minimum of two required `
Type of siding
Roofing Note: One set of approved plans is
Other finishes
Finish grades required to be kept on during
Building heights
Height of chimney above roof construction.
Roof pitch
ftvisedSeptem6er9, 2004
r-- Town of Montville, Building Department Receipt
No
Date
i
From:
Job Address:
Cash Check Check #
Amount (circle onci
Permit # r
Received b
NEW RESIDENTIAL PERMIT CALCULATION (2 STORY)
Address:
House Construction A
Average Custom
QTY $/UNIT $/UNIT TOTAL
Living Area 2420 SF $ 7208 $ - $ 174,433.60
Finished Basement 'SF $ 16.01 $ - $
Unfinished Basement 127!` SF $ 5.41 $ - $ 6,546.10
Kitchen 1 EA $ - $ $ -
Plumbing
Full Bath 2 Fro $ 4,229.40 $ - $ 4,229.40
Half Bath 1" EA $ 2,691.15 $ - $ -
Garages
Attached, 1 car EA $ 8,885.10 $ - $ -
Attached, 2 car 1` EA $ 15,113.70 $ - $ 15,113.70
Attached, 3 car EA $ 20,913.90 $ - $ -
Detached, 1 car _'EA $ 11,657.10 $ - $ -
Detached, 2 car _ _.._.....r,_ EA $ 17,456.25 $ - $
Detached, 3 car - EA $ 23,256.45 $ - $
Under, 1 car EA $ 1,304.10 $ - $
Under, 2 car EA $ 1,757.70 $ - $
Fireplace & Chimney
Prefab EA $ 3,963.75 $ - $
Masonry, exterior EA $ 3,963.75 $ - $ -
Masonry, interior EA $ 3,701.25 $ - $ '
W/2 fireplaces EA $ 6,746.25 $ - $ -
Breezeway/Decks
Open i2d SF $ 22.31 $ - $ 2,67720
Enclosed SF $ 94.76 $ - $ -
Porches
Open _ SF $ 62.69 $ - $
Enclosed _'SF $ 123.90 $ - $
Heating Adjustment 2420 SF $ (2.76) $ - $ (6,679.20)
Air Conditioning 2420 SF $ 2.84 $ -
Electrical 2420 SF $ (5.16) $ - $ (12,487.20)
Plumbing 2420 SF $ (5.04) $ - $ (12,196.80)
TOTAL BUILDING CONSTRUCTION COST, LESS MEP $ 171,636.80
Y Is air conditioning included (YIN)? $ 6,872.80
PERMIT FEE CALCULATIONS
Fee
Building $ 171,637 $ 1,376.00
Y Plumbing $ 12,197 $ 104.00
Y Mechanical $ 13,552 $ 112.00
Y Electrical $ 12,487 $ 104.00
Work Commenced before permit issuance $ -
CO Fee $ 25.00
Plan Review $ 169.60
State Ed Fee $ 209,873 33.58
Total Fees $ 1,924.18
Based on 2003 RS Means REsidential Cost Data
12/20!2004
i Town of Montville
Building Department
310 Norwich-Neva London Tpke.
Tel. 848-3030, Ext 382 Uncasville, CT 06382 Fax. 848-7231
Residential Building Permit Application Form
Permit # RECEIVED
New Construction ❑ Addition ❑ Alteration ❑ Accessory Structure N 0 V 2 4 2004
❑ Single Family ❑ Two-Family ❑ Townhouse BUILDING DEPT.
Job Address s;7 l-'h
(Number) (Street) (Unit)
Job Description
Owner 1 ~7' Mailing Address 535- ~
City C- /-3 State- C-1 Zip 06 3V 'L Tel /fys// ~Y
Contractor ' ► Mailing Address
City State Zip Tel
Contractor's License/Registration Type & Number ✓ 7 Exp. Date -0 3C, l L) 5
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
tYiat awn aut odd to ma pp ica 'onae~nit for such work as described above.
Separate applications are required for electrical, plumbing, a ,
Owner /Agent Signature J Date
Construction Value Fee
Building $ $
Plumbing $ $
Mechanical $ $
Electrical $ $
Certificate of Occupancy $
Plan Review Fee $
State Education $
Total $ $
(See averse side for additional requirements)
qZ v edseptem6et9, 2oo4
Town of Montville -
Residential Permit Requirements
❑ Two (2) complete sets of construction documents (to scale) including site plan are required and shall show the .
following information if applicable. This list is not all-inclusive, additional information may be required for your
particular project.
• Supporting Documentation; • Building Section(s) & Details
Completed. signed and dated Building Permit Application Floor-to-floor heights
Permit fee - calculated upon completion of plan review Material type, size, and spacing
Completed building permit affidavit for property owners or sole Stair details (rise, run, treads, nosing, width, headroom)
proprietors or copy of workers compensation insurance Handrail details
Copy of Contractor Registration or, license Guardrail details
Construction pert, sign-off sleet signed by all departments Roof ventilation
Model Energy Code Analysis
Heat loss calculations • Framing plans
Engineering data for steel beams, engineered lumber, roof trusses or any
other engineered products or design Design loads -for floors, ceilings, roofs
Street address of project on all drawings and documents Bearing partitions
Direction of framing
• Site plan Spans, beam
Wood species and grade
Property lines Framed openings
Distance from property to structure Sheathing type and thickness
Structure dimensions Window and door header sizes
Driveway Decking material, size, spacing
Topography (existing and proposed) Note: Unusual structural conditions may require that additional
Footing drain inverts, outlet and separation engineering back up be submitted
Proposed utilities
Wetlands and flood zone limits and elevation • Chimneys and Fireplaces
Signed-by-P & 7,-W-etlands,-Uneas-Health, WPCA
earances to coffibusiubTe materials
Manufactures data for metal flues
• Foundation Plan Exterior fresh air source for fireplaces
Assumed soil hearing pressure Flue sizes
Dimensions Manufacturers data and installation instructions for metal fireplaces
Wall thickness
Footing sizes • Electrical Plan(s)
Anchor bolts, size and spacing
Window and door sizes and locations Panel location(s) with main size
- Hatchways Meter. socket location
Columns GFCI outlet locations
Floor construction data Smoke detector locations
Drainage details Lights and switches
Waterproofing details Stair illumination
Crawl space ventilation
Cxa , sp
_ se-aESCSS-- _ . • Mechanica-p- l lap(s)
Concrete strengths Dryer vent
Bathroom exhaust ventilation (natural or mechanical) type and size
• Floor plan(s) Hood exhaust
Dimensions Type of heat
Door and window sizes, egress window Heating, ventilation, and air conditioning plant location
Glazing in hazardous locations Oil tank size, location, and piping
Garage/dwelling opening protection LP-Gas tank location, size, and piping
Garage/dwelling separation Make-air requirements '
Kitchen layout Manufacturers data for equipment
Bathroom layouts, tub sizes in gallons, space clearances
Indicate use of all rooms • Plumbing plan(s)
Stair location Building trap location if on municipal sewer
Attic access location and size Sewer location
Square footage for each habitable level of the structure Domestic water location
Required light and ventilation for each habitable room Manufacturers data for whirlpools, corner tubs, & larger tubs
Water heater size, type, and location
• Elevations - minimum of two required
Type of siding
Roofing Note: One set of approved plans is
Other finishes
Finish grades required to be kept on during
Building heights construction.
Height of chimney above roof
Roof pitch
ftvUedSeptem6er9, 2004
NEW`HO CONSTRUCTION CON'iLACTOR
RTTDEVFLOPMENT
35 BLAIS RD
UNCASVILLE, CT 06382 .
EFFECTIVE EXPIRES
LICJREG NO.
10/01/2003 C9 " _
GNEp~ ~r
State of Connecticut
Workers' Compensation Commission -
Please TYPE or PRINT IN INK
~t\MEt
41// rA~hIIT
Proof of Workers' Compensation Coverage when Applying
for a Building Permit for the Sole Proprietor or Propert Owner
who WILL act as General Contractor or Principal Employer
Applicant . Building
Permit
Name of Applicant for Building Permit
Property located at
in the City / Town of
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 act as the general contractor or principal employer, you must provide proof of workers' compensation insurance coverage for all
employees.
Complete this form and, if applicable, sign the Affidavit below in the presence of a Notary Public or a Commissioner of the Superior Court.
CHECK ONE (1) BOX ONLY, provide the appropriate information, and sign:
41 am the OWNER of the above-named property. 1 WILL act as the general contractor or principal employer and, as such, will submit proof of workers'
compensation insurance coverage for all employees who are doing work on the site of the construction project at the above-named property.
Signature of OWNER Applicant
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
❑ I am the SOLE PROPRIETOR of a business doing work at the above-named property. I WILL act as the general contractor or principal employer and, as
such, will submit proof of workers' compensation insurance coverage for all employees who are doing work on the site of the construction project at the above-
named property.
Signature of SOLE PROPRIETOR Applicant
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
❑ lam the OWNER of the above-named property or the SOLE PROPRIETOR of a business doing work at the above-named property. I will not personally
submit proof of workers' compensation insurance coverage, but I will attest to the following:
AFFIDAVIT
I hereby swear and attest that I will require proof of workers' comp do ' rance f r every contractor,
subcontractor, or other worker before he or she does work on site a constr ion project at the
above-named property in accordance with Section 31-28 the rkers' Co nsation Act.
Signature of OWNER or SOLE PROPRIETOR Applicant J Q
Name of Business-if applicable ~/3' dial
Federal Employer ID# (FEI N)-4f applicable
Subscribed and swom to before me this day of 200
Signature of Notary Public / Commissioner of the Superior Court
Town of Montville - ~e Building Department
848-3030, Ext 382
CONSTRUCTION PERMIT APPROVAL
operty Address
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
® Tag Collector f
S ¢.fy.
' iiaturel dal 1
❑ WPCA
Sl rnawre / date
i
❑ Planning & Zoning Li
i.gnawref &,te
❑ Health Department
"igllature; (late
❑ Department of Public Works
Sigtiaturc/ date
❑ State Dept. of Transportation
Ke dtite,-
❑ Fire Marshal
Signatu:rea/ date
Comments/Conditions:
PsvkedSgtember9, 2004