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Home My WebLink About2001 - Roof Town of Montville Building Department Phone: 848-716 310 Norwich New London Tpk Fax: 848-723 Y Building / Trades Permit Permit Number BP2001-339 Permit Date 6/26/01 Permit Typ Building Permit Code R4 Job Street # 47 Job Location BEECHWOOD ROAD Map/Lot 081/072-000 Job Description Roofin - Stri Owner Contractor Mark & Elizabeth DeCora Mark & Elizabeth DeCora Address 47 Beechwood Road Addres 47 Beechwood Road City Oakdale State Ct. City Oakdale State Ct. Zip 06370 Telephone 848-7020 Zip 06370 Telephone 848-7020 Lic/Reg Number Lic/Reg Type Exp Date: Use Group R4 Code 1995 CABO Type Construction 5B Building Value $1,260.00 Building Fee $10.00 Plumbing Value $0.00 Plumbing Fee $0.00 Mechanical Valu $0.00 Mechanical Fee $0.00 Electrical Value $0.00 Electrical Fee $0.00 Other Value $0.00 Other Fee $0.00 Total Values $1,260.00 C/O Fee $10.00 Comments Plan Review Fee $0.00 State Ed Fee $0.20 Total Fees $20.20 Building Official's Signatur Date 46" / ICt1 It is the owners res onsi sc edule the followin required inspections minimum 24 hours notice required): ❑ Footings - prior to po ng concrete ❑ Backfill -footing drains and waterproofing ❑ Fireplace Throat ❑ Concrete Slab, prior to pouring ❑ Fireplace Final ❑ Rough Framing ❑ Chimney - one flue above thimble ❑ Rough Electrical ❑ Firestopping/draftstopping ❑ Electrical Service ❑ Insulation ❑ Rough Plumbing and leak test ❑ Pool bonding ❑ Gas piping - pressure test and installation ® Final Inspection ❑ Rough HVAC ❑ Certificate of Occupancy - PRIOR to use or occupancy 06/19/01 03:17 FAX 8487231 BUILDING DEPT 01 Town of Montville Permit # Building Department 310 Norwich-New London Tpke. Tel. 848-7166 Uncasville, CT 06382 Fax. 848-7231 Application for Building or Trades Permit Buildina Permit Trades Permit ❑ Wew Constmawn ❑ .Accessory Stnutur'e ❑V&m&ng ❑.96 mhaniraf ❑ -UStian ~DemaCstivn, ❑EfeclAwf 9feating ❑ .Afters lion ~.Qthes f 2 ~ ~ jZsz , f /{1 N C~ I.~ ~ ~ _ JZir L'o~tiorrirtg Job Location 7 C } wd ~ Z/r i`X 4 P 17 J_ Cy t_ lfz 1,6 Job Description/Materials~ -Swou6vu / Owner jn4 f'r K lrU -zA U-1 iZA Mailing Address 4 7 I F(waa i City OK Ij A L A C -r State CCf Zip A6 Tel / Prl 7 ,6 Contractor ~ kl-/l! 0--r' A, 'a Mailing Address City State Zip Tel Contractor's Licensel Z*stration Type & Number Exp. Date / New Home Construction Contractors: Have you entered into a contract with a consumer for the proposed new home? 0 Yes 0 No 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 describdd above. f Q J Owner /Agent Signature Date Construction Value Fee Building $ $ Plumbing $ $ Mechanical $ $ Electrical $ $ Other $ $ Certificate of Occupancy $ Plan Review Fee $ State Education $ Total $ $ Town of'[ontville Building Departmt Receipt No. Date=/__ From: - h ,3 Ef E- ~ h Ccck Check 4 _ ? Cas t• _ Amount (c i«iC onc) a' Permit ~~Zcccwed by 06/19/01 03:17 FAX 8487231 BUILDING DEPT Q03 Permit Fee Qdculation Sp►eadsheet MISCELLANEOUS PERMIT CALCULATION Above Ground Raind -T+- rEA $ 3.000.0D S - Oval 1=A $ 5 D00.40 $ - In-Ground, Including fence & polo EA $ 18,000.W $ - Roofing Strip & Reroof SQ $ 210.00 $ 1,260,00 Overlay Sq $ 175.00 $ - Shads Wirh Eledric ' SF $ 25.00 $ - No Elechic ~ `SF $ 25.00 $ Dark - - SF 3 15.00 $ - TOTAL BUILDING CONSTRUCTION COST, LESS MEP S 1,260,00 I PERMIT FEE Builting $ 1,260 $ 10.00 Elechicral $ - $ - T 1'37 7.7,XT -7; CO Fee $ 70.Op Plan Review $ Store Ed Fee $ 1,260 $ 0.20 Total Fam 5 20.20 I Based an 2000 AvwM* Cormmctlon Cast Bf 1$/01 06/19/01 03:17 FAX 8487231 BUILDING DEPT 102 4. STATE OF CONNECTICUT WORKERS' COMPENSATION CQMNflSSION Building Permit AfFdavit for Property Owners or Sole Proprietors (Conn. Gen_ Stat. § 31-296b) Property located at C to 6 d `ji ~ ~~~t✓~ { G / ~P,~Td In the town of U PU-C f"A Name of building permit applicant- M Please check titre; I . _ I am the owner of the above property. 2- _ 1 am the sole proprietor of a business. 2A. Name of business 213. Federal Employer Identification Number (FEIN) Pursuant to § 31-286b, "a property owner or sole proprietor [who] intends to act as a general contractor or principal employee' may provide either a certificate of workers' compensation ;nsurs+nce or a "sworn notarized 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 check 0 1. I do not intend to act as a general contractor or principal employer. [Sign and stop rel Signature of applicant 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 - 1 hereby swear and attest that I will require proof of workers` compensation insurance for every contractor, subcontractor, or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act (Chapter 568). 1 understand that pursuant to § 31-275 C.G.S., officers ofa 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. i Signature of applicant Subscribed and sworn to before me this day of 200! (Notary Public/ Commissioner of the Superior Court) I