HomeMy WebLinkAbout12x14 Shed Town of Montville
Building Department
310 Norwich-New London Tpke.
141 Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231
RESIDENTIAL PERMIT APPLICATION FORM Permit No.:
jape of Work Occupancy Type {Permit Type
New Construction 13Single Family ,iI Building
❑Addition ❑Two-Family ❑ Plumbing
❑Alteration ❑Townhouse El Mechanical
❑Accessory Structure ❑ Electrical CRS#:
Property Address: 370 (. Ay I j���� �1 P
(Number) J (Street) ( (Unit)
Job Description: 1Z'lc ^t t
S� -.
Owner: 'I SL A. EtSL
Address: 3 / V 6,7 4 y \-': 1
City: U in c.43„:1 t t. J State: G I Zip Code: 013 3 a. Telephone( b 1 0) 70° -_ 1495
Applicant: . -
DBA:
Address:
City: State: Zip Code: Telephone( ) -
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.
iBy checking this box, I will follow the requirements of the 2014 NEC as the alternative compliance per section E3401.1 of the Residential Code,
instead of the electrical requirements in chapters 34 through 43 of the Residential Code.
Owner/Agent Signature: Date: 7/3V!1
Construction Value Permit Fees
Building Value: / °00 Building Fee:
Plumbing Value: P tubing Fee:
Mechanical Value: "M hanical Fee:
Electrical Value: y i\ lectrical� Fee:
Total Value: I'�` -n ,.,w�V/ Pena Fee:
`�
02/f Fee:
0 1 an Review Fee:
AO State Ed Fee:
/), T I Fee:
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Revised:August 23,2007 ii5
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Town of Montville
Building Department
1.
CONSTRUCTION PERMIT APPROVAL
37° C-7/ 1—0A 1Z .1 J ekc,vv,ll-c-- c r (1,3 r--
Property Address
Job Description
Required Department Permit Issuance Approval
Approval '
III Tax Collector
Signature/date
Comments:
❑ Fire Marshal
Signature/date
Comments:
PlanninGtQarNg & Zoning 7 131 1 I -1
Re wired for all permits except Si ature/date
Plumbing,Electrical,Mechanical, Roofing,Siding,Windows&Doors 11105‘11105‘ 'U pa,yet k/ 1i„�
a Health Departmentpik.444.* �.S a 7—i 1`I 7
Re. ired for properties with private septic or well Signature/date
Comments: /VU Per Inekt.4.K ev4`t— Gk.r,,d a hc,,,,
❑ WPCA, Administrative Ye)
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
ReviserfMarch 23,2015
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i ' CAI Technologies
ZNING/WETLANDS Montville, CT
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Data shown on this map is provided for planning and informational purposes only.The municipality and CAI Technologies are not responsible for any use for other purposes
or misuse or misrepresentation of this map.�
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