The URL can be used to link to this page

Home My WebLink AboutStrip and Re-Roof 2002 Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville,CT 06382 860-848-3030, Ext. 82 Building Permit Permit Number: B2002-582 Permit Date: 26-Sep-2002 Permit Code R4 Job Location: 59 RAINBOW DRIVE UNIT: MAP/LOT: 016/T29-000 Job Description: strip&re-roof Owner Contractor SHIRLEY A KUBAT Shirley Kubat 59 Rainbow Drive 59 RAINBOW DR Unit: Uncasville,Ct.06382 UNCASVILLE CT 06382 Telephone: 367-0428 Lic/Reg Type: Use Group R4 Lic/Reg Number: 0 Code 1995 CABO Exp Date: Construction Type 5B Construction Values Permit Fees Building Value: $2,100.00 Building Fee: $16.00 Plumbing Value: $0.00 Plumbing Fee: $0.00 Mechanical Value: $0.00 Mechanical Fee: $0.00 Electrical Value: $0.00 Electrical Fee: $0.00 Other Value: $0.00 Other Fee: $0.00 Total Value: $2,100.00 C/O Fee: $10.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $0.34 Total Fees: $26.34 It is the owners responsibility to schedule the following required inspections(minimum 48 hours notice requested); ❑ Footing-Prior to pouring concrete ❑ Rough HVAC ❑ 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 0 Final Inspection ❑ Gas Piping and Pressure Test • C: ' cate of upan.• -Prior : use or occupancy Building Official's Signature: "z � „c - Town of Montville Building Department Permit#‘6{\20,)V-5:5".R 310 Norwich-New London Tpke. Tel. 848-3030,Ext 82 Uncasville, CT 06382 Fax. 848-7231 One & Two Family Building Permit Application Form 0 New Construction 0 Additionteration 0 Accessory Structure PAL 0 other Job Location -5–/ p2A/avi3 U &Ai Job Description/Materials Sr/2//' / 'gen/ Owner ..5;//.Q4-e ( Lc A r- Mailing Address cr, 44/A/Av`"., /.),e- City /ii I',4-5-V)LC(' State Li- Zip Uro 3 b2 Tel a i 3o' 7/ 0'/2 Contractor S6 L f Mailing Address City State Zip Tel / / Contractor's License/Registration Type &Number Exp.Date / / 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 described above. Owner/Agent Signature Date 9 / u / O a— G��-�'/ Construction Value Fee Building $ (... / 0c-.9 $ Plumbing $ $ Mechanical $ $ Electrical $ $ Other $ $ Certificate of Occupancy $ / O Plan Review Fee $ �/ State Education $ 1=2� � 37� Total $ 7 STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION Buildin: Permit Affidavit for Pro.e Owners or Sole Pro.rietors (Conn. Gen. Stat. §31-286b) Property located at c In the town of E' Name of building permit applicant Please check one: 1._I am the owner of the above property. 2. I am the sole proprietor of a business. -24.Name of business 2B.Federal Employer Identification Number(F Pursuantto ..................•.--.----.-------•- a Property owner or solero rietor[who]intends to act as a general . . contractor or principal employer"ma P P insurance or a"sworn no y provide either a certificate of workers'cora notarized affidavit... stating that he will require proof of workas'hon compensation insurance for all those employed on the job site in accordance with this chapter." Please check one: 1.)' I do not intend to act as a general contractor or principal emplo er. [Sign amid stop/here] Y Signature of applicant 2. I intend to act as a general contractor orine r ; provide a certificate of workers'compensation P �employer.Applicant must either below. insurance or sign the affidavit ...----...•.................... Affidavit ................. I hereby swear and attest that I will require ...------- contractor,subcontractor,or other worker beforehe/sheby he end compensation insurance for every in accordance with the Workers'Compensation Act gages in work on the above property (Chapter 568). I understand that pursuant to§31-275 C.G.S.,officers of a co partnership may elect to be excluded matron and partners in a from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coYerage unless he files his intent to accept coverage. Signature of applicant Subscribed and sworn to before me this day of 200 . (Notary Public/Commissioner of the Superior Court) r i Town of Montville Building Department Receipt . c Date 9 /076 / dG,-, No. 02209 From: +. Job Address: Ll'A ' ' CL Amount $ .? G, 3 el Cash 410 Check # /a6 (circle one) Received by ),10,4„,,,42,_4242_ __ Permit #,,fopo 062 _ .57:5'. i Permit Fee Calculation Spreadsheet MISCELLANEOUS PERMIT CALCULATION Pools&Spas Above Ground Round EA $ 3,000.00 $ - Above Ground Oval EA $ 5,000.00 $ - In-Ground EA $ 18.000.00 $ - Heater EA $ 3;300.00 $ - Hot Tub EA $ 5,000.00 $ - Roofing Strip&Reroof 10 SQ $ 210.00 $ 2,100.00 Overlay SQ $ 175.00 Sheds With Electric SF $ 25.00 $ _ No Electric : SF $ 25.00 $ - Deck SF $ 15.00 $ _ Porch SF $ 23.00 $ - TOTAL BUILDING CONSTRUCTION COST $ 2,100.00 PERMIT FEE Building S 2.100 $ 16.00 Mechanical S - $ - Electrical S - $ - $ $ CO Fee $ 10.00 Plan Review $ - State Ed Fee S 2,100 $ 0.34 Total Fees $ 26.34 Based on 2000 Average Construction Cost 9/26/02 Town of Montville Building Department 848-3030, Ext 82 ONE &TWO FAMILY CONSTRUCTION PERMIT SIGN-OFF SHEET Property Address Job Description: The owner/agent shall be responsible for the completion of the form, no certificate of occupancy will be issued until all signatures below have been obtained. HEALTH DISTRICT 848-3030-882 Approved ❑ Permit#: ❑ Not Applicable Septic System Date Approved ❑ Permit#: ❑ Not Applicable Private Well Date WPCA DEPARTMENT 848-3030,Ext.881 Approved ❑ Permit#: ❑ Not Applicable Municipal Sewer Date House Trap ❑ Outside ❑ Inside Approved ❑ Permit# ❑ Not Applicable Municipal Water Date DEPARTMENT OF PUBLIC WORKS 848-7473 Approved ❑ Permit#: ❑ Not Applicable Director Date PLANNING &ZONING DEPARTMENT 848-3030.Ext.81 In-Compliance ❑ Permit#: ❑ Not Applicable Zoning Date In-Compliance ❑ Permit#: ❑ Not Applicable Inland-Wetlands Date Revised 6/28/2002