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Town of Montville
Building Department
CERTIFICATE OF OCCUPANCY APPROVAL
t)7/ ea,,v [( c�
Property Address
Job Description
Required Department Permit Issuance Approval
Approval
Planning & Zoning 1 /
Signature/date
Comments:
❑ Health Department
Required for all permits except Signature/date
Plumbing,Electrical,Mechanical, Roofing,Siding,Windows& Doors
Comments:
❑ WPCA, Administrative
Required for properties on sewer Signature/date
Comments:
❑ WPCA, Operations •
When Required by WPCA Signature/date
Comments:
❑ Fire Marshal
Required for all properties EXCEPT one and two family 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
Revised May 23,2011
Field Inspection Notice
Town of Montville
Building Department
860-848-3030 Ext.382
Address: 21 Rankin Court
Job Description: Pole Shed
Permit Number(s) B2012-0320 Permit Date: August 7,2012
Not Approved Approval
INSPECTION Date: Deficiencies Special Date
Conditions
Piers 8/8/12 DJ
Framing •
8/8/12 DJ
Final inspection for • •
certificate of 8/8/12 DJ
occupancy
**NOTE** After one re-inspection additional inspection fees payable prior to re-inspection,are as follows:
Residential inspections(except SFR C/O& SFR Additions C/O)-$10.00 SFR and Additions C/O re-inspections -$10.00
Commercial re-inspections(except Certificate of Occupancy- $25.00 Commercial Certificate of Occupancy- $50.00
NOTICE:Before a certificate of occupancy can be issued,a C/O signoff sheet must be completed and returned to the building
department.Signoff sheets are available in the building department.
Rev.Date:1/18/06 Page 1 of 1
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: B2012-0320 Date: 07-Aug-12 Map/Lot: 101/059-000 Owner ID: 5787000
Project Location: 21 RANKIN COURT Unit:
Job Description: Pole Shed
Owner Nam Barbara A.and David M Crosier Tenant Name N/A
Careof:
21 Rankin Ct
Uncasville CT 06382- Telephone:
Contractor Nam Home Owner Telephone:
DBA: Lic/Reg Type
Lic/Reg No 0
Exp Date:
Construction Value Permit Fees Construction Information
Building Value: $500.00 Building Fee: $30.00 Use Group: IRC
Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 2005 State Building Code
Mechanical Valu $0.00 Mechanical Fee $0.00
Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type IRC
Total Value: $500.00 Penalty Fee: $0.00 Permit Code: R9
C of 0 Fee: $0.00 Comment
Plan Review Fe $0.00
State Ed Fee: $0.13
Total Fee Paid: $30.13
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.
BUILDING PERMIT INSPECTIONS PLUMBING,MECHANICAL,ELECTRICAL PERMIT INSPECTIONS
❑
Fooling-Prior to pouring concrete ❑ R Plumbing and leak test
❑ Deck Piers ❑ R Electrical
❑ Backfill-Fooling 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 framin ❑ Electrical Service CRS No: 0
❑ Framing ❑ R HVAC
❑ Masonry Fireplace Throat or Chimney Thimble ❑ Gas Piping and leak test
❑ Fireblocking Draftstopping INSPECTION REQUIRED UPON COMPLETION
❑ Insulation ❑ Certifica - of Approval
'n C .' 'cafe of Occupancy
Building Official's Approval: -72 - iC f
Town of Montville
Building Department
310 Norwich-New London Tpkc+.
Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231
RESIDENTIAL PERMIT APPLICATION FORM Permit No.: 66)0
Type of Work Occupancy Type Permit Type
❑ New Construction ❑Single Family IA Building
❑Addition ❑Two-Family ❑Plumbing
❑Alteration NiTownhouse I=]Mechanical
Accessory Structure ElEElectrical CRS#:
Property Address: V kna/"/ �`///
•
(Number)_/ (Street) (Unit)
S�1�(0
Job Description: ° G o f P® Z e s 4el
Owner: e a J/L7 /ui 0,2 a5' den
Address: G" ,eahkl; (� Qq
City: (tel"C� v�" v'v State: r. Zip Code: oeiv` Telephone( )
Applicant: $ice "e o heo/e
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 1 am authorized to make application for a
permit for such work as described 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: ,k>r....,c..e � . Date: .c/9/2"
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:
Revised.August 23,2007
7A
v'"v State of Connecticut N
r���y`)4 t CWorkers' Compensation Commission
CU
Ce
,�'%�, rn'/� Please TYPE or PRINT IN INK
itIMIZzy
Proof of Workers' Compensation Coverage when Applying
for a Building Permit for 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 ,i0 / A e d s j/2
Property located at 2/Z"[//(/ //r/ ef.
in the City/Town of 4/Ne ✓ !' /
ATTEST
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:
-21 I am the OWNER of the above-named property.I WILL NOT act as the general contractor or principal employer.
Signature of OWNER ApplicantX 4 `
4,,
❑ 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 ID#(FEIN)
Signature of SOLE PROPRIETOR Applicant
Town of Montville
Building Department
File Receipt
Date: 06-Aug-12 Receipt No: 7645
Received From: David M. Crosier
Job Address: 21 Rankin CT
Fees Collected State Educational Training Fee
Cash: $30.13 Cash: $0.13
Check/Card $0.00 Check/Card $0.00
Check No: 0
Short/Over: $0.00
Construction Value: $500.00
Demolition Value: $0.00
Received By David Jensen ,� /yje_gp—
Address: 21 Rankin Court
ITEM QTY $/UNIT TOTAL
Building Plumbing Mechanical Electrical
BUILDING AREA
Basement,Finished SF $ 41.96 $ - $ -
Interior Renovations SF $ 36.09 $ - $ - $ -
AMENITIES
Kitchen EA $ - $ - $ -
Full Bathroom EA $ - $ -
Half-Bathroom EA $ - $ -
GARAGE
Detached SF $ 71.53 $ - $ -
MECHANICAL
Warm-Air n Y/N $ -
Hot Water n Y/N $ -
Electric n- Y/N $ -
Air Conditioning n- YIN $ -
ELECTRICAL SERVICE
Upgrade Amps $ -
Subpanel EA $ 699.00 $ -
Gen Set EA $ 3,850.00 $ -
SOLID FUEL BURNING APPLIANCES
Prefab Metal Fireplace EA $ 6,497.70 $ -
Masonry w/tfireplace EA $ 7,096.65 $ -
Masonry w/2 fireplaces EA $ 11,095.70 $ -
Wood Stove,free standing EA $ 2,692.25 $ -
Wood stove insert EA $ 1,859.77 $ -
DECKS,PORCHES,SUNROOMS
Deck SF $ 44.07 $ -
Porch SF $ 149.38 $ -
Sunroom SF $ 176.90 $ - $ -
POOLS&HOT TUBS
Hot Tub EA $ 8,016.25 $ - $
-
Inground Pool EA $ 31,550.00 $ - $
-
Above Ground Round EA $ 6,299.46 $ - $
-
Above Ground Oval EA $ 7,019.75 $ - $ -
Pool Heater EA $ 8,984.25 $ - $
-
Inflatable Type Pool EA $ 1,200.00 $ - $ -
SHEDS
w/o electrical SF $ 25.55 $ -
w/electrical SF $ 26.85 $ - $ -
RENOVATIONS
Roofing,Overlay SF $ 3.50 $ -
Roofing,Strip&reroof - SF $ 4.50 $ -
Roof Sheathing - SF $ 1.51 $ -
Siding SF $ 6.75 $ -
Windows EA $ 550.00 $ -
Skylights EA $ 1,051.10 $ -
Doors,Exterior EA $ 601.50 $ -
Oil Tank,275 Gallon - EA $ -
Oil Tank,550 Gallon - EA $ -
MISCELLANEOUS CALCULATIONS $ 500.00
TOTALS $ 500.00 $ - $ - $ -
PERMIT FEE CALCULATIONS
Construction Value Fee
Building $ 500.00 $ 30.00
Plumbing y $ - $ -
Mechanical y $ - $ -
Electrical y $ - $ -
Working before Permit Issuance n $ -
Certificate of Occupancy Fee $ -
Plan Review Fee $ -
State Education Fee $ 0.13
TOTALS $ 500.00 $ 30.13
Figures are based on the 2006 RS Means Residential Cost Data
Town of Montville
Building Department
• 310 Norwich-New London Tpke. Fax. 860-848-7231
Tel. 860-848-3030, Ext 382 Uncasville, CT 06382
CONSTRUCTION PERMIT APPROVAL
Applicant is responsible for obtaining all of the required approvals. No permit will be issued until all the required signatures are obtained.
V ,aff / 0-
Property Address
cW,e,&/ /gel( /0/ 1/, ,;
Job Description
111 - Required for all permits ® - At least one required for all permits ❑
-Required as indicated below
Required Department Permit Issuance Approval
Approval
® Tax Collector ',Ns/6„// Y
Signature!date
Comments: C-It'2--12
® Planning & Zoning YAP-Z-
Signature!date
Comments: iji , X 1 ' C g l-t S(f C
® Fire Marshal Signature/date
Comments:
® Health Department
Required for properties with septic systems-Not required for Plumbing,Electrical,Mechanical,Roofings gning,Windo
datews
&Doors
Comments: \ S i Q
® WPCA, Administrative Y 4 -'I/
j---( I l )7
Required for properties on sewer Signature/date
Comments:
n WPCA, Operations Signature/date
When Required by WPCA
Comments:
❑ Department of Public Works Signature/date
Required when project includes driveway work or certain drainage requirements g
Comments:
❑ State Dept. of Transportation
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 Review Complete Signature/date
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NOTICE OF VIOLATION
TOWN OF MONTVILLE
Building Department
310 NORWICH-NEW LONDON TURNPIKE
UNCASVILLE, CT 06382-2599
TEL. (860) 848-3030 X382 FAX. (860) 848-7231
7/11/2012
Barbara A. and David M Crosier
21 Rankin Ct
Uncasville CT 06382-
Delivery method: CERTIFIED MAIL. RETURN RECEIPT REOUESTED and FIRST CLASS MAIL
property located at: 21 RANKIN COURT Unit: Map/Lot: 101/059-000
You are hereby ordered to discontinue the violation at the above referenced property per
Section R113.1 of the 2003 IRC portion of the 2005 Connecticut Building Code.
You must STOP WORK as per
Section R114.0 of the 2005 Residential Code portion of the 2005 Connecticut Building Code
and you must submit to the Building Department a plan of compliance within ten (10) calendar days from the date of
receipt of this notice in order to avoid legal action.
The violation consists of:
The construction of a shed roof structure with out approval(s) and permit(s)
a-Lpd
David M. Jensen, Deputy Building Official
Cc: File
Office Use Only:
Date: Inspector: Comments:
6
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. S gnatyre / 0 Agent
item 4 if Restricted Delivery is desired. `/ g
• Print your name and address on the reverse X14/./4` 1�FA,_. 0 Addressee
so that we can return the card to you. B. Received by(Pnnt d Name) C. Date of Delivery
• Attach this card to the back of the mailpiece, � / 6 i
or on the front if space permits. ✓..,A4)C- tcf P <'hecGei-- 8 r
D. Is delivery address different fro . 0 Yes'
1. Article Addressed to:
If YES,enter delivery addre5 elow: .�Na"
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.Certified Mail 0 Express Mail
❑ Registered . eturn Receipt for Merchandise
❑ Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number
(Transfer from service label) 7008 1300 0000 7705 9913
PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540
{ U.S. Postal Service,.
CERTIFIED MAIL, RECEIPT
ni (Domestic Mail Only;No Insurance Coverage Provided)
1-1
Er For delivery information visit our website at www.usps.coma
OFFICIAL USE
(�- Postage $
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Certified Fee
Postmark
O Return Receipt Fee Here
(Endorsement Required)
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Restricted Delivery Fee
(Endorsement Required)
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Sent To
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PS Form 3800,August 2006 See Reverse for Instructions t.