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HomeMy WebLinkAboutSFR 2005 , Lt)! C) 1 0! YA N Q, o Q • C Z' z Z# E. O T'" waw y 12 O 70 U a) > f0 is a) U c as i E! w ,i, 3C (13d a. = fa C = E >, 4 a) a. - k..) a., m fai O _C - _, is .- .I.- -a u V >. >-, L O O C En (f) 0 ' � v 4-$ ya) H C C C a) ra a G c O E V a) sn as CD U U � m >- cr v o 0 C E U a) a) --o u o 0 W z C o o C `z Q 0 Q o > 17_, U T 5 ( rf, coLn of i- CV '` o Z Q 0 c a • aiCP d fa a) M o. Cl) D • ~ �'" 4 C _C N 1L rn W � 0 -O 0 c- C a} 1/40 0 V H fn fa C C4 t .; U E' o o ui Z Z Q — ra O o d „ 0 V o a) - J t �' u Cl)illo = Cl) - c o; _o co F- O J ti U CA w vii U G Cs Z 0 CV m o)15 cv 6 -v co U 0 m >• fY v, fs v a) +- QQ _� m v - = DL c o - C fa; LA 'f3 �O O C Q a)s m CD LA, d� p_ 'I- (1) ; J M N 1 � O C J a) 4 , U w t1); cc) DG (J) N i ca C O Us Ul a) -1 0 L C IA Crl U) I "O -0 'II Zs m fp 'CI CO p ' 03 = J u 4--1 ta N 0 U O V N Z L i u) C Lfl 0 .fl a) 13 N fa C H U rri a 0 a J U U) 0 Town of Montville Building Department Field Inspection Notice Address: 350 Raymond Hill Rd. Job Description: Single Family Dwelling Permit Numbers, B2004-0585-M2004-0277—P2004-0138—E2004-0359 Footing Not Approved: Approved: 11/1/04 JS Comments: 1. House numbers required Backfill Not Approved: Approved: 11/30/04 JS Comments: 1. Discharge pipe not installed See note 1 Framing Not Approved: Approved: Comments: 1. Rough Electric Not Approved: Approved: Comments: I. Electrical Service Not Approved: Approved: 1'5'15.1S Comments: 1. Rough HVAC Not Approved: Approved: Comments: 1. Rough Plumbing Not Approved: Approved: Comments: 1. Gas Line Not Approved: Approved: 3/14/05 JS Comments: 1. Stove Only Fireplace Throat/ Not Approved: 12/28/04 JS Approved: 1/5/05 JS Chimney Comments: 1. Not started Fire/Draftstopping Not Approved: Approved: Comments: 1. Insulation Not Approved: Approved: Comments: I. Certificate of Not Approved: 3/14/05 JS Approved: 3'16/1)5 JS Occupancy Comments: 1. House numbers required at the street,min.4"of contrasting With conditions,rear slider is color blocked shut.garage is not 2. No steps to doors on front of house completed and garage door is 3. Second floor right front bedroom—top half of receptacle does blocked shut not work 4. Door to garage is blocked shut 5. Rear slider is not blocked shat 6. Kraft paper exposed in basement 7. Underside of stairs to be insulated S. Exposed wiring on the exterior above basement door 9. Garage is not completed 10. Plumbing vent behind garage may be to low Not Approved: Approved: Comments: 1. Not Approved: Approved: Comments: I. Not Approved: Approved: Comments: 1. Comments: Page 1 of I Town of Montville Building Department 310 Norwich-New London Tpke. Uncasville, CT 06382 Tel. 860-848-3030,Ext. 382 Fax. 860-848-7231 CERTIFICATE OF OCCUPANCY APPROVAL C1cM �� cnkk W11 Rc\. NbrvTtftIli Property Address � ) 4cr 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 Approval Department Certificate of Occupancy Approval ❑ WPCA SIeliaitire: date Planning&Zoning u&A , u, 3//6/G 3 2oy-a 7/ Signature/date ❑ Health Department pfl�� 3 if-d5-- Sign' re:'date Department of Public Works � -7o-03-- Signature/ date ❑ State Dept. of Transportation Si:mat tire/date ❑ Police Department Signature-date O Fire Marshal Signalurei date Comments/Conditions: Rivise6Septemfer9,2004 TOWN 00 MONTVILLE Building Department 310 NORWICH-NEW LONDON TURNPIKE UNCASVILLE, CT 06382-2599 TEL. (860) 848-3030 X382 FAX. (860) 848-7231 MECHANICAL PERMIT Permit Number: M2004-0277 Date: 21-Dec-04 Map/Lot: 032/003-002 Owner ID: 5830000 Project Location: 350 RAYMOND HILL ROAD Unit: Job Description: Heating Owner Name: CMC Builders LLC Tenant Name: N/A Careof: 24 Willow Lane New London CT 06320- Telephone: Contractor Name: Y&M Services Telephone: (860)267-9964 DBA: Lic/Reg Type: S3 Lic/Reg No: 306756 P.0. Box 59 Exp Date: 31-Aug-05 East Hampton Ct 06424- Construction Value Permit Fees Construction Information Building Value: $0.00 Building Fee: $0.00 Use Group: R-4 Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1999 State Building Code Mechanical Value: $0.00 w/2004 Amendment $0.00 Mechanical Fee: Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type: 5B Total Value: $0.00 Penalty Fee: $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comments: Plan Review Fee: $0.00 Included on Building Permit State Ed Fee: $0.00 Total Fee: $0.00 jt shall be the owners rensonsibility to schedule the following insoections 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 ❑ Footing-Prior to pouring concrete ❑ R Plumbing and leak test ❑ Deck Piers ❑ R Electrical ❑ Backfill-Footing 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 framing ❑ Electrical Service CRS No: 0 ❑ Framing ❑d R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble ❑ Gas Piping and leak test ❑ Fireblocking_Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation ❑ Certificate of Appro :I e • • upancy Building Official's Approval: �— Town of Montville Building Department 310 Norwich-New London Tpke. Tel. 848-3030,Ext 382 Uncasville, CT 06382 Fax. 848-7231 Residential Trades Permit Application Form Permit# Z} 7 7 Plumbing DElectrical g3lechanical CRS # 4 .7feating Air Conditioning Gas Piping El Single Family ❑ Two-Family El Townhouse Job Address ,3,jDff�- (Numbe>' l�7' (Stree (Unit) Job Description7fa 2 /77 Owner C- /v! Mailing Address City State Zip Tel Contractor rei �!1 �i���t-C,(� Mailing Address Cit' State Zip © #'2 ' Tel D / j‘2 r Contractor's License Type&Number 0,6 75 Exp. Date 8 /30 / 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 wor as described above. 47E/ Owner/Agent Signature , Date //7/ UC� Construction Value Fee Plumbing $ $ Mechanical $ lar ! $ Electrical $ $ Plan Review Fee $ State Education $ Total $ $ (Complete reverse side) 2jcvi eiSeptemfer 9,2004 Town of Montville Building Department 310 Norwich-New London Tpke. Uncasville, CT 06382 Tel. 860-848-3030, Ext. 382 Fax. 860-848-7231 CO► STRUCTION PERMIT APPROVAL —Jr .orf/ Property 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 Tax Collector C ( 0 4 ❑ WPCA / • a �,\o`-i �+'att_ itu'i�'ala ❑ Planning&Zoning ;it2nu1u,ire (late ❑ Health Department s._ at uri."'' ❑ Department of Public Works ❑ State Dept.of Transportation i jnaturc!date ❑ Fire Marshal Signa'.ure;" date Comments/Conditions: cvisetSeptem6es9,2004 C State of Connecticut g 7A - 7B - 7C = Workers' Compensation Commission • { DIRECTIONS DIRECTIONS for FILING FORMS 7A,7B and 7C Building Permit Requirements for Workers' Compensation Section 31-286b of the Workers'Compensation Act requires anyone who requests a building permit to first submit"proof of workers'compensation coverage for all of the employees who are engaged to perform services on the site of the construction project for which the permit was issued." The only exceptions to this law are the sole proprietor or property owner who will not be acting as general contractor or principal employer. What to give to the Building Official to obtain a Building Permit: 1. The General Contractor or Principal Employer must provide a written certificate of workers' compensation insurance for all of the employees on their project.This certificate may not be for liability, disability or any other type of insurance. 2. The Sole Proprietor or Property Owner who will not act as a general contractor or principal employer is not required to have workers'compensation coverage. In order to obtain the building permit,a FORM TA should be completed and given to the building official. 3. The Sole Proprietor or Property Owner who act as a general contractor or a principal employer must provide a written certificate of workers'compensation insurance for all of the employees on their project and must file a FORM 7B with the building official—OR he will sign a sworn notarized affidavit on FORM 7B,stating that he will require proof of workers'compensation insurance for all those employed on the job site. 4. The General Contractor or Principal Employer who has properly excluded himself from coverage using the appropriate WCC form(see Non below)must file the FORM 7C with the building official.This form certifies that they have properly excluded themselves, and attests that they will require proof of workers'compensation insurance from every employee that works on the designated job site. NOTE: The general contractor or principal employer may exclude himself from workers'compensation coverage by filing one of the following forms with the appropriate Workers'Compensation Commission district office: Form 6B for employees who are Officers of a Corporation or Managers/Members of an LLC Form 6B-1 for employees who are Members of a Partnership TOWN OF MONTVILLE Building Department 310 NORWICH-NEW LONDON TURNPIKE UNCASVILLE, CT 06382-2599 TEL. (860) 848-3030 X382 FAX. (860) 848-7231 PLUMBING PERMIT Permit Number: P2004-0138 Date: 21-Dec-04 Map/Lot: 032/003-002 Owner ID: 5830000 Project Location: 350 RAYMOND HILL ROAD Unit: Job Description: Plumbing Owner Name: CMC Builders LLC Tenant Name: N/A Careof: 24 Willow Lane New London CT 06320- Telephone: Contractor Name: Y&M Services Telephone: (860)267-9964 DBA: Lic/Reg Type: P3 Lic/Reg No: 207992 P.O. Box 59 Exp Date: 31-Oct-05 East Hampton Ct 06424- Construction Value Permit Fees Construction Information Building Value: $0.00 Building Fee: $0.00 Use Group: R-4 Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1999 State Building Code Mechanical Value: $0.00 Mechanical Fee: $0.00 w/2004 Amendment Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type: 5B Total Value: $0.00 Penalty Fee: $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comments: Plan Review Fee: $0.00 Included on Building Permit State Ed Fee: $0.00 Total Fee: $0.00 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 ❑ Footing-Prior to pouring concrete 0 R Plumbing and leak test ❑ Deck Piers ❑ R Electrical ❑ Backfill-Footing 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 framing ❑ 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 ❑ Certificate of Approval L • e o occupancy Building Official's Approval: - --� f Town of Montville Building Department 310 Norwich-New London Tpke. Tel. 848-3030,Ext 382 Uncasville, CT 06382 Fax. 848-7231 Residential Trades Permit Application Form / Permit# r O a --3 Arc,r ` Plumbing 0 Electrical El4leclianical CV' # .Pleating Air Conditioning Gas Piping ❑Single(Family 0 Two-(amily J Townhouse Job Address 3 /P�? ��� ,- (Number) (Street) p (Unit) Job Description V � / Owner G Ale- jLz-t4i-op Mailing Address ' City State Zip Tel / / Contractor � __y____ifrf 5 i�/�Mailing Address� l'// City. /.Zs� p State A' Zip at,',/-,(02/_.Tel V60 / / /�'/ Contractor's License Type&Number ,9_.e,7 79-,z re5 Exp.Date l� / 3// az,, 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. / „i/ - - , Owner/Agent Signature / 1" r/ Date /2-/ /5 /D r , Construction Value Fee Plumbing $ 70. $ Mechanical $ $ Electrical $ $ Plan Review Fee $ State Education $ Total $ $ (Complete reverse side) 14.viseiSeptem6er9,2004 • Town of Montville Building Department 310 Norwich-New London Tpke. Uncasville, CT 06382 Tel. 860-848-3030, Ext. 382 Fax. 860-848-7231 CO O'UCTION PERMIT APPROVAL YJ-& Prope .dress 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 Tax Collector 0�L � /1 /.443,0± # ,.. ❑ WPCA /a Signature ate ty ❑ Planning& Zoning Sit4naturev date ❑ Health Department 7 `.,1t;natu e. �latt.. ❑ Department of Public Works cligc ❑ State Dept.of Transportation Signature; date ❑ Fire Marshal Signature; date Comments/Conditions: 44viseiSeptem6er9,2004 • • 7A( State of Connecticut - 7B7c • 'L, = Workers' Compensation Commission DIRECTIONS /Nom- DIRECTIONS for FILING FORMS 7A,7B and 7C Building Permit Requirements for Workers' Compensation p on Section 31-286b of the Workers'Compensation Act requires anyone who requests a building permit to first submit"proof of workers'compensation coverage for all of the employees who are engaged to perform services on the site of the construction project for which the permit was issued." The only exceptions to this law are the sole proprietor or property owner who will not be acting as general contractor or principal employer. What to give to the Building Official to obtain a Building Permit: 1. The General Contractor or Principal Employer must provide a written certificate of workers' compensation insurance for all of the employees on their project.This certificate may not be for liability, disability or any other type of insurance. 2. The Sole Proprietor or Property Owner who will not act as a general contractor or principal employer is not required to have workers'compensation coverage. In order to obtain the building permit,a FORM 7A should be completed and given to the building official. 3. The Sole Proprietor or Property Owner who ji,act as a general contractor or a principal employer must provide a written certificate of workers'compensation insurance for all of the employees on their project and must file a FORM 7B with the building official—OR he will sign a sworn notarized affidavit on FORM 7B,stating that he will require proof of workers'compensation insurance for all those employed on the job site. 4. The General Contractor or Principal Employer who has properly excluded himself from coverage using the appropriate WCC form(see NOTE below)must file the FORM 7C with the building official.This form certifies that they have properly excluded themselves, and attests that they will require proof of workers'compensation insurance from every employee that works on the designated job site. MOTE: The general contractor or principal employer may exclude himself from workers'compensation coverage by filing one of the following forms with the appropriate Workers'Compensation Commission district office: Form 6B for employees who are Officers of a Corporation or Managers/Members of an LLC Form 6B-1 for employees who are Members of a Partnership TOWN OF MONTVILLE Building Department 310 NORWICH-NEW LONDON TURNPIKE UNCASVILLE, CT 06382-2599 TEL. (860) 848-3030 X382 FAX. (860) 848-7231 ELECTRICAL PERMIT Permit Number: E2004-0359 Date: 28-Dec-04 Map/Lot: 032/003-002 Owner ID: 5830000 Project Location: 350 RAYMOND HILL ROAD Unit: Job Description: Electric&Electric Service Owner Name: CMC Builders LLC Tenant Name: N/A Careof: 24 Willow Lane New London CT 06320- Telephone: Contractor Name: Paul Sucholet Telephone: (860)887-9770 DBA: Lic/Reg Type: El Lic/Reg No: 121829 20 Pinecrest Court Exp Date: 30-Sep-05 Norwich Ct 06360- Construction Value Permit Fees Construction Information Building Value: $0.00 Building Fee: $0.00 Use Group: R-4 Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1999 State Building Code Mechanical Value: $0.00 Mechanical Fee: $0.00 w/2004 Amendment Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type: 5B Total Value: $0.00 Penalty Fee: $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comments: Plan Review Fee: $0.00 Included on Building Permit State Ed Fee: $0.00 Total Fee: $0.00 It shall be the owners reosonsibility 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 ❑ Footing-Prior to pouring concrete ❑ R Plumbing and leak test ❑ Deck Piers R Electrical ❑ Backfill-Footing 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 framing 0 Electrical Service CRS No: 3979554 ❑ Framing ❑ R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble ❑ Gas Piping and leak test ❑ Fireblocking_Draftstopping INSPECTION REQUIRED UPON COMPLETION ❑ Insulation ❑ Certificate of Approval ❑ Certificate of Occupancy Building Official's Approval: Town of Montville Building Department 310 Norwich-New London Tpke. Tel. 848-3030,Ext 382 Uncasville,CIE 06382 Fax. 848-7231 Residential Trades Permit Application Form Permit# � �O�' a 5 Tfum6ing VIECectrica1 Mechanical cis39 73---(-1 # Yfeating Air Conditioning Gas Tieing Single Family [] Two-Family ❑ Townhouse Job Address 3S"0 R Ay wt.o/1 ift I l (c (Number) (Street) (Unit) Job Description n .g;„i (l o d owl e_ Owner +r'1 8o, dam,,-s Mailing Address City 11 ov)-tv 1 [j P State Zip Cj 6 35 Tel .6o / /3'I/ /a3 a Contractor DKv I S�,c,l o I-t Mailing Address ph e cre ,t Csoc.J.--1— City n o - , c.-k State t— Zip Oh 36 0 Tel %o / /772D Contractor's License Type&Number E-I / / a l Exp. Date 9 /3 o / ao0 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 / AI �� /Agent Signature G � Date Id1. / 2 / Construction Value Fee Plumbing $ $ Mechanical $ $ Electrical $ //a-D 0 $ Plan Review Fee $ State Education $ Total $ 11 (Complete reverse side) cvisedSeptem6er9,2004 14 State of Connecticut g 7A - 7B - 7c ti . 'L r Workers' Compensation Commission •� {t -) DIRECTIONS •• � DIRECTIONS for FILING FORMS 7A,7B and 7C 'x Building Permit Requirements for Workers' Compensation Section 31-286b of the Workers'Compensation Act requires anyone who requests a building permit to first submit"proof of workers'compensation coverage for all of the employees who are engaged to perform services on the site of the construction project for which the permit was issued." The only exceptions to this law are the sole proprietor or property owner who will not be acting as general contractor or principal employer. What to give to the Building Official to obtain a Building Permit: 1. The General Contractor or Principal Employer must provide a written certificate of workers' compensation insurance for all of the employees on their project.This certificate may not be for liability, disability or any other type of insurance. 2. The Sole Proprietor or Property Owner who will not act as a general contractor or principal employer is not required to have workers'compensation coverage. In order to obtain the building permit,a FORM TA should be completed and given to the building official. 3. The Sole Proprietor or Property Owner who will act as a general contractor or a principal employer must provide a written certificate of workers'compensation insurance for all of the employees on their project and must file a FORM 7B with the building official—OR he will sign a sworn notarized affidavit on FORM 7B,stating that he will require proof of workers'compensation insurance for all those employed on the job site. 4. The General Contractor or Principal Employer who has properly excluded himself from coverage using the appropriate WCC form (see NOTE below)must file the FORM 7C with the building official.This form certifies that they have properly excluded themselves, and attests that they will require proof of workers'compensation insurance from every employee that works on the designated job site. NOTE: The general contractor or principal employer may exclude himself from workers'compensation coverage by filing one of the following forms with the appropriate Workers'Compensation Commission district office: Form 6B for employees who are Officers of a Corporation or Managers/Members of an LLC Form 6B-1 for employees who are Members of a Partnership ".'C State of Connecticut Workers' Compensation Commission 7A Please TYPE or PRINT IN INK o: 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 .Q\J Property located at 3SD \��, Int c o cL ( ( R n.„d in the City/Town of MO-1IJ i l! i - 06 3S� 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: • ❑ I am the OWNER of the above-named property.I WILL NOT act as the general contractor or principal employer. Signature of OWNER Applicant 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 Pfiv 1 J v L L0I$ l Et e Federal Employer ID#(FEIN) Signature of SOLE PROPRIETOR Applicant TWO— - "/,4 — I • 01 ( t ► \ 1 t 114 I I •ELECTRICAL i JL1D CQ1�ITRACTOR L1 • PALJA..J CI LET 2O * t ES NOitwitAl. 4634 ©9/ J5 a ,e SIGNED_._.` i W��� TOWN OF MONTVILLE Building Department 310 NORWICH-NEW LONDON TURNPIKE UNCASVILLE, CT 06382-2599 TEL. (860) 848-3030 X382 FAX. (860) 848-7231 MECHANICAL PERMIT Permit Number: M2005-0021 Date: 08-Feb-05 Map/Lot: 032/003-002 Owner ID: 5830000 Project Location: 350 RAYMOND HILL ROAD Unit: Job Description: Gas Tank&Gas Line Owner Name: CMC Builders LLC Tenant Name: N/A Careof: 24 Willow Lane New London CT 06320- Telephone: Contractor Name: Advanced Gas Telephone: (860)859-9070 DBA: Lic/Reg Type: G1 Lic/Reg No: 386875 183 East Haddam Rd. Exp Date: 31-Aug-05 Salem Ct 06420- Construction Value Permit Fees Construction Information Building Value: $0.00 Building Fee: $0.00 Use Group: R-4 Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1999 State Building Code Mechanical Value: $275.00 Mechanical Fee: $8.00 w/2004 Amendment Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type: 5B Total Value: $275.00 Penalty Fee: $0.00 Permit Code: R5 C of 0 Fee: $0.00 Comments: Plan Review Fee: $0.00 State Ed Fee: $0.04 Total Fee: $8.04 It shall be the owners reosonsibility 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 ❑ Footing-Prior to pouring concrete ❑ R Plumbing and leak test ❑ Deck Piers ❑ R Electrical ❑ Backfill-Footing 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 framing ❑ Electrical Service CRS No: ❑ Framing 0 ❑ R HVAC ❑ Masonry Fireplace Throat or Chimney Thimble 0 Gas Piping and leak test ❑ Fireblocking_Draftstopping INSPECTION REOUIRED UPON COMPLETION ❑ Insulation ❑ Certificate of Approval Certificate of Occupancy Building Official's Approval: dj —__ Town of Montville Building Department 310 Norwich-New London Tpke. Tel. 848-3030,Ext 382 Uncasville, CT 06382 Fax. 848-7231 Residential LP-Gas Permit Application Form Single cFami[y Two-'Family Townhouse Permit#J ,2 o 0 5 . i-' 7 / Job Address (Number) Dh d G//&& 2flCsSI',/J9/ (Street) (Unit) Job Description .Tlc5 y , Z.3 //b/1 S hyn Ar' Lrl �//;Bs deeSA,Pe Owner fi 1T' /as Mailing Address 350 fgti� SAj//'fid -7 City //i State cr Zip 4ei ,.3S-ts--Tel / it, goo/ Contractor f Jdl/l ,Ceed d.95 Mailing Address /r3 A40,012420i'Di P City cS49tein State C-71— Zip A /24) Tel W4 o/ S S,/ '7 Contractor's License Type&Number 1/43%x75 ' Hee_ Exp. Date Otr /3/ / c1.Lbs'' 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. Separate applications are required for electrical. Owner/Agent Signature 54Date 2. / O// 2,005 Construction Value Fee Mechanical $ 2 7v $ V.0 0 Electrical $ $ Plan Review Fee $ State Education Total $ 0275-e7) • 0 to Li4 2jevisaSeptem6er9,2004 Town of Montville Building Department Receipt Date / / / a S'• No. 04613 From: Avu2f, Job Address: 3)O PAy i/AiD Amount $ .as � Check Check# V.34Received by ,,, � , . . Permit # o-,c-vo, iv. lor+m,v. r L It.vitaa Jdi vit,vo - , OOv I IJ ,CC`J H I State of Connect ' Department of scut Consumer Protection . LICENSE VERIFICATION This Is to certify that the Connecticut Department Indicate the following Information regarding: ent of Consumer Protection's record. rd -:: MARK MARTIN 67 FORSYTH RD - - —___--— SALEM, CT 06420 ::..''':::.„,i' STAT Or CONNECTICUT + DEPARTMENT OF CONSUMER: P :O — --- – '� PROTECTION ) �.� Be itkno -tat I ,< ' i 1 ;-.-1- . i '67'FORSy ,j RD SALE11�1, <J6420 I has been certified by the De g. s; of C ,,e er Protection;as:,a licensed HEATING, PIPfiNG & Y:ii::':." 1 c a _ , .2 t tR ..;k, ss CONTRACTOR ' \* ✓' >tt ka ° 41g ----- '-` rQANS7. :: yam.. 0. !' 1.0.--- -?.- . ,A I Effective: 09/01/2004 Expiration: 08/31/2005 i........ ..- Eaai,.i,Rodriguozr COMMUsionu-. 1 �+ - - -- - -. _... _. .,..—.....—.. ...,, .....,,,,,5 nv��.viw 11,1%.eU.) 14:V I p.m. 1V-Vl-ZUV4 'L/ _ ACORD.. CERTIFICATE OF LIABILITY INSURANCE OP ID PB DATE(MM/DDVYY is PRODUCFA ADVAN-6 10/07/“ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Bailey Agencies, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 178 Bridge Street ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. Groton CT 06340 Phone: 860-446-8255 Fax:860-448-1608 INSURERS AFFORDING COVERAGE INSURED NAIC I INSURER A: Ranger Insurance Agdvancced Ga Sales & Service INSURER B: American Home Assurance 1l3CeiaBt Ga Road INSURER C. Sa em CT 06$ 0 INSURER D: am INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IHSH AUV L LTR NSRC TYPE OF INSURANCE POLICY NUMBER POL CY EFFECTIVE POLICY EXPIRA,I N DATE{MMrDOJYY)_ DATE(MM/DD/Yyg_ LIMITS GENERAL LIABILITY A X COMMERCIAL GENERAL.LIABILITY R/ENG023753200 EACH OCCURRENCE $ 1000000 10/01/04 10/01/05 PREMISES(Eatnrr rvow.) $ 100000 CLAIMS MADE X OCCUR MED EXP(Anyone parson) 15000 PERSONAL&ADV INJURY $ 1000000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE :2000000 7 POLICY n Ix& n Loc PRODUCTS•COMP/OP AGO 52000000 AUTOMOBILE LIABILITY — A X ANY AUTO R/SBA0364746 10/01/04 10/01/05 (Ea as COMBden)INGLELIMIT $ 1000000 ALL OWNED AUTOS — SCHEDULED AUTOS BODILY INJURY _ HIRED AUTOS (P«person) $ NON-OWNED AUTOS (BPODILoe LYY(INJURY $ — PPERTY(Pa accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY•EA ACCIDENT $ OTHER THAN EA ACC S EXCESS UMBRELLA LULBIUTY AUTO ONLY: ACNO i A OCCUR CLAIMS MADE R/CUP0421934 EACH OCCURRENCE $ 1000000 10/01/04 10/01/05 AGGREGATE : l000000 _ DEDUCTIBLE _ X _RETENTION $10000 i WORKERS COMPENSATION ANDS $ EMPLOYER 'LIABILITY B x(TORY LIMITS I ER AM PROPRIETOR/PARTNER/EXECUTIVE 10/01/04 10/01/05 E.L. ACHACCIDENT OFFICER/MEMBER EXCLUDED? = 500000 U yyes Eesalbs under E.L.DISEASE•EA EMPLOYEE S 50000_0_0 SPEGIUL PAOVISwNS Dalow ~— OTHER E.L.DISEASE-POLICY UMR 1 5 0 0 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Proof of insurance with regards to the named insured. Original Issue Date 10/07/04 CERTIFICATE HOLDER CANCELLATION ADVANC1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO : DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN s':: NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Advanced Gas Sales & Service Stacy Martin IMPOSE NO OBLIGATION OR LIABIUTY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 183 East Haddam Road REPRE' NTATIVES, Salem, CT 06420 AU •ORUED EPRESENTATIVE dooy / ' ACORD 26(2001/08) //� 0 ACORD CORPORATION 198E Iiir Town of Montville Building Department 848-3030, Ext 382 RESIDENTIAL LP-GAS PERMIT CONSTRUCTION PERMIT APPROVAL ScO Onyypt.ek Ac o / Property Address /UK_ ,4"-- ,1/,Lc.. 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 Approval Department Permit Issuance Approval 91( Tax Collector C_____)zoz,4 -3 3--k` c WPCA l/V 1 Sagnattli- c O Planning&Zoning 'tiignaturc ci lie ❑ Health Department ❑ Fire Marshal Comments/Conditions: cRyvise Septem6er9,2004 ADVANCED GAS 183 E.HADDAM ROAD SALEM,CT 06420 SALES & SERVICE Tex Telephone e hone860829-9070 RE: BUILDING PERMIT APPLICATIONS PROPERTY ADDRESS: 3SD fect3monci 12oct.d K I/cas'U1./1. ,, Pat IQ �,es 06,38Q,OWNER: Q� DESCRIPTION OF JOB: Di31 .CX 9 gn�p;�; rO QS y K� 60 2.A -b aeoK Soo v e �l STARTING DATE: off-, ((Q I DC- LICENSED CONTRACTOR: MARK MARTIN HTG.386875 LICENSED CONTRACTOR'S AGENTa) PLEASE ALLOW MY EMPLOYEE TO PULL OR DELIVER THIS PERMIT. Sincerely, STATE OF CONNECTICUT 4,1111114- / 'l, DEPARTMENT OF CONSUMER PROTECT/ON / HEATING,PIPING&COOI ING pJ lTED CONTRACTOR 4 G1 MAR MARTIN MARKTIN' PRESIDENT 67.*QI-R$Y1'T8 tD SALEM,Cr;o6430 k:, L 13G�r NQ. '00E704' 08/M115155 {Gr,c 114.0�F` r *ANS,- ; SIGNED ..-.. ADVANCED ,a3 E.HADDAM RGA SALES SALEM,CT 0843 SALES a swancE Telephone 880869.8070 • Fax 080469-3027 RE: BUILDING PERMIT APPLICATIONS PROPERTY ADDRESS: OWNER: DESCRIPTION OF JOB: STARTINCQ DATE: LICENSED CONTRACTOR: MARK MARTIN HTG.386875 LICENSED CONTRACTOR'S AGE 4111111Irro . '. i,r • PLEASE ALLOW MY EMPLOYEE TO PULL OR DELIVER THIS PERMIT, Sincerity, • STATE OF CONNECTICUT PH'I/.7ur '.r 11! <<,.ttic..,�rr, jARMrr rrr,-ti BEATING,!PIING&COPr.FrfCON7*ACTOR 3 MARK MARTIN 4. PRESIDENT M.A.1Viute D. ' M;f `: b64i0" i; rosrfr' OSISIMS r ti,,th<Alt j. APAP !00/1.002 S31YS SEI 033Nb'AOV X1+3 !! SLGon7./tn/7n 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: 82004-0585 Date: 09-Nov-04 Map/Lot: 032/003-002 Owner ID: 5830000 Project Location: 350 RAYMOND HILL ROAD Unit: Job Description: Single Family Residence,Garage Owner Name: CMC Builders LLC Tenant Name: N/A Careof: 24 Willow Lane New London CT 06320- Telephone: Contractor Name: SNE Modular Home Inc. Telephone: (860)537-4669 DBA: Lic/Reg Type: NHC Lic/Reg No: 1582 420 So. Main Street Exp Date: 30-Sep-05 Colchester Ct 06415- Construction Value Permit Fees Construction Information Building Value: $184,229.00 Building Fee: $1,480.00 Use Group: R-4 Plumbing Value: $13,361.00 Plumbing Fee: $112.00 Code: 1999 State Building Code Mechanical Value: w/2004 Amendment $14,846.00 Mechanical Fee: $120.00 Electrical Value: $13,679.00 Electrical Fee: $112.00 Construction Type: 5B Total Valuer $226,115:-00 --Penalty Fee: $0.0 Permit Code: R2 C of 0 Fee: $25.00 Comments: Plan Review Fee: $182.40 State Ed Fee: $36.18 Total Fee: $2,067.58 It shall be the owners reosonsibility 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. ❑d Footing-Prior to pouring concrete ❑d R Plumbing and leak test Backfill-Footing drains and waterproofing 0 R Electrical 0 Concrete Slab-Prior to pouring concrete ❑ Elec Trench-with conduit installed ❑ Framing 0 Electrical Service CRS No: 0 ❑ Fireplace Throat-One flue above throat ❑d R HVAC ❑ Chimney-One flue above thimble ❑ Gas Piping and leak test • Firestop Draftstopping ❑ Final Inspection ❑d Insulation k Certificate of Occupancy Building Official's Approval: %%./ ', Town of Mmtville Building Department 310 Norwich-New London Tpke. Tel. 848-3030,Ext 382 Uncasville,CT 06382 Fax. 848-7231 Residential Building Permit Application Form Permit# 112 New Construction D Addition 0 Alteration []Accessory Structure r-1/Sirt0`Family 0 Two-Family[] Townhouse Job Address JZ / ,r��,J I'i/ . (20/— 2 ) ,. (Number) (Street) (Unit) Job Description C;A/sixttti 51414 //// 1570‘:,()el, .4,S/ , / 2- C.Qie K:66 4 Z Owner (7,-/fr loliS j/ Mailing Address J/ ///;,,,,.► 1�a% City /14-4) /P-i/e/en State (� Zip 043;i0 Tel R e) / Mt f..23 t) Contractor SO' /1i/L,t.e ilCd/es ile, Mailing Address_ . 1 ,z:� S i City -(:.afrz'''M' State �"— Zip CZE :)--- Tel Wi / .537/ A/66 f Contractor's License/Registration Type&Number4164fe ti 1 ' to0 Exp. Date Cc-7 / 3C / 01-- 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. Separate applications are required for electrical,plumbing, mechanical, etc. (.Owner/Agent Signature / at_ . Date r / to / 0V V. Construction Value Fee Building $ a eet $ Plumbing $ 3S0 $ Mechanical $ cra $ Electrical $ 300o $ Certificate of Occupancy $ Plan Review Fee $ State Education $ Total $ /91-/1. O $ (See Weverse side for additional-requirements) Town of Montville Building Department Receipt Date 9 /73 / cam No. 04265 From: WC /4. . .exe&,e Job Address: 3 d /6' ' Amount $ _. _ Cash 40210 Check # / (Circle one) Received by 4t moi' r de / Permit # NEW RESIDENTIAL PERMIT CALCULATION (1-1/2 STORY) Address: 350 raymond hill road House Construction A Average Custom QTY $/UNIT $/UNIT TOTAL Living Area 2651 SF $ 70.56 $ - $ 187,054.56 Finished Basement SF $ 18.38 $ - $ - Unfinished Basement 1675 SF $ 5.67 $ - $ 9.497.25 Kitchen 1 EA $ - $ - $ Plumbing Full Bath 2 EA $ 4,229.40 $ - $ 4,229.40 Half Bath 1 EA $ 2,691.15 $ - $ 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 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 SF $ 22.31 $ - $ - Enclosed SF $ 94.76 $ - $ Porches Open SF $ 62.69 $ - $ Enclosed SF $ 123.90 $ - $ - Heating Adjustment 2651 SF $ (2.76) $ - $ (7.316.76) Air Conditioning 2651 SF $ 2.84 $ - Electrical 2651 SF $ (5.16) $ - $ (13,679.16) Plumbing 2651 SF $ (5.04) $ - $ (13.361.04) TOTAL BUILDING CONSTRUCTION COST,LESS MEP $ 184,229.10 Y IIs air conditioning included(Y/N)? $ 7,528.84 PERMIT FEE CALCULATIONS Fee Building $ 184,229 $ 1,480.00 Y Plumbing $ 13,361 $ 112.00 Y Mechanical $ 14,846 $ 120.00 Y Electrical $ 13,679 $ 112.00 Work Commenced before permit issuance $ CO Fee $ 25.00 Plan Review $ 182.40 State Ed Fee $ 226,115 36.18 Total Fees $ 2,067.58 Based on 2003 RS Means Residential Cost Data 9/7/2004 •• STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors (Conn. Gen. Stat. § 31-286b) Property located at: -Tv." ,y ;) ' In the town of Name of building permit applicant: (i ce 4,244,5 . LL C Please check one: 1. VI am the owner of the abovero e P PrtY• 2. I am the sole proprietor of a business. 2A. Name of business: 2B. 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 employer" may provide either a certificate of workers' compensation insurance or a "sworn 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 one: 1. I do not intend to act as a general contractor or principal employer. [Sign and stop here] 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 -----�—� I 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). I understand that pursuant to § 31-275 C.G.S., officers of a 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 require have coverage unless he files his intent to accept coverage. Signature of applicant Subscribed and sworn to before me this day of ' , , 200 y. (Notary Public/Cor ;asp ate 4,, �e-Supe6er Court) ELIZABETH M. KNOX NOTARY PUBLIC MY COMMISSION I MRp MIG.B.31111 /Y V 5k‘,'::',01///,.. s r s i1. f t t- tr ••!--,-;;•,....4..;., vim, �� : f A, ,J j t t p,•.: r f J „,i,..2;•••;,;, o • f ..,;,v•• `� . 1 z -. 1 o x :: of / ” c. m xo Z E ,.` + cu ilt w Wi� ' . Qcn EE (40 ccs n.a p g 1_: :-...,7z:., C....) a o O a U , 00 WI of ' 4_, O cn O al » : (4! ,:c: „i �+ x N; g < ��4r F i _ wCO r n, . 5 z. nit f/'/ w ,,, O cU ! il .__i •tez W a) M i .r= O Z O - U - O ... N r •„-,•-?-4,::: \ (!. O o, • Imo!` w . > 1 i,:- E~ 0 • n1r'' 7 �N.., W W >>z' K"�!t ff' Ii Q� �f' yf - yf y/ y 7f �f 4,V 1 $1J..: yf `J1 :131\,, Jl\ + �� •••,•,;,.. '�� ��'_ ••••,....;a::::•?its. rte 0. ,i. ��ii.i+ t.,,A\ Town of Montville Building Department 848-3030, Ext 382 RESIDENTIAL CONSTRUCTION PERMIT SIGN-OFF SHEET 3S-CD '-----Z,VA-40) //i(?' 42,p /z,,,,, Property Address �� 6 Job Description: 44-1) Wve z) The applicant is responsible for the completion of the form, no permit will be issued until all signatures beh obtained. lowa have been HEALTH DISTRICT 848-3030,Ext.339 114461',1\ °�, 1,1\ Vc K k�. l Z -C� Approved No Permit S Sys.e Permit#:Z03.7 ❑ Required Date Approved No Permit Private Well 0 Permit#: _ 0Required WPCA DEPARTMENT Date 848-3030,Ext 376 N��% Approved No Permit Municipal Server 0 Permit#' ❑ Required Date Building Trap 0 Outside 0 Inside 441Approved No Permit Municipal Water ❑ Permit# ❑ Required DEPARTMENT OF PUBLIC WORKS Date / 848-7473 ' Approved I '_s�,,,„ i , �_� Q,/ No Permit N' ;: ❑ Permit#: Required ° 1� d 7"__1 Date PL• NG&ZONING DEPARTMENT ' -;1 -' ��, , . Zle•tea 848-3030,Ext.37: Z O Approved No Permit Permit#: O9_z 7/ 0 Required Zoning ate Approved No Permit Inland-Wetlands 0 Permit#: 0 Required Date