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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: 62009-0001 Date: 06-Jan-09 Map/Lot: 030/049-000 Owner ID: 106000
Project Location: 8 AZALEA LANE Unit:
Job Description: Remodel 4th Bedroom to Master Bath & Closet
Owner Name: Charles L Ir And Diane L Rogoff Tenant Name: N/A
Careof:
8 Azalea La
Uncasville CT 06382- Telephone: (860)848-4674
Contractor Name: Home Owner Telephone:
DBA: Lic/Reg Type:
Lic/Reg No: 0
Exp Date:
Construction Value Permit Fees Construction Information
Building Value: $2,000.00 Building Fee: $16.00 Use Group: IRC
Plumbing Value: $200.00 Plumbing Fee: $8.00 Code: 2005 State Building Code
Mechanical Value: $300.00 Mechanical Fee: $8.00
Electrical Value: $0.00 Electrical Fee: $0.00 Construction Type: IRC
Total Value: $2,500.00 Penalty Fee: $0.00 Permit Code: R4
C of 0 Fee: $0.00 Comments:
Plan Review Fee: $0.00
State Ed Fee: $0.45
Total Fee Paid: $32.45
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 Rj R Plumbing and leak test
❑ Deck Piers 6 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 ficate Approval
Ce 'f. to of Occupancy
r
Building Official's Approval:
v,
Town of Montville
Building"beQarfinent ~ . _
310 Norwich-New London Tpke.
Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 8607848-7231
.8a00<-t =000
RESIDENTIAL PERMIT APPLICATION FORM Permit No.: -
Tvoe of Work Occupancy Tyne
1j hlew Construction ❑ Single Family
Addition ❑ Two-Family ❑ Plumbing
0 Alteration 0 Townhouse 0 Mechanical
0 Accessory Structure ❑ Electrical CRS#:
Property Address: A2-4 cA Lpv,~,) 1✓ -
Nu (Unit)
(Number) (Street)
Job Description: le- tYK01D (5t ' 1 t
Omer. C~►
Address: t ~1 W7,7
:
city
Ally(" J ► 1 tE State: ~ Zip Code:_ Telephone 1 Blfg- Applicant: C i r--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 omaosed work is authorized by the owner in fee and that f am authorized to make anplicaihiae► fora
g_ermft for such work as described above.
0 By checking this box, I will follow the r ements of the 2005 NEC as the alternative compliance per section E3301.2.1 of the Residential Code,
instead of the electrical require ch ers 3 throu h of e R ntial Code.
Owner /Agent Signatur Date: 12-
Construction G
Construction Value Permit Fees
Building Value: QDC3 00 Building Fee.
f~ Plumbing Fee:
Plumbing Value:
Mechanical Value: 7 Q~~ Mechanical Fee:
Electrical Value: Electrical Fee:
Total Value: Penalty Fee:
C of O Fee
Plan Review Fee:
State Ed Fee:
Total Fee:
AUPSt 23, 2007
Town of Montville
Building Department
File Receipt
Date: 31-Dec-08 Receipt No: 4173
Received From: Charles Rogoff
Job Address: 8 Azalea Lane
Fees Collected State Educational Training Fee
Cash: $0.00 Cash: $0.00
Check: $32.45 Check: $0.45
Check No: 6541
Short/Over: $0.00
Construction Value: $2,500.00
Demolition Value: $0.00
Received By David Jensen
Address: 8 Azalea La.
REM OTY $/UNIT TOTAL
Building Plumbing Mechanical Electrical
BUILDING AREA
New Construction SF $ 113.03 $ - $ -
Basement, Finished SF $ 22.96 $ - $ -
Basement, Unfinished SF $ 12.40 $ - $ - -
Crawl Sapce SF $ 9.30 $ -
Interior Renovations SF $ 35.09 $ - $ - $ -
MANUFACTURED HOMES
Ground Anchors SF $ 6.45 $ - $ - $ -
Basement SF $ 12.41 $ - $ - $ -
Crawl Space SF $ 9.31 $ - $ - $ -
AMENITIES
Kitchen EA $ - $ $ -
Full Bathroom EA $ - $ -
Half-Bathroom EA $ - $ -
GARAGE
Attached SF $ 54.35 $ - $ -
Detached SF $ 69.53 $ - $ -
Under SF $ 10.03 $ - $ -
Carport SF $ 19.89 $ -
MECHANICAL
Warm-Air n YIN $ -
Hot Water n YIN $ -
Electric n YIN $ -
Air Conditioning n YIN $ ,
ELECTRICAL SERVICE
Upgrade Amps $ -
Overhead, new Amps $ -
Underground, new Amps $ -
Subpanel EA $ 599.50 $ -
Gen Set EA $ 3,850.00 $ -
SOLID FUEL BURNING APPLIANCES
Prefab Metal Fireplace EA $ 6,497.70 $ -
Masonry w/lfireplace EA $ 7,096.65 $ -
Masonry 42 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 $ 43.07 $ -
Porch SF $ 149.38 $ -
Sunroom SF $ 176.90 $ - $ -
POOLS & HOT TUBS
Hot Tub EA $ 8,016.25 $ - $ -
Inground Pool EA $ 21,373.44 $ - $ -
Above Ground Round EA $ 5,099.46 $ - $ -
Above Ground Oval EA $ 6,019.75 $ - $ -
Pool Heater EA $ 8,984.25 $ -
Inflatable Type Pool EA $ 1,550.00 $ -
SHEDS
w/o electrical SF $ 20.35 $ -
w/electrical SF $ 20.35 $ - $ -
RENOVATIONS
Roofing, Overlay SF $ 3.00 $ -
Roofing, Strip & reroof SF $ 4.00 $ -
Roof Sheathing SF $ 1.31 $ -
Siding SF $ 3.50 $ -
Windows EA $ 500.00 $ -
Skylights EA $ 1,051.10 $ -
Doors, Exterior EA $ 601.50 $ -
Oil Tank, 275 Gallon EA $ -
Oil Tank, 550 Gallon EA $
MISCELLANEOUS CALCULATIONS $ 2,000.00 $ 200.00 $ 300.00
TOTALS $ 2,000.00 $ 200.00 $ 300.00 $ -
PERMIT FEE CALCULATIONS
Construction Value Fee
Building $ 2,000.00 $ 16.00
Plumbing y $ 200.00 $ 8.00
Mechanical y $ 300.00 $ 8.00
Electrical y $ - $ -
Working before Permit Issuance $
Certificate of Occupancy Fee $
Plan Review Fee $ -
State Education Fee $ 0.45
TOTALS $ 2,500.00 $ 32.45
Figures are based on the 2006 RS Means Residential Cost Data
State of Connecticut =
Workers' Compensation Commission -
Please TYPE or PRINT IN INK
an z~rc~
reerrs~ s~
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
f-~'I1
Name of Applicant for Building Permit
Property located at 7 ;k C P~ A+
in theCity /Town of CT-
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 notrequired to have workers' compensation insurance coverage.
CHECK ONE (1) BOX ONLY and complete the following:
yak 1 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
Federal Employer ID# (FEIN)
Signature of SOLE PROPRIETOR Applicant
a
Town of Montville
Buiidina Department
310 Norwich-New London Tpke. Fax. 860-848-7231
Un
Tel. 860-848-3030, Ext 382 casville, CT 06382
CONSTRUCTION PERMIT APPROVAL '
Itcant is responsible for obtaining all of the required approvals. Ho permit wilt be issued until all the required signatures are obtained.
p►PP
Property Address
® Job Description ~tCfZ~
- Re uired as indicated below
_ Required for all permits At least one re uired for all er-m-M ❑
Permit issuance Approval
Required Department
Approval
® Tax Collector Signature/ date
Comments: /
Planning & Zoning signature/ date
Comments:
® Fire Marsh~Acnu;;~, Signature/ date
Comments: Health Department
Required for properties with septic systems - Not required for Plumbin Electrical Mechanical Roof, S'gnlatu of date & Doors
`
Comments:
WPCA, Administrative
~4,, uired for ro envies on sewer t ature/ date
Comments:
WPCA, Operations Signature/ date
When Required by WPCA
Comments:
Department of Public Works Signature/ date
Required when ro'ect includes drivewa work or certain drama ere uirements
Comments:
F-1 State Dept of Transportation
Required for Structures over 100 000 s a. ft. or with more than 200 12artdna spaces - Officio! co of STC Cerfificate of O erafron required - er
CGS 14-311 Signaturel date
Building Department Review Complete signature/ date
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