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Town of Montville
BUILDING DEPARTMENT
310 Norwich-New London Turnpike
Uncasville, CT 06382
(860) 848-3030, Ext. 382
Building Permit
Permit Number: 82003-0283 Date: 12-Jun-03 Map/Lot: 030/076-000 Owner ID 4001
Job Location: 9 --AZALEA -LANE Unit
Job Description: Garage
Owner: Contractor:
Barry M. & Nadean E. Rudolph Barry Rudolph
9 Azalea Lane
9 Azalea Lane Uncasville, Ct. 06382-
Uncasville CT 06382 Telephone: (860) 848-3873
Lic/Reg Type/No. 0 Exp Date:
Tenant:
Self
Telephone:
Construction Values Permit Fees Construction Information
Building Value: $15,114.00 Building Fee: $94.00 Use Group: R-4
Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1995 CABO
Mechanical Value: $0.00 Mechanical Fee: $0.00 Construction Type: 5B
Electrical Value: $500.00 Electrical Fee: $10.00 Permit Code: R7
Other Value: $0.00 Other Fee: $0.00 Comments:
Total Value: $15,614.00 CO Fee: $10.00
Plan Review Fee: $9.40
State Ed Fee: $2.50
Total Fees: $125.90
It is the owners responsibility to schedule the following inspections (minimum 48 hours notice r q sir d)a
Footing - Prior to pouring concrete ❑ Rough HVAC
❑ Backrill - Footing drains and waterproofing ❑ Fireplace Throat
d❑ Concrete Slab - Prior to pouring concrete ❑ Chimney - One flue above thimble
❑ Rough Framing ❑ Frestopping/draftstopping
Rough Electrical ❑ Insulation
❑ Electrical Service ❑ Final Inspection
❑ Rough plumbing and leak test Certificate of Occupany
❑ Gas piping and test
Building Official's Signature:
i
Town of Montville
Residential Plan Review
Dater uhc '2-mo"
Job Address: A-2--ALEFA L A"ig7
Job Description: '7DOTA c44ac~
We have received a building permit application for the above referenced property. In accordance with Connecticut General
Statute 29-263, your application is being rejected for the following reason(s) that are checked-off or commented on:
• Supporting Documentation Access 18"x24" (409.2)
Plans are to be drawn to scale including dimensions of rooms and .Floor plan(s)
spaces and all framing information (112.1)
Building permit application not completed, signed, dated Plans required
A Permit fee $ /Z15,9* Dimensions
Worker's comp. Affidavit or worker' comp. Insurance Finish floor elevation
Copy Contractor's reiistration or license Minimum mom sizes (304.1)
Construction permit sign-off sheet Door and window sizes
Provide all documentation to show compliance with the Model Kitchen layout
Energy Code (1995 MEC). Contact your insulation contractor, Bathroom layouts, tub sizes in gallons, space clearances
Northeast Smart Living Center (1-800-228-7764) or your local Stair location (min. width 36") (311.1)
building official for information. Attic access location and size
Street address of project on all drawings and documents _ Identify the use of each room
Total square footage for each level of the structure
Indicate required light (8% of floor area per room) and ventilation
• Site plan (4% of floor area per room) for each habitable room or space (303.1.)
Plans required Indicate safety glazing in areas required such as: doors, windows, tub
Finish floor elevation & shower enclosures, etc. (308.4.)
Signed by P&Z, lines not Wetlands, Uncas health, WPCA Indicate bedroom egress windows (5.7 sf net clear opening, 24" clear
Property y lines not provided opening height, 20" clear opening width) (310.2.1.)
Distance from property to structure Egress window maximum sill height 44" (310.2)
Structure dimensions Are basement stairs enclosed/accessible? If so, protect with
Driveway minimum'A" sheetrock (310.3.)
Topography (existing and proposed) Designate which door is the required exit (36" minimum, hinged)
Footing drain inverts, outlet and separation Garage
Proposed utilities Minimum 5/8" Type X gypsum board separation (on garage side) to
Wetlands and flood zone limits and elevations all living spaces - all combustible support framing to be covered with
minimum 5/8" Type X gypsum board if it supports habitable rooms
• Foundation Plan (309.2)
Plans required Indicate minimum 1 3/a" solid wood,door, 1 3/d' solid core steel door, 1
Dimensions ;/4" honeycomb core steel door, or 20 minute rated door from the
Wall thickness garage to the house and its basement or attic (309.1)
Footing sizes Indicate self-closing devices on all doors from garage to the house
~_Frost protection required and its basement or attic (309.1)
Window and door sizes and locations Indicate slope for garage floor (309.3.)
Hatchway
Foundation - indicate the assumed soil conditions that the system has . Elevations
been designed for or provide engineering data. If presumptive soil Plans required
conditions cannot be met, provide soil bearing engineering data (401) Type of siding
Concrete strength - foundation, floors, exterior porches, Walks, slabs Type of roofing
(402.2) Other finishes
Basement - finished of unfinished? Finish grades
Vapor barrier between sub-grade and concrete basement floor Building heights
(505.23) Dimension height of chimney above roof
Minimum height of foundation walls above finished grade (404.1.3) Roof pitches
Perimeter insulation, if conditioned space
Anchor bolts - size and location (403. La)
Floor thickness and control joint location (403. La) • Building Section(s) & Details
Lally column size, attachment and spacing (408) Plans required
Column footings - size (403) Floor-to-floor heights
Waterproofing details (406) Handrails and guardrails - detail, including height and maximum
Rebar if required - wall length, unbalanced fill, or soil conditions will opening, handrail cross-section, continuity and required returns
determine this. Provide engineering data for complex design. Riser height (8 1/4" max), tread depth (9" min.), and nosing (3/4" - 1
Fireplace/chimney base y")
Concrete piers and anchor details - decks Show minimum headroom in stairways - 6'-8" measured from nosing
Foundation drainage - sump, drain to grade, or town storm system; plane to lowest point of ceiling
indicate pitch (405.1) Stud size and spacing, species and grade (or minimum Fb and E)
Beam pockets - minimum clearances Sheathing - size, thickness, type
Crawl Spaces Siding, material, type, style - underlayment per mfg.
Crawl space data - clearance to joists, slab thickness (if provided), Insulation - R-value, type - including basement walls if applicable
vapor barrier (409) Flashing detail - windows and doors - type, material
Ventilation (409.1)
Town of Montville
Building DeP artment
Permit # Ad _ -d-~
310 Norwich-New London Tpke.
Tel. 848-3030, Ext 382 Uncasville, Cr 06382
. ,w. Fax. 848-7231
One & Two Family .Building Permit Application Form
[l a(ow Cowtructimc ~Wwon Afteration spry Structure
[Other
Job Locatio 9 l c~
Job Description/Materials c
Owner 11 eA_c{ - Mailing Address / Ir-,4 e
City-4 cam` S w ~l State Zip 001.7-T
el NO . N_/ 173
Contractor Mailing Address.
City State Zip Tel /
--1
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 wo as described above.
Owner /Agent Signa Date
Construction Value Fee
Building $
Plumbing $
Mechanical
Electrical $
Other $ _ $
Certificate of Occupancy
Plan Review Fee $
State Education
Total $
(See *Oerse si4 for ad4tiondm1uirewnu)
.f
Town of Montville Building Department Receipt
LL
Date No.
r^
From: 0,-
Job Address: Cry .
$ C~ Cash /--Qheek Check # ZO-A
Amount
r' (cuc C one)
Permit #
Received by
-~e M ~ EiV
Permit Fee Calculation Spreadsheet
RESIDENTIAL PERMIT CALCULATION (1 STORY)
House Construction A (E=Economy, A=Average, C=Custom)
QTY $/UNIT $/UNIT $/UNIT TOTAL
Living Area SF $ $ 88.52 $ - $
Finished Basement SF $ - $ 24.73 $ - $ -
Unfinished Basement SF $ - $ 9.35 $ - $
Kitchen EA $ - $ - $ - $ -
Plumbing
Full Bath EA $ - $ - $ - $ -
Half Bath EA $ - $ 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 -T EA $ - $ 3,96315 $ - $ -
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 0 SF $ - $ (2.76) $ - $
Air Conditioning 0 SF $ - $ 2.84 $ - $
Electrical 0 SF $ - $ (5.16) $ - $ -
Plumbing 0 SF $ $ (5.04) $ - $
TOTAL BUILDING CONSTRUCTION COST, LESS MEP $ 15,113.70
Is air conditioning included (Y/N)? $ -
PERMIT FEE
Building $ 15,114 $ 94.00
Plumbing $ - $ -
Mechanical $ - $ -
Y Electrical $ 500 $ 10.00
Other $ -
CO Fee $ 10.00
Plan Review $ 9.40
State Ed Fee $ 15,614 $ 2.50
Total Fees $ 125.90
Based on 2003 RS Means Residential Cost Data
6/9/03
sA
STATE OF CONNECTICUT '
WORKERS' COMPENSATION COMMISSION
Building Permit Affidavit for Property Owners or Sole Proprietors
(Conn. Gen. Stat. § 31-286b)
Property located at: /e ,
n
In the town of S" v
Name of building permit applicant:
Please the one:
1. I am the owner of the above property.
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
2v . 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 f ver with the appro ria a District Office; and that a sole proprietor
of a business is not required t aye co ge unless file a to accept coverage.
Signa o 'cant
Subscribed and sworn to before me this day of _ 20Q.~.
(Notary Public/Commissioner of the Superior Court)
INDA L. ROBERTS
NO TARy PUBLIC
;;AY OMMISSION EXPIRES OCT. 31, 2007
Town of Montville -
Bulding Department
848-3430, Ext 382
ONE & TWO FAMILY
CONSTRUCTION.PERMIT
SIGN-OFF SHEET_
Property Address I
Job Description: to n:±2 %U L
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, EgL 881
Approved
Permit #:50 t ❑ Not Applicable
Municipal Sewer Date
House Trap ❑ Outside ❑ Inside
Approved
❑ Permit # Not Applicable
Municipal Water Date
'~bEPARTMENT OF PUBLIC WORK5 848-7473
&At, i ~ 6 ~ 0-, Pa, t r Approved
- F- 03 U] Permit ❑ Not Applicable
Date
r PLANNING & ZONING DEPARTMENT 848-3030.. Ext. 81
In-Compliance
o aZ 1-- Fexmit - 7 Not Applicable
g Date
In-Compliance
- El Permit DY-N'4,Applicable
Inland W ds Date
s