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HomeMy WebLinkAbout2004 - Addition - 8x14 Town of Montville BUILDING DEPARTMENT 310 Norwich-New London Turnpike Uncasville, Cr 06382 (860) 848-3030, Ext. 382 Building Permit Permit Number: 62004-0311 Date: 15-Jun-04 Map/Lot: 076/057-000 Owner ID 7007 Job Location 115 BEECHWOOD ROAD Unit Job Description: Addition Owner: Contractor: Georgina Chongo Georgina Chongo 16 Beechwood Rd. 16 Beedhwood Rd Oakdale Ct. 06370- Oakdale Cr 06370 Telephone: Uc/Reg Type/No. 0 EV Date: Tenant: Self Telephone: Construction Values Pemit Fees Construction Information Building Value: $8,651.00 Building Fee: $52.00 Use Group: R4 Plumbing Value: $0.00 Plumbing Fee: $0.00 Code: 1995 CABO Mechanical Value: $309.00 Mechanical Fee: $10.00 Corrsbvction Type: 513 Electrical Value: $578.00 Electrical Fee: $10.00 Permit Code: R3 Other Value: $0.00 Other Fee: $0.00 Comments: _ Total Value: $9,538.00 CO Fee: $10.00 Plan Review Fee: $5.20 State Ed Fee: $1.53 Total Fees: $88.73 is the owners responsibility to schedule the following insnectigm (minimum 48 hours notice reauilredl: © Footing - Prior to pouring concrete W Rough WAC ❑ Badcfill - Footing drains and waterproofing ❑ Fireplace Throat ❑ Concrete Slab - Prior to pouring concrete ❑ Chimney - One flue above thimble ® Rough Framing © Firestopping/draf stopping © Rough Electrical ❑d Insulation ❑ Electrical Service CRS 0 ❑ Final Inspection ❑ Rough plumbing and leak test ® Certificate of Occupany ❑ Gas piping and test f r~ Building Official's Signature: Town of Montville Plan Review Form 7L~ Date: Street Address: 6 a~"C~✓~ 40 Job Description: 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 Plans are to be drawn to scale including dimensions of rooms and spaces and all framing information Building permit application not completed, signed, dated Permit fee $ Worker's comp. Affidavit or worker' comp. Insurance Copy Contractor's registration or license Construction permit sign-off sheet Street address of project on all drawings and documents Field set of approved plans need to be picked up from our office Comments: 0 " r/~ GRNs s "Zlov t, v c d r c t l t,~1 /L_ oT ~ Z Ta C,~rl air r~fi~q s e~ti 1C` Cdr ~6 1C &-taaegp/1-3 An &e 1-776, 016 1 tije csa' cJ't O- A'~nmling 4offficial Town of Montville Building Department 310 Norwich New London Tpke. Tel. 848-3030, Ext 382 Uncasville, CT 06382 Fax. 848-7231 Residential Building Permit Application Form Permit # E:] New Construction ❑ Addition ❑ ACteration ❑ Accessory Structure Si fe famify ❑ Two-Tamily ❑ Townhouse Job Address (Number) (Street) (Unit) Job Description d 1 Owner Mailing Address l City wl State Zip Tel Contractor 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. Separate applications are required ectric , p1' ing mec al, etc. Owner /Agent Signature Date_ O /j / Construction V e Fee Building $l $ Plumbing $ $ Mechanical $ c~ $ Electrical $ Certificate of Occupancy Plan Review Fee $ State Education Total $ - $ Orly (See averse side foraddtiona(requirements) Town of Montville Building Departnnent Receipt No. Date -~~F- From: Job Address:, Cash ` 'Check Check # Amount Received by f Permit Fee C"alculation`Spreadsheet RESIDENTIAL PERMIT CALCULATION (1-112 STORY ADDITION) House Construction A (E=Economy, A=Average, C=Custom) QTY $/UNIT $/UNIT $/UNIT TOTAL Living Area 112 SF $ $ 9020 $ - $ 10,102.40 Finished Basement SF $ $ 26.15 $ $ Unfinished Basement _ SF $ - $ 10.50 $ - $ - Kitchen EA $ $ 4,410.00 $ $ Plumbing Full Bath EA $ - $ 4,229.40 S - S Half Bath EA $ - $ 2,691.15 $ - $ - Garages Attached, 1 car EA $ _ $ 8,885.10 $ - $ Attached, 2 car EA $ - $ 15,113.70 $ - $ Attached, 3 car EA $ - $ 20,913.90 $ $ Detached, 1 car EA $ - $ 11,657.10 $ S - Detached, 2 car EA $ - $ 17,45625 $ $ - Detached, 3 car EA $ $ 23,256.45 $ - $ Under, 1 car EA $ - $ 1,304.10 S - $ - 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 S - $ Dormers Gable SF $ - $ 23.10 $ - $ - Shed SF $ - $ 14.70 $ - $ - BreezewaylDecks Open SF $ - $ 22.31 $ - $ Enclosed SF $ $ 94.76 S - $ Porches Open SF $ $ 62.69 $ - $ Enclosed SF $ - $ 123.90 S - $ - Heating Adjustment 112 SF $ - $ (2.76) $ - $ (309.12) Air Conditioning 112 SF $ - $ 2.84 $ $ Electrical 112 SF $ $ (5.16) $ - $ (577.92) Plumbing 112 SF $ $ (5.04) $ - $ (564.48) TOTAL BUILDING CONSTRUCTION COST, LESS MEP $ 8,650.88 n ils air conditioning included (Y/N)? - PERMIT FEE Building $ 8,651 $ 52,00 n Plumbing $ - $ - Y Mechanical S 309 $ 10.00 Y Electrical $ 97Q $ 10.00 Other $ - CO Fee $ 10.00 Plan Review $ 5.20 State Ed Fee S 9,538 $ 1.53 Total Fees $ 88.73 Based on 2003 RS Means Residential Cost Data 6/14/04 STATE OF CONNECTICUT WORKERS' COMPENSATION COMMISSION Building Permit Affidavit for Property Owners or Sole Proprietors (Corm. Gen. Stat. § 31-286b) Property located at: e GOVd 1 1 In the town of Name of building permit applicant: i ► L Please check one: 1. / I am the owner of the above property. 2. 1 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 one: 1. chI do not in nd to a _t a a general contractor or principal employer. [Sign a o e i ature of applicant 2. 1 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 required to have coverage 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) Town of Montville Building Department 848-3030, Ext 382 RESIDENTIAL CONSTRUCTION PERMIT SIGN-OFF SHE T" c~ Q~CU Property Address rr~ Job Description: The applicant is responsible for the completion of the form, no permit will be issued until all signatures below have been obtained. HEALTH DISTRICT 848-3030, Ext. 339 Approved No Permit ❑ Permit ❑ Required Septic System Date Approved No Permit ❑ Permit ❑ Required Private Well Date WPCA DEPARTMENT 848-3030, Ext 376 Approved No Permit ❑ Permit Required mcipal Sewer Date Building Trap ❑ Outside ❑ Inside Approved No Permit ❑ Permit # ❑ Required Municipal Water Date DEPARTMENT OF PUBLIC WORKS 848-7473 Approved No Permit ❑ Permit ❑ Required Director Date PLANNING & ZONING DEPARTMENT 848-3030, Ext. 379 Approved No Permit c~c r'd~ermit El Required ing Date Approved No Permit ❑ Permit ❑ Required Inland-Wetlands Date Town of Montville Buildina Department 310 Norwich-New London Tpke. Tel. 860-848-3030, Ext 382 Uncasville, CT 06382 Fax. 860-848-7231 CERTIFICATE OF OCCUPANCY APPROVAL Property Address /`t ~d r TlF® Job Description No Certificate of Occupancy will be issued until all of the required signatures have been obtained. Required Department Certificate of Occupancy Approval Approval ❑ WPCA Signature/ date Comments: Planning & Zoning cv~~ Comments: Signature/ date ❑ Health Department Signature/ date Comments: ❑ Department of Public Works Signature/ date Comments: ❑ State Dept. of Transportation Signature/ date Comments: ❑ Police Department Signature/ date Comments: ❑ Fire Marshal Signature/ date Comments: 4xvisedAugust S, 2005 f i C Jam, POH w --,oj 1~v Spa ; q e JFJ 161, 1 3 V, ~ Y ,N 0 s 013 ;rte Illog ~(2011 f Pdu f i\q r i f~ IK; f S f 5~- C4-) r i If re, Y _ € mod`. ,w.~ .~•uf 4 ~ ~ m _ ~ r'° L 1 _ t 176 s o Q Pry All -t Y' 4 Virg -46 wtple-4 old --ed ~ It, t a RF y t ~*f pj a ~ . Ply