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TOWN OF MONTVILLE6:1)991
Building Department 6 11
848-7166
APPROVED BUILDING PERMIT OR TRADES PERMIT
For 180 Days
Permit No: 9006 Approval Date: 11/14/90 Expiration Date: 5/14/91
Estimated Cost: 400.00 Fees: 10.00 PRF: C.O: 5.00
Owner: Ed Davies Address: 21 Pennsylvania AvenueTel : 859-1732
Job Location: same
Code: 06
Contractor: self Address: same
Tel : same
Stick Built: Modular Home: Manufactured Home: Commercial :
Addition: Garage: Car Port: Shed: Remodeling: Roofing:
Siding: Fireplace: Chimney: x Windows: Pool : Demolition:
Plumbing: Heating: Electrical : Air Conditioning: Gas:
Patio: Porch: Deck: New: Repair/Replacement: x
Type of material used/discription: brick chimney above roof and install liner
Size:
Type of Heat : Fireplace:
No.of Stories: No. Rooms: Breezeway:
No. Baths: Garage: Use:
I hereby certify that the proposed work will conform to the Basic
Building Code and all other Co s as adopted by the State of Connecticut, and
the Town of Montville.
___
Applicant's Signature: 4X41 /jv`. Date.
//-&- 9d
If signed by Contractor, type of license/regi rat on & No:
Nom d)/,‘)Ai e Ir
Building Official's Signature: 611-4)400-47/4( .ii Date: 1/--/17/-' 7�
Date of Health Dept. Approval : ,(J/4'
Date of Zoning Approval : N//9'
THIS IS TO INFORM YOU THAT UNDER THE CONNECTICUT AMENDMENT OF THE
BUILDING CODE, SECTION 119. 1 A CERTIFICATE OF OCCUPANCY IS REQUIRED PRIOR TO
ANY USE OF THE STRUCTURE.
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TOWN OF MONTV%LLE
Building Department
r`/ App_ for a Permit
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Owneru�/-~~ /_�3(/x411 Address x /7 / �}�.<��� ,� �l z�z�~ /� J'l
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Job Location:
Contractor: ~cri)S4Fi-/`:- Address : ---'- ---
Tel :
Stick Built : \/ Modular Home : Manufactured dome :
Addition : Garage : Car Port : Shed : Remodeling : Roofing :
Siding : Fireplace : Chimney : ')r Windows : Pool : Demolition :
Plumbing : ' Heating : Electrical : Air Conditioning : Gas :
Patio : Porch : Deck : New: Repair/Replacement :
Type of Material to be used/job description : '��/�/r. �� /»y��� --------
Size : Type of Heat :
Fireplace :
^�
No. of Stories : ~� No. Rooms :
-- Breezeway :
/
No. Baths : '
Garage :
Use :