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TOWN OF MONTVILLE 41,
Building Department
848-7166
APPROVED BUILDING PERMIT OR TRADES PERMIT
For 180 Da s �,I- �lp../ 7 7V
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Permit No: 10071 Approval Date: 5/27/92 Expir ion Date: 11/27/92
Estimated Cost : 3 , 900 . 00 Fees : 22 . 00 PRF: 2 . 70 C.O: 5 .00
Owner: Ralph E. Jackson Address: 64 Pennsylvania Ave . Tel : 859-2724
Job Location: 64 Pennsylvania Avenue Code: 05
Contractor: self Address : same Tel : same
Stick Built: x Modular Home: Manufactured Home: Commercial :
Addition: Garage: Car Port : Shed: Remodeling: Roofing:
Siding: Fireplace: Chimney: Windows: Pool : Demolition:
Plumbing: Heating: Electrical : Air Conditioning: Gas:
Patio: Porch: Deck: x New: x Repair/Replacement :
Type of material used/discription: pressure treated wood frame deck
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 Codes as adopted by the State of Connecticut, and
the Town of Montville.
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Applicant 's Signature: `��/�_/ =i. Date:
If signed by Contractor, type o license/registration & No: t9-4^`04 _2
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Building Official 's Signature: Friidijae4( i/; .�� Date: -2, 7/9 ...
./6/4Date of Health Dept. Approval :
Date of Zoning Approval : OK
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.
TOWN OF MONTVILLE
Building Department
/ � / Application for a Permit
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Owner: 911 6.tJ�4CLOP4 Address: 4y /iE,4i). gvG 44togtc Tel : ?0- 27.24(
Job Location: � ' ��t)/ y vakA1/L . AOe. Duk ( tt E
Contractor: Address: Tel :
Stick Built: Modular Home: Manufactured Home: commercial :
Addition: _ Garage: Car Port: Shed: Remodeling: Roofing:
Siding: _ Fireplace: _ Chimney: _ Windows: Pool : _ Demolition:
Plumbing: _ Heating: _ Electrical : _ Air Conditioning: Gas:
Patio: _ Porch: Deck: New: Repair/Replacement:
Type of Material to be used/job description: -1 S�f�� ���4 7 Z Gl•�t C� v� ,
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Size: /DY/ /('K /t,� Type of Heat: Fireplace:
No.of Stories: No. Rooms: Breezeway:
No. Baths: Garage: Use:
ZONING PERMIT
ASSESSOR'S MAP NUMBER (702 /FNUMBER r 8 2 EXPIRATION DATE
ZONING PERMIT NUMBER f--4-1/4'1J/
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APPLICANT )\-.--,)d-Z/0/4/ e J3CK50•,-1
APPLICANT'S ADDRESS 62'.27 „/JC3//i 1'7/ a_ J E_ ,-(Dkl3111,, TELEPHONE NUMBER S' )'1 2 7 2
PROPERTY OWNER
LOCATION LOT AREA ZONE
BUILDING HEIGHT PROPOSED FLOOR AREA /. 0 f/`/ ',wit,- Q /ea IX /G 1 he l,'r"-
NATURE OF REQUEST/PROPOSED USE ; // . ? Lc7-1.' L bziZtOk a 8,4* ,-. 14)4,6z -
HAS
4)4,62HAS A VARIANCE EVER BEEN GRANTED FOR THIS PROPERTY j I YES 1 NO HAS BOND BEEN FILED? n YES I 1 NO
SKETCH BELOW OR PROVIDE TWO COPIES OF PLANS DRAWN TO A SCALE OF AT LEAST 1": 40' SHOWING: DIMENSIONS OF THE LOT. THE SIZE, AREA.
AND LOCATION OF EXISTING, PROPOSED, PRINCIPAL AND ACCESSORY STRUCTURES, DRIVEWAYS, SANITARY FACILITIES AND WATER SUPPLY, PARKING
FACILITIES, AND ADJACENT STREETS; DISTANCES OF PROPOSED STRUCTURES FROM PROPERTY LINES. IN THE CASE OF FILL OR EXCAVATION REQUESTE
(UNDER 500 CUBIC YARDS), DIMENSIONS OF FILL OR EXCAVATION AREA MUST BE INCLUDED. A PLAN PREPARED BY A CONNECTICUT REGISTERED
LAND SURVEYOR MAY BE REQUIRED. THE PROPOSED USE SPECIFIED ABOVE SHALL NOT BE AUTHORIZED UNTIL AN ACTUAL CERTIFICATE OF USE AND
COMPLIANCE IS ISSUED BY THE COMMISSION OR ITS APPOINTED AGENTS.
THIS PERMIT AUTHORIZES THE APPLICANT TO PROCEED TO THE BUILDING DEPARTMENT FOR ANY REQUIRED PERMITS.
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THE APPLICANT AGREES TO:
?, ADHERE TO ALL THE APPLICABLE REQUIREMENTS OF THE ZONING REGULATIONS.
2. NOTIFY THE COMMISSION OR ITS APPOINTED AGENT OF ANY ALTERATION IN THE PLANS.
3. CONTACT THE ZONING OFFICER (848-8549) AT LEAST 24 HOURS BEFORE CONSTRUCTION BEGINS TO 4LLOW ZONING OFFICER TO INSPECT
LOCATION.
4, CALL FOR FINAL INSPECTION AND REQUEST CERTIFICATE OF COMPLIANCE BEFORE ISSUANCE OF A C.O.
/
72
APPLICANT'S SIGNATURE( DATE �� /l /73
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/
THE LETTERS NA (INDICATING 'NOT APP ICABLE') SHALL BE NOTED IN LIEU OF A ZONING PERMIT NUMBER IN THE EVENT THAT A ZONING
PERMIT FOR THE PROPOSED USE IS NOT REQUIRED.
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COMMISSION AGENT DATE
OM ntJUK'J I"µU' IVUT5tK ;�C LUI IVUTItl< / ) - UrimI1UV UH It 5 —/ 5 —7J
',MING PERMIT NUMBER 5:,,,2 _//G znuIlAG PEWITAPPLICANT /4 L/-'/L/ -j �S` c C � i';
APPLICANT'S ADDRESS C,y ,r?�,U,vr Yl v(4,,..1...)/ct ,-1 tic-- TELEPHONE NLNBER �5-/-;272'!
PROPERTY OWNER
LOCATICN LOT AREA ZONE
BUILDING HEIGHT PROPOSED OOR AREA /o k�y''i,,F /g X /i. ' e,,,,.NATURE OF REQUEST/PROPOSED USE :t�:�.L�/ 2 4,rvc-c_ et i o..' f�4c 4 „f' acs c.
HAS A VARIANCE EVER BEEN GRANTED FOR THIS PROPERTY? TT Yes E No
Sketch below or provide two copies of plans drawn to a scale of at least 1"--0' showing: dimensions of the lot, the
size, area, and location on the lot of existing, proposed, principal and accessory structures, driveways, sanitary
facilities and water supply, parking facilities, and adjacent streets; distances of proposed structures frau property
lines. In the case of fill or excavation requests (under 500 cubic yards), dimensions of fill or excavation area mus
be included. A plan prepared by a Connecticut Registered land surveyor may be required. The proposed use specified
above shall not be authorized until an actual certificate of use and compliance is issued by the Carmission or its
appointed agents. THIS PERMIT AUTHORIZES 1}E APPLICANT TO PROCEED TO THE BUILDIM [EPARi?dE711T FtR ANY REQUIRED PERMIT!
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THE APPLICANT AGREES TO:
1. Adhere to all the applicable requirements of the zoning regulations.
2. Notify the Commission or its appointed agent of any alteration in the plans.
3. Contact the Zoning Officer (848-8549) at least 24 hours before construction begins to allow zoning officer to
inspect location.
4. Call for final inspection and request Certificate of Compliance before issuance of a C. 0.
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4r1li 's S' 'afore Date /
THE LEVERS NR (INDICATING "NOT APPLICABLE") SHALL BE NOTED IN LIEU OF A ZONING PER+IIT tiJ`BER IN THE EVENT THAT A
ZONING PERMIT FOR THE PROPOSED USE IS NOT REQUIRED.
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ION AGENT DATE