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TOWN OF MONTVILLE 111 C%
Building Department
848-7166
APPROVED BUILDING PERMIT OR TRADES PERMIT
For 180 Days
Permit No: 10402 Approval Date: 10/2/92 Expiration Date: 4/2/93
Estimated Cost: 21 ,000 .00 Fees: 124 .00 PRF: 13 .40 C.O: 10 .00
Owner : Alejo Ortega Address: 29 Ricky Ln . ,Preston Tel : 889-9937
Job Location: Black Ash Swamp Road Code: 08
Contractor: self Address: same Tel : same
Stick Built: Modular Home: Manufactured Home: Commercial : x
Addition: Garage: Car Port: Shed: Remodeling: Roofing:
Siding: Fireplace: Chimney: Windows: Pool : Demolition:
Plumbing: Heating: Electrical : Air Conditioning: Gas:
Patio: Porch: Deck: New: x Repair/Replacement:
Type of material used/discription: concrete walls with wood framed roof , felt
paper and asphalt shingles
Size: 25 '8" x 32 '6" 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 .
Applicant 's Signature: / _ I >
'--�� � Uv Date: i"
If signed by Contractor , t of •
YP- � e eg nse/rtr o ion & No : / _Alf
Building Official 's Signature:� , , - ' i/1 -4090,09110
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Date of Health Dept . Approval : . Ah
Date of Zoning Approval : c
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 MONTVILLE
Building Department
Application for a Permit
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Owner: �,) Address: g"29 rr -nx- Tel : q- 99 ,
Job Location: �7�`""'` "''': 6,24k,-,
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Contractor: (!l )2 -f'GI _/ -i(1 i : ' :01-14-re--- ;2..4 M
.� Tel : J
/4.). A..,.,.4)pievia.t-
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: 061"..4- k% Lima--- ( G'G/
--�-e- 4- - � o�,
Size: c,2rS/8'" ,k 3cn ' Type of Heat: Fireplace:
No.of Stories: No. Rooms: Breezeway:
No. Baths: Garage: . Use:
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