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TOWN OF MONTVILLE
Building Department / CW
848-7166
APPROVED BUILDING PERMIT OR TRADES PERMIT
For,180 Days
Permit No: 1+239 Approval Date: 7/207/98 Expiration Date: 1/20/99
Estimated Cost: 1,200.00 Fees: 10.00 PRF : C.O: 5.00
Owner: Mike & Mary Bra/cki Address: 12 Avery Road Tel: 848--3798
Job Location-.12 Avery Road Code: 05
Contractor: self . Address: same
Tel= same
Stick Built: Modular Home: Manufactured Home: Commercial:
Addition:- Garage: Car Port: Shed:. Remodeling: Roofing= x
Siding: Fireplace: Chimney: Windows: Pool: Demolition:
Plumbing: Heating: Electrical: Air Conditioning: Gas:
Patio: Porch: Deck: Retaining Wall: New: Repair/Replacement: X
Type of material used/discription: strip roof and appl
shingles y 15# felt and asphalt
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.
Apr-1I -
signature, ~
Date:
If signed by Contractor, type o li isIr ion & No:
Building Official's Signature: _ Date=
Date of Health Dept. Approval
Date of Zoning Approval-..
THIS IS TO INFORM YOU THAT UNDER THE CONNECTICUT AMENDMENT OF THE
BUILDING CODE SECTION 1] 9 A CER- IFICAY Off" c)CCIjPANCY° IS _REQUIRED PRIOR TO
ANY USE OF THE STRUCTURE
A MINIMUM OF 24 HOUR NOTICE TO THE BUILDING DEPARTMENT-IS_REOUIRED FOR
INSPECTIONS.
TOWN OF MONTVILLE~.
Builaing Department
Ap li.cati.on for a Permit
Owner: Address : eY Tel
Job Location: Ayctv
Contractor ~/S1_°~'VLr I. Address: Tel: Q7G9 '39F
Stick Built: Modular Home: Manufactured Home: commercial:
Addition: _ Garage: _ Car Port: _ Shed: _ Remodeling:.- Roof ing:_Z
Siding: _ Fireplace: _ Chimney: _ Windows: Pool: _ Demolition:
Plumbing: _ Heating: _ Electrical: _ Air Conditioning: - Gas:
Patio: Porch: _ Deck: _ Retaining Wall: _ New: _ Repair/Replacement:
Type of Material to be used/job description:
Size: Type of Heat: Fireplace:
No.of Stories: No. Rooms: Breezeway:
No. Baths: Garage: Use: