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TOWN OF MONTV I LLE
r
Building Department
848-7166
APPROVED BUILDING PERMIT OR TRADES PERMIT
For 180 Days
Permit No: 11276 Approval Date: 1/13/94 Expiration Date: 7/13/94
Estimated Cost: 119,780.00 'Fees: 670.00 PRF: 78.80 C.O: 10.00
Owner: Chris & Donna Funk Address: 50 Holmes Road Tel: 443-3170
Job Location: 75 Beckwith Road Code: 01
Contractor: Connecticut Valley Address: E. Lyme Tel: 739-6913
Stick Built: Modular Home: x 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: Retaining Wall: New: x Repair/Replacement:
Type of material used/discription: modular Cape
Size: 44' x 27'6" Type of Heat: hot water - oil Fireplace: one
No.of Stories: 1 1/2 No. Roams: 8 Breezeway: n/a
No. Baths: 2 1/2 Garage: foundation only Use: residential
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: dA2L:~,-a- Date:
If signed by Contractor, type of Vicense/registration & No: _
Building Official's Signature: ate:
Date of Health Dept. Approval:
Date of Zoning Approval: tS
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
A MINIMUM OF 24 HOUR NOTICE TO THE BUILDING DEPARTMENT IS REQUIRED FOR
INSPECTIONS.
TOWN OF MONTVILLE
Building ,Department Fee's
Ape_lication'for a Permit MF
co
Tel ~,IG/~-170
caner Address:
ontractor C'o~~ 1/ti /tip /forPS Address- L1~ ~v' Tel: ~y:~9~3
~.5~- Lyme
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: Retaining Wall: New: _ Repair/Replacement: _
Type of Material to be used/job description: 1. i(~Ac Coo :SA4 I 4L
Size: Type of Heat: 171°T U1-1 41-' Fireplace: ff
No-of Stories: No. Rooms: Breezeway:
No. Baths: Garage: Use: A/11"
' ZONIW.3 PERMIT
ASSESSOR'S MAP NUMBER 19 LOT NUMBER 3 EXPIRATION DATE 9'd3 -ys~
ZONING PERMIT NUMBER 9.3`aS~
APPLICANT ! i S a n f- (/~i/IlC
APPLICANTS ADDRESS .SUD /Jy► PJ Lv e~) G c`< /P TELEPHONE L/ L~ - 3 J 7(J
PROPERTY OWNER
LOCATION 75 BccK-,TH ~I D LOT AREA 7 ZONE LJXP 16"0
BUILDING HEIGHT Q/ PROPOSED FLOOR AREA ,~DD SGi. Ff;
NATURE OF REQUEST/PROPOSED USE yA SAP
HAS A VARIANCE EVER BEEN GRANTED FOR THIS PROPERTY ❑ YES RNO HAS BOND BEEN FILED ❑ YES aNO
SKETCH BELOW OR PROVIDE TWO COPIES OF PLANS DRAWN TO A SCALE OF AT LEAST 1"m 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 REQUESTS
(UNDER SW 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 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
b
I ULC 2 2 s ju 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. Q.
APPLICANTS SIGNATURE DATE:"
THE LETTERS "NA" (INDICATING "NOT APPLICABLE") SHALL BE NOTED IN LIEU OF A ZONING PERMIT NUMBER IN THE EVENT THAT A
ZONING PERMIT FOR THE PROPOSED USE IS NOT REQUIRED.
r
COMMISSION AGENT DATE
i
i ,
kecelr7 DATE PROFESSIONAL SERVICE CHARGE PAID NEW PREVIOUS NAME
nurse HR BALANCE BALANCE
YOU PAIL) THIS AMOUNT -
THIS IS A STATEMENT OF YOUR ACCOUNT TODpTE-J SS . . . . . . . . . . . . . 45
RP $'25
SP 45
UNCAS HEALTH DISTRICT CE $ 35
401 W. THAMES STREET RP .
$ 45
NORWICH, CONNECTICUT 06360 FS1 , .`.........$250
TELEPHONE 823-1189
FS2 $ 50
FS3 ..$100
SS -SITE SUITABILITY FS 1 - VENDORS' FS4 . $150
RP -REVIEW PLANS FS2 - LESS THAN 50 SEATS
SP-SEPTIC PERMIT FS3-50 TO 100, SEATS FSft $ 25
CE - CERTIFICATIONS F S4-MORE THAN 100 SEATS FSP 5
RP -RENOVATION PERMIT FSR - REINSPECTIONS WP $ 15
FSP - PERMIT
WP - WELL PFRMIT
NEXT 3754
.
APPOINTMENT -AT NO.
45
M3c:,
3 a ~i
_ DEC 2 2
c.
I
ke'' SITE INVESTIGATION FOR SEWAGE DISPOSAL SYSTEM
OWNER`: r~ v -LOCATION:
PERCOLATION TESTS: DATE: SOIL MOISTURE:'
TEST READINGS
PERC it 1 * PERC # 2
ME RF.AT
F
ffi
TIME READING TIME RkADING TIME -t? TIME R A
/ 2 D it GY 1
O
PERC # LOCATION DEPTH PRESOAK PERCOLATION RATE MIN/IN
L
OBSERVATION PITS DATE: WATER TABLE:
SOIL DESCRIPTION
- Pit Pit
374
-
1 I ' f
71-7 g
_ a l
GEC22 {{g.
3~ ~s
--,JS
OIL
PIT LOCATION DEPTH LEDGE r, laIM
4 /0
owNER:
l TUCATION:
SPECIAL CONDITIONS
C 7 System Design` Larger Than 2,000 G . P. D. Limited Useable Area
[7 High Ground Water [less than 3 ft.]; 17 Watercourse,Pond,Wetland
Sesonal,High Ground Water C7 Possible Seasonal Flooding
[ ] Mir .-Pere Rate Faster Than 1; min/in C ] Shallow. Ledge [less than 5ft. 7
[7 Min. Per-6 Rate Slower Than 30 min/in Excessive Slope [over 25%]
Nearby Public Water Supply well Other
CONCLUSION
Suitable For Sewage Disposal Unsuitable For Sewage Disposal
Additional' Investigation Required Retest During Wet Season
C7 Engineer's Plan Required
DESIGN RKC2ZF2l DNS
12
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