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TOWN OF MONTVILLE
Building Department
848-7166
APPROVED BUILDING PERMIT OR TRADES PERMIT
For 180 Days __....._._.
Permit No : RL=97--H Approval Date : 1/15/9-x. Expiration Date: /15/91.
Estimated Cost : 5. 7.00, 0171
Fees : 16. 0171 PRF: C. 0:
Owner: Lee Boltz
Address : New London f, 5r-,_
Tel : 4 -,.,mow,
,-,
.Tob Location : Lot 40._ ,.P Raymrond Hill Rated
Contractors
Contractors (_3 A. Li Hee. i r ri Address ' 39 Branch Hill Rd.,
Tel : 88e-01.88
Stick Built : Modular Home : Manufactured Homs: Commercial :
Addition : Garages Car Porta Shed: Remodeling : Roofing :
q
Siding Fireplace: Chimney : Windows ..
Pool : Demolition :
Plumbing : Heating: x Electrical : Air Conditioning : Gas :
Patio : Porch : Deck : New: x
Repair/Replacement :
Type of material used/discription : instm , l f, -�n_7ce
-F': w-ori c ??C �1 p,�;'f' i n 1'7 c��c i-o!71._ry i. l.
Size : Typo of Heat :
Fireplace :
No. of Stories : No. Rooms :
Breezeway :
No. Baths : Garage :
Uses
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 Si gnat ure e ci f _
_..__.__._.-.._.----_........_.._._... Date : __./Z5--- 9z• _ _ _
If signed by Contractor, type of license/registration & Noa S' ---- _sr
c
Building Official' s Signature' / _4f, , _ . -.,./ Date: Ae46-44____ __
ifor.J4,1,
Date of Health Dept. Approval : / / •:�
Date of Zoning Approval :
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.
9y9 ?",
TOWN OF MONTVILLE
Building Department
Application for a Permit
Owner: / 'e'e 60 L/ z Address: d:;.10 4 eif ) Tel e 1 : /y.„3-075-3C)—
Job Location: J '57 iv,---we'{ /V//r /?lel 14,74 yam - /�
Contractor: /-71/(-5 //ems/; Address : s/ �I /ej.-t-elf/,li// Tel :
Stick Built : Modular Home: )( Manufactured Home:
Addition : Garage : — Car Port : Shed:
Remodeling: Roofing :
Siding: Fireplace : Chimney: Windows : Pool : Demolition:
Plumbing : Heating, ix, Electrical , Air Conditioning: Gas:
Patio: Porch : Deck: Newa
Repair/Replacements
Type of Material to be used/job description: /9 %G if Grie,Ll , •
Size: Type of Heat : /j/o7-6-z. Tom,?
Fireplace :
No. of Stories: 2- No. Rooms : 4
Breezeway :
No. Baths: Garage :
Use :