Loading...
HomeMy WebLinkAbout1986 - SFR TOWN OF MONTV I LL,-BUILDING DEPARTMENT APPLICATION FOR BUILDING PERMIT Date Sz c/ Permit No._~ Estimated Cost Fee Address Tele. Owner Contracto ddress ele. Zone No. Location o Building demolition, sign erection) Additions & Alterations. (Including moving, New Building - Type of Construction Size f Type of Heat, j'2,-- _No,, of Stories No . Rooms ~ Breezeway _le~r=:e - Garage Use No. Baths I hereby certify that the proposed construction will conform to the applicable zoning reg- ulations of the Town of Montville and the Basic Building Code of-the State of Connecticut , and that all statements herein contained are true and correct. Approved e lef Signed Inspec Date Bu i l d i ng i - Inspections For: Footings Framing Rough Wiring Electric Service Rough Heating Fireplaces Other Misc. - Final Inspection for C.O. Rejected_ Signed Approved CONSUMER PROTECTION WELL DRILLING, BOARD STATE OF CONNECTICUT PERMIT NUMBER CPR-8 REV. 11-82 DEPARTMENT OF CONSUMER PROTEC 1N WELL DRILLING PERMIT 165 CAPITOL AVE., HARTFORD, CONNECTICUT 06106 ~W 17j-1 0-r LOCATION OF WELL (Town) trees C 4 NumberI) DATE tin E0 C, - - - OWNER OF WELL El INDIVIDUAL L BUILDER El OTHER (Specify) OWNER'S ADDRESS (V4 H1 PR-FSMN :5 BUSINESS TEST Est. No. of PROPOSED EXDOMESTIC 0 ESTABLISHMENT FARM WELL People being USE OF served. SUPPLY INDUSTRIAL CONDITIONING ❑ PUBLIC AIR OTHER WELL SKETCH OF MELL LOCATION Locate well with respect to at leost two roads, showing distance from intersection and front of-lot Location of lot to at least two roads Well location on lot and to house (if present) Indicate North !'e Approximate number of feet from well to nearest source of possible contamination: The undersigned is aware that, upon completion of the well, a "Well Completion Report" containing construction details and information required under Section 25-131 of the 1969 Supplement to the General Statutes must be sent to the owner, the Board and the Water Resources Commission on the form provided by the Board. This per 't is not valid til oil infor " ion is filled in and it has been counter-signed-by the Director of Health or his agent. APPLI :gna re) J APPLICA 'S ADDRESS REGISTRATION NO. e D k 63 -!J BY(I`own H h Officer or , en , DATE APPROVED El REJECTED 7,19 7 REMARKS DIRECTOR OF HEALTH WELL COMPLETION REPORT STATE Of CONPIECYICUT DO NOT fill in DEPARTMENT OF G®NSUMER PROTE( IN STATE WELL NO CPR-9 REV. 11-82 WELL DRILLING BOARD 165 CAPITOL AVE. OTHER NO. HARTFORD, CONNECTICUT 06106 NAME ADDRESS *m, y OWNER d £ f 3 ° r k is n ~F¥ y3 (No. & Street) g`~ (Town) (Lot Number) A O ELL Y f k ' F L BUSINESS DOMESTIC E] ESTABLISHMENT FARM TEST WELL PROPOSED USE OF * OTHER AIR WELL ❑ SUPPLY INDUSTRIAL CONDITIONING El (Specify) DRILLING 1 COMPRESSED CABLE OTHER EQUIPMENT D ROTARY AIR PERCUSSION ~ PERCUSSION D (Specify) i. V H WAS CASING GROUT? CASING LENGTH (feet) DIAMETER (inches) WEIGHT PER FOOT DETAILS ? THREADED WELDED YES NO YES NO HOURS t YIELD (G.P.M ) YIELD PUMPED COMPRESSED AIR. TEST ❑ BAILED WATER MEASURE FROM LAND SURFACE-STATIC (Specify feet) DURING YIELD TEST (feet) Depth of Completed Well in feet below Land surface. ,P T LEYEIr MAKE LENGTH OP~TO UI FER (feet) SCREEN GRAVEL SIZE (inches) FROM (feet) TO (feet DETAILS SLOT SIZE DIAMETER (inches) IF GRAVEL Diameter of well including PACKED: gravel pack (inches): DEPTH FROM LAND SURFACE FORMATION DESCRIPTION Sketch exact location of well with distances, ro at least two permanent landmarks. FEET TO FEET ~cj J, -72 1 If yield was tested of different "depths during drilling, list below FEET GALLONS PER MINUTE ~T~* t E e wnp--~+~w~tws: 3' 8 l;r DATE WELL COMPLETED PERMIT NO. REGISTRATION NO. DATE OF 'REPORT WELL DRI R (Si azure) J11, LOCAL DIRECTOR OF HEALTH { k y; LCNINC PEPW-lT TCm,(, OF JA0NTVILI!' .C(?NNCCTICUi (=ee Faid.$ ix i s - Date ' Permission is hereby granied i0 S on 4Yhe side of to erect a~ stories high; i ~sfollows. Size,- ft. ong,i a,ft. wi e, _ft, W • ft• distance i'ro ~ side lot line C s distance from rva center line , N L. for the use o he facility as a s 4 - //Zoning anc' Planning Commission, Town or . Montville, Connecticut. 1 r ~ + y 9 b THIS PE4MIT IS VALID FOR ONE `(CAR Zoning !went s' owner or as re ressn~in, The recipient of this permit 'accepts it on the condition that hof.th,e Town of h1►onYvi Ircable ordinances and regulation the. owner, agues to comply with all,opj~ nd the State Statutes of the State of Connecticut regarding the use; yoccupdncy'and tYPe o acYiv, 0 to be instituted. it is furihercore understood that the facility' can not be used until a Certificate c IIaiIt 11pS been issued by the Zoning and Planning Commission and that any c'+iange Use C Use and Co,~p use similarly does require a new Certificate of Use and Compliance. Before a and certified in Compliance will be issued a plot plan drawn to a scale of 1 prepared e lations must be sub~;~ifted ; tompfiance with provisions contained in Section $.2 of the Z all buildings oning Rouer g and as is location(s) o the Zoning ant; Planning Commission showing all boundaries T. h C- r, 9 on the property incluc'-rnr 'the center line of any public or prilvol-e ri ht-of-way, sanitary facilities anc wale ysupply• APPLICATION FOR A ZONING PERMIT, TOWN OF MONTVILLE, CONNECTICUT To be filled out by Applicant - 1 original and two.- carbon copies Date 198/. The undersigned hereby applies to the.Zoning and Planning Commission for a permit to Location of Property Name of SubdivisionoiS Lot No. - Assessor's Block No. Assessor's Parcel No. r - Name of (Owner) (Agent) (,a Address 1 C Area Gq• ft Size of Building in ft.: Front overall , Depth overall-9,~ No. of bedrooms No. of stories Height in ft. No. of rooms r: No. of bathroom, Zoning District '/fL O Area of Lot 20'?.Z7sq. ft. , Lot frontage oZ~~CJ ft. Lot Widt 00 ft., Front Yard Depth h?~ ft. Rear Yard Depth Y17 ft., Side Yard Depth '-/0_ft. Purpose of building and/or use is `G cf//til C• j-) L Y Sanitary facility to consist of Water Supply to consist of aD(s~pS r Date of Sanitation Officer approval ! Remarks I hereby agree to conform to all requirements of the Laws of the State of Connecticut and the !.Ordinances and Regulations of the Town of Montville, and to notify the Zoning and Planning Commission of any alteration in the plans for which this permit is being asked. I furthermore agree that the above described facility is to be located at the proper distance from all street lines as required by the Zoning Regulations or any other applicable local and state ordinance: and regulations and it is understood that the facility upon completion will be used in compliance wit the Zoning Regulations of the Town of Montville. r I hereby apply for a Certificate of Use and Compliance for " " described in the above application for a. ' permit. It is my` understanding that the facility can not be occupied until a Certificate of Use and Compliance has been issued by the Zoning and Planning Commis. Signed (Owner) (Agent) ' Tel. No. , I r f Approved by Zoning Agent Date Zoning Permit No.;.1 issued. Date Disapproved by Reason 1C/10/70 , J . USE THIS SPACE BELOW FOR PLOT PLAN OF PROPERTY Plot plan to a scale of 1" - 40' Prepared in compliance with Section 8.2 of the Zoning Regulations showing all boundaries of the property and the location of the building or buildings on the property including the center line of any public or private right-of-way, sanitary facilities and water supply. ANY CHANGES FROM THIS DRAWING MUST FIRST BE CHECKED WITH AND OBTAINED IN WRITING FRON THE ZONING AND PLANNING COMMISSION OR ITS APPOINTED AGEN'T'. Plot plan may be drawn or attached to this sheet. I 1 J ;os y _ ca~ 5-0 -3 ~J Date , Inspected by Zoning Agent Remarks Dat- Certificate of Use and Compliance Issued by IC/10/70 DEPARTMENT OF HEALTH TOWN OF M O N TV I LLE TAX MAP LOT PERMIT PERMIT TO CONSTRUCT ❑ Well New Sewage Disposal System Check ❑ Replacement Disposal System X Cash . /Permit Fee ____Payable to the Town of Montville ' Lot Location V----------. Size OwnerY_!667JZ t &L Tel. No. 7_1 Address5,t--- _&A' f -tractor - License No. - \ - - Addresslp ~ r ~ - - - Tel. No. - q, Basement Facilities ~V ) Baths P, ) Soil Residence No. of Bedrooms __~D___________ We., _ Commercial Water Dug Well ( ) Dr'lle _d____ _ ( ___V__)__ Municipal Septic Tank - Capacity in Gal . ( ) 1_~--__~__---- 1 ( ) Garbage Grinder ( ) Dry Wells No. ( ) Leaching Bed ( Trenches ( ) Galleries f No. of Feet 1/ Depth Width - Size of Stone Size Pipe --f----------------------- t2 Instructions: T) No backfilling allowed until final inspection. - 2) On space at right draw plan. Locate 3) House Road 4) Property Lines Water Supply 5) Septic Tank - Dry wells or Leaching Tr. 6) Distribution Box 7) W er Supply and leaching on adjoining propertyn Signed: - "Date A------ - Contrrctor Approved By Sanitarian The private sewage system serving the above premises was constructed essentially in accordance with plans filed with this district and the terms of the Permit issued- This Certificate shall not be construed as permission to create or maintain any sewage nuis- ance and in the issuance of the certificate, the Town of Montville Health Department assumes no responsibility for the future operation and maintenance of the system.