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TORN OF M®NTVILLE
Building Department
848-7166
APPROVED BUILDING PERMIT--0 R` 'TRADES PERMIT-
For 184 Days
Permit No: 10934 Approval Date: 7/26/93 Expiration Date: 1/26/94
Estimated Cost: 1,100.00 Fees: 10.00 PRF: 1.50 C.O: 5.00
Owner: Jean & Steve Blaisdell. Address: 12 Beechwood Road Tel: 848-9141
Job Location: 12 Beechwood Road Code: 05 _
Contractor: self Address: same Tel: same
Stick Built: x Modular Home: Manufactured Home: Commercial:
Addition: Garage: Car Port: Shed: Remodeling: Roofing:
Siding: Fireplace: Chimney: Windows: Pooh: Demolition:
Plumbing: Heating: Electrical: Air Conditioning: Gas:
Patio: Porch: Deck: x Mew: x Repair/Replacement:
Type of material used/discription: pressure treated wood frame
Size: 12' x 12' 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
d all l other Cod as adopted b j,y ~ the State of Connecticut, and
Building Town of Code and Montville.
the e
Applicant's Signature: Date'
If signed by Contract type of license/registrati n & No:
Building Official's Signature: Date: -7-2.,6 wf"'
,fl
Date of Health Dept. Approval:
Date of Zoning Approval: 2
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.
TOWN OF MONTVILLE
Building Department
Application for .a Permit
Tel Tft
Address: -
Owner~ l 9
Job Location=
I Address- Tel:
I Contractor= -
Manufactured Home: Commercial: -
Stick Built Modular Home:
Shed: Remodeling: Roofing=
Car Port:
Addition: Garage:
~ Pool= Demolition
PlSidingumbi:ng: Fireplace: ace: Chimney: Windows:
~II
9 Electrical: Air Conditioning: Gas:
, -
j _ Retaining Wall- _ New: Repair/Replacement:
~ Patio _ Porch _ Deck
Type of Material/job description: A (16E- 7) 16
Gt ! S
i
Type of Heat: Fireplace:
Size* _
No. of Stories: No Rooms: Breezeway:
No. Baths= Garage- Use'
I
a , (^4
ZONING PERMIT
ASSESSOR'S MAP NUMBER 7 / LOT NUMBER 4 EXPIRATION DATE
ZONING PERMIT NUMBER Al/,t
APPLICANT ~G7 Yl. C c/ G11S
APPLICANT'S ADDRESS TELEPHONE NUMBER
PROPERTY OWNER (fir VL Tc U
LOCATION A vl/ e- LOT AREA ZONE - a ~
BUILDING HEIGHT PROPOSED FLOOR AREA t>C
NATURE OF REQUEST/PROPOSED USE E ACA C -E 7 P\
HAS A VARIANCE EVER BEEN GRANTED FOR THIS PROPERTY. ~a YES F7 NO HAS BOND BEEN FILED? ~ YES ~ NO
SKETCH BELOW OR PROVIDE TWO COPIES OF PLANS DRAWN TO A SCALE OF AT LEAST t'= 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 REQUESTc,
(UNDER 500 CUBIC YARDS), DIMENSIONS OF FILL OR EXCAVATION AREA RUST 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 USE AND
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.
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 ?CERTIF SATE OF COMPLIANCE BEFORE ISSUANCE OF .A C.O.
APPLICANT'S 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.
uATE
COMMISSION AGENT~,~
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