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Town of Montville
Building Department
848-7166
CERTIFICATE OF OCCUPANCY SIGN-OFF SHEET
Ri a a AVE. EXT 96`9-
Property Address Map/Lot
Job Description: EII CLDSE S.iCa*'aQ,Er 1E' vt/Ar 4 01-M 91711,r Jo' bz-
The owner/agent shall be responsible for the completion of the form, no certificate of occupancy will be issued until all
signatures below have been obtained.
HEALTH DISTRICT 823-1189
Approved
❑ Permit#: ❑ Not Applicable
Septic System Date
Inspected and
❑ Approved ❑ Not Applicable
Food Service Establishment Date
Approved
❑ Permit#: ❑ Not Applicable
Private Well Date
WPCA DEPARTMENT 848-7094
Approved
❑ Permit#: ❑ Not Applicable
Municipal Sewer Date
Approved
❑ Permit# El Not Applicable
Municipal Water Date
DEPARTMENT OF PUBLIC WORKS 848-7473
Approved
❑ Permit#: El Not Applicable
Director Date
POLICE DEPARTMENT 848-7510
Approved
❑ Permit#: ❑ Not Applicable
Officer in Charge Date
PLANNING & ZONING DEPARTMENT 848-8549
/ In-Compliance
�Qf�
0/1-7 00 w Permit#:9O j_ c� ❑ Not Applicable
Zoning Date a 9
In-Compliance
❑ Permit#: ❑ Not Applicable
Inland- etlan s Date
FIRE MARSHAL'S OFFICE 848-1175
Approved
❑ Permit#: ❑ Not Applicable
Fire Marshal Date
Town of Montville
Building Department
Date I1 /! //__042 Field Inspection Notice Permit# - (7
Job Location / 7 7 a. r /11/p, CX 71.
51/•kppr oved Type of Inspection -e•. 6 ( 4
y
Not Approved - Please call for re-inspection when the following corrections have been completed:
Building Official
1.V nfrt AWN' 471r1117,7 .71,17 ; -7raNMITUflirrigilliFTW7Wigg
• Town of Montville •
Field Inspection Notice
Permit #
Location: /"7 7 POiZk.. A Ire' B'X Type of Inspection: t)I c.k P C12)
Issued to: Delivered to:
PPROVE NOT APPROVED
The following orders are hereby issued for their correction:
Please call for inspection when corrections have been completed 860-848-716• �.
Date: .//%i By:
Building Official