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Town of Montville
Building Department
848-3030, Ext 382
RESIDENTIAL
CERTIFICATE OF OCCUPANCY
SIGN-OFF SHEET
3
P0 /72/ �� Lip ,
Pperty Address
Job Description:
The applicant is responsible for the completion of the form, no certificate of occupancy will be issued until all signatures
below have been obtained.
HEALTH DISTRICT
848-3030,Ext.339
Approved No Permit
Septic System
0 Permit#: 0 Required
Date
Approved No Permit
Private Well ❑ Permit#: ❑ Required
WPCA DEPARTMENT Date
848-3030,Ext.376
Approved No Permit
Municipal Sewer ❑ Permit#: ID Required
Date
House Trap ❑ Outside
❑ Inside
Approved No Permit
Municipal Water ❑ Permit# ❑ Required
DEPARTMENT OF PUBLIC WORKS Date
848-7473
Approved No Permit
Director ❑ Permit#: ❑ Required
PLANNING&ZONING DEPARTMENT Date
Z 848-3030,Ext.379
OccV0?"
In-Compliance No Permit
ea Permit#: 20y-/6& ❑ Required
Zoning Date
In-Compliance No Permit
Inland-Wetlands
0 Permit#: ❑ Required
Date
Town of Montville
Building Department
Field Inspection Notice
Address: 3 Polly's Lane
Job Description: Deck
Permit Numbers:B2004-0269
Footing Not Approved:
Comments: 1. Approved: 6/15/04 JS
Backfill Not Approved:
Comments: 1. Approved:
Framing Not Approved:
Comments: 1. Approved:
Rough Electric Not Approved:
Comments: 1. Approved:
Electrical Service Not Approved:
Comments: 1. Approved:
Rough HVAC Not Approved:
Comments: 1. Approved:
Rough Plumbing Not Approved:
Comments: 1. Approved:
Gas Line Not Approved:
Comments: t. Approved:
Fireplace Throat/ Not Approved:
Chimney Comments: 1. Approved:
Fire/Draftstopping Not Approved:
Comments: 1. Approved:
Insulation Not Approved:
Comments: 1. Approved:
Certificate of Not Approved:
Occupancy Comments: 1. Approved: 7/15/04 JS
Not Approved:
Comments: 1. Approved:
Not Approved:
Comments: 1. Approved:
Not Approved:
Comments: 1. Approved:
Comments:
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