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T0WN OF MONTV I LLE
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Permit No.3 Date
Estimated Cost P C== Fee 3~"-
Owner Address ~I C t L4, Tele. ;t(T--71 S da
Contractor~ Address Tele.
Location of Buii ng _ Zone No.
Additions & Alterations (Including moving, demolition, sign erection)
New Building - Type of Construction
Size Type of He Fireplace
No. of Stories No. Ro s Breezeway
No. Baths G age Use
I hereby certify that the oposed construction will conform to the applicable zoning reg-
ulations of the Town of Mo'ntville and the Basic Building Code of the State of Connecticut ,
and that all statements herein contained are true and correct.
Si gned e-- Approved ,j-7 y
~
.
Date ~ ~r~ ~ B i 1 di ng Inspector
-T =----------------------------------u---------
Inspections For:
Footings
Framing
Rough Wiring
Electric Service
Rough Heating
Fireplaces
Other Misc.
Final Inspection for C.O.
Approved Rejected Signed