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TOWN OF MONTV I LLE
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Permi t No. Date~~j
Estimated Cost ~ - 9 Fe e :Z
Owner, `Address 7 Tele.
Contractor Address Tel e.
Location of Building c~2~5~ , ~ Zone No.
Additions & Alterations (Including moving, demolition, sign erection)
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New Building - Type 6;Construction
Size Type of Heat Fireplace
No. of Stories No. Rooms Breezeway
No. Baths Garage Use
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 al TZ/ contai ed are true and correct.
Signed Approved
Date Building Inspecto L
------1-
Inspections For:
Footings
Framing
Rough Wiring
Electric Service
Rough Heating
Fireplaces
Other Misc.
Final Inspection for C.O.
Approved Rejected Signed