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T0AIh OF MONTVILLJE
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Permi t No. DateSO'
Estimated Cost Fee '
0
Owner,d Address Tel e.
Contractor A- ov'_4- Address Tele.
Location of Building ~2f VAI--6 iP Zone No.
Additions & Alterati ns (Including moving, demolition, sign erection)
t s- -
N Building - Type of Construction
Size Type f Heat
Fireplace
No. of Storie N . Rooms Breezeway
No. Baths Garage Use 7Z
I here 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 all statements herein contained are true and correct.
Sig Approved ~d
Date Building Inspector
Inspections For:
Footings
Framing
Rough Wiring
Electric Service
Rough Heating
Fireplaces
Other Misc.
a
Final Inspection for C.O.
Approved Rejected Signed