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``'TOWN OF MONTV I LL'
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
`
Permit No. Date
Estimated Cost ee_4~3
t3c~c ~ Address e~y Tele. ~4
Owner
Addresses Av.e~~, Tele.~~~
Contractor i`~1►
Zone No.
Location of Buildin-g Q t~fe+~CZC
Additions & Alterations (Including movin , demolition, ign erection)
New Building - Type of Construction
Size !x r Yype 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 all statements herein contained are true and correct.
Signed Approved
Date ~'1pz13/ /7 Building Inspector
-
Inspections For:
Footings
Framing
Rough Wiring
Electric Service
Rough Heating
Fireplaces
Other Misc.
Final Inspection for.C.O.
Approved Rejected Signed_
_ il_