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TOWN OF MONTV I LLE
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT 1:2
Permit No. Date Estimated t Fee
Owner Address Z 46A -Tele.
Contractor 1-411A 'A Address Tele.
:Z Aee
Zone No.
Location of Buil ing
Additions & Alterations (Including moving, demolition, sign erection)
C
I 1
New Building - Type 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 all statements herein contained are true and correct.
Signed, r Approved
Building Inspector
Date
0 q
Inspections For:
Footings
Framing
Rough Wiring
Electric Service
Rough Heating
Fireplaces
Other Misc.
Final Inspection for C.O.
Approved Rejected Signed