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TOWN OF MONTV I LLB
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Permit No. Date
Estimate ost Fee
Owner ~ J~ Address Tele.
Contractor Address Tele.
Location of Building Zone No.
Additions & Altera ions ((Innn uding moving, demolition, sign erection)
New Building - Type of 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 he Town of Montville and the Basic Building Code of the State of Connecticut
and that 1 tatements herein contained are true and correct.
Signed Approved
Date Building Inspecto
I
Inspections For:
Footings
Framing
Rough Wiring
Electric Service
Rough Heating
Fireplaces
Other Misc.
Final Inspection for C.O.
Approved Rejected Signed