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TOWN OF MONTV I LLE
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT Permit No. Date
'
Estimated Cost0 Fee a0
Owner Add ress~e4 Tel e.
Contractor Address Tele.
Location of Building) `7 Zone No.
Additions & Alterations (Including moving, demolition, sign erection)
New Building - Type of Constructio
Size IcV- 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.
r ,
Signe , ' Approved
If ?4_
Buildin Ins ector
Date g p
a e-
Inspections Fo
Footings /f -
lap Framing
Rough Wiring
Electric Service
Rough Heating
Fireplaces
Other Misc.
Final Inspection for C.O.
Approved Rejected Signed