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TOWN OFMONTVILLE
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date
Permit No.
Fee
Estimated Cost
Address ele. -
Owner
Address Tele.
Contractor _
Zone No.
Location of Building
demolition, sign erection)
Additions & Alterations (Including moving,
New Building - Type of Construction
Type of Heat Fireplace
Size
No. Rooms Breezeway
No. of Stories
Garage Use
No. Baths
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 e~ Building Inspector
Inspections For:
Footings
Framing
Rough Wiring
Electric Service
Rough Heating
Fireplaces
Other Misc.
Final Inspection for C.O.
Rejected Signed
Approved