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TOWN OF MONTVILLE
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Permit No. Date ,oz~,61 ~2?- 17
Estimated Cos Fee
Address 70 T' Tel e.
Owner
Address Tele.
Contractor
Location of Building Zone No.
Additions & Alterations (Including moving, demolition, sign erection) e c)Xle
,v
New Building - Type of Construction
Type of Heat Fireplace
Size
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
Building Inspector---
Date f
Inspections For:
Footings
Framing
Rough Wiring
Electric Service
Rough Heating
Fireplaces
Other Misc.
Final Inspection for C.O.
i ,
Approved Rejected_ Signed_