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TOWN OF MONTV I LLE ce)
BUILDING DEPARTMENT Ci,f1`_
APPLICATION FOR BUILDING PERMIT ��`"'
Permit No, 7$8.6 Date I /,(r.
Estimated Cost l d U, ()U Fee
Owner �" ,I— l,� PL 100(„O Address 3elyvri oni H i LL R..b Tele.
Contractor } ricK rurAddress '5'% i c oc`f
Mysne__Tele.c.)05--:?6:-Dk6e
Location of BuildingO U cs—
RA�wy,_v i) Hu.L 1) Zone No.
Additions & Alterations (Including moving, demolition, sign erection)
I-F A1J. . l OA a I)r t) RiVr\ P ,
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 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 Z"�. Approved ff 9kr
Date
99 Building Inspector _,
Inspections For:
Footings
Framing
Rough Wiring
Electric Service
Rough Heating
Fireplaces
Other Misc.
Final Inspection for C.O.
Approved Rejected Signed
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