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TOWN OF MONTV I LLE J
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date 1
Permit No. ''L -ft
Estimated Cost - Fee ' j- -
Owner Address Tele.
Contra for
zl2kf~, 2~:~ Address Tele.
Location of Building Z ne No.
Additions & Alterations (Including 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 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 14. Approved 7/9
Date Z-7 /9V Building Inspector
Inspections For:
Footings
Framing
Rough Wiring
Electric Service
Rough Heating
Fireplaces
Other Misc.
Final Inspection for C.O.
Approved Rejected Signed