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TOWN OF MONTV I LLE
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Permit No. Date Estimated Cost A4 6 C" Fee U O
Owner 11,, *1 C4IoV Address 19 Tele.
Contractor ~~p I Address Tele.
Location of Building /'F & , vy- Zone No. ,4 --go
Additions & Alterations (Including moving, demolition, sign erection)
New Building - Type of Construction
Size 1,LX/t 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 I ) A m Approved
Date Building Inspector`'
Inspections For:
Footings
Frami ng
Rough Wiring
Electric Service
Rough Heating
Fireplaces
Other Misc.
Final Inspection for C.O.
Approved Rejected Signed