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M TOWN OF MONTVILLE 7 13
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Department of Public Works
Application for Building Permit
Date
Application & Permit No. f y- .
Fee / •J a
Estimated Cost • • . f.f . ~ . .
Address
Owner
-:7......... Address .
Contractor •
Address . . . . . . . ,
Architect Zone No'
Location of Building
Additions & Alterations (including moving or demolition and sign erection)
Ne Building - Type of Construction ~Ao• et` Z"
- Type of Heat
Size Fireplace
No. of Stories Breezeway " "
No. of Rooms'
. . . . . . . . . Garage
No. of Baths Zr• . . . . . . .
Proposed Use,.
I hereby certify that the proposed construction will confor ttoo f e applicable zoning regulations o f the
Connecticut.
Town of Montville and the Basic uilding Code dof the
~ G l( /I ~~✓..E7`" Approved ,e;1?
Date ..7. Building Inspector . .
Form No. BIMO 70-100-1
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LOCATO
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INSPECTIONS: (DURING CONSTRUCTION)
x.,
:FOOTINGS
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FEMCING.
ROUGH PLMN~.,
ROUGH WIRING
N (FOR 014- ID211ANCY)
SPECTIONS.
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WIRING
HEATI N •,F.T._. SS A, ~ ~ _:.x.z_.
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Foxm No., BI 3-8-73-100