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TOWN OF MONTV I LLL
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Permi t No. u J1" Date
Fe
Estimated Cost 0 d
Owner Address Tel e.
t
Contractor Address Tele.
Location of Building Zone No.
Additions & Alterations (Including ving, demolit on, sign erection)
r
New Building - Type of Con uction
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 Approved
Date Building Inspector 1~---'
Inspections For:
Footings
Framing
Rough Wiring
Electric Service
Rough Heating
Fireplaces
Other Misc.
Final Inspection for C.O.
Approved Rejected Signed