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TOWN OFMONTVILLE
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Permit No. X/V4 Date
EstlmAed Cost 7,52, Fee
Own r Address Tel e
Contractor J&L~~ddress ~~,O -
el
Location of Building
Zone No.
14 Ae~L~ ~
Additions & Alterations (Including moving, demolition, sign erection)
(24 _14V
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 Approved pll ,
Date Building Inspector
IIAL
Inspections For:
Footings
Framing
Rough Wiring
Electric Service
Rough Heating
Fireplaces
Other Misc.
Final Inspection for C.O.
Approved Rejected Signed