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T 0 W N OF M 0 N T V I LLE
1
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Permit No. Date
Estimated Cost 6)n, Fee
Owner Address ale Tel e. v"
Contractor Address -5~~' Tele.
Location of Building .p_' al_ Zone No.
Additions & Alterations (Including moving, demolition, sign erection)
New Building - Type of Construction
Size Type of Heat Fireplace
No. of Stories 7'e--No. Rooms Breezeway -7 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.
Approved
Signed
Date /0 _ _ Building Inspect
Inspections For:
Footings
Framing
Rough Wiring
Electric Service
Rough Heating
Fireplaces
Other Misc.
Final Inspection for C.O.
Approved Rejected Signed