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OWN OF M'ONTV I LLE
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Permit No. 8764 Date 1C-
Estimated Cost ,R10 V0 Fee
Owner Address,37 CC9~ CC.f> Tele. i
Contractor s - 3 i a i C td/ j lZ )QQ-, Address/qjd k ,-C- 64V f),f&L Tel e.
Location of Building CC®n Zone No.
Additions & Alterations (Including moving, demolition, sign erection)
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
Date Building Inspector
Inspections For:
Footings
Framing
Rough Wiring
Electric Service
,Rough Heating
Fireplaces
Other Misc.
Final Inspection for C.O.
Approved Rejected Signed