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OWN OF MONTV I LLE`
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Permit No._~ Date
Estimated Cost Ioc>o. 0 a Fee X/Q lx
Owner c,--:> ( l V} Cale 44--) Address g 7-e- ecG Z E I Tel e.
C-->,A _
Contractor K-astcer Address Tel e.
Location of Building oatcA6e-, e-T Zone No.
Additions & Alterations (Including moving, demolition, sign erection)
a.c} ~ ~n ram ~ 8 A: P 'fL S klwlvb ~+ea .v , _
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
~ RZ
Inspections For:
Footings
Framing
Rough Wiring
Electric Service
Rough Heating
Fireplaces
Other Misc.
Final Inspection for C.O.
Approved Rejected Signed__ __'r,