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TOWN OF MONTV I LLE
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Permit No. /.2 Date -5Z
Estimated Cost 0 Fee
Owner Address Tel e. ZPo'-f 7
Contractor Address Tele.
s
Location of Building Zone No.
Additions & Alterations (Including moving, demolition, sign erection)
New Building - Type of Construction CIG~
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
A
Framing
Rough Wiring
Electric Service
Rough Heating
Fi replaces
Other Misc.
~ ~/7 4
Final Inspection for C.O.
Approved Rejected Signe
;7
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