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T0WN OF 1M0NTV I LL.L R
BUILDING DEPARTMENT
APPLICATION FOR'BUILDING PERMIT
A6ZZ?
Dermi t No.~ Date
~
Estimated Cost 10.1? 00 _Fee
Owner eA ,iZi Address es /'Joo~) Tele. °
Contractor Address S a, r" ~ Tele. a, M,
l
Location of Building ~ ~e, Zone No.
fco J °
Additions & Alterations (Including moving, demolition, sign erection}
0U)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 s tements herein con ined are true and correct.
L6
Signed Approved 6
Date Building Inspector
Inspections For:
Footings
Framing
Rough Wiring
Electric Service
Rough Heating
Fireplaces
Other Misc. -
Final Inspection for C.Q.
Approved Rejected Signed