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NATURE OF 'UORKK
IUSPECTIONS = (DURING CONSTRUCTION)
FOOTINGS y-
ROUGH PLUMBING
ROUGH WIRING
OTHER---
INSPECTIONS: (FOR OCCUPANCY)
PLUMING
WIRING
HEATING
OTHER
FOP,',','! ~x0 o EIMO 70-100-5 ale!p
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TOWN OF MONTVILLE
Department of Public Works
Application for Building Permit
Application & Permit No. % Date ....:'1Pr'~ ..1.972
Estimated Cost .1$.50.. Fee ..$5..QQ..............................
Owner W131.... J9..QiAMIXI Address 114 .Maple..Ave...................
Contractor t~?u ..T` ~.6ertt~r? Address ....Utica sville,. C.onn..............
Architect 5S.F Address
Location of Building Laurel..Pt., . Drive L:XObQx.0.. Lal-,e....... Zone No .
Additions & Alterations (incLiding moving or demolition and sign erection)
................................Tnt.er.ior. re-modeling...................................
New Building - Type of Construction
Size Type of Heat
No. of Stories Fireplace
No. of Booms Breezeway
No. of Baths Garage
Proposed Use ..................summer .r.°sideilC..e
I hereby certify that the proposed construction will conform to pplicable zoning regulations of the
Town of Montville and the c wilding Code of the Stat of C neeticut.
~~1 Appro ~ .
Signed I/`!
Date T$ . Apri .1.97 2 Build g Ins ctor A... P....Br o d.eUr
Form No. BIMO 70-100-1