HomeMy WebLinkAboutFema Flood Zone Affidit TO % -OF 3MOLTI3.
1146 Route 28, South Yarmouth, MA 02664
508-398-2231 ex . 1261 Fax.508-398-0836
Office of the Building Commissioner
i 1
FINAL COST AFFIDVIT FOR WORK IN FEMA FLOOD ZONE
To the Building Commissioner,
In accordance with 780 CMR Section 109 of the Massachusetts State Building� Code, the total estimated cot of
construction, including all related costs* of the building at 'j//Z!g/ i9. CJ 4 sf a714
and constructed, reconstructed, altered, repaired, or extended under building permit no. RIP-as-'0 v 0 663
amounts to $ /601 /14
I, ,' a,V,Qs•//viecjV 6 ,being referred to as the owner/agent identified below,do solemnly
swear that the statements made herein are strictly true, correct and made in good faith
*Related construction costs include all work done with or concurrently with the work contemplated by the building
permit including construction, reconstruction, repairs, demolition, HVAC work, etc. Furnishings and portable
equipment are not part of the total construction costs.
Signature of owner/agent_
D. C. ART101A
Notary�uktl,t
COMMONWEALTH9F*149swS!
My CommissiorrExpin,E On
• Sept.mb.ias.2223 �_
Notary Public Signature „M' My Commission Expires
Notary Seal:
.►y