HomeMy WebLinkAboutDocument_20201020153402_001TOWN OF YARMOUTH
BUILDING DEPARTMENT
1146 Route 28, South Yarmouth. lIA 02664
Telephone 508-398-2231 ext. 1261 Fax 508-398-0836
Owner's Affidavit: Substantial lmprovement or Repair of Substantial Damage
/*-. 9-/1+-Propefi Address:
Parcel lD Number:
Ourne/s Name:
otnner's Address/Phone:
Contractor:
Date:
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pr0$e
name
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Contracto/s License Number:4as
Date of contracto/s Estimate:
I hereby attest that the description lncluded in the permit application for work on the existin8 building all
improvements, rehabilitation, remodeling repairs, additions, and other forms of improvement. lfurther
attest that I requested the above.identified contractor to prepare a cost estimate for all of the worl! including
the contractor's overhead and profit. t acknowledge that it during the course of construction, I decided to add
more work or to modify the work described, that the Town of Yarmouth will re-evaluate its comparison of the
costof work to the market va lue of the buildint to determ ine if the work is substantial improvement. Such re-
evaluation may require revision of the permit and may sub.iect the property to additional requirements.
I also understand that I am subject to enforcement action and/or fines if inspection of the property reveals
that I have or authorized repairs or improvements that were not included in the description of work, and the
cost estimate for that work that were basis for issuance of a permit.
on .no& *, A.bb(-l02g, ooo,,Owne/s S ndersl publlc, pe Peared
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lo be the person whos!
rs 90n!d on the praaldin allached documant a
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rlSNotarized:
lly Commrssron E|Dlres February 12,2m1
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