HomeMy WebLinkAboutBLDC-23-35 Town of Yar Department
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1146 Route 28, South Yar ',• M ' °' w el. 508-398-2231 ext.1261
Use and : ,-�, ,•� .
_ } pplication
In accordance with theprovisions . , M++TTAt r, Eg£/�� +`
)- •a �s State Building Code, section 105.1
Application for a certifica'=xy4'i` se and occupancy permit
Name of Business 577r01/ /2-- Phone # 77 y S/D 1/2.'7
Type of Business /'lvS/G So v9 ii -i': /? 1-,S Email al/a4 C? vd o/ 'vcl
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Property Address24 l.///1/7 3 p y i yfrivii rrr7/ /VA- d2. yUnit#
*Square Footage to be occupied 7hV *attach floor plan Fee: $60
The applicant is required to obtain approval sign-offs from the following departments as
checked off below:
x Health Department-508-398-2231 ext. 1 - _____- _RFCV �E i -
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241
X_Fire Department-Fire Prevention, 96 Old Main Street, 508-398-22121 JUL 12 1023
Other i
Anyu b ,-
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Building owners Signature
Applicant Signature
Please note: this permit is for use and occupancy only. Any work requiring a building ermit
will require a licensed contractor to submit an additional application with all the required
information based on the scope of the project.
**Office use only**
Zoning District bi
Proposed Use --5C Change of Use: Yesk No
Allowed Use: YesNo APD Waiver:Yes NoX N/A
27"--4L.2,n)
Bui mg Officials Signa ure Date
Updated 3/21
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