HomeMy WebLinkAboutFema final cost affidavit •
TOWN--OF- H
, 1146 Route 2& Sotath Yarmouth, rtil,k 02664
5 8 398 2231-eflt _ 126 `ax 508-398-0836
Office of the ildi .g Commissioner
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 cost of
construction, including all related costs* of the building at 4 JLe,(C n ce /r1/. w, ' gin co fill 1314,4, 0e:l/7
and constructed, reconstructed, altered, repaired, or extended under building permit no. ZZ- co o J S $
amounts to $ // ')Y 71
I, ''�- `5r Agi' ,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
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*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
rtary Public Signature My Commission Expires
A C.ANDREA BREEN
is can/Seal: ,r, ` Notary Public
v; v Commonwealth of Massachusetts
My Commission Expires April 21,2028
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