HomeMy WebLinkAboutFEMA Flood Affidavit 121923 TOWN OF.' O E TH
1146 Route 28, ' . atinouth, MA 02664
508-398-22314 e 6 a 508-398-0836
Office of the,,,Bulkli tirmissioner
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FINAL COST AFFIDVIT FOR WORK IN FEMA FLOOD ZO ' T
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 172. ' iyq,,vtgw € Sfl M�iN? fu
144
and constructed,reconstructed, altered,repaired, or extended under building permit na ,3 - C 3 0
amounts to$ °7Q,'1$L,Zj
I, OL.h ,being referred to as the owner/agent that the statements made herein are identified below,do solemnly
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.
ignature owne agent
`iNiCHELLff PEHEZ
'V'c. Notary Public,State ofConnecdp
MN Commission Expires Dec.31,2026
of Public Signat My Commission Expires
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Notary Seal: