HomeMy WebLinkAboutBLDC-24-3- Town of Yarmp tV 8t41 ing Department
1146 Route 28, South Yarn o 0 04el. 508-398-2231 ext.1261
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Use and �eCu n' � Ginjt°Application
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In accordance with the provisions of� ri assachuset'ts State Building Code, section 105.1
Application for a certificafe fuse and occupancy permit
Name of Business _ ;Q-i-o P>e--(-4.-, Phone # cog' 332 (�C09---
Type of Business -� A- -t- ,t.c.�• ce mAA(•
Property Address 1 I . .y ' —4 / $ - yov n------7\--L Unit # D
• *Square Footage to be occupied /`3 v 0 *attach floor plan Fee: $60
The applicant is required to obtain ap
proval q sign-offs from the following R3e-teiermy sr,::
checked off below: - -
x Health Department—508-398-2231 ext. 1241 I JAN 09 2024
BUILDING DEPARTMENT
X Fire Department— Fire Prevention, 96 Old Main Street, 508-398-2212 -----
Other
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Building owners Signature Applicant Signature
Please note: this permit is for use and occupancy only. Any work requiring a building permit
will require a licensed contractor to submit an additional application with all the required
information based on the scope of the project. V//),\
**Office use only**
Zoning District \� - Proposed Use \3 Change of Use: Yes NON
Allowed Use: Yeses` No APD Waiver: Yes No N/A
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Building Officials Signature Date
Updated 3/21 % L,LI-3
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