HomeMy WebLinkAboutBLDC-24-25 ,5 1 i /zc Town oc' Yarmouth Building Department
1146 Route 28, South Yarrnouth,.. 114/4 02664 teL 508-398-2231 ext.1261
Use and Occupancy Permit-Application
;n accordance with the provisions of the Massachusetts State Building Code, section 10%
Application for a certificate of use and occupancy permit
iarne of Business 1\)P TLEQ_U C ‘-v__ Cr L-C._,Phonp II 71 Tc...) -ask_ )GL,i.,,
Type of Business n4,0'1 C--,(0c.,,,,v-t.j %A-6NA_, _ hmailac,,,phcLA ne--i. __IC._._osii„,
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ProPertY Address --'-C7,1---1 ,'.V--_,,. ...:___: )....'?.._,_1_C.:_?2),-. : 4/1-,.. A9__1:- _ Unit it V ._
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'Square Footage to be occupied / ( ' -. _ *attach floor plan Fee: S6C
The applicant is required to obtain approval sign-offs from the following departments as
checked off below:
X '4ealth Department — 508-398-2231 ext. 1241 i
ient --- Fire Prevention, 96 Old Main Street, 508-398-2212
building owners Signature Applicant Signature
Please note: this permit is for use and occupancy only. Any work requiring a building permit
twill require a licensed contractor.to submit an additional application with all the required
.nformation based on the scope of the project.
Office use only' BLDC_"2.4—) .•5"--
:oning District \‘ 1--, Proposed UsF.f. CS Change of Use: Yes No V
flowed Use: Yes,_ No
APD Waiver: Yes No N/A V\ ,
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Building Officials Signature
Date
aced il:1
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NOT TO SCALE�
Unit
door
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