HomeMy WebLinkAboutBLDC-24-70 Town of Yarm,o8th.10410qf Department
1146 Route 28, South Var.` v '� tel 508-398-2231 ext.1261
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Use and O44,:,
upual �tt ' p rmit ►pplication
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In accordance with the provisions o 1 aefit tts State Building Code, section 105.1
Application for a certific tf use and occupancy permit
Name of Business R �� �'k' Rl') l cc c°1-'rl co phone#�l T�o�`�
Type of Business iCi Cc 00 ,X 11 ILI 6 Email A Ir .tv(?` Q gA /c nil
Property Address ( 3 P (,!J ftt 1 - rf Ti4 Unit #v-.3 A
*Square Footage to be occupied *attach floor plan Fee: $60
The applicant is required to obtain approval sign-offs from the following departments as
checked off below: RECEIVED
X Health Department— 508-398-2231 ext. 1241 I JUN 2 0 202k
X Fire Department— Fire Prevention, 96 Old Main Street, 508-398-2212
BUILDING DEPARTMENT
Other BY.
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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.
**Office use only**
Zoning District f3l Proposed Use \I Change of Use: Yes No '1`
Allowed Use: Yes `'c No APD Waiver: Yes No N/A d\
%�- 6/ 6 I
Building Officials Signature Date
Updated 3/21
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