HomeMy WebLinkAboutBLD-22-007405 final affidavitProject Title: Date: Permit No.
Leoni d Klebanov 7 /27 /2022
Property Address:
31 rcehouse Rd, Yarmouth, MA 02664
Projecfi Check (x) one or both as applicable:
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Newconstruction ExistingConstruction
A.Final Construction Control Document
To be submitted at completion of construction by a
Registered Design. Prof essional
for work per the nitth eilition of the
Massachusetts State Building Coile, 780 CMR, Section
X
Project description:
Andrew Bre i te r-tvuI MA Registration Number: Expiration date: , am a registered design professional, and I have
prepared or directly supervised the preparation of all design plans, computations and specifications conceming:
Architectual
Fire Protection
Structural x
Electrical x
Mechanical
Other: Describe
for the above named project. I, or my designee, have performed the necessary professional services and was
present at the construction site on a regular and periodic basis. To the best of my knowledge, information, and
belief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved
as part of the building permit and that I or my designee:
1. Have reviewe4 for conformance to this code and the design concept, shop drawings, samples and other
submittals by the contractor in accordance with the requirements of the constmction documents.2. Have performed the duties for registered design professionals in 780 CMR Chapter 17, as applicable.3. Have been present at intervals appropriate to the staSe of construction to become generally familiar with
the progress and quality of the work and to determine if the work was performed in a manner consistent
with the conskuction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107
Enter in the space to the right a "wet" or
electronic signature and seal:
fiwl,rul Lrrntv-Ulw
phonenumber: 6L7-314-5785 Email: andrewGbreiterplan€t.com
Building Official Name Permit No
Building Olficial Use Only
Date:
Elec+riL
lEeck L
g I tlLL
JUL 2? 2022
fDING DEPARTMENTBIJ I
RECE iveo
Version 0l 0l 2018