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APPLIGATION FOR PERMIT
City or Town:Yarmouth
Date:o4 / LL /2025
permit Number: 103479
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
bY: JoANNE LEBLANC
Address: 62 IROQUOIS BOULEVARD /west Yarmouth, MA 02673
For permission to: Unvented Gas Heater lnstallation 527CMR 1.12.8.6
Name of Competent Operator LEBLANC/SCIOLETTI PLUMBING ANO HEATING Cert. No.
By
(SEnatu.e ofappliatn0
Fee: 550.00 $ paid
184
62tR01
Due
Date lssued-Rejecled 04 / LL / 2025
Date of Expirationl