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APPLICATION FOR PERMIT
City or Town:
Date:
Yarmouth
06/L1 /2OOB
permit Number: 00196.8
ln accordance with the provisions of M.G.L. Chapter 148, as provided in Section 10 A application is hereby made
by: cathi oiaz
Address 168 Route armouthPort, MA 02675
For permission to: lnstall Carbon Monoxide Alarms (CMR 31.00)
Name of Competent Ope;61er; michael Sawicki Electrician
Date lssued-Rejected 06/17 /2O0A By
Date of Expiration: o7 /f7 /2008 Fee: 160 ' 00 $ Paid
Cert. No
115
AGAPOOl
nature a rcan
Due
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MA Zp code 02675Cityaon.tu B:mstableYarmouth Port
eo.o** Geoffrey & Rebecca Newton & Kathryn Diaz
Properry Add.ess 168 Main Street
Lender/crient T0 Banknorth, N.A.
SKETCH ADDENDUM
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AFEA CTCULAI]ON StIrll\,tARYrl..rir6 isr.art
TOTAL WABLE to'rrd€d)
LI\II.IG AREq AFEAKM!\NAt.kdd sdrdB
8 Cdc'lallo.6 Told (luJnded)
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Day One FolG for Windows - I E00{ET-DAYI
-O\4CES OF CAPE COO & THE ISLANDS
SKETCH ADDENDUM Pa8. I of I
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158 Main S'tre€t
Eamstable 02675Citysr.r. MA zip Cod.Yarmouth Port
Boro".. GeolLeJ & Rebecca Newlon & Kathryn oiaz
Lcnder/Clienr TD Bankno.lh, N.A.
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AFEA CALCLJI-ATIOTIS SL-IIIMARYO*'pa6 SE t.r T-ti
TOTAL WABTE (q.nd€d)750
U!1iIG AREA BFEAKMW!E .td*r sun<aE
1 Cdcddion Tdd (ornded)7fi
Day On. Foms for wirdows - I EOOCFI-DAY I SKETCH ADDENTDUM Pas. I of2
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