Form ID

Publication date

Location of premises

Certificate

33 Unit Motel addition (Five (5) Storey) Building

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Lorenzo D’Amico
Address of Owner
5577 Ellen Ave., N.F., ON
Name of Contractor
Chalet Motor Inn
Address of Contractor
5577 Ellen Ave., N.F., ON
Name of Certifier
Lorenzo D’Amico
Address of Certifier
5577 Ellen Ave., Niagara Falls, Ontario L2G 3P5

Identification of Premises

5577 Ellen Ave., N.F., ON L2G 3P5, Reg. Plan 3039