HomeMy WebLinkAbout0031 MAIN STREET (COTUIT) 6F
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Town of Barnstable _
Building
Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this CardMust be Kept )
Posted Until Final Inspection Has Been Made.039. Permit
39.t° Where a Certificate•'of Occupancy is Required,such Building shall-Not be Occupied until a'Final Inspection`'has been made. l
Permit NO. B-20-1639 Applicant Name: Robert Rostocka Approvals
Date Issued: 07/02/2020 Current Use: Structure
Permit Type: Building- Insulation-Residential Expiration Date: 01/02/2021 Foundation:
Location: 31 MAIN STREET(COTUIT),COTUIT Map/Lot: 009-017 Zoning District: RF Sheathing:
Owner on Record: CANAVAN, BENJAMIN J&SARA J =Contractor Nam %,,,-:.ROBERT A ROSTOCKA Framing: 1
Address: 1567 RACE LANE Contractor License: CS=113252 2 .
MARSTONS MILLS, MA 02648 _ Est Project Cost: $3,425.00 Chimney:
Description: Insulation &Air Sealing. Permit Fee: $85.00
I Insulation:
Project Review Req: ai Fee Paid}' $85.00
4 Date: 7/2/2020 Final:
Uy - Plumbing/Gas
Rough Plumbing:
- _ 4 Building Official Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within"six months after;issuance.
All work authorized by this permit shall conform to the approved application and the`approved construction documents for which this permit has been granted. Rough Gas:
All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes.
This permit shall be displayed in a location clearly visible from access street,or road and shall be maintained open for public inspection for the entire duration of the Final Gas:
work until the completion of the same. r
Electrical
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit.
Minimum of Five Call Inspections Required for All Construction Work: Service:
1.Foundation or footing Rough:
2.Sheathing Inspection -
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final:
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection
5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough:
6.Insulation
7.Final Inspection before Occupancy
Low Voltage Final:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health
Work shall not proceed until the Inspector has approved the various stages of construction.
Final:
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A).
Fire Department
Building plans are to be available on site
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final:
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oF�t„EESS PERMITTown Of Barnstable *Permit#
'Expi es 6 months ror a date
1�Y 2 1 2010 Regulatory Services F
* BARNSTABLE,
v _o. • ®F BARN;STABLEThomas F. Geiler,Director .
rED MP't A ,
Building Division
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us..
Office: 508-862-4038 Fax: 508_-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number ( r.�Yg�/
Property Addressr 1 "zi�^CT_Q f
[residential Value of Work '__5L3G,0 , Minimum fee of$25.00 for work under$6000.00
Owner.'.s_Name&Addresses
ell
Contractor's Name MC— Telephone Number
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman-'s Compensation Insurance
Check one:.
❑ I am a sole proprietor
Lki am the Homeowner'
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit;
Permit Request(check box)
❑ Re-roof(stripping old shingles) All construction debris will be taken to
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
#of doors_
Replacement Windows/doors/sliders.U-Value (maximum.44).#of windows
*Where required: Issuance_of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
'Note: . Property Owner must sign Property Owner Letter of Permission:' r
A copy of the Home Improvement Contractors License&Construction Supervisors License is ,
re wired.
SIGNATURE: / .
f
Q\WPFILESTORMS\building permit formsEXPRESS.doC r
Revised 090809
- -
-
The Commonwealth of Massachusetts
Department oflndustrialAccidents
IT). Office of Investigations
�f 600 Washington Street
Boston, MA 02111
. � wwrv.mass.gov%dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information C��,r, �^ � � y Please Print Legibly
Name (Business/Organization/lndividual):
Address:
City/State/Zip: Phone#:
Are you an employer? Check the'appropriate box: Type of project(required):
1.❑ I am a employer with 4•. ❑ I am a general contractor and I 6 ❑New construction
employees (full and/or part-time).* have hued the sub-contractors
listed on the attached sheet. 7. M lemodcling
2.El I am a sole proprietor or partner-ship and have no employees These sub-contractors have employees and have workers' 8. ❑ Demolition
working for me in any capacity. 9. ❑ Building addition
o workers' com insurance comp.insurance.
[N p• 10.❑ Electrical repairs or additions
equired.] 5. ❑ We are a corporation and its
3.L�J I am a homeowner doing all work officers'have exercised their 11.❑Phunbing repairs or additions
ri lit of exemption per MGL •
- - ---- •------�'yself,..[No -:_... ....,._-.. ..._g......-..._._..-.- p..... P.. .-....12.❑Roof.reparrs... ....... .. .. ...
c. 152, §1(4),-and we have no
insurance required.] t 13.❑ Other -
employees. [No workers'
comp.insurance required:]
*Any applicant that checks box#l must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
$Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. if the sub-contractors have employees,they must provide their workers'comp.policy number.
1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site.
information.
Insurance Company Name:
Policy #or Self-ins. Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify it er the pain a aloes ofperjury that the information provided above is true and correct.
Si nature:
Date:
Phone#: !� , /6 3 Z -
Off vial use only. Do not write in this area, to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3, City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector
6. Other
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for.their employees.'
Pursuant to this statute,an employee is defined as "...every person in the service of another under any contract of hire,
express or implied, oral or written."
An employer is defined as "an individual,partnership,association, corporation or other legal entity, or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who employs persons to do maintenance, construction or repair.work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6) also states,that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please full out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if
necessary, supply sub-contractor(s)name(s),address(es)and phone number(s) along with their certificate(s) of .
insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships (LLP)with no employees other than the
members or artners,are not re hired to c workers con ensation insurance If air L);C of LLP does have
employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit- The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly, The Department has provided a space at the bottom
of the affidavit for you to full out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to full in the permit/license number which will be used as a reference number. In addition, an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write "all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to bum leaves etc,)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Fax# 617-727-7749
Revised 4-24-07
wwtiv.mass.gov/dia
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Town of Barnstable .
Regulatory"Services
uxNsrnsiE Thomas F. Geiler,Director J
Mass.
i839• Building Division
�fD MAC is
Tom Perry,Building Commissioner 7, .
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Fax: 508-790-6230
Office: 508-862-4038
Property Owner Must
Complete and Sign This Sec n
F If Using A Builder
{ , as Owner of the subject property
hereby authorize to act on mybehalf,
in all matters relative to work aut by this building permit application f or:
(Address of Job)
Signature of er
_ - Dat
Print Name
If Pro e Owner is applying for permit please mplete e
Homeowners License Exemption Forth on th reverse sid
Q:F0F NIS:o WNERPERMISS]ON
Town of Barnstable
o Regulatory Services
Mxxszas Thomas F. Geiler,Director
Mass.
9� 1639. ,�� Building Division
PTfDy a Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION: � � J t`''
� T� 1
number street ,( .village
HOMEOWNER": CV\CX,,-\pe Agee�/j
�
name home phone 4 work phone a1
CURRENT MAILING ADDRESS:
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and
to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as
supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to
be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner, Such
"homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be
responsible for all such work performed under the building permit. (Section 109.1.1)
The undersigned "homeowner"assumes responsibility for compliance with the State Building Code and other
applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
'1
Signature of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for licensing Construction Supervisors,Section 2.15) This lack of awareness often resuhs in serious problems,particularly
e the homeowner hires unlicensed persons. In this case,our Board cannot proceed_against the unlicensed person as it would with a licensed
when
Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,
that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
several towns. You may care t amend and adopt such a fonTdcertification for use in your community.
Q AWPFILESTORM3\homeexempt.DOC
The Town of Barnstable
• s�xivsrnsc.E, •
9 � Department of Health Safety and Environmental Services
Eo n+p't" Building Division
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
SHED REGISTRATION
Location of shed(address) Village
Property owner's name Telephone number
10 f 2, C1 / 1-7
Size of Shed My p Parcel#
[Qc) fqq
Signatu a Date
Hyannis Main Street Waterfront Historic District? J0
Old King's Highway Historic District Commission jurisdiction? �C)
Conservation Commission(signature required)
THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN
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MADE the � "rd of
*' in the year of our Lord one thousand.nine hundred and
"�} x �ttt¢�sBilg. That Y. Roboll d of Sannt ;i•t• �,asis,
c �»�� 5 t a ,' 9p k� r •,
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F �y'� da hereby lease,.demise, and let-unto .Vernon A. ,Patts1�a+
" r #1u.0 Air,S'orco Zip-so Falmouth, .Hass � �or�. �oO
} F tithe property. located .:pty epaxtMeAtr on MAU $t.
.,. s .��` for use and occupancy of one family only, together with the household fnrius�ungsandegnipm
:bat no bed linen, table lunen,::or table silverware.
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•.'•S�t7�h*4 ��;��j 1w Z:,ci,,,'G 3�.°-;1J� * ,. ..i �tshk�e ��Yw«�� � ,T iw�a,e
the leases is a member of..the'armed forces of the. United States` and should be transfers d o _`
e {station,'the lessor hereby agrees:.to.,oaneel this lease This cancellation howe� oes io a 1
e sand lessee,from the payment of any rent,that may be due, or other obligations hereby�a reed
f rth period of occupancy:
'E'"k'pS
t
Z� Old from ,jwio 1 1 s : r� �f t �r �m� f
9da of one thousand nuie h�indred & d�
y
elding'and paying therefor the. rent of $61r,00 per �OAt}l�• �►d
Apia said asses do(es) promise to pay said rent as.follows �� ►bo�o tt4�'��'b
� 'S ,"�'`���� .�T�+ «�`t.A�.''�'�" }, {y'. .• .- _ x -' t?�; c i�: F' � �. -ram, ',
d to quit and deliver up the.premises to the, Lessor. 'or attorney, peaL9'"
"at�tie end of xhe term, xn..as.good order and condkon; reasonable Nuseand wear�uug?ter�eq# re d ,:
* Zther unavoidable casualties excepted, as,.the same, now are,`"or may be,put into by the said Lessor i
and to,pay the:rent.as above stated during the term,.and also'the'.rent as;above stated for`such i�rther-
M,
time.as the Lessee may hold the.same, and not make or suffer any.waste thereof;nor leasg,por�under 4 z
let,nor:permit.any other person:or persons to.occupy or improve the same, or,make or utiffero beFinade�
any alteration therein, but with.the approbation of the Lessor thereto in.writuig having firstbeeu}o �x
. tamed; and that,the Lessor _to view and';make improvem
may enter ents, and to expel the Less if
h ` ' he shall fail to pay the rent, as.aforesaid, or make or suffer any strip or waster thereof
tsr +
The Lessee ,;further agrees to pay.all charges, if any, that may be Incurred:' y Lesseew�'for fuel,� .ae,*
electricity, and telephone;.`,pay for the removal of rubbish and garbage, take carer oflawnand
f r grounds; and pay .for, or replace, any breakage or damage to property df Lessor�f;;including{chuia *
1 E and,glassware. When vacating the premises the lessee agrees to clean the;house thoroughly ,
t r T range ;the furniture in its present order, cut'any grass that needs to be:cut,.dispoae'.of rubbshRLd
i arba a and otherwise .restore. .the"property to its.present condition All personalproperty.�of �e
r�h$ <LS
of -those occupying premises"with said Lessee , ';and brought"onto said premis,Yes,shall;�i'e��`
at the sole risk,of the said Lessee
rDUi�C�.ttIgg, that`in. case the premises or any part,thereof, during said term, be destroyed
' or damaged'by fire or other unavoidable casualty; so that.the:same shah be thereby rendered pn8tor
;use:and habitation, then, and in such case, the rent hereinbefore reserved or ajnat`8nc �proportao Y
YR thereof,aeeordin to:-the-.nature=and-extentrof-the injuries-sustamed lislifie stis dad oi�al�au
-part-. � � -
until the said premises shall-have been put in proper condition for use and habitation`by-the'a Ie .
sor , or these presents shall thereby be determined .and ended at the_ eleelaon of the said Lasso`nor
her legal representatives. y
#the Lessor hereby agrees to pay a broker's comission of :( percent on} the totat rental to
from the initial'payment made b said Lessee " and to�.pay said
H® en ', Robin'
p y >,
" " =R�1�ri . 1toiSiaapn a.commission, from year to•year`on subsequent rentals'or a saleof the
, remises .described herein _to t_he.said Lessee or to persons occupying.premises with saidf�iessee .a
pr, .
11ItriE$8 �l 40rEDf, the' aid parties:hereto (IN TRIPLICATE OF LI$E TENOR) .sett'them
hands "and seals the day,and' year first above written '
* , Broker, as a party hereto
r t
' x x a sxY
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Assessors office(1st Floor): �p
Assessors map and lot number - O ! of a, yT os Tw t To
Conservation ���� W
Board of Health(3rd floor): � � _w � ;
Sewage Permit number Aj ,DI ,-
.Engineering Department(3rd floor): ENVORON EWTW,
co; r°o o�
House number -� T OWN RE
Definitive Plan Approved by Planning Board 19 �p==Xe I "
APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only
TOWN OF BARNSTABLE
BUI DING ` I PECTOR
APPLICATION FOR PERMIT TO 1 C
TYPE OF CONSTRUCTION Q
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to fotlo ing information:
Location 1 loq I H S r -L 1 U Z 4 3
R'
Proposed Use ej �d���
Zoning District Fire District 6
Name of Owner V 04 V) Address P-0 C 111 l m`1 0 Z 1ST
�
Name of Builder Address_ f
Name of Architect Address
Number of Rooms Foundation 0
Exterior V C— Roofing f kt4 /
II
Floors w Interior J
Heating ®1 I Plumbing h VCV1 J `
Fireplace Approximate Cost
AreaAr E �
Diagram of Lot and Building with Dimensions Fee
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction.
Name 7
Construction Supervisor's License
77(( AGOSTON, DR. STEVEN T.
J
No 3 418 2 8 P Permit For REPLACE DAMAGE h;. -
Sngl•e f Family Dwelling
Location '� 31Main,:Streetit
f f t
c J COtuit �. !e { f f { f ? ..s
ca
Owner Dr. IS eveii .T Agostori
Type of Construction `Frame - r:I
Plot' •Lot
Permit Granted " F bruar 19 ; 9,2
Date of'lnspect n — e�- 19 I
Date Completed 19 -
y 1 ,
ell
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TOWN OF BARNSTABLE
BUILDI
NG DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please printqq
DATE Z .10 -4Z
JOB LOCATION U V lG(.( ✓1
Number Street Address
;Section Of Town
Fi0_MEGWNER" Y . S`F�',�( �. i
Name Home Phone Work Phone
PRESENT MAILING ADDRESS - / `"
C10- asS
C)Z
City/Town � 2J
State - Zip Code
The current exemption for "h(!meowners" was extended to include owner-
occupied dwellings of six units or less and to allow such homeowners to
engage an . individual for hire who does not possess a license, provided that
the owner acts as supervisor.
DEFINITION OF HOMEOWNER: }
,fA
Persons) who owns a .parcel of land on which he/she resides or intends to
reside, on which there is,, or is intended to be, a one to six family
dwelling, attached or detached structures accessory to such use and/or farm
structures. A person who constructs more than one home in a two-year
period shall not be considered a homeowner. Such "homeowner" shall submit
to the Building Official on a form acceptable to the Building Official,
that he/she shall be responsible for all such work performed under the
building permit (Section 109. 1. 14
The undersigned "homeowner" assumes responsibility for compliance with the
State Building Code and other applicable codes, by-laws, rules and
regulations.
The undersigned "homeowner" certifies that he/she understands the Town of
Barnstable Building. Department minimum inspection procedures and
requirements �---
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Note: Three family dwellings 35,000 cubic f t, or larger, will be
required to comply with State Building Code ection 127.0, Construction
Control.
NIscS r -<,
1
HOME OWNER'S EXEMPTION
The code states that: "Any Home Owner performing work for which a building
permit is required shall be exempt from the provisions of this section
(Section 109. 1. 1 Licensing of Construction Supervisors) ; provided that if
Home Owner engages a person(s,) for hird ,to do such work, that such Home
Owner shall act as supervisor. "
Many Home Owners who use this exemption are unaware that they are assuming
the responsibilities of a supervisor (see Appendix Q, Rules and Regulations
for Licensing Construction Supervisors, Section 2. 15) . This lack of
awareness often results in serious problems, particularly when the Home
Owner hires unlicensed persons. In this case our Board cannot proceed
against the unlicensed person as it would with licensed supervisor. The
Home Owner acting as supervisor is ultimately responsible.
To ensure that the Home Owner is fully aware of his/her responsibilities,
many communities require, as part of the permit application, . that;.the Home
Owner certify that he/she understands the responsibilities of a supervisor.
On the last page of this issue is a form currently used by several towns.
You may care to amend and adopt such a form/certification for use in .your
community.
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1