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HomeMy WebLinkAbout0499 SKUNKNET ROAD �c cti {y� ear SNfi ,A {� cam'• n "./j� rtY„SPSj, ,h. aL ,.,;n ',.q `Er. - .. . k4-. l ,:?�fFi"'•( � s.�`� lP .' 'JiCu. ,�1ik 'Yi• Dui W./'r.. i' .6.- i rei ,Q ttd/� .i:'}�._ w..:�rkyo.:, =,fCY.k,,;Cy �(,y�a..a.,',tcq: � �ilAy6?;. �t ,, ..,. lr,�. Qd. �..•,•. Wp+' ai.,p.,dr .�,n �f ' .rf r,°l �t.. .µ. .'��." .�:., ..L i'r�R :pr r.d,.:.�a br" �. �.b� »i.".• r± �... . ., ✓�i�.sY� ,.c �.,, ,, .�c k,� m:�k'N, ¢i '�y o,�° �. '/�k�" ���&'�li�u�� ;,�"" rU qyq r� .."+- _ /... /.4], ,:' �_. t'h;9! �I ...Y_i Y{i.r� _.. ..4��' =..n,.•".Et•w, � • � f 1 _ ,• k I,a t Y� Y 1 Su A 4:V iW _ 4 C ,Y T n a V r Y 99 e , , 4M� 5 �44ps'�� c��r� 1 )c:tl I 1_ ?0 �00HE7 Town of Barnstable *Permit# o rf s 6 nro h wrr issue d le Regulatory Services C ' v Tliomas F. Geiler,Director1639. MIT / 009 Building Division ( �� Tom Perry, CBO, Building Commissioner OF BARNSTABLE 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 ivithont Red,'-Press Imprint Map/parcel Number I�� Property Address ti'ICt q 0o\2, 0 ❑'Residential Value of Work 6 6 Minimum fee of$25.00 for work under$6000.00 Owner's Name &Address . Contractor's Name �� {'l�- �( L✓ 1. Telephone Number Home Improvement Contractor License#(if applicable) E Construction Supervisor's License#(if applicable) q to DIVorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner [�I have Worker's Compensation Insurance Insurance Company Name d VY\ NA Q Workman's Comp.Policy# 6 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Be-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 *Wliere required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. **.*Note: Property Owner must sign Proper Owner Letter of Permission. A copy of t Home ipro e nt.Contractors License & Construction Supervisors License is . Mred,iSIGNATURE: Q:\WPFILESTORMS\building permit forms\EXPRESS.doC • Revised 090809 f - The Commonwealth ofMassachusetis Department of Industrial Accidents Office ofInvestigations I' 600 TYashington Street Boston, ]VA. 02111 fvww,mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): Address: z° \ City/State/Zip: Ce A Mpr Phone #: y m 63r12 t 0 Are you an employer? Check the appropriate box: Type of project(required): 1.H-1 am a employer with 3 4. I am a general contractor and I employees (full and/or part-time), * have hired the sub-contractors b. New construction listed on the attached sheet. 7. ❑ Remodeling 2.❑ I am a sole proprietor or partner- ship'and have no employees These sub-contractors have g, � Demolition .workingfor me in an capacity, employees and have workers' Y P Y• 9. ❑ Building addition [No workers' comp. insurance comp. insurance.1 required.] 5. We are a corporation and its 10.❑ Electrical repairs or addition 3.❑ I am a homeowner doing all work officers have exercised their 1 1,[] Plumbing repairs or addition myself. [No workers' comp. right of exemption per MGL 12.[-�'Roof repairs insurance required.] 1 c. 152, §1(4), and we have no employees. [No workers' 13.0 Other comp, insurance required.] *Any applicant that checks box fl1 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. ff the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. -Below is the policy and job site information. Insurance Company Name: (V\ Policy# or Self-ins. Lic.#: S 6 I;3-© Expiration Date: Job Site Address:_�� xS V_,�v11 n���� �� 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 fin 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 nit er the airs an pe It' ofperjury that the information provided above is trite and correct. \ I Signature: Date: 1 Phone#: Official Ilse only. Do not fvrlte 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 Contact Person*: Phone#: 1 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 ajoint 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 conunonwealth 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 fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary,supply sub-contractors) 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 partners, are not required to carry workers' compensation insurance. If an LLC or 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 pen-nit 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 fill out in the event the Office of Investigations has to contact you regarding the applicant. - Please be sure to fill in the permiUlicense number which will be used as a.reference number. In addition an applicant that must submit multiple permiUlicense 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 may be provided to the applicant as proof that a valid affidavit is on file for fiiture permits or licenses. Anew 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 burn 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 www.inass.gov/dia ✓76V/00J7/I17.407.11JP °./.✓l�Gll.QJAClL000P. b'� - - .. --•� Board of Building Regulations.and Standai Ids License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration 126480 Board of Building Regulations and Standards EMirafion 6Fg/2010 Tr# 267766 One Ashburton Place Rm 1301 lvi T }e Individual Boston,Ma.02108 �t xYP MARK HERBST '•c� +i MARK HERBST �t f ; ; 35 PEEP TOAD RD` i CENTERVILLE,MA 02632" Admmstrator Not valid without signature ; 1 I onstrUCti". $�-u�► Piarwsor License = . 7; License! .N� $ 48546k " 1~u /27/2010 Tr#. 14362 (� MAR , ' $r i I ER K D HBS j' t 35 P4.-+ TOgp Rp r CENTERVILLE, '-off Co -- mmissioner �e i u ecru i i uvo-rc r s.--; 777 ` n �►\ MARK H'ERBST _ 35 PEEP TOAD ROAD CENTERVILLE MA'- 508.420.621617744 38-2938 � www.morkhdst.com PROPOSAL SUBMITTED TO: WORK PERFORMED AT Y Cape AbIlNes 895 Mary Dunn Rid 499 Skunlo*Road' HWnls MA CertteMlle MA Att Ray Parma We herby propose to furnish the materials and perform the labor neowmry for the completion of: NewRwt Remove f/over of exrstlna shimtes instant B"'dnD aloe �� / instant raa&wets►.shield at®day instal l51b feltoecer inataA°L'attefnTeed 3Qvr.Arch tal ahlrrale Mort __ inaliff ILi+. ls.YRlt A-M6—AbIna boots Ct�idce d+ir�sfell cCb►a shrm shlrtoias`` CIL Price"lmudes mnt .�bor b damn Eyes All material is guaranteed to be as spa Med. The above work wits be performed in accordance with the epecHlsations submllbd and completed in a substantial workmanlike manner for the sum of:Six-Thousand Six-Hundmd d My Dol ,6W.")v.4th payments:arfoliows: tug amount due upon comphow °Any iterations from above prop si,invdlVIng extra costs will be added under a separate written agreement and become an extra charge over and above said.proposal. RESPECTFUL US 11t2�l09 Mark Herbst ACCEPTANCE OF PROPOSAL The above price,specifications and�oc,ditions are satisfactory.I herby accept this proposal. You are authadzsd to do the work ant payments will be as a ab6vs. SIGNATURE: "This proposal may be withdrawn by said company if not accepted within 3o days. --------------------------- ---- ,�i/ear �����1 NOTICE EarN®TICS TO TO EMPLOYEES EMPLOYEES The Commonwealth of Massachusetts DEPARTMEN T �® EENDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I(we)have provided for payment to our injured employees under the above mentioned chapter by insuring with: ASSOCIATED INDUSTRIES OF MASSACHUSE17S MUTUAL INSURANCE COMPANY NAME OF INSURANCE COMPANY 54 THIRD AVENUE, P.O. BOX 4070, BURLINGTON, MA 01803-0970 ADDRESS OF INSURANCE COMPANY AWC 7016215012009 01/10/2009 - 01/10/2010 POLICY NUMBER . EFFECTIVE DATES P O Box 494 Leonard Insurance Agency Inc Osterville, MA 02655 (508)428-6921 NAME OF INSURANCE AGENT ADDRESS PHONE Mark Herbst 35 Peep Toad Road Centerville, MA 02632 EMPLOYER ADDRESS 12/23/2008 EMPJ,OYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDICAL TREATMENT The abovp,lamed insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the Fast Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer,if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention,employees are hereby notified that the insurer has arranged for such attention at the NEAREST AND $E$T MEDICAL. FACILITY NAME OF HOSPITAL ADDRESS ',t-O BE POSTED BY EMPLOYER _ , Property Location: 499 SKUNKNET RD MAP ID: 169/109/ Vision ID.- 11197 Other ID: Bldg#: 1 Card 1 of 1 Print Date:02/08/2001 NO 4-, Description C ode Appraised Value Assessed Value DWYER I)AiNihu A %DWYER,DANIEL A&DEBRA A RES LAND 1010 --------33-,900 33,80 801 499 SKUNKNET RD RESIDNTL 1010 80,100 80,100 CENTERVILLE,MA 02632 Barnstable 2000,MA Accou Tax Dist. 300 Land Ct# Per.Prop. #SR Life Estate #DL I LOT 18 Notes: VISION #DL 2 GIS ID IT �MM',L1P,'0A1T,' y1i SA1WFVU(*,,P, 191 JIM "'w",9 wX I 88'"llo 00 Yr. Code lissessed value 1r. C;oae Assesse a e r. 0 Assessed value DWYEK,DAMELA v DOANE,KATHLEEN A 96PI379EP1 12/24/1996 U 1 1 1A T9" ON 33,8001998 Will 33,8 WALKER,DONNA D-M-792 10718/131 0 1999 1010 56,6001998 1010 56,600 WALKER,DONNA D 3380/ 33 Q 0 10a .90,40U.—7-oTar- 90,4N o a.: Mai�Pw "" J110"Iff qlyb acT now lages a visit by aData Collecto ear lypelDescription Amount Code Description Number Amount Comm.Int. LAMY Appraised Bldg.Value(Card) 77,500 Appraised XF(B)Value(Bldg) 2,600 Appraised OB(L)Value(Bldg) 0 7-0TaT- Appraised Land Value(Bldg) 33,800 AL W— 4� Special Land Value Total Appraised Card Value 113,900 Total Appraised Parcel Value 113,900 Valuation Method: Cost/Market Valuation et Total Appraised Parcel Value 113,900 X-HUWWWA emVt 1, IM Issue Date lype Description Amount Insp.Date Comp. Date Co'mp. Comments Date- TD Ud. urposelResult rlr799F-- ----TO79797— AD New Addition JU J,y B# Use Code Description one D Trontage ept n is Unit Price Pactor actor Notes-Adil5pectal Pricing A dj. Unit rice an value I 1U1U Single tam oes:IUIBLDG- 67,5UU.UU 33,800 -OTULa—nd Value I otal Cara L U.511��arce TotatLandArea Property Location: 499 SKUNKNET RD MAP ID: 169/109/ Vision ID:11197 Other ID: Bldg#: 1 Card 1 of 1 Print Date: 02/08/2001 n ement Gd. ICh. Description CommeretatDard Elements Style/ ype ape Cod Element Ud. Ch. Description Model 1 Residential Heat Grade C C Frame Type BAS BAS Stories 1.5 1 1/2 Stories Baths/Plumbing BMT Occupancy 0Ceiling/Wall ooms/Prtns Exterior Wall 1 14 Wood Shingle /o Common Wall 2 Wall Height Roof Structure 3 able/Hip 24 24 2 Roof Cover 3 sph/F GIs/Cmp UMP- Interior Wall 1 8 Typical ,. i•r, .... :: .mac':. 2 Element Code Description actor Interior Floor 1 10 Typical omp ex 2 Floor Adj 24 18 24 Unit Location eating Fuel 2 Oil Heating Type 09 Typical Number of Units C Type 01 None Number of Levels /o Ownership Bedrooms 02 2 Bedrooms athrooms 1.5 1 1/2 Bathrms C,0SI � p 11 1 Full+1H unadj.Elase Kate 45.UU Total Rooms Rooms Size Adj.Factor 1.03292 Grade(Q)Index 0.98 ath Type Adj.Base Rate 48.59 Kitchen Style Bldg.Value New 94,459 Year Built 1979 ff.Year Built 1979 rml Physcl Dep 18 uncnl Obslnc con Obslnc rH , pecl.Condo Code escrt t:on ercenta a peel Cond/o Code mg a am verall /o Cond. 2 eprec.Bldg Value 77,500 Code Description LIV Units Unit Price Yr. Lp Rt NoUnd Apr. Value - IM irep- Code Description LivingArea CirossArea Eff Area Unit cost \n•eprec. value First oor48,979 BMT Basement Area 0 576 115 9.70 5,588 FAT Attic,Finished 216 432 216 24.30 10,495 FHS Half Story,Finished 403 576 403 34.00 19,582 GAR Attached Garage 0 576 202 17.04 9,815 t. ross LivlLease Area 1,627j , g Val: 94,4 L.�r � _(�' n,Nt d a f 1 , {" E�" ...� £}^v'S•e �"Y�� �• ^ 3 n , , 22-;ab Cr 04-25-2 QU!TCLAIM DEED 1,KATI',LF,!_N A.DOANE,of 3 Stuart Road,Gloucester,Essex Cowity,?~Massachusetts of 93ii, r 1: n as I:xccutrix under d+c Will of Donna Doane Walker,Barnstable Probate Number 96'1379;iti.by = r the power confened by license to sell dated April 17, 1997 and every other power, r' y for considermion of EIGHTY-EIGHT THOUSAND AND 00/100 QS8 00P.OQj DOLL.AILS fmid,': r� grant to 't DANIEL A.DWYER and DEBRA A.DWYF R.hushand ar:d wife as tenants by the entirety•,both a ot499•Skunkrtet Road,Banutable(G°rnteml!e),Beimstublr County,A9assachusctu 02GOI _.d the land,together with the buildings therwri,situated in Barnstable-(Centimi Je)4.Batnstable'„ourt w Massachusetts,more pa n;cularly bounded and described as follows t Being shown as LOT IS on plan of land entitled"Subdivision flan of Lard in Centerville, t for JKS Trust Scale I"=66'March 3, 19?9 George Low&Co.,2 Turner Lane,South 1'emtouth ' Mass.Dieing a Subdivision of Land as recorded in the Registry of Deeds,Plan Boob:324,f age'7s:l"_ � Said lot is conveyed subject to an easement sixty(60)feet in width in favor of the New Edgl nd Telephone and Telegraph Co.crossing the southerly portion of'the premises and shown on said pl-in rerori.'ed in Plan Book 324,Page 73. ?� 1 r S:u+l htt is coin cy•cd tor•rth r+a't �` a ,. c with tt.c right and eaumcnt to use,to common•.,ith Vi'lal c find!} 1•ttta will,other:+to bite to time entitled thereto;all of th:-streets and Hays>hu++n rrc•t riled rt iternstnt tc County Registry of Deeds in..Mn 13ook 318.Page 15 F iful hoot. 4 a t,.gr.t4 t r.tfc..rt 9*,:,age 32,)Tern Book 3"t4 1 a6 e 73 and flan li,oA 324, r,+,c 7?ft,r[:;! 1 ! � � � 2 putpuses ton�Iucli...cc IS n.x i rti:ma"nn+'or in the lutarr be ecstom nth t..c in tha'G�.t;{cf l" t . lternstab;e, t.clr.durg I rit'ttt to:nstail,nutitr.ain and replace utilities arid cr.tltr ser+icc,. This co,^,vc}mtcc is t;:is t n;tth;r with Id!nil hu,rcacna:ions.revric;iuns and ca,cint-its of rccurd y w Ysx�� insofar as the M.rtt,may nowbe in force and apphcabie,and to utility cu:ap :y cati r,tc.0 of record. �? For title,sec Deed recorded with the Bat•r}stable County Registry of f)ceds in Book 3399,I'aSc 033L See also,Barnstable County Probate No.96111379EP1. WITNESS my hand and seal this 2T9S day of April,1997. FA!IiLI-E'NA.DOANE,I?xecutrix r MOE �yS n��`` .�w,���`v�:, nE�, .•.sya .... q_... 2R^�. .e t'�t ,yF s rlfn'iF R k7s , s rh ,"'` tY; x} •'l>t'3".^ue�f�,x�t1 k��„,, ` `s� al ✓ i Y"h N 5 4 i 1•am 3.et •. t r' R,)g_ t y 'F!c{f $ Ag Mt+'"'". '1"t Px� t �•f f , "�'y{.d..4 F.YS'". S.A L e'T M 6.Nk72. ? F ih^ 'Y + : s c s v. l Y.*E9�v 3,,y �. �.�L" J A• .S:zr .!G Y ' Fy5�..iQ'Ct2"t.�`xS' 'r .r€Y(",tq' +,. ;Y> .t• rtY 'II" x t. ,a �""" kYrk � too.'%` m' I .M;,•r 1Y+.vwjiY'p,,.e,a��.Fd r y°_, Sj h.: ��� ,+Z'�S 'E�.c '�' », / 7 �` .t5': t W i:; •✓. 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O �.�.� MAP 169 PARCEL 109 .'� DWYER D. 99 Skunknet 'III 1 ! topography,and NOTE: :parcel linesare only graphic representations ( IPlanimetrics• interpreted" from 1995 aerial photographs Vegetation%we 1 11'11 National 1 property boundaries. 1 1 locations, W.SewallI ICompany. Topography andvegetationinterpretedfrom 'aerial photographs 1 GEOD Map Accuracy 1 11 I at IscaleI 11 1'representactual relationships 1 physical objectsCorporation. ' 1 1 I11 11 andvegetation mapped 1 ^ National 11 Accuracy I I scale of 1 I I Parcel :Ifrom111 I Barnstable'\ s I • • •• 1• •• 1 11 1 1 ' 'own of Barnstable Assessors Division Page 1 of 3 8 e§ `�t a'Arr' j / e S t Your Location : Home : Town Departments : Administrative Services : Assessors Division Property Results «Back-Forward>> Thursday,April 11, 2002 Assessors Division- Property Results Data is based on Fiscal Year 2002 Assessor's database and is provided for informat purposes only. 499 SKUNKNET ROAD Map/Parcel/Parcel Extension: Mailing Address: 169/109/ DWYER, DANIEL A Owner of Record: %DWYER, DANIEL A& DEBRA A DWYER, DANIEL A 499 SKUNKNET RD Property Location: CENTERVILLE, MA 02632 499 SKUNKNET ROAD Parcel ID: 169109 l�t#IrMap' Fiscal Year 2002 Assessed Values Appraised Value Assessed Value Building Value: $ 102,700 $ 102,700 Extra Features: $2,600 $2,600 Outbuildings: $0 $0 Land Value: $48,800 $48,800 Totals: $ 154,100 $ 154,100 Sales History Owner: Sale Date: Book/Page: Sale Price: DWYER, DANIEL A 4/25/1997 10718/ 132 $ 88,000 DOANE, KATHLEEN A 12/24/1996 96P1379EP1 $ 1 WALKER, DONNA D 3380/33 $ 0 WALKER, DONNA D *M-792 10718/ 131 $ 0 Land and Building Description Land Building Lot Size (Acres): 0.5 Year Built: 1979 Appraised Value:$48,800 Living Area: 1627 Assessed Value: $48,800 Replacement Cost: $ 118,079 Depreciation: 13 Building Value: $ 102,700 http://www.town.barnstable.ma.us/comeonin/Departments/Administrative_Services/Financ... 4/11/2002 Town of Barnstable Assessors Division Page 2 of 3 Construction Details Style: Cape Cod Interior Walls: Drywall Model: Residential Interior Floors: Carpet Grade: Average Grade Heat Fuel: Oil Stories: 1 1/2 Stories Heat Type: Hot Water Exterior Walls Wood Shingle AC Type: None Roof Structure: Gable/Hip Bedrooms: 2 Bedrooms Roof Cover: Asph/F GIs/Cmp Bathrooms: 1 1/2 Bathrms Total Rooms: 4 Rooms Outbuildings & Extra Features Code Description Units/SQ FT Appraised Value Assessed Value FPL2 Fireplace. 1 $2,600 $2,600 Building Sketch P / , 3 3 Mala. Sketch Legend BAS First Floor, Living Area FST Utility Area (Finished Interior) UAT Attic Area (Unfinished) BMT Basement Area (Unfinished) FTS Third Story Living Area (Finished) UHS Half Story(Unfinished) CAN Canopy FUS, Second Story Living Area (Finished) UST Utility Area (Unfinished) FAT Attic Area (Finished) GAR Garage UTQ Three Quarters Story (Uni FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story (Unfi FHS Half Story (Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story (Finished) i http://www.town.barnstable.ma.us/comeonin/Departments/Administrative_Services/Financ,... 4/11/2002 Tbwn of Barnstable Assessors Division Page 3 of 3 " Back- s Home I Departments Town Information Contact Town Hall Website Developed and Maintained internally.by the Town of Barnstable Information Systems Department Town Hall-367 Main Street- Hyannis,MA-02601 -508-862-4000 DISCLAIMER: Although we strive to provide accurate information,we are only human. Please consult directly with the appropriate department if there is a question of accuracy. Copyright 20010 Town of Barnstable. All Rights Reserved. http://www.town.barnstable.ma.us/comeonin/Departments/Administrative_Services/Financa... 4/11/2002 °FINE A Town of Barnstable Regulatory Services v Muss. g Thomas F.Geiler,Director Building Division Peter F.DiMatteo Building Commissioner 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 M4yenO,2002 Daniel and Debra Dwyer 499 Skunknet Rd. Centerville,MA 02632 RE: Illegal Apartment Map: 169 Parcel: 102 Dear Mr.and Mrs. Dwyer: A review of our records,including the permitting history of 499 Skunknet Rd.,Centerville, as well as Zoning Board of Appeals records indicate that the use of that address as anything other that a single family home is illegal. You are hereby ordered to discontinue the use of the above referenced property as it is now being used and restore it to a single-family home. You are to accomplish this work and notify this office to inspect within fourteen(14)days or receipt of this letter. A building permit must be applied for to residing the layout to accommodate the conversion. You must do this before you make any changes. You have the right to appeal this decision. If you so choose,we will be more that happy to help you. If we do not hear from you within the 14 days,we will be forced to seek criminal action against you. Very truly yours, Gloria M.Urenas Zoning Enforcement Officer GNU/ 0.�y`. Q:zoning5 . f TME Tpk� Town of Barnstable Regulatory Services 9snFwMASS. + Thomas F.Geiler,Director rF1639a. Building Division Peter F.DiMatteo Building Commissioner 367 Main Street,Hyannis,MA 026.01 Office: 508-862-4038 Fax: 508-790-6230 ch 20,2002 Daniel and Debra Dwyer 499 Skunknet Rd. Centerville,MA 02632 RE:Illegal Apartment Map: 169 Parcel: 102 Dear Mr. and Mrs.Dw yer: wyer: A review of our records,including the permitting history of 499 Skunknet Rd.,Centerville, as well as Zoning Board of Appeals records indicate that the use of that address as anything other that a single family home is illegal. You are hereby ordered to discontinue the use of the above referenced property as it is now being used and restore it to a single-family home. You are to accomplish this work and notify this office to inspect within fourteen(14)days or receipt of this letter. A building permit must be applied for to residing the layout to accommodate the conversion. You must do this before you make any changes. You have the right to appeal this decision. If you so choose,we will be more that happy to help you. If we do not hear from you within the 14 days,we will be forced to seek criminal action against you. Very truly yours, Gloria M.Urenas Zoning Enforcement Officer GMU/ Q:zoning5 i �n ineerin~ De t 3rd"flo Ma g g ( p l Parcel F c,��I � Permit# �1(0 a./,� (�[ House# q q I �CJS� Date Issued o a % ^ `J Bard of Health•(3rd floor)(8:15 - 9:30/1:00-4:30 GF ee. 0 Conservation Office(4th floor)(8:30-9:30/1:00_-2:00) ol U,WIML Ae l4 SEPTIC SYS?'��1 E M. g' TA1 E 19 a EN1►IRQ �'Pa STANX. D TOWN OF BARNSTABL"N REGui_ Building Permit Application �Project Street Address �� �() 1�L2 f /� / LOT .-o eru; ll� Village a - Owner Da VI (ej + QJ5,KA Dwybc Address !. -,Telephone }' f ,_Permit Request OY1 j- 3 � ivv1 y Gib �� t—C,t� Q ba V Q-, xzok. t. C�,►n d G�; P,�`fZ'.L C�r �t a LL c6� vQ. ' First Floor 3 2-q r '� , square feet Second Floor 3 02 G- ,'� square feet Construction Type stimated Project Cost $ �60 Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes I(No On Old King's Highway ❑Yes ul�o Basement Type: dFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) �- Number of Baths: Full: Existing New Half: Existing �_ New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New o� First Floor Room Count Heat Type and Fuel: ❑Gas U/Oil ❑Electric ❑Other Central Air ❑Yes &f/No Fireplaces: Existing INew Existing wood/coal stove ❑Yes 2<0 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes R(No If yes, site plan review# Current Use Proposed Use Builder Information p Name e f,,_ Telephone Number Address C License# {/ Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO I SIGNATURE ADATE b 7 44� V, V - N. BUILDING PERMIT DENIED FOR HE FOLLOWING REASON(S) /� � _ • FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED:. MAP/PARCEL NO ' • ' - x r 4."ADDRESS VILLAGE, -_ , OWNER DATE OF•INSPECTION: FOUNDATION d FRAME F INSULATION FIREPLACE 1 ... fn ` ELECTRICAL: .c U FINAL PLUMBING:k U( A FINAL t GAS: Ix + FINAL, - FINAL.BUILDI f•�P 'DATE CLOSED GA rs S + ASSOCIATION PLAN NO. ' t • Environments,! Protection WUUam F.Wold croftmw Trudy Coxe Argoo Paul Celluccl 80--/' u.Govemw arld B. stun, C4mm".Orwr SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION PropertyAddresat 499 .Skunknett Road Centerville ,MA Katie Doane Date of t) 3 Stuart Road In.peatl 2/2 2/9 7 Addreaa of Owner.Name Name of Inspector. Joseph P.Macomber Jr. Qf differenGloucster,Mass . Company Name,Address,and Telephone Number e . 0 o 93 J . P.Macomgb�er & Son Inc . Bc�t�tl�c�'AQ sTA vi1.1e ,Mass . 02632 508-775-3338 I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is trine, accurate and complete as of the time of inspection. The inspection was performed based oa my training and ex maintenance of on aits"wagedisposal perience in the proper function and poaal systems. The system: ZPasses _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Slgnature: Date: pK,- 'j/- The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the "Port to the appropriate regional office of the Department of Environmental Protection. Th•original should be sent to the system owner,and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY: Check A.B, C, or D: Al_SY3_TEM_PASSES:_ have eat found any information which indicates that the system violates an of the failure Y criteria as defined in 310 CMR 15.303. . Any failure criteria not evaluated are indicated below. B) SYSTEM CONDITIONALLY PASSES: V d or more system components need to be replaced or rape it ed The spsrxm upon completion of the replacement or repair, paaaes pectian. Iadirste Yes,`1no, or not determined(Y, N, or ND). Describe basis of determination in all instances. If-not determined., explain why not) .&y Ths septic tank is metal, cracked; structurally unsound, shows substantial infiltration or enfiltration,.or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a ponforming septic tank as approved by the Board of Health. (revised 11/03/915) 1 -Ono Wlnt•r Street • Boston,Massachusetts 02108 • FAX(617) 556-1049 • Telephone(617)282-550p i Printed on.Ragckd Paper - ti '..A '7' S -"'a t ;d'"4m, C.K G..1_ ,kdS�, -.{rc J i �f �S n t ➢ M L r s��' -1� ��.., �....�u r..�� ...r �* i -..� •�.�'.ys�^ .z<,nc �,9`.'��....� F.. i may... -.� °'�"`- *d'��,'��w,a�.- .i. '' � ., -E,.. .-'_ ss�a� ;ram. �--. �-fit=_ _ =����'�J•� � .a.�� _:'��-a��.-.....w_ -_�•. „ .r.t-. sue.-�^=..,.t z-�x�;, ._ �� :,..--. s. "�` ���'- 'ocat'e all wells`_.within 100 ' Centerville Osterville Marstons Mills Water Company 428-6691 4Q 9 7 . 'yogi ��. I DEPTH TO GROUNDWATER 16 , depth to groundwater r+pth.od of determin ion or �approximaticz o w No ts.r encountered . h 1 sy-s�,em, was installed .V QUERY PERMITS : QUERY END QUERY PERMITS ` f PENTAMATION----------------------------------------------------------- 08/29/00 PERMIT NUMBER 26215 PARCEL ID 169 "109 499 SKUNKNET ROAD PERMIT TYPE BREMOD RESIDENTIAL ALT/CONV DESCRIPTION ADD FAM RM/2ND FLR BDRM SEW. PT#CARD ON FILE CONTRACTOR PERMIT FEE 181 . 54 VARIANCE STATUS C COMPLETED CONSTRUCTION TYPE 434 GROUP TYPE 1 APPLICATION 10/19/1991 EXPIRATION VALUATION 58560. 00 DATE ISSUED 10/09/1997 COMPLETED 05/26/1998 DEPARTMENT-----STATUS---DATE-----DEPARTMENT-----STATUS---DATE---- (N) EXT/ (P) REVIOUS/ (C) ONTRACTORS/ PR(0) PERTY/ (I)NSPECTIONS/ (H) ISTORY/ (F) EES/ (A) RCHITECTS/ (V) IOLATION/ (E)XIT e QUERY PERMITS: QUERY END QUERY PERMITS ' PENTAMATION----------------------------------------------------------- 08/29/00 PERMIT NUMBER 28668 PARCEL ID 169 '109 499 SKUNKNET ROAD PERMIT TYPE BPLUM PLUMBING PERMIT DESCRIPTION REMODEL 2CND FLOOR BATH 4 FIX CONTRACTOR PERMIT FEE 50 . 00 • VARIANCE STATUS C COMPLETED ' CONSTRUCTION TYPE 753 GROUP TYPE APPLICATION 02/03/1998 EXPIRATION VALUATION 0. 00 DATE ISSUED 02/03/1998 COMPLETED 04/27/1998 DEPARTMENT-----STATUS---DATE-----DEPARTMENT------STATUS---DATE---- (N)EXT/ (P) REVIOUS/ (C) ONTRACTORS/ PR(0) PERTY/ (I)NSPECTIONS/ (H) ISTORY/ (F) EES/ (A) RCHITECTS/ (V) IOLATION/ (E)XIT NO MORE RECORDS IN THIS DIRECTION 4 a r . _ QUERY PERMITS : QUERY END QUERY PERMITS PENTAMATION----------------------------------------------------------- 08/29/00 PERMIT NUMBER 28297 PARCEL ID 169 109 499 SKUNKNET ROAD PERMIT TYPE BELEC WIRING PERMIT DESCRIPTION WIRE 2 LEVEL ADDITION/SUB PANEL/SMOKE DET. CONTRACTOR PERMIT FEE 30. 00 VARIANCE STATUS C COMPLETED CONSTRUCTION TYPE 753 GROUP TYPE APPLICATION O1/13/1998 EXPIRATION VALUATION 0 . 00 DATE ISSUED O1/13/1998 COMPLETED 04/06/1998 DEPARTMENT-----STATUS---.DATE-----DEPARTMENT-----STATUS---DATE---- (N) EXT/ (P) REVIOUS/ (C) ONTRACTORS/ PR(0) PERTY/ (I)NSPECTIONS/ (H) ISTORY/ (F)EES/ (A) RCHITECTS/ (V) IOLATION/ (E)XIT 4 Building Deparl3nent Complaint/Inquiry Report Date: 2 Rec'd b,.--4 ODL Assessor's No.: 6 / Complaint Name: Location � -��i1�/UT der•('- Address: -` Originator Name: Vt�y�l/I,�eyJ S Street: village: ware: Zip:—.— ephone:D/C Complaint /(rlG( � o/Z LrV— t_ i1_ Description Inquiry 0 � t�-�.� Description: Lf-1-4 '� For Office Use Only Inspector's Action/Comments -Date: - Inspector.. 00 Follow-up L� OY�O k1 a"YL� 00 iB o w . Action 0 6'�+r1Gv'h� d't iL , a Additional Info.Attached Copy M=butron: White-Depw=cvt File Yelloiv-Inspector pink-Inspector(Return to OlTce 3fanager) ..µYE ,:�.�'�^•:......r�i r•�3.iSy,�J+-.f�.�l-.K*nLW`�.;wii�r^,�b-^�s'+.�41�..eT�'Y:'..,�R.� 'cal,frY..,.. ryy+trLL�',�;xt"�r�4�.i�".w`;.i»3F't�;/r...r,.,r'..�..i-v4`-y,rP�iT/f.-+.X�w.�..+w^ `oFt r The Town of Barnstable BARNSTABLE.D Department of Health Safety and Environmental Services MASS. 0 �Fo Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner t Inspection Correction Notice Type of Inspection Location Lq Q—�uiq Permit Number f0 -.- y Owner Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: (S f 7 ko (D cj� Please call: 508-790-6227 for re-inspection. Inspected by L�c -�-Y- Date r l U p v , '.za Ye bp•D .ate � . _ r ........................:f Z-Cr 2��1 6.3 OCA OF 1 GEORuc' GY's J. pp-p74 Vj D� DlD w � uaNio�s . �•' ��U No. 22723 su':� :. . �, .asp, . • � ��� Tip%.Y 1074 hl ;>li:� %ok✓.j �cl�^l7S ar•' �� '•�`.,23'• _. F1,U,D. Cammwr� �An.el '"2Saool�oo�D�i 1. .L.ANJ /wC,� NTc�VI ' L..`'. IVA. R L ors 18 • � 1? � , _. . OWNS a fd7 :7 r r, t c� Deec(S •"� r I3 S G Fb, . LAIti!l D 'v:: a 2 SrE A /!/1/I n/M n n A 4 - rz- 10 i � L7 � :c � iC �t IL I i WALL i . �• ,; 8�c1�rt�� �La�� S� Tl�tcl� F,6r,A16 S The' own of Barnstable w Thc• Cuntntottwealth ofMassachusett_v -_: Department of 111di strial Accnlenls t ,1 �. rA OficeolinyesMations 6(1(l lVdAinrtrn Street w`.i•'+ '. Briton, fa.Y.v. 02111 Workers' Compensation Insurance Affidavit li ant information• -- Please PRINTaeb' name: //Q loeition `% ( C17 k41L 61N. ahone 0 9L I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity [I I am an emplover providing workers' compensation for my employees working on this job. cmm�an.• name: address „•phnne#• �— insurance cn l�zt —= nolic�• I am a sole proprietor" general contractor, o homeowner irc1c ate) and have hired the contractors listed below who have the following workers' compensation polices: comnany name: �C✓ 1 l>(/ jYIQ�(� 7 address: (D/ C?.�r,� � cit.". phone#• 4 2- insiirinccrn. ��C.yL-� I Q1 S. WC— cam gin. name: l 000C 'sCGLef address: C-? ` e .1hnr,e#: insurance c 5 oiic•$$ -5 000�20402 .Attach additional sheet if necessary; ;:. •-__. _ ,; :.. - _.•.. _ "';.: "-'""•::..: , _,'w.:Z'►"--" _• Failure to secure cos teat a:ts require)under Section:SA of AIGL 152 can lead to the imposition of criminal penalties of a Iine up to SI.500.00 andior une.cars' imprisonment as w0l as civil penalties in the form of a STOP NVORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement mac be forwarded to the Offtcc of Investigations of the DIA for coverage verification. 1 tlo herehv certljr ndrr t/te pttitts a penafies of perjure•that the information provided above is true and correct. Signature Date e�" Print name (�����`7 �Lit � Phone# ofiicini use uniy do not write in this area to be compacted by tiny or town official y city or town: permit/license# riBuilding Department C3Liccnsing Guard 0 check if immediate response is required c3Scicetmen•s Office ►.. 011c2lth Department contact person: phone#: nUthcr Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for tile: employees. As quoted from the "1a�� an cmpinree is defined as every person in the service of another under anv contract of hire, express or implied.,oral or written. An einplorer is defined as an individual, partnership, association. corporation or other legal entity. or anv two or more the foregoing, en-aged in a joint e,terprise, 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. Howe%'er 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, Ito,. or on the `,rouiids,or building appurtenant thereto shall not because of such employment be deemed to be an employer MGL chapter 152 section 25 also states that even-state or local licensing agency shall withhold the issuance o►- renewal of license or permit to operate a business or to construct buildings in the commonwealth for am• applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, 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 i, been presented to the contracting authority. ,applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying, company names. address and phone numbers as all affidavits 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 requires to obtain a workers* compensation policy. please call the Department at the number listed below. City oC Downs Please be sure Pl,za :he affidavit is complete and printed legibly. The Department has provided a space at the bottom 0.: the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Lyle: be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questior please do not hesitate to `,ive us a CZ11. Tile Department's address. telephone and fax number: The Commonwealth Of Massachusetts •S.y Department of Industrial Accidents Office of investigations 600 Washington Street Boston,Ma. 02111 fax #: (617) 727-7749 phone 9: (617) 727-4900 ext. 406, 409 or 375 THE t _ The Town of Barnstable ���' Department of Health Safety and Environmental Services foa+o�t' Building Division 367 Main Street,Hyannis MA 02601 office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissior. For office use only Permit no. Date AFFIDAVIT ' HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with , certain.exceptions,along with other requirements. . ` r Type of Work: ', Est.Cost Address of Work• Owner's Name �— Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s):, Work excluded by law Job under S1,000. Building not owner-occupied f Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME MOROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL G 142A SIGNED UNDER PENALTIES OF PERJURY I here ply fo, a permit as the age, of t owner: Dati Contractor Name Registration No. OR I • TOWN OF BARNS-TABLE • BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION -------------- - ----------------------- - Please print., DATE 7. JOB LOCATION Number Street address Section of town "HOMEOWNER" 1 l',b/L6� , �✓� O�0 'S O b - -•O Name Home phone mark phone . PRESENT MAILING ADDRESS City town State Zip code The current exemption for "homeowners" was extended to include owner-06=13i.E dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire, who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person (sj who owns a parcel of land on which he/she resides or intends to re side, 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 Offic. on a form acceptable to the Building Official, that he/she shall be responsi:. for all such work performed under the buildinca permit. (Section 109.1. 1) The undersigned "homeowner" assumes . responsibility for compliance wit' the S: (Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of arnstable Building Department minimum inspection procedures and requirements nd that he/she will comp )ith sa 'd procedures and requirements. OMEOWNER'S SIGNATURE IkPPROVAL OF BUILDING OFFICIAL Tote: Three family dwellings . 35 , 000 cubic feet, or larger, will be required :o comply with State Building Code Section 127. 0, Construction Control. HOME OWNER`S EXEMPTION The. code state 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 persons) for hire to do such work, that such Home OwnE 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 awarene often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it wc3u.ld with licex sed Supervisor. The Home ''Owner act'_. as supervisor is ultimately responsible, ,. To ensure that the Home Owner is fully aware of his/her responsibilities, ma: communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On th; 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.