12 MESSERVY ST - BUILDING INSPECTION il9W T-BE fiLf�'1idfl;APPROVED BY T+IE
IAI
u P C7S?13 ,P R T-WA PERMIT.I3FING GRANTED
r
y,CITY OF SALEM
`N
No w, V- ! '�` �� � �� Date
s:
Ward
a - ,
Nit oo - Zoning District
Is Property Located In Location of // /
the Historic District? Yes_No T Building /� /yL2SS2 cVU d
Is Property Located in X
the Conservation Area? Yes_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Sidin , Construct Deck, Shed, Pool,
Repair/Replace, Other: rt_
PLEASE FILL OUT LEGIBLY & COMPLETELY TO AVOID DELAYS IN PROCESSING
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the following
specifications: �'!
Owner's Name `/o-r,A
Address & Phone ld n2?aery' /
Architect's Name
Address & Phone ( )
Mechanics Name
Address & Phone ( )
What is the purpose of building?
Material of building? If a dwelling, for how many families?
Will building conform to law? Asbestos?
Estimated cost �5bd a0b0 City License # State License #
Rome Improvement
Lic. i
Signature of A c t
��" I SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE /.
edQc/GJ Sha ruQ e(.''CLr lob(r ate/
MAIL PERMIT TO: A SS A6o✓5
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CITY OF SALEM
BUILDING DEPARTMENT
AOIv EOWNER LICENSE E?MMP'IION
Please Ptild
DATE l0 ro 03
JOB LOCAT1014. /14 QSS erV y �LPit FYI /
. HOMEOWI�A �UV E
ADDRESS
HOMEOWM 7 p 7&
TEUPHONE QQ
PRESENT MAILING
The curm t cxcmption of"homeowners"was extended to include owvcr-occupied dwclgmp of TWO
Units or im and to allow such homeowners to cnpp an individual for bare who doa mt posses a
License,provided that the owner ad as suptrviaor.
DEFINITION OF HOMEOWNER:
Person(s)who owns a pw=l of land on which he/she resides or intends to reside,on which
Poch u,�
intended to be,a one to two family dwelling,attached or detached suucnna ae�wty
in a two- ear od sball not be considered
arm structtua.A tson who constnxts more than one home y l�
f Pe
a homeowner. Such"homco h=r shall'submit w the Building Official.on s form acceptabk to the
Building Official,that he/she be tcspormblc to all such work pafotmed undo the bonding pertnk
The undcnignod`homeowner"assumes respons-111 ty for compliance witb the State Building Code w d
other applicable goes by-laws,Hiles and regulations.
The undenigted"homeowner" certifies that he/she undmu-nds the City of Salem Building Depwzmal
minimum kq cction procedures and regain-=nu and that h1she will comply with said pcomdam and
ngturcmems.
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING INSPECTOR
See other sde for state code
HOMEOWNER'S EXEMPTION
The code states that "any homeowner performing work for which a building permit is required sball be
exempt from the provisions of this section (Section 109.1.1-lictnsing of Construction Suptrd rs),
Provided that is a homeowner engages a person(s)for hire to do,such work,that such homeowner shall set
as supavisor.� '
Many bomeowners wbo use this cxcmption are imav an that they are assuming the nspoasrowdo or a
supervisor(sec Appendix Q,Rules and Regulations for I.irznsiog COnstrueilon Supervisors,Seetiw
.2.14 This lack of swam often rutilts in serious problems,particularly when the horteosrmbires
unlicensed persons. In this case your Board cannot proxcd against the unliarssed person as it awld wi&
licensed Supervisor. Ile bomconvtr string as supervisor b ultimately responslbiL
To ensure that the homeowner is fully award of hiRrcr respounbilitles,marry eorrmunitia require;as pM
of the permit applicatim that the homeowner certify that helshe wukrrmnds the responsibilities eta
supervisor. You may care to amend and adopt such a forml cnification for use in Yew CommUnkV.
NOTES: ASSESSORS:
1) THIS PLAN IS NOT TO BE CONSIDERED AN ALTA/ACSM MAP JJ,, LOT 621
LAND 777LE SURVEY. REFERENCES•
2) 7HIS PLAN PREPARED FROM AN ON ME GROUND DEED BOOK 14806, PAGE J2J
INS TRUMEN T SURVE
COR. Y. MESSERVY STREET
CONC. WALL 100.00' _ (STREET LINE REESTABLISHED FROM APPLETON FIELD NOTES)
° 49.29' I
a
J g SARAH J. CALLAND Q Q
a < (PLAN 12 OF 1928) a
Q vv .* N
o Ln
w oa nn
z +I of
F N >
m OLD FENCE
a 0 POST (TYP)
i
!. S84'28'10"E 49.29'
2 a 50.00'
a5a7
BASE OF BASE OF
22"TWIN 18"MAPLE
MAPLE
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2}2 STORY
WOOD FRAME 3
DWELLING d
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40.0' _ 100.00, _ 35.00' 0.72
COR. «175.72'>> N84'28'10"W SPIKE
CONC. WALL (FD)
WILLOW AVENUE EXHIBIT PLAN
OF [AND 1N
SAL£M, MA
PROPERTY OF
� tQ MICHA£L & SANDRA /ANNUZZ/
WWdCUAA SCALE. 1" _ 10' AUGUST 8. 1001
No SBtT!
H7gAANCOCK SURVEY ASSOCIATS, INC.IN
2m NEmuRY smaT, LUNVERS, wssnHuum 01973
VOICE 978-777-MSS FAX 978-774-7816 '
PROFESSIONAL LAND SURVEYOR www.hmmckossocmiss.c
CHECKED Br. IyG,T pB71
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