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6 MILK ST - BUILDING INSPECTION -l%*NSi"TIDEf1L£$4aND APPROVED BY T44E 1dSP.F=w Pa CH TOA.PE MfT SEND GRANTED zQ CITY OF_SALEM D&W In oS I..J. Is Propwty Located in Location of y r Qw HWoric OWdd? Yak No ✓ Dnildiaa M ttr— S1 I Is Propwty Loud In Ir Corwrwagn Mao Yoe No BUILDING PERMIT APPLICATION FOR: Permft to: (Circle whichever apply) Instal Siding, Con" Dad*, Shed, Pool, C4 r . Other: PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS IN PROCESSWG TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit to build according to the following specifications: Owner's Name Address & Phone A4I0K %965 I 'MAO78) 74f19+ Architect's Name Address & Phone ( ) Mechanics Name Address & Phone ( ) What w Iw ptrpow of btrldktpT �i/Loa L6—fit[�� s/da✓C� ma ww of bLo*lg? Gyood I a dwaMYq,for how many Win? WIN MOM cordons to law? Yg S AsbWm? A✓O Eatimawl cost j /Z 00 CIy Uoww r KI A Seta Umm r Hawn LWrowawant Lie. f ' Signature of Applicant SIGNED UNDER THE PENALTY OF PERJURY DESCRIPTION OF WORK TO BE DONE MAIL PERMIT TO: Z21171V IV68� �a ,Lw tcr— STxe'�57- Sfh�M� ©0 76 No. APPLICATION FOR PERM TO •�C1 ,�s A �oo LOCATION PERMIT GRANTED 2.0 .4 APP7P INSPECTOR OF BUILDINGS a T 'u"psorm"00%mmoff 120 wuMOWSK•MSS SM ftMW wsww►e�stie TIL i» 7464m aw.a w FAR 19741 7•s••re erAMr�� x DMOiM.OP IN l AMDAM ti 000eo�ioo�e•vib drpoo�woo dfM4 44 334t I oil o►IIII win bamd dv<�•aeodlleo �+��.e�r..t rmr area•�e�e�► t3oeido.dlt•df�eoo/drr fl/o dllo� � DN 1RAi.Y oaopbl•�b0owler iebmrllos �L1A=i P�IId!Cb�A�L.Y� Na Ap p&M PLuN�Naoy 0 Al ST �_�_aL� 70 ,+ed.�csq►s der. 1fr glow sew nquir.r d�d�blr ao.�daolldo�roe•re(o�neat ar aer skald o dbdiy a aoeea erd vow b aAepel�Qe.M1 oolt/..tioer df�•ui � i�o�d i�� ms1 dr bulbormb ar ka"Re r CITY OF SALEM, MASSACHUSETTS PUBLIC PROPERTY DEPARTMENT 120 WASHINGTON STREET, 3RD FLOOR SALEM, MASSACHUSETTS 01970 STANLEY J. USOVICZ, JR. TELEPHONE: 978-745-9595 EXT. 380 Mwvoq FAX: 978-740-9846 HOMEOWNER LICENSE EXEMPTION Please Print. Date o / p� Job Location_Cp /nql(,K 5��1✓� S/{ �",tf� Home Owner Address Home Owner Telephone Present Mailing Address n1. L 01970 The current exemption of"Homeowners",was extended to include owner-occupied dwellings of two Units or less and to allow such hgmeowners,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 be responsible for all such work performed under the Building Permit. The undersigned "homeowner"assumes responsibility for compliance with the State Building Code and other applicable by-laws and regulations. The undersigned"homeowner"certifies that he/she understands the City of Salem Building Department minimum inspection procedures and requirements and that he/she will comply with said proceduresZanduire ents. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING INSPECTOR See other side for state code EXEMPTION AV ' The Code states that: ,Any Homeowner performing work for which a Building Permit is nsing iequired shall be exempt from the Provisions of this section(Section 1person(s) for hire to provided that a Homeowner engages a Construction Supervisors); of C onstrur. do such work, and that such Homeowner shall act as Supervisor. the Many Homeowners who use this exemption are unaware Q Rules thatnd theyegu boas ormLrcensing responsibilities of a Supervisor(see AppendixThis lack of awareness often results in serious Construction Supervisors, Section 2.15). Persons. �this case your problems,Particularly when the Homeowner hires n i us it nlicensed with a licensed Board cannot proceed against the unlicensed P sor is ultimately responsible. Supervisor. The Homeowner acting as sup µ# To ensure that the Homeowner is fully aware of hiss tione�the1H meowner cer*that communities require, as a part of the Pemrit Application, he/she understands the responsibilities of a Supervisor- On the last Paget f this is is a form currently used by several towns. you may care to amend and adopt form/certification for use in your community F R� G 13p� 200 S