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77 MOFFATT RD - BUILDING INSPECTION � J fL1MN61Nli8i"BE f�L $+MdD OVER BY 7W jbwz=DB �r 11Qq 7) p.E ZING GRANTED 1. CITY OF SALEM o. , J — J N �_J J � .. � / D 1 6 Is Property Located in Loeacion o the Historic District? Yas_Nox TT f4 Is Property Located In the Conservatlgn.Area? Yes_No BUILDING PERMIT APPLICATION FOR: Permit to: (Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Sh Poo • Repair/Replace, Other: PLEASE FILL OUT LEGIBLY&COMPLETELY TO AVOID DELAYS IN PROCf3BfIll IS TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit to build according to the following specifications: Owner's Name k>pj �Rfl+.ICs�1 S Address & Phone 72 016MA-7 RD, (978) 7 Oq Architect's Name Address & Phone L ) Mechanics Name Address & Phone What Is the purpose of bulldkq? • Material of bulidirq? I a dwelkq,for how many families? , will building conform to law? SAPS Asbestw? 40i Estimated cost. 3J to ti City License• N, state A Home IaProveeent I tic. r ignat A licant SIGN UNDER THE P OF PERJURY DESCRIPTION OF WORK TO BE DONE 5WNmvr G POOL 1NS1�11AT©� � III If 'I' 1�I r TA ul MAIL PERMIT TO; I , I IMF- NO.' APPLICATION FOR PERMIT TO LOCATION PERMIT GRANTED AP • vfo IN-S-PECTON OF BUILDINGS s r r CTIY OF SAmd BUIIAING DEPAYTMM HOMEOWNER UCENSE EXEW n0N Please Print DATE 4 301310CATION 7Z MOFF�TII F1�A HOMEOwm morr-RTT RD. • ADDRESS ��++++��` 'J HOMEOwtg3l �g72'S 17-1�Jl��� . . TEUPHOM PRESENTMAILING ADDRESS �CY1 F l Tbc array c_xcmp6vn.of"homcow DaC was r--nendcd to include ewmrocwFk4 dweMOp of TWC) Units a less and to slow such hornwwners to engage an V&vidual for hire wLo don not posxs tI h'ecrtse,.yrovided thaw tlx owpa ad as supetvbor. DEFINf170N OF HOMEOWNPR Pcrson(s)who owns s pw=l of land on which hdshc resides or irucnds to reside,on which Isa�� intended to be,a om to two family dwelling,attached m dctachtd smtcracs ods�T71 zuol be st and1w farm sruawm.A person who constructs mort than one Mmx in a two-? pen a homeowner. Such"homeow'rtd shall'submit to the But7ding fJl£icial on a form atzcptable to t4s Building oMcW,that Wshc be rupormble w all such work pafonrwd w4cr the building pa=IL The undcniped"Homeowner" Lw m=rcspon�tbility Sor complit rttz with thK Stau Building Code ttttd othu applicable goes by-12ws,rules and regulatic= The undarsigttrd'hotnevwna"ccrd5es that he/she undamanda the City of Salem Bulld'mg De wum t. minimum in�on pro=duTm and ttquircmcms and that Id will comply with said proRdures ttrd mequimnatL HOMEOWNER'S SIGNA APPROVAL OF BUILDING INSPECTOR See other side for state code HO) E0NVNER'S EXEMPTION The code natu that.' "any homcowmcr performing work for which a buDdtng permit is required shall be exempt hvm tht prm'isions of ibis section (Section 199.1.1-1Uccosiog of Construction Superriwr7); Pro.'idod that is a Donwcwncr encases s person(s)for hire to do.such work,that sueb bomeowm chap sex as Supavism.. many bomcownris wbo tssc Us catmpdon an i nawae that they arc asswnmg the tespoasrbMiSm of supervisor (sec Appcodh Q,Rults and Regulations for 1krusiog Construeiion Superrbon,See&* Y.1S} This lack of awareness often nsulu in serious problc=,pardcu"wbm the bomcowner Lire{ unlicensed persoas. In ibis cau your Board m mot proceed asahm the urXornsed person as k-%V d widh liansed Supeniwr. The bomcon-ocr skiing as supervisor b u}dmatdp rtspooSIW To cnaac that the homeowner is fully aware of Mn=responnbilitia many cornmvnldes regrmt;as pat of the permit 2pplicat5or4 that tltc homawncr ccnify that Mhhc tmdcratards the ruponsibiliMs of a supcn'isor. You tray care to amend and adopt such a fomVc cr&icatitat for tsse in your ex>mnonQ,