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BINLDWG PERMIT APPLICATION FOR:
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TO THE INSPECTOR OF BUILDINGS: '.
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SNJNED UNDER TIIE PENALTY
DESCRIPTION OF WORK TO BE DONE OP PERJURY
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APPLICATION FOR
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PERMIT GRANTED
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CITY OF SALEM, MASSACHUSETTS
PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3RO FLOOR
SALEM, MASSACHUSETTS 01970
STANLEY J. USOVICZ, ,JR. TELEPHONE: 978-745-9595 EXT. 380
MAYOR FAX: 978-740-9846
HOMEOWNER LICENSE EXEMPTION
Please Print.
Date
Job Location 88 M 0 F r-X-1 R
Home Owner Address SNM E
Home Owner Telephone -_34
Present Mailing Address'.
' F pr
The current exemption of"Homeowners"was extended to#include owner-occupied dwellings of two Units or less and to allow such homeowners to engage an individual for
hire who does not possess a license,provided that the ownetacts 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 procedures and requirements.
HOMEOWNERS SIGNATURE K
APPROVAL OF BUILDING INSPECTOR
See other side for state code
HOMEOWNERS EXEMPTION
: ,Any Homeowner performing work for which a Building Permit is
The Code states thatthissection
required shall be exempt from heev prov
of Construction Supervisors):P that a Homeowner engages a person(s) for hire to
do such work, and that such Homeowner shall act as Supervisor-
the
Many Homeowners who use this exemptionendix Q R es and Regulations for Licensing
responsibilities of a Supervisor(see:App
Construction Supervisors, Section 2.15). This lack of awarenesser►rs case Y ur
problems,Particularly when the Homeowner hues unlicensed ld rsons. In wit a licensed
Board cannot proceed against the unlicensed P responsible.
Supervisor. The Homeowner acting as supervisor is ultimately
To ensure that the Homeowner is fully aware of his/her es ohsib1t the Homeown r certify that
communities require, as a part of the Permit Application,
responsibilities of a Supervisor- On the last page of this issue is a
he/she understands the respo t such a
form currently used by several towns. You may care to amend and adopt
form/certification for use in your community.
R� G 130 I Zoo S