33 NURSERY ST - BUILDING INSPECTION j y 1L91MS1*!JST:eEfjL-eP i 'APfLROVED BY T44E
IAMF ECTDj3 ,PfflDR T-0 A.PEf3MIT .B,EING GRANTED
,CITY OF SALEM
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No. r f�Ol( ;yam• : Date �� p� 3 -2?
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b ? Ward
mneo° Zoning District
Is Property Located in Location of
the Historic District? Yes_No Building 33
Is Property Located in /
the Conservation Area? Yes No I/
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, nstall Siding, Construct Deck, Shed, Pool,
pair/Replace, t r: tQv,.J Co ,<A-rurAk,,,.
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 Ga Lrp—V01 -e Ay1►1 �a uoi C
Address & Phone 3�J Nu-V evl re
Architect's Name
Address & Phone ( )
Mechanics Name
Address & Phone r ( )
What Is the purpose of building? { CaV�LI
Material of building? If a dwelling, for how many families?
Will building conform to law? y xn�S Asbestos? tVp
Estimated cost 000."a City License # State License #
t ap/ Home Improvement
I.0 Lic. i
Signat re pplicant
30�9 SIGNED UNDER THE PENALTY
(-woq OF PERJURY
DESCRIPTI N OF WORK TO BE DONE
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Home Design famliy room Monday, October 20, 2003
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Home Design famliy room Monday, October 20, 2003
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Home Design famliy room Monday, October 20, 2003
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.�o CITY OF SALEM9 MASSACHUSETTS
PUBLIC PROPERTY DEPARTMENT
a
120 WASHINGTON STREET, 3RD FLOOR
'j• 'f0 SALEM, MA O1970
TEL. (978)745-9595 EXT. 380
FAx (978) 740-9846
STANLEY J. USOVICZ, JR.
MAYOR
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the provisions of MGL c 40, S34,I acknowledge that as a condition
of Building Permit# , all debris resulting from the construction activity
governed by this Building Permit shall be disposed of in a properly licensed solid-waste
disposal facility, as defined by MGL c III S 150A.
N(;;N4td•e Car}In5 -JAC-
The debris will be disposed of at: stud, . -Osco* CoQA SJ&,i Mck • 51Fst^
Location of Facility
SiNaWA of Permit Applicant Date
FULLY complete the following information:
(PLEASE PRINT CLEARLY)
Name of F2finit Applicant
Firm Name, if any
Address, City & State
The above statute requires that debris from the demolition,renovation,rehab or other
alteration of building or structure be disposed in a properly-licensed solid-waste disposal
facility as defined by MGL cIII, S 150A, and the building permits or licenses are to
indicate the location of the facility.
I
CITY OF SALEM
BUII..DING DEPARTMENT
HOMEOWNER INCENSE E)mwnON
Please prild
DATE c
JOB LOCATION 322 J Murseu
HOMEOWt�R �a-r �4UO�E'
ADDRESS
HOMEOWNER
TELEPHONE 2 L
PRESENTMAILTNri ADDRESS 2 J
The curreme-Nemption of"homeow=C was c-=nded to include ewocroceupied dwelliup of TW()
Units or less and to allow such bomcowmn to engage an individual for bin who does not possess a
license,.provided that the owner ad as supervisor.
DEFINMON OF HOMEOWNER:
Person(s)who owns a pa=1 of land on which hdshe resides or intends to reside,on which theft i;w is
intended to be,a one to two family dwelling,anached or detached strucnaa arxawry to vxb use=AIW
farm structtoes.A person who constructs more than one home in a two-year period shall not be considered
a bomcowua. Such"homcownct" shall submit w the Building Official,on a form acceptable to$ter
Building Official,that Wshe be responm'ble to all such work performed wda the building po=k
The undersigned"bomeaw ner"asnunes responnbiliry for compliance with the State Building Code and
other applicable goes by-laws,ndes and Tegulatiorts.
The uncicniptd"homeowner" catifies that hdshe understards the City of Salem Building Departraft
minimum inspection proccdums and requincments an
and tha will comply with said proadtues d
mqulrcmeds. f
HOMEOWNER'S SIGNATURE
APPROVAL OF MMMING INSPECTOR
See other side for state code
HOMEOWNER'S EXEMPTION
The code state that: "any homeowner performing work for which a building permit is reelubed shall be
exempt from the proNisions of this section (Section 199.1.1-1; ID 91g of Construction Supervisors);
Provided that is a homeowner engages a person(s)for hire to do.such work that sueb bomeowaer shall act
as supervisor.'
Many bomeowncrs wbo use this exemption are imawarc that thq arc asstmting the mponsibBi of a
supervisor(see Appendix Q,Rules and Regulations for l ictnsioY Construction Supervisors,Section
2.24 This lack of awareness oficn tenths in serious problems,particularly when the boroeowrrerbirs6
uriliccn$cd perskms In this cast your Board cannot proceed against the UnUccumd person as ltatwld with
licensed Supcnisor. Tbc bemeoxDer*cling m supervisor is uldmatdy responslbit
To ensure that the homcowrer is fully aware of IAnwr responsibilities,many eormunitiu tegrme;as peat
of the permit sppliczd m,that the homeowner certify that hclshc tmdentaids the responsibilides of a
supcn'isor. You may care to amend and adopt such a fornJoenification for use in your wntrnuedp.