32 OAKLAND ST - BUILDING INSPECTION (2) q� O� CITY OF &U.EM
PUBLIC PROPERTY
DEPARTMENT
KIf01F21.6Y D�wvv L
MAYOR
120 WA SUNGRON SMWM♦SAIEK MAssnansera 01970
7FL 978-73S-9S9S * FAX 978-74O9946
HOMEOWNER LICENSE EXEMPTION
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Job Location E I IPn 1=v N
Home Owner Address 3
Home Owner Telephone 91R 5�l4—►61'�
Present Mailing Address 3,-,\ a' tU f.d F.
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 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 procedures and requirements,
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING INSPECTOR
See other side for state code
JUN-20-02 12:54 PM Bav Ssace Sur..avans 970 927 7817 P. 01
T MUM 1
6AY STATE SURv"G ASSOCIATES INC. JOB
100 CUMMINGS CENTER, SUITE#310J, SEVERLY,MA., 01915
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LOCA'd0N ' f1Qb,i� i..rGll�If................_......... 1)This Is s mortgage inspecd.011 survey and tall an
i tstrumaru survey,therefore tits pidn i",is far
ses
SCAL.d : 1" ; 70 DATE :...�k.: �:..� ,.....»....... be�a�o�a�blish boundon aries w ftr do construction
of any�� as of based on a a
rim
�I............_.. Thts autvey survey mat"of 601M
31 Bushes,shrubs,lances and B.e 11110011110 fiat
JAV; rex .P.E..12F,CP.S._.......... _.. necessarily indicate property Ones..
q whenever an offsat is T ti Of lait.as boumard
GA S r�R/U QA eJK survey is recommended to didetndm prop"
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Tie locolon of the building(:)as shown,either flits and any Possible
elMlled with the local zoning setbacks at the time of q offsets shown are approxbnsta,s"are MAN
=anstauCtion or is exempt tram violation enforcement action tread only for the determirutdon at zonb►g.Not to
earner Miss.G.L.Title Via Chapter esA Section 1 be used to estabOsh property An"
n in my protesstonai opinion tit bup ilegIs)am not
located in the special flood hazard tons,elk
dadned by H.U.D.MAP# Z $O1 O 7. Q S 43-
LeT Lot 59
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PUBLIC PROPERTY
DEPAR'I�VT
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APPLICATION FOR THE REPAIR. RENOVATION CONSTRUCTION
DEMOLITION, OR CHANGIE OF USE OR OCCUPANCY FOR ANY EXISTIN
ST MMIC OR WELDING
1.0 SITE INFORMATION
Location Name �en r'wj 13uikting:
Property Address _ .. ._ ..
32 C�i�kxtid 5fi_
Property Is bcated In a:ConseMMM Area YIN HlsOorto Dlstrld Y/N
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land f.-
Name: E I � Fi;;U
Address: 3�;L Oay- r\d. St- MA 0)9rY
Telephone: 9"7�59+
3.000MPLETE THIS SECTION FOR WORK IN t�ri_QTING BUI ONLY
Addition ,LDING111
xisting
Renovation Numenovated
Change in Use ew
Demolition istingApproximate year of Area novatedconstruction or renovation
of existing building w
Brief Description of Proposed Work:
15 fit; Pool
—- - Mail Permit to:
What is the current use of the Building? if dwelfi- . • • •how many units?�—
Material of Building? if
Will the Building Conform to Law?
Architeas Name
Address and Pirrone
Mechanles Name
Address and Phone HIC Registration S
Coeatruation Super sore Ucense 8
Estimated Cost of Projed S 3' Permit Fee Caiarlalfon
Permit Fee S Estimated Cost X$71S1000 Residential
- -
_ Estimated Cost X S111S1000 Commercial
- An AddnkwW$5.00 is added as an
Administrative d1orgO•,
Make sure that all fields are properly and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building permit to build to the above stated
specifications. Signed under penalty of perjury X
Date
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