17 PLYMOUTH ST - BUILDING INSPECTION I1.1h}116iY W T- E fiLf-B APPROVED By T44E
.MWZCTAB PF" TD A PERMIT BEING GRANTED
CITY OF SALEM �^
No.36OL Date S
fi
Is Property Located In // Location of �7
the Historic District? Yes No V t3uilding 1-7 r L`[kaLM4
Is Property Located in
Me Conservation Area? Yes No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
Repair/Replace, Other: I a s'f FEL<_ Stt-0
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: 1
Owner's Name Ed,., r d 21 � �t 64AL MRR16-U�(
Address & Phone 7 y 4 Y W u T-14- Sr (Rik If V 3 P z
Architect's Name
Address & Phone ( 1
Mechanics Name
Address & Phone j )
Whet is to purpose of building? (j' pTt1>E0 SKEW fif-3 f-[D Lt) l (L �ooLS
Material of building? WOoZ-�) If a dwelling,for how many families? f�j
will building conform to law? VC-75 Asbestos? P D
Estimated cost T 21 0 D City License ae N P' state License at _
9me Improvement
Lie. /
Signature'of Ap .' t
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE r
Ef2xZT/DFJ OF N - 'r Mt"id w-rp -
MAIL PERMIT TO:
No.
APPLICATION FOR
PERMIT TO
LOCATION
PERMIT GRANTED
1121,lo s-2-0
AP OVfD
4
INSPECTOR OF BUILDINGS
CITY OF''SALaEMv MASSACHUSETTS
PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3RO FLOOR
a SALEM, MASSACHUSETTS 01970
STANLEY J. USOVICZ, JR. TELEPHONE: 978-745-9595 EXT. 380
MAYOR FAX: 978-740-9846
HOMEOWNER LICENSE EXEMPTION '+
Please Print
Date I 1tw5�
Job Location f 7 P,_Y M to L m4 S'r sA L e'y11
Home Owner Address Eh,,_m E as A 1>a ,e—
Home Owner Telephone 1, 9-) 4 .-7Sj 4� 2(f
Present Mailing Address:.: I___
The current exemption of"Homeowners"was.extended to.include.owner-occupied
dwellings of two Units or less and to allow such homeowner 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
HOMEOWNERS EJ�TION
The Code states that: ,Any Homeowner perform g work for which a Building Permit is
required shall be exempt from the provisions of this section(Section 1 o g.1.1 —Licensing
of Construction Supervisors);provided that a Homeowner engages a persons) for hire to
do such work,and that such Homeowner shall act as Supervisor.
Many Homeowners who use this exemption are unaware that they are assuming the
responsibilities of a Supervisor(see Appendix Q,Rules and Regulations for Licensing
Construction Supervisors, Section 2.15). This lack of awareness Often results
this
case serious
problems,Particularly when the Homeowner h� 'tens d persons
ld with a In third
ur
Board cannot proceed against the unlicensed P responsible,-
To
The Homeowner acting as supervisor is ultima4lY
ensure that the Homeowner is fully aware of his/her responsibilities, many
communities require, as a part of the Permit Application,that the Homeowner issue is a
he/she understands the responsibilities of a Supervisor. on the last page such a
form currently used by several towns. You may care to amend and adopt
form/certification for use in Your community
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