5 RAVENNA AVE - BUILDING INSPECTION -PL-* ISimtsreEfiL*94,ND APPROVED BY T44E
.IItISREGTm PP" TO.A.PEBMIT BEING GRANTED
CITY OF SALEM
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Date 7��l
Is Property Located In Location of
the Historic District? Yes No—?—C Hni J ldinB 'CE?tt= A6-
Is Property Located in
ft Conservation Area? Yes No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
Repair/Replace, Other.S-�earL�/�-1r.
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 Am!a ��a,`rS
Address & Phone 4y?AAc, Are (lit ,f 9K 6LL6 3
Architect's Name
Address & Phone j )
Mechanics Name
Address & Phone PP )
What is the purpose of building? Lyn f S C,� d Y A-mj i Al icc k r X:A
Material of building? If a dwelling, for how many families?
will building conform
��to��law? YES Asbestos? .Lb
Estimated cost'�,3�— Ctty Licenses NIP' State U 8
Home Improeenant
6 �� Lic. =-
�3173 Si ��ttl!re of Applicant
6 S NEb UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
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MAIL PERMIT TO:
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APPLICATION FOR
PERMIT TO
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LOCATION
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PERp�MIT GRANTED
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CITY OF SALEM, MASSACHUSETTS
PUBLIC, PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3RD FLOOR
a SALEM. MASSACHUSETTS 01970 ,
STANLET J. UEOVICZ, JR. TELEPHONE: 978-745-9598 EXT. 380
MAYOR FAX: 978-740-9846
HOMEOWNER LICENSE EXEMPTION
Please Print
Due 61- LI.-Of-
Job Location _
Home Owner Address
Home Owner Telephone_ ) ,��.y O4 a 3
Present Mailing Address, ; .. n,i n. Jl1
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 kts 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 re uirements.
HOMEOWNERS SIGNATURE
APPROVAL OF BUILDING INSPECTOR
See other side for state code
HOMEOWNERS EXEMPTION
The Code states that: .Any Homeowner performing work for which a Building Permit is
required shall be exempt from the provisions of this section(Section I og.1.1 —Licensing
of Construction Supervisors);Provided that a Homeowner engages a person(s) for hire to
do such work,and that such Homeowner shall act as Supervisor.
Many Homeowners who use this exemption are unaware that they ar 9
the
responsibilities of a Supervisor(see Appendix Q,Rules and Regulations
Construction Supervisors, Section 2.15). Thisng
lack of awareness resultstseriouss case
problems,Particularly when the Homeowner hires unlicensed i p with a licensed
our
Board cannot proceed against the unlicensed p alven
Supervisor. The Homeowner acting as supervisor is ultimately responsible.
To ensure that the Homeowner is fully aware of his/her responsibilities, many
th
communities require, as a part of the Permit Application,that the Homeowner eownerof certify iue is a
he/she understands the responsibilities of a Supervisor. On the last P g 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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