Loading...
6 SALT WALL LN - BUILDING INSPECTION ft�116,MIST�E filO&OA D APPROVED 'IV T*E w&RLC=AMR ID♦Plat AOwf3 GRANTED CITY OF_SALEM owe __in lagatim of Or 1YMab OM�lol9 YM ft"" a OorMMl�apn Awa? Y�l�No� 6UII.OM PERMIT APPLICATION POOL Perrntt to: (Clrole whWm wr apply) Roof, Reroof, instal Skft CoPA" 0" Pool, RmawpApbw Omer PLEASE FILL OUT LEGEILY&COMPLETELY TO AVOID DELAYS W PROCESSING TO THE INSPECTOR OF BIN, NG&- The WW@mgrwd hereby applies for a pw t to build acwmft to 00 bAomV O~s Name 19LI4 2 �" 2 i Addraes& Phone Lk f 9 7,9 y o AmhkeWs Nwm Address & Phoro j 1 Medwnics Nano Address & Phorw No is w pupon d bWltlMp? MAW W W OuY w � o© s a Ow".for how vM b A ft ao"m b to w? 4 - 5 AtbNlos? Ea "W a CUy t iorrw• N P` 8ws r ut. f St Ins iqwawmmt , , �1,"m of t SIGNED UNDER PENALTY OF PERJURY DEWJWTION OF WOVA TO SE DONE MAIL PERMIT T0: pem r io W✓I G] i i sot�a-ime �o a �` eds�n z — o h/ // NOLLVO(n 'YIY8 Ol IWV40d j v CITY OF SALEM, MASSACHUSETTS PUBLIC PROPERTY DEPARTMENT . t 120 WASHINGTON STREET, 3RD 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 Y 'y Job Location S�Len.�, Home Owner Address. Sy4 nc Home Owner Telephone may/ 420i G Present Mailing Address The current exemption of"Homeowners"._was extended to include owner-occupied dwellings of two Units or less and to allow such h0meownels to engage an individual for hire who does not possess a license,provided that the ownpticts as supervisor. DEFINITION OF HOMEOWNER_ Persons)who owns a parcel of land on which helshe recedes or intends to reside, on which there is,or is intended.to be,a one or two family dwelling, structures accessory to such use and/or farm structures. A person who detached P 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 PO�al, that he/she be responsible for all such work performed under the Building t. The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable by-laws and regulations. The undersigned"homeowner'•certifies th he/she and tands the City of Salem Building Department minimum inspection p ores an requirem is and that he/she will comply with said procedures and requir ts. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING INSPECTOR See other side for state code H0ME0WNERS E MPTI0N 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 109.1.1 —Licensing of Construction Supervisors);provided that a Homeowner engage$a person( ) for hire to do such work, and that such Homeowner shall act as Supervisor- Homeowners who use this exemption are unaware that they are assuming the Manyg responsibilities of a Supervisor(see Appendix Q,Rules and Regulations Construction Supervisors, Section 2.15). This lack of awareness Often results this case your problems,Particularly when the Homeowner hires n as it would persons.wit a licensor Board cannot proceed against me unlicensed p alven Supervisor. The Homeowner acting as supervisor is ultimately responsible. To ensure that the Homeowner is fully aware of hise responsibilities,li Homeowner certify that communities require, as a p�of the Permit Application, of this issue is a he/she understands the responsibilities of a Supervisor. On the last Page such a form currently used by several tom. You may care to amend and adopt form/certification for use in your community. 12ao'.r-