0044 SCHOOL STREET - BPA 06-195 IS ~111E#11101104fe AVM1OYNi BY im
AMPUMI PIEW m A.PEAW DEW GRANTkD
w, L�_ 1 CITY OF SALEM �j
bIs
�OntAot7 w Y No v re.aeso. of
a.sws.a Ny 3c,�er�r ��
Is Plawly Loombd in
Guwwrbon Awot' YM No z
r,
Pamlk to: BMLDM PER W APPLIC TM POW
(Ckab whichever apply) Roof. Ramof, InaWl S , p, CWWAi t DUK Shal, Pool.
RapaidRap*Am OIMr: rov�k
PLEASE M L OUR LEONLY A COMPLEMY TO AVOW DELAYS N PIIOCESpq
TO THE INSPECTOR OF SWLDING&The wWwaipW '•
hmiby appbs W a poem to build as dnp,to the tft&"
i
Owners Name G�lacs AAWn W6)e-6/ba9e
AddNft a Phase N9 Sctxe st #� sQ�un�M4a,oc(9�Yf 590 -3yI
Arohkact'a Name
Addnaaa a Phoi ( 1
Mad+anim Name
Addmu a Phai .
w o M in p0000r it wwwcl
1MIMr a O�qt' W ca� N•d�q,for now�r NnlaaY_
MIN bAbq aodann b Irrlr Ab~ _NO
Ebwwd ooa�� SIrO.flD Clq►uorrr r etM.Llowr r
w
Lis.
of Applioam
wo TM PENALTY,
oPePum,
M
oESCRIPT1Ofif OP WORK TO BE DONE
U
MAIL PERMIT 01970
SONKn n :jo dog
NOLLV=
o
m CITY OF SALEM, MASSACHUSETTS
<_ PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3RD FLOOR
SALEM, MASSACHUSETTS 01970
STANLEY J. USOVICZ, JR. TELEPHONE: 978-745-9595 EXT. 380
MAYOR FAX: 978-740-9846
HOMEOWNER LICENSE EXEMPTION
Please Print
Date
Job Location �Aj SG I Sa&\& A.4 Q/9 7d
Home Owner Address l{q S& S+ Zts SaA.wl /1/<1 /9 76
Home Owner Telephone — /4
Present Mailing Address SdkdgF.P Sf **'2 X4_g qw 0717 76
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-iii 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.
,,r
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 require ent
HOMEOWNERS SIGNATURE /
APPROVAL OF BUILDING INSPECTO /Y�
See other side for state code
� F �
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 109.1.1 —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 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 in serious
problems, Particularly when the Homeowner hires unlicensed persons. In this case your
Board cannot proceed against the unlicensed person as it would with a licensed
Supervisor. The Homeowner acting as supervisor is ultimately responsible.
To ensure that the Homeowner is fully aware-of his/her responsibilities, many
communities require, as a part of the Permit Application, that the Homeowner certify that
he/she understands the responsibilities of a Supervisor. On the last page of this issue is a
form currently used by several towns. You may care to amend and adopt such a
form/certification for use in your community.
((by G 130�20o s
'di,4�T�10 wr
01 ale INUMI io%jm»d fMw4 M PIE W I S IF'IDW dq P OPP R 41
�o
Ptc&.w On'&-b d�oa Poea>at�- 0&9 t m p odmp a4 wmxw io fmp mum oogiaue
argio 'aMAOQu XTUnbu I q 31 &&Oqw S4I.
OL 6/o v�i WS V AiD*Wv
T. 9 hh
ter.�x�a
X=Rddv
ID I !7
(JLMMM INM RSVTW
ftyAqm ow a%d=*JLTUU
ftmdp WPW7
Flo on A IP-lP a4 ma gp9pF @%L
'1 is sm a wR 6q PAP R'Awq PRFAlP
Ri!� �►��m4P P'__A��HI�
maqwo a n>fqi rP% * I'tES b►o'IDi4lo V.W 4 q
J IAVMM SR93Q d0 T►SOMG
a10AVM
'Yf VOW AM Y A2'+V1S
waawc (Oca) m.A
o�c A1[s sass-M csc�) 1u
ocsiovr�'wl+rs
woo,w out 1&3muif MOAOMIM>NJM OZ 1
1
iMsM"vrs0 ALV3dOVd Onand
SJA2SnH*VSSVVl •NX=IVS AO AL12