27 SILVER ST - BUILDING INSPECTION (2) y 1�1
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,• VED BY TiiE
a=Na GRANTED
CITY OF SALEM
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BUILDING PERMIT APPLICATION FOR:
Pernik to:
(Chia whichever apply) Roof, Rarooi� Instep ldhp� Cps Deck. Shad, Pool,
RspaldRep ar(Oth_er_� na w�,t�-}—r,v�
PLEASE FILL OUT LEGIBLY A COMPLETELY TO AVOID DELAYS IN PROD
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the foibmft
spaoificatlons:
Owner's Name ,viz !�• Q�Apesma, , ponvl or D M otrm r;r✓ .
Address sir Phona 27 S i r<,g — (opt 1 411— o 01 G
Amhk@Ws Name
Address 3 Phone ( 1
Madmics Name
Addreea sir Phone
wtit b In p qmo i Novi e,
Mdadb1 w M~ N a dwsalrp,for now mmy hnom? 2
WNkdh*Vnordoi bbwr El P1�A +3
E.Inwf�a cod. I OOGZ N
Cly LbNw o N p`— -awe
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Signature of Applkent "
SIGNF,D UNDER THE O'
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
TkrvmoGAein Ck4<4— DNS ;
MNL PERMIT TO• r
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APPLICATION FOR
PERLar TO
Glhali f on
� LOCATION
PERMIT GRANTED
APP P -
INSPECTOR OF-BUILDINGS
s
CITY OF SALEM
BUILDING DEPARTMENT
HOMEOWNER LICENSE E0MO14
Please Prix I
DATE 5I� l 0 '
IOB LOCATION
ADDRESS
TELEPHONE
PRESENT MAILING ADDRESS same as abode .
The naraY.ecemption of"homeowners"was tmuded to include oxoerocwpkd dxcTOnip dTWC
Unin or ka and to allow such homwwners to cnpage an individual for hire who does not poawt f
license..provided that the owner ad as wpervhw-
DEFINITION OF HOMEOWNER
Pcrson(s)who owns a parcel of land on which bdshe resides or intends to reside,on w hkh O i;OF W
tw
vxh
dAff
str
intended to be,a om to o firmly dwelling,stac}hed or dctadned swam=ada notbe dered a M
farm uctum A pawn who constructs more than one home in a two-y Period P
s hourcawaa. Such`homwp rxt" shaD'n*n*to the Building OfficiaL on a form acceptabk to$f
Building OffxW,that b0shc be recponsi'bk to all such woric pafoTmed under the building Pam
The rmdasigned'bomeowncr"Lwurnes responsibility for COmPlianee with the State Building Code ttfd
other applicable goes by-laws,rules sad rt:gttlatitatt
The undcsipcd"hov=wner"ccru5cs that hdshc undam+dnds the City of Salem Building Dgwvm f.
n Wmun inspa'cion pmcrdu=and nett nu that hlsbc will comply with said pm=&ua tmd
MqIa
HON EOWNMIS SIGNATLiRE
APPROVAL OF BUILDING INSPECTOR
See other side for Slate code
HOMEOWNER'S EXEMPTION Y
The code states that.• "any homeowner performing work for which a buDding permit is mquir d sbaD be
' exempt from tite pronsums of this section (Section ll*.11-Lecosl09 Of COustrrnWon SOPtrYlsOri);
provided that is a homeowner engages a person (s)for hire to do.such work,that sueb bomeow=am ad
as .
Many bomeownen wbo use this=111 ion are imawart that they are assuraimg the responsibilities di
svpctriwr(sec Appcodiz Q,R lu and)ltgulariODs for IjCLDsiOg CODatr wcdon,Super&om Sedt m
.2.14 This be4k of awareness often rcndts in serious probiems,partieularV when the borai awna biro
ur kcnsed persom in this case your Board cannot proceed against the miliocnstd pa;o'n U k watdd wish
licensed Svjxnjsor. Tbt bomean-ocr acting as supervisor b Dltimatti4y rssrosiblL
To cnstiac that the homeovrncr is fully aware of hinM MSP011n'bi]ititS,marry eornrmtudd=rapnrt;as pant
of the permi4 application,that the homeowner ecrnfy that helshe rmdermnds the responsibiliroes eta
supcnimt. You may cart to amend and adopt such a Sornt/c enifica6M for rase iA your gyp.
PUBLIC PROPERTY DEPARTMENT
J 120 WASHINGTON STREET, 9RD FLOOR
SALEM,MA 01970
TEL (978)745-9595 Err. 660
FAX (979) 740-9846
STANLEY J. USOVICZ, JR.
MAYOR
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the provisions of MGL c 40,S34,I aclmowledge that as a condition
of Building Permit g .all debris resulting from the Construction activity
governed by this Building Permit shall be disposed of in a properly licensed soH&wasta
disposal facility.as AcEned by MGL c 131,S150A.
The debris will be disposed of at �
Location of Facility
'�� 05�o�i �b`f
Signature of Permit Applicant Date
FULLY complete the following iaf nation:
(PLEASE PRINT CLEARLY)
Pgu l,q D. M ati mbn-c,
Name of Permit Applicant
Firm Name,if any
2ti SJYeg s�- SA� ,no , MR 01al70
Address,City k State
The above statute requires that debris from the demolition, renovation,rebab or other
alteration of building or structure be disposed in a properly-licensed solid-waste disposal
facility as defined by MGL cIII, S 150A,and the building permits or licenses are to
indicate the location of the facility.