10 SUMNER RD - BUILDING INSPECTION -PLOWSiMIlST9EfiLf� APPROVED BY T+IE
A5PFG1DB PP" To A.PST BEING GRANTED
CITY OF SALEM
_
No.� LL.Ll1L.(J ',a.\� � Date /U �/�•G J—
s
Is Property Located In Location of
the Historic District? Yes No Bal"Ins to Su ti„ v ham/
Is Property located in X
dw Qrwervatlgn Ares? Yes No_
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
RepaidReplace, Other: f3u i 1c.1 6:�,x R z -
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:
Owners Name : o 4� J 7e 4 e e n J .
Address & Phone /v S c /Zc,/ (754) f 3 Fr-c� fy 6 3
Architect's Name
Address & Phone j
Mechanics Name
Address & Phone f 1
What is the purpose of building? nCalis4 ,, c f- G r
Material of building? If a dwelling,for how many families?
WIY building conform to law? Y-e 5 Asbestos? tiU
Estirnated cost fl o1,1000 Ctty license N N A State License e
Bowe Improvement Q
Lic. i
S' atur f Applican
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
MAIL PERMIT TO: /0 s ur,'i e r- Az"/ S t /e
G'/
•1
' a .
No. C�
APPLICATION FOR
PERMIT TO
/aH S 1-R.r cJ' 4�A.Z9-t P r��m.Gow
LOCATION
PERMIT GRANTED
e
AP ROVFD
OR OF BUILDIW
t
Rmericau laub *urbep Room , Inc.
42 UPERRYSTREET GLOvCESrI X W,4 01930 978-281-7878
NOTES:
ASSESSORS MAP 31 LOT 77
OWNER: JOHN J. TEHEEN JR.
ADDRESS : 10 SUMNER RD
DEED REFERENCE :
BOOK 23426 PAGE 524
PLAN REFERENCE :
BOOK 16 PLAN 16
ZONE : R-1
LOT COVERAGE WITH
PROPOSED GARAGE=28%
LOT 84
LOT 83
75'
24'D.
ABOVE A= 8,653 +/- S.F.
GROUND
POOL MAP 31
LOT 77
N
O
EXIST
DECK
LOT 76 �� LOT 78
_ 10'+
18, —
No. 10 PROPOSED!
EXISTING 4' GARAGE
.,
DWELLING
_ 10'+
4'
75'
SUMMER ROAD
PROPOSED
THIS PLAN IS BASED ON THE REFERENCED PLOT PLAN OF LAND
PLANS,DEEDS,AND THE RESULTS OF A
FIELD SURVEY AS OF THIS DATE NO L, tea in
CERTIFICATION IS INTENDED AS TO
PROPERTY TITLE OR AS TO THE EXISTENCE SALEM, MA
OF UNWRITTEN OR UNRECORDED Prepared By
EASEMENTS American Land Survey Associates, Inc.
Kirk W. Benson PLS
42 Cherry Street Gloucester,MA 01930
�,�PI,'SM of lt7gss9 978-281-7878
KIRK cy�m SCALE 1" =20' MARCH 26, 2005
W. Prepared For
KIRK W.BENsoN PLs No.aoo3s JOHN J. TEHEEN J .
� SSIONp P
SUTBI 'A ? 's3 k-C-"�1G3
J-614
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6
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E3'y
CITY OF SALEMp MASSACHUSETTS
PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3RD FLOOR
SALEM, MASSACHUSETTS 01970
STANLEY J. LISOVIci, JR. TELEPHONE: 978-743-9595 EXT. 380
MAYOR FAX: 978-740-9846
HOMEOWNER LICENSE EXEMPTION
Please Print.
Date lO-/f--off
Job Location /O
Home Owner Address S c
Home Owner Telephone -7 k1 _.o
Present Mailing Address:to ,<<, 6t d
The current exemption of"Homeowners",was extended to.include.owner-=upied
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 owm acts as supervisor.
DEFINITION OF HOMEOWNER...., a,
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 Q�
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
1 —Licensing
empt from the provisions of this section(Secti�o a 109
required shall be ex .1. s for hire to
of Construction Supervisors);provided that a Homeowner engag pin( )
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 awarenessed sfften resulns. In tseriouss case
problems,Particularly when the Homeowner hireserson as it would with a licensed
Board cannot proceed against the unlicensed p responsible.
Supervisor. The Homeowner acting as supervisor is ultimately
lities,many
To ensure that the Homeownerpart of the is lPemu�App of lication,that the 1Hom Homeowner certify that
communities require, as a p of this issue is a
he/she understands the responsibilities of aSupervisor. 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.
zoos"