37 WALTER ST - BUILDING INSPECTION -OLANSIAOSTIBEf4UEO-�v APPROVED BY T44E
.WSPEGTL>R PRWR TP A_PERMIT 13FJNQ GRANTED
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CITY OF SALEM
Date �.
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is Property Located in Location of � BUJ
the Historic District? Yes No_ Building V
Is Property Located in NO Cl
the Conservation Area? Yes_No )
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, Shed, Pool,
Repair/Replace, Other:
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 L
Address & Phone 3^? C J CAA- CAC: G 5—cc \
Architect's Name . I
Address & Phone ( )
Mechanics Name
Address & Phone ( )
What Is the purpose of building? —�
Material of building? — If a dwelling, for how many families?
Will building conform to law? Asbestos?
Estimated cost O CQ00,60 City License x N P' State License n
Horoe Improvement
ure of
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SIGNED UNDERApplican
PENALTY
OF PERJURY
D€SCRIPTION OF WORK TO BE DONE
MAIL PERMIT TO.
No. _ok
APPLICATION FOR
PERMIT TO
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LOCATION
PERMIT GRANTED
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INSPECTOR'OF BUILDINGS
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4DCITY OF SALEM, MASSACHUSETTS
' i PUBLIC PROPERTY DEPARTMENT
120 WASHINGTON STREET, 3RD FLOOR
SALEM, MASSACHUSETTS 01970
STANLEY J. USOVICZ, JR. TELEPHONE: 978-745-9595 EXT. 380
MAYOR FAX: 978-740-9845
HOMEOWNER LICENSE EXEMPTION
Please Print.
Date
Job Location
IIOme Owner Address
Home Owner Telephone_ \\ \77 �1
Present Mailing Address
The current exemption of"Homeowners"
,was extended to include owner-occupied
dwellings of two Units or less and to allow such homeowncMto engage an individual for
hire who does not possess a license,provided that the owner acts as supervisor,
r q .
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 proc es an
HOMEOWNERS SIGNA
APPROVAL OF BUILDING INSPECTOR
See other side for state code
HOMEOWNERS F.XEMpTION
The Code states that: "Any Homeowner performing
work for which a Building Permit is
required shall be exLicensing
empt from the provisions of this section(Section a 109.1 s) for hire to
of Construction Supervisors); Provided that a Homeowner engagesPeTSO
do such work,and that such Homeowner shall act as Supervisor.
Many Homeowners who use this exemption
are Q Rules and Regulations that are four i Licensing
responsibilities of a Supervisor(see AppendixThis lack of awareness often results in serious
Construction Supervisors, Section 2.15). persons. �this case your
problems,Particularly when the Homeowner heunlicensed ld with a licensed
Board cannot proceed against the unlicensed P is ultimately responsible.
Supervisor. The Homeowner acting as supervisor ; ,^
many
To ensure that the Homeowner is fully aware of his/hernthat e sponstH meo certify that
communities require, as a part of the Permit Application,
he/she understands the responsibilities of a Supervisor. On the last page of this issue is a
towns• you may care to amend and adopt such a
form currently used by several
form/certification for use in your community
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