36 CIRCLE HILL ROAD - BUILDING JACKET c9co
1L-tNS10tST-eEfIUEG-AN0 APPROVED BY T44E
I1 PirCI41 ,PRWR TO A_PERNT BEWG GRANTED
CITY OF SALEM
No. Date 7 f n/
SO(�
Is Property Located In Location of
the Historic District? Yes_No Building
Is Property Located in
the Conservation Area? Yes_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroo Install Siding, Construct Deck, Shed, ool,
Repai eplac 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 Z f)• 0W
Address & Phone Ek Lac-leKrW Rol 1QZ8L 0)V-/i3G
Architect's Name
Address & Phone
Mechanics Name 4
Address & Phone 1
What Is the purpose of building?
Material of building? If a dwelling, for how many families?
7 Will building conform to law? Asbestos?
Estimated cost City License # N A State ucen e#
a Home Improvement
Lic. / �.�
X Signature of Applicant
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE /` p
MAIL PERMIT TO:
No.
APPLICATION FOR
PERMIT TO
Ile
LOCATION
PERMIT GRANTED
AP OV�D
INSPECTOR OF BUILDINGS
, _ _ � � Ck-_.�'-b��
�� -��� �,� � : �a��
� — -- - ,CommonwealthofMassachusetts RECEI"
fBuildingRegulationsandStandards INSPECTIOh:r'� SEfC5TYF0�
� Massachusetts State Building Code, 780 CMR SALEM
���� ' 9 R�vis�/h�bi�1011
� Building Pertnit Application To Constmct,Repair,Renovate Or a
One-or Two-Family Dwelling
This Section For Official Use Only
Building Pemtit Number: Date Applied:
Building Official(Print Name) Signature Date
SECTION I:SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers
36 Circle Hill Road pg 0231
l.l a Is this an accepted street?yes X no Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
R1 residence-no change
Zoning District Proposed Use Lot Area(sq R) Frontage(R)
1.5 Building Setbacks(ft) n/a
Front Yard Side Yards Rear Yard
Required Provided Required Provided Required Provided
1.6 Wa[er Supply: (M.G.L c.4Q§54) 1.7 Flood Zone lutormation: 1.8 Sewage Disposal System:
Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal 0 On site disposal system ❑
Check if yesO
SECTION 2: PROPERTY OWNERSHIP�
2.1 Owner�of Record:
Richard Sakowich Salem, MA 01970
Name(Print) Ciry,State,ZIP
36 Circle Hill Road g78-836-2920 rsakowich@aol.com
No.and Street Telephoce Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORKZ(check all that apply)
New Construc[ion❑ Existing Building❑ Owner-Ocwpied ❑ Repairs(s) ❑ Altera[ion(s) ❑ Addition ❑
Demolition ❑ Accessory Bldg. ❑ Number of Units O[her � Specify: solar
Brief Descrip[ion of Proposed Work2: Installation of a 7.425kW roof mounted solar array using 27 SolarWorld
SW275 Mono modules,27 Enphase M250-60-2LL-S22 micro inverters,and all associated electrical work.
SECTION 4: ESTIMATED CONSTRUCTION COSTS
Item Estimated Cosu: Official Use Only
Labor and Ma[erials
1.Building $ 6,000 1• Building Permit Fee: $ Indicate how fee is detemiined:
❑Standard City/Town Applica[ion Fee
2.Electrical $ 26,000 ❑Total Project Cost}((tem 6)x multiplier x
3. Plumbing $ 2. O[her Fees: $
4.Mechanical (HVAC) $ List:
5.Mechanical (Fire $ �
Su ression Total All Fees:$
Check No. Check Amount: Cash Amount
6.Total Project Cost: $ 32,000 ❑paid in Full ❑Outstanding Balance Due:
SECTION 5: CONSTRUCTION SERVICES
. 5.1 ConshucHon Supervisor License(CSL)
101487 11/7/16
Gary Beals License Number Expiration Date
Name of CSL Holder
• List CSL Type(see below)
61 Turnpike Road
No.and Street Type Description
U Unrestricted uildin s u to 35,000 ca R.
Ashbv MA 01431 R Reshicted 1&2 Famil Dwellin
City(I'own,State,ZIP M Mason
�/� _ RC Roofin Coverin
��'�' WS Window and Sidin
_
SF Solid Fuel Buming Appliances
978-855-8568 gary.beals@rgsenergy.com I Insulation
Tele hone Email address D Demolition
5.2 Registered Home Improvement Contrector(HIC) 162709 4 6 �,
Alteris Renewables dba RGS Energy HIC Registration Number Expiration Date
HiC Company Name or HiC Registrant Name
32 Taugwonk Spur,Al2 kimberly.hendel@rgsenergy.com
No.and Street Email address
Stonington, CT 06378 860-5353370
Ci /Town S[ate ZIP Tele hone
SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. t52.§ 25C(6))
Workers Compensation Insurance affidavi[mus[be completed and submi[ted wi[h this application. Failure to provide
this affidavit will result in the denial of the Issuance of the building permit.
Signed Affidavit Attached? Yes .......... C� No...........❑
SECTION 7a:OWNER AUTHORlZAT10N TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I,as Owner of the subject properiy,hereby authorize Alteris Renewables dba RGS Energy
[o act on my behalf,in all matters relative to work au[horized by this building pertni[application.
see signed authorization form attached i 7 �,y�
Print Owner's Name(Electronic Signature) ate
SECTION 7b:OWNER� OR AUTHORIZED AGENT DECLARATION
By entering my name below,I hereby attest under[he pains and penalties of petjury that all of[he information
contained in this application is We and accurate[o[he best of my knowledge and understanding.
�-Iy,..'c(�.� l� i��s
Print Owner's or Authorized AgenPs Name(Electronic Signature) Date
NOTES:
1. An Owner who obtains a building pemii[to do his/her own work,or an owner who hires an unregistered con[ractor
(not registered in the Home Improvement Contrac[or(HIC)Program),will not have access ro the arbi[ratioo
program or guaranty fund under M.G.L.c. 142A.O[her important information on the HIC Program ca�be found at
www.mass.eov/oca Information on the Cons[ruction Supervisor License can be found a[www.mass.eov/dps
2. When substandal work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or poroh)
Gross living area(sq. ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of hea[ing system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project CosY'
� Februar 25 2015
y ,
• To: Code Enforcement Division
From: James A. Mazac, Jr. P.E.
Re: Engineer Statement for Sakowich Residence, 36 Circle Hill Rd., Salem, MA
- Solar Roof Mount Installation
I have verified the adequacy and structural integrity of the existing Main Roof 1 (two
layers composition): 2"x 6" rafters at 16" o-c, having rafter slope distance 14'-6" with
rafter span 11'S", pitch 21 deg.; Main Roof 2 (two layers composition): 2" x 8" rafters at
16" o-c, having rafter slope distance 15'-8" with rafter span 22'-9 having vertical shut for
rafter support", pitch 9 deg.; for mounting of solar panels and their installation will
satisfy the struchual roof framing design-loading requirements of the Massachusetts
building code—780 CMR Residential Code 8th Ed.
For the installation of the solar mounting, the Unirac Solarmount rails with Eco-Fasten
Green-Fasten with ECO-CP-SQ Bracket will be perpendicular to the rafters with L-foot
supports at 32" sp. max. and securely fastened with 5/16" dia. x 3 %2" SS lag screws. All
attachments are staggered amongst the framing members. The mounting system has been
designed for wind speed criteria of 100 mph Exp. C and ground snow criteria of 40 psf.
The Photovoltaic system and the mounting assemblies will comply with the applicable
sections of the Residential Code and loading requirements of roof-mounted collectors.
Thereby, I endorse the solar panel installation and certify this design to be structurally
adequate.
Sincerely,
� �PSSACH(�SF�
�F rs
�J P
c
�,5��' w
„7 w �p.`s�-+S" 65 o z
M1 z �'PG\.'�°� �
i James A. Marx, Jr. ���� 2� ��y�"v
Professional En meer o� RE P
MA 36365 g. .,\P�FESS\� �s'S
10 High Mountain Road
Ringwood,NJ 07456
cc: RGS Energy
, � February 25, 2015
• To: Code Enforcement Division
From: James A. Ma�, Jr. P.E.
Re: Engineer Statement for Sakowich Residence, 36 Circle Hill Rd., Salem, MA
- Solar Roof Mount Installation
I have verified the adequacy and structural integrity of the existing Main Roof 1 (two
layers composition): 2"x 6"rafters at 16" o-c, having rafter slope distance 14'-6" with
rafter span I 1'S", pitch 21 deg.; Main Roof 2 (two layers composition): 2"x 8" rafters at
16" o-c, having rafter slope distance 15'-8"with rafter span 22'-9 having vertical strut far
rafter support", pitch 9 deg.; for mounting of solar panels and their installation will
satisfy the structural roof framing design-loading requirements of the Massachusetts
building code—780 CMR Residential Code 8th Ed.
For the installation of the solaz mounting, the Unirac Solarmount rails with Eco-Fasten
Green-Fasten with ECO-CP-SQ Bracket will be perpendicular to the rafters with L-foot
supports at 32" sp. max. and securely fastened with 5/16"dia. x 3 '/z" SS lag screws. All
attachments are staggered amongst the framing members. The mounting system has been
designed for wind speed criteria of 100 mph Exp. C and ground snow criteria of 40 psf.
The Photovoltaic system and the mounting assemblies will comply with the applicabie
sections of the Residential Code and loading requirements of roof-mounted collectors.
Thereby, I endorse the solar panel installation and certify this design to be structurally
adequate.
Sincerely, �\o�Mr+ssacy�
TT
Q
^.� 3� P��S p� N
4 � �P���� 5 �
G� '�
}q� No� �� .
James A. Marx, Jr. `�J REG�`��� ��
Professional Engineer �p�FESSI�NP� 2�25 iS
MA 36365
10 High Mountain Road
Ringwood, NJ 07456
cc: RGS Energy
� rc�ocri�'�rwi,�;noFg `�\s/,�
Grid-Tied Photovoltaic System RGs
DC Rating: 7.425 kW ENERGY
Sakowich, Rich
�,e�.,F.�.�,mM����5.
32 Taugwonk Spur,Al2
36 Circle Hill Road Sheet List Stonginton,R06378
Salem, MA 01970 Sheet No. Sheet Title Phone(860)535 3370
Faz�413)683-2225
Jurisdiction: City of Salem P�-000 coveR GRID-TIED
PV-A01 SITE PIAN PHOTOVOLTAIC SYSTEM
- � PV-A02 MODULE LAYOUT 7.425kW DC�STC
PV-A03 DETAILS SAKOVV�CH, RICH
. 36 CIRCLE HILL ROAD
G@Il@f8I NOt@S: PV-A04 MATERIALS SALEM, MA 01970
$COp@ Of WO�k: 1. System follows any/all Fire Code Setbacks per Ordinances of the City of Salem. Projed# 10241324
RGS Energy shall install a 7.425 kW Grid-tied Photovoltaic("PV")System totaling PV-E01 ELECTRICAL DIAGRAM
(2�Solarworld Plus SW 275 mono black Modules with (27) Enphase Ener y Z. All projects will comply with the Ordinances of the City of Salem. pEs,�„ER: BJC
9 PV-E02 SYSTEM CALCS
3. All work will comply with Article 690 of the National Electric Code
M250-60-2L�-S22 Micro-Inverters.The Modules shall be installed on a roof R���R. MLM
mounted racking system.The PV System shall be interconnected with a load side 4. Construction Hours: 7am-Spm Monday-Friday, 9am-8pm Saturday, No time on PV-G01 SIGNAGE
� breaker connection. Sunday or legal Holidays. �EA�b��*E. 2015-02-25
5. Produd Data Sheets shall be inGuded. REVISIONS
6. Rooftop penetrations shall be completed and sealed per code by a licensed
All Work to be in Compliance with: �o�t�aao�. � a Bv oece Notes
2014 National Electrical Code(NEC) 7. All Photovoltaic modules shall be tested and listed by a recognized laboratory. � �
2009 Intemational Residential Code(IRC) 8. Certifications shall include UL1703, IEC61646, IEC61730.
2009 Intematfonal Building Code(IBC) 9. A continuous ground shall be provided for the Array and for all Photovoltaic Z
2012 Intemational Fire Code(IFC) Equipment. 3
2012 Uniform Mechanical Code(UMC) 10. DC Wiring shall be run in metal conduit or raceways within enclosed spaces in a .
2012 Uniform Plumbing Code(UPC) building.
� MA 780 CMR, Sth Edition 11. Conduit, Wre systems and Raceways shall be located as close as possible to ,
-including 2/4/11 revisions to Tables R301.2(4) &R301.2(5) ridges, hips, and outside walls. �.
� ASCE/ANSI 7-05 Minimum Design Loads for Buildings and Other Structures 12. Conduit between Sub Arrays and to DC Combiners/Disconnects shall use
As amended and adopted by City of Salem guidelines that minimize the total amount of conduit by taking the shortest path.
13. Space Requirements for electrical equipment shall comply with NEC ARicle 110.
$It@ $peCIfIC8t10t1S: 14. Equipment grounding shall be sized in accordance with Table 250.122.
Occupancy: II 15. Connedors that are not readily accessible and that are used in the circuits
Design Wind Speed: 100 mph operating at or over 30V AC or DC shall require a tool for opening and are
SExposure Category: C required to be marked"Do not disconnect under load"or"Not for current -
� Mean Roof Height: 25 ft. interrupting", per 690.33(c)&(e). ; '
o Ground Snow Load:40 psf 16. AII signage to be placed in accordance with local building code. _
Adj. Roof Snow Load: 30.8 psf 17. Signs or Directories shall be attached to the electrical equipment or located .
� adjacent to the identified equipment. ��, � �
� EC�Ulpfl'IQllt $p@CIfICBtIO�1S: 18. Signs should be of sufficient durability to withstand the environment. �,>� ,
- Modules: (27)SolanvoAd Plus SW 275 mono black 19. Any plaques shall be metal or plastic with engraved or machine printed letters,or �y
N Inverter 1: (27) Enphase Energy M250-60-2LL-S22 eledro-plating, in a red background with white lettering, a minimum of 3/8"height
a Roof Mount 1: UniRac SolarMount and all capital letters. � ._
Attachment Flashing 1: Eco-Fasten Green-Fasten with CP-SQ-Slotted Bracket � . �1!' f-!l�Pp�
and Aluminum Flashing . y,,. � ..
' 4r�
m Roof Mount Specifications: �
o Roof 1: Roof 2: ,�� ��y
AsphaMlComp. Shingle AsphaltlComp. Shingle � � °��.
(2 Layers) (2 Layers) ��� Notto Scale
2"x 6" Rafters @ 16"O.C. 2"x 8"Rafters � 16"O.C.
Pitch: 21° � Azimuth: 206° Pitch: 9° � Azimuth: 206° COVER
Array Size: 18 Modules Array Size: 9 Modules
,
�'�° - m"'��'�' PV-000
� FOR CONSTRUCTION i �o�1l�v
. � ' %�����
RGS
ENERGY
Cl.�an P'o.�.un^`r Sa.r�s-.
. . 32 Taugwonk Spur,Al2
. Stonginton,CT 06378
Phone(860)5353370
� Fax(413)683-2225
GRID-TIED j
PHOTOVOLTAIC SYSTEM
��r(+� 7.425kW DC�STC
e y� SAKOWICH, RICH
, ��
�R�,I 36 CIRCLE HILL ROAD
. � \��• • y SALEM, MA 01970
(E) Property Line � a a ' \ �.� Project# 10241324
��• , � d , � Q OESIGNER: BJC
n . : Q
� . d. '� R��R MLM
• �E Drivewa � .1 O
� Y : e . � O . •\ VERSIONpqiE. ZO I S-OG-ZS
� < . � �� a ' � ° � �\ . REVISIONS
�\
� d .Q . � ' ' , � �\ # BY Date Notes
� 'a ' d . ° ' '� - i
a
� a, . . . . d .\ z �
% •\ 3
a
n . . a a •\ � a
� � a d . ' (E)Single Family Dwelling
J� / •� 5
� / e 9 �•
Q /.
� O
� d /
Q �•
/ d �
S %� p /•/
x
o � �
9 i/ �� Exterior Equipment Location:
� (E) Utility Meter
LL � � Interiar Equipment Location:
a � (E) Main Service Panel
�(N) PV Array on Roof 1: / (N) PV Production Meter/Monitor
18 Solarworld Plus SW 275 Mono Black Modules (N) PV AC Combiner Panel
18 Enphase Energy M250-60-2LL-S22 Micro-Inverters �
Asphalt/Comp. Shingle Roof �
; 2"X 6" Rafters @ 'I6"O.C. /
s Pitch:21°
Azimuth:206° �•
/
� �� (N) PV Array on Roof 2: �� 1/16"= 1'-0"
9 Solarworid Plus SW 275 Mono Black Modules
/ � 9 Enphase Energy M25480-2LL-S22 Micralnverters N SITE PLAN
� � AsphalUComp. Shingle
/ 2"X 8" Rafters @ 16"O.C.
� �' Pitch:9° w E
� � Azimuth206� PV-A01
� �•
s
' FOR CONSTRUCTION ``el�j�
PV ARRAY 1 -MECHANICAL LOADS PV ARRAY 2 -MECHANICAL LOADS ����1e�
Array Area: 326.9 ft' Total Photovoitaic Dead Load: 2.98 psf Array Area: 163.4 ft� Total Photovoltaic Dead Load: 3.02 psf RGS
Array Weight: g75.0 Ibs Avg. Dead Load per Anchor. 23.2 Ibs Array Weight: 494.0 Ibs Avg. Dead Load per Anchor. 27.4 Ibs E N E RGY
AnchorQty.: q2 AnchorQty.: 18 c�N�.�ao.,w-.a�ac,e�.�:,�,.
Design Values by Roof Zone: Comer Egde Interior Design Values by Roof Zone: Corner Egde Interior 327augwonk spur,a1z
Stonginton,CT 06378
Max. UniRac Rail Span: qg in.O.C. 60 in.O.C. 60 in.O.C. Max. UniRac Rail Span: 42 in. O.C. 60 in.O.C. 60 in. O.C. Phone(a5o)535-3370
......................... .......................... ......................... ................................................... ......................... Fax(413)683-2225
Max. UniRac Rail Cantilever. 16 in.O.C. 20 in. O.C. 20 in. O.C. Max. UniRac Rail Cantilever. 14 in. O.C. 20 in.O.C. 20 in. O.C.
Adjusted Anchor Span: 32 in. O.C. 48 in. O.C. 48 in. O.C. Adjusted Anchor Span: 32 in. O.C. 48 in.O.C. 48 in. O.C. GRID-TIED
Downforce Point Load: 249.31bs 373.9 Ibs 373.9 Ibs Downforce Point Load: 252.7 Ibs 379.1 �bs 379.1 Ibs PHOTOVOLTAIC SYSTEM
Uplift Point Load: _314.61bs -290.8 Ibs -2002 Ibs Uplift Point Load: -342.9 Ibs -325.8 Ibs -208.51bs 7.425kW DC @ STC
Minimum Anchor Strenglh: 707 Ibs Minimum Anchor Strength: 707 Ibs
Average Safety Factor. 3.pq Average Safery Factor. p gq SAKOWICH, RICH
36 CIRCLE HILL ROAD
SALEM, MA 01970
: ; : : Project# 10241324
;�..................................................................................................................................... qg�_���� .....................................................................................................................................�; :................................. �q�_4�� ...............................^
OESIGNER BJC
.... ..... t . � : : : .......... .. AEme^�n: MLM
� i............... �� �.
veasiory oa�e. 2015-02-25
� . REVISIONS
z�_3�� . # By Date Notes �..
z I
' a
14�_6�� E .. 2�_z�� ... � a
� s
� � Array 2 down a�
from this point zz�_y"
` ` :
N ...�.....
...1.................. :
� .
a �............................................................................... gp,_5�� ...............................................................................�>�............................... �q���� ............................_.� q�_2�� ;�... :
� . . .
X
� � PV Array 1
m y
v Scale: 3/16" = 1'-0"
4
m
LL
N �
6
UniRac SolarNAount Mounting Notes: �
• Integrated Full System Grounding and Bonding to UL 2703
r • Total Quantity of Attachments=60
< . Roof Zones are defined by dimension, a= 3.0 ft. �.�� PV Array 2
� • Maximum Allowable Cantilever for UniRac Rail is�the Maximum Rail Span L
• Racking and Attachment: UniRac SolarMount with Eco-Fasten Green-Fasten with CP-SQ-Slotted Bracket and Scale: 3/16" = 1'-0"
Aluminum Flashing attached with 5/16"x 3-'1/2" Lag Bolt, Hex Head, 'I&8 SS °u� 3/16"= 1'-0"
. All Dimensions shown are to module edges, including 1/4 in. Spacing between Modules required when using the
Top Clamp Method. tiy MODULE LAYOUT
. The SolarMount Raiis will extend 1-1/2 in. beyond the Module Edge in order to support the End Clamps.
• UniRac requires one thermal expansion gap (4 in.)for continuous sectlons of rail greater than 40' in length `�
• Array Installed according to the UniRac SolarMount Design&Engineering Guide PU614NOV03
. Attachment Locations, If shown, are approximate. Final adjustment of attachment location may be necessary � PV-A02
depending on field conditions. All attachments are staggered amongst the framing members.
S
36 Circle Hill Rd.
I.
Plans must be filed and approved by the Inspector before a permit will be granted.
City of Salem Ward_/
IS PROPERTY LOCATED IN THE
HISTORIC DISTRICT? Yes_NoC/ c
IF SIDING, HAS ELECTRICAL �"fccbxcm�d
PERMIT BEEN OBTAINED? Yes No Home Phone #
APPLICATION Bus. Phone # Sys= j 7
F
PERMIT TO ROO , REROO OR INSTALL SIDING
Salem, Mass.,
TO THE INSPECTOR OF BUILDINGS:
The undersigned herebv applies for a permit to build according to the following specifications:
Owner's name and address
Architect's name
Mechanic's name and address cl. ✓ e-z
Location of building,No. Q.
What is the purpose of building?
Material of building? 4 e -Izt Asbestos?
If a dwelling,for how many families _
Will the building onfonn to the requirements of the law?
Estimated cos - ntr rs Lic. No. % Z
Signature of applicau
REMARKS SIGNED UNDER THE
PENALTY OF PERJURY.
� a
d,
No. `/ Ward
APPLICATION FOR
PERMIT TO ROOF
REROOF OR INSTALL SIDING
Location t, C;r c
PERMIT GRANTED
is 9�
Approve —\
/6 ccj Bu4nsp7ector
40� ,�a'
69
` Plans must be filed and approved by the Inspector before a permit will be granted. �a3/
No. /—�V City of Salem Ward /
�X uq
Is Property Located in the
Historical District? Yes_ No «i 5 fy 4 S _ 3 S 3
R Home Phone# g
Is Property Located in a r
Conservation Area? Yes_ Not,-/ Bus.Phone# yk 2405
APPLICATION
FOR
PERMIT TO CONSTRUCT ,
Salem, Mass.,
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby ap �s fora permit to build according to the following specifications:
Owner's name and address QR �Cs2�c s 34, C!I 1 p [& Il ew. Vl'ta-
Architect's name
Mechanic's name and address Z. Wp .
Location of building, No.
What is the purpose of building? -1-
Material of building? l.Jo� A
If a dwelling,for how many families?
Will the building conform to the requirements of the law? 19 5
Estimated cost Contractors Lie. No. 0 C<J rj4-dk-
Signature of applicant (2c-'e,W� ,
Signed Under the Penalty of Perjury
REMARKS J
Nr-22L— Ward
APPLICATION FOR
PERMIT TO CONSTRUCT
SWIMMING POOL
Location 94 �wC Q� t LQ Q� Tc(
PERMIT GRANTED \
19 S�
Ap ove
wilding Ins pec r
MORTGAGE INSPECTION
BAY STATE SURVEYING SERVICE INC.
234 CABOT ST. , BEVERLY, MA.
-OCAT ION AL (- 1l J.t/�.'?`� To .. Y.ti1N 5c� SAVItil_C7 ` f:
iCAI._1= I11 = y0 FT DATE l2_ll .y... I hereby certify that I have examined the premises and that the
EPi_kGNCE = .I, `:l.a.:. `zh..�?. .?_�?.'?. 1 ......__ building (s) shown on this plan are located on the ground as
' l shown and that they conformed to the zoning Whacks of fhe
GL
y_C_fT, L �/------ --- when cnnsirucled.
a M}"!"'ag.^ Inspection survey and not The building(s) are not located In the special Fl ,oll Iv:—ra
!ii iw0rument survey , therefore this plot plan is for zone, as defined by KU.D. �J
nortgage inspection purposes only. ,/ ^? � '•^
LOT 2 y ct3 .� L C> 2
-Z 9
1 '
1,0 ' 0
AKE:A-
L• 02 5 14 `7001 SF.
•o
Q a5
1 ,
3�
y s-ry, \V7
- y0 . 0
1
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CITY OF SALEM
EUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
?lease Pr/int 6
DATE - 9 - 99
JOB LOCATION ';?�- (-
Number Street address Section of Town
"HOMEOWNER �nrYv���. �(4 Z�4O�j
Name Home pnone Work phone
PRESENT MAILING ADDRESS _ 3 (, (?,� r,�, L, J LI (2-A
'�' l Vkc o (9
City/Town State Lip Code
-he current exemption of "homeowners" was extended to include owner-occupied
dwellinas of six units or less and to allow such homeowners to engage an in-
di'vidual for hire who does not possess a license. provided that the owner
acts as supervisor. ; State Building Code Section 109. 1 . 1 )
DEFINITION OF HOMEOWNER:
Person(s ) who owns a parcel of land on which he/she resides or intends to re-
side. on which there is, or is intended to be, a one to six 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 shall be responsible
for all such work oerformed under the building permit. Section iO9. 1 . 1
The undersigned "homeowner" .ssumes cesponsibiiity for compliance rjith the State
3uildind code and other applicable codes. by- laws. rules and reduiations.
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 a of requirements.
HOMEOWNER' S SIGNATURE CLLco
APPROVAL OF BUILDING OFFICIAL
NOTE: -hree family dwellings 35.000 cubic feet. or larger. be required
to comply with State Building Code Section 127.0. Construction Control .
HOME OWNER ' S EXEMPTION
The Code states that: "Any Home Omer oerforminc work for which a building
permit s required shall be exempt from the provisions of this section
(Section 109. 1 . 1 - Licensing of Construction Supervisors ) ; provided that is
a Home Owner engages a person(s) for hire to do such work, that such Home
Owner shall act as supervisor. "
Many Home Owners 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 aware-
ness often results in serious problems . particularly when the Home Owner
hires unlicensed persons. In this case your Board cannot proceed against
the unlicensed person as it would with licensed Supervisor. The Home Owner
actinq as supervisor is ultimately responsible.
u ensure that the Home Owner is fully aware of his/her responsibilities.
nany ccmmunities require. as part of the permit application, that the Home
Owner 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.