5 WHEATLAND ST - BUILDING INSPECTION (2) °i 'dsil�i��`• Na,1 44p11,,)8•`hRRRR r f
. I{lY1y1`d
f1 fQSiITIIST�9E flL � 013ROVED BY T44E ;
IMS�PECTLIB OtDR tD"A PE
S,EWG GRANTED
✓�\ �,� CITY OF SAtLEM
No vt \'� DateO
�`1,C4-
Is Property Located in Location of
the Historic District? Yes_No_� Building
Is Property Located In
� the Conservation Area? Yes No
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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 Da 1ki I�e— 11 � e r
Address & Phone SlkJ�e.44� -Ak O/A Z4t - �963
Architect's Name
Address & Phone )
Cflf)j AG-(Wr P
—MeeharncrName 1— U 1 .5 •
Address & Phone 0%h ri 12 ILI
r
What Is the purpose of building?
Material of building? If a dwelling,for how many families? _
WIN building conform to law? Asbestos? ',
Estlmm cost 0 .6 fl City License•
\ ,NN
Bme Lmgsovemut
C _ Signature of Applicant
SIGNED UNDER THE PENA'kTT
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
0 41, 17e K Jul0 +
}
,
MAIL PERMIT
• iu .
APPLICATION FOR
PERMIT TO
LOCATION
PERMIT GRANTED
Wd 9/ 2-0 .—
APPS�OVfD
INSPECTOR OF BUILDIN(.;S
Y ..
CITY OF SALEM
B=ING DEPARTMENT
HOMEOWNER LICENSE E)MW•nON
Please Print
DATE _a
JOB LOCATION V- CAJ
• ' Holgowl�lt 3C,J h e ,9.�-�9K�� 5
ADDRESS
TELEPHONE
PRFSENTMAILiNG ADDRESS
The current exemption of"homww=C was r-acrtded to include owvcr-occupied dwcIIDV of TWO
Units or less and to allow such homcownen to engage an individual for but wbo does not posses a
license,provided tbal the owou ad rs supervisor.
DEFlN1770N OF HONMOA'NEB:
Person(s)who owns a parscl of land on which he/she asides or intends to reside,on wluchemereK or's .
intended to be,a one to two family dwelling,anachcd or detached strum s accessM 10 vxb
we cor +edan
dhr
farm swamcs.A person who concocts mart than one home in a two-? period shad de
a bomeowner. Such"homewAT et' "h 5ubnnt to the Budding Offidal,on a form soceptabk am tht:
Building Official,that hdshc be responsible to all s»ch work performed wxkr the building pawk
The undersigned"bomeawncr"assumes responsibility for compliance with the State Building Code and
other 2pp5cablc goes by-laws,ntles and regulations
The undersigned"homeowner"ca dSts that hdshe tmdersstarrds the City of Salem Building Deparoaoit.
ndnimmn inspection pro«dmu and rds and that Ijft will�comply whb said prof &uu and
requirements. C:�/la1
NOME URE
OWNM'S SIGNAT
APPROVAL OF BUILDING INSPECTOR
Sec otber side for s=code
v
HOMEON'N�ER'S EXEMPTION
The code states that "any homeowner performing work for which a building permit is required shall be
exempt from the pra isiots of this section (Section 10p 1.1-Umsiog of Construction Supervisors);
Prodded that is a homeowner engages a pen= (s)for hue to do.such wort.that such homeow as shall ea
as supervisor.'
Marry bomcowters who use this exemption an"wan that they arc assttraimg the msponsibilida act
supervisor(set Appeodis Q,Ruks and Regulations for Licensing Construction Supervisors,Section
.2.24 This lade of awareness often results in serious problems,particularly when the homeownu bhu
unlicensed perst m In this case your Board cannot proceed against the IUMMased pawn so h'%V tld vft
licensed Supmisot. The bomeovroer acting as supervisor b aitimateiy ropoosibit.
To ensure thm the homeowner is fully aware of hi/lter responstbilit M snotty eornmunitia ngtnte;as pot
of the permit appliotion,that the homeow=certify that helshe underwwAs the nsponsibilities of a
super .isor. You may can to amend and adopt such a form/ccnVication for use in your eontmrnip.