11 WILLIAMS ST - BUILDING INSPECTION (3) 0011 WILLIAMS STREET UNIT #2 464-07
GIs : 5668 COMMO ALTH OF MASSACHUSETTS
Map: 35
Black: CITY OF SALEM
Lot: 0166
Category: REPAIR/REPLACE
Permit# 464-07 BU IN ERMIT
Project# JS-2007-000680
Est. Cost: $10,000.00
Fee Charged: $75.00
Balance Due: $.0o PERMIS I S HEREBY GRANTED TO:
Const.Class: Contractor: License: Expires
Use Group:. owner
Lot Size(sq. ft.): 4228 Owner. Max Engelhardt&Shannon Engelhardt
Zoning: R2
Units Gained: - - Applicant: Max Engelhardt&Shannon Engelhardt
Units Lost: AT. 0011 WILLIAMS STREET UNIT#2
Dig Safe#:
ISSUED ON. 30-Nov-2006 AMENDED ON: 30-Jan-2007 EXPIRES ON. 30-May-2007
TO PERFORM THE FOLLOWING WORK.
RENNOVATE KITCHEN/BATH UNIT# 1 &2 ADDITIONAL COST OF$10,000.00 CHECK RECEIVED FOR$75.00 FOR
THE ADDITIONAL COST
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Electric Gas Plumbing Building
Underground: Underground: Underground: Excavation:
Service: Meter: Footings:
Rough: Rough: Rough: Foundation:
Final: Final: Final: Rough Frame:
Fireplace/Chimney:
D.P.W. Fire Health
Insulation:
Meter: Oil:
Final:
House# Smoke:
Treasury:
Water: Alarm:
Sewer: Sprinklers:
THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF ITS
RULES AND REGULATIONS.
Signature:
Fee Type: Receipt No: Dale Paid: Check No: Amount:
BUILDING REC-2007-000835 30-Nov-06 744 $75.00
GeoTMS®2007 Des Lauriers Municipal Solutions,Inc.
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DELIC PROPERTY
Pt1RTNiENT
1:I.%MFRI.EY DRISCOLL
MAYOR I?0 WASHINGMN S'IREEr♦SAWA,XASSACHLSLI15 01970
.
-7�IVI 7 -4"� TEU 978-74S-9595* FAX 97&740-98"
APPLICATION FOR THE REPAIR. RENOVATION CONSTRUCTION
DEMOLITION, OR R CHANGE OF USE OR OCCUPANCY FOR ANY EXISTING
STRUCTURE OR BUILDING
1.0 SITE INFORMATION _
Location Name: Building:
Property Address:
Property is located in a; Conservation Area Y/N Historic District Y/N
2.0 OWNERSHIP INFORMATION
2.1 Owner of Land 0 c�,u .��� I k�✓cl+ b
Name: S(tihnn0A
Address: t 16,44,
( 0(5 71,
Telephone:
3.0 COMPLETE THIS SECTION FOR WORK IN EXISTING BUILDINGS ONLY
Addition Existing /
Renovation Number of Stories Renovated S
Change in Use New s,
Demolition Existing /5l00
Approximate year of Area per floor (sf) Renovated s
construction or renovation
of existing building New sue_
Brief Description of Proposed Work:
Mail Permit to: /�� Ms
What is the current use of the Building?
Material of Building?
rA/06 4 If dwelling, how many units?
Will the Building Conform to Law? �C2S Asbestos? N c�
Architect's Name h
Address and Phone
i ( )
Mechanic's Name
Address and Phone
HIC Registration#
Construction Supervisors License# g
Estimated Cost of Project$ Permit Fee Calculation
Permit Fee$ 7`5 Estimated Cost X$7/$1000 Residential
Estimated Cost X$11/$1000 Commercial
An Additional $5.00 is added as an
Administrative charge.
Make sure that all fields are properly and legibly written to avoid delays in processing.
The undersigned does hereby apply for a Building Permit to build to the above stated
specifications. Signed under penalty of perjury X
Date
o
N
y
bCIA
a, g
CITY OF SALEM
PUBLIC PROPERTY
DEPARTMENT
KIMBERLEY DNTSCOLL
MAYOR 1-V WASHINGTON STREET•SALEK A%ssAViusm1s 01970
ixi 978-745-9595• FAX:978.740-9W
HOMEOWNER LICENSE EXEMPTION
Please Print
Date
Job Location 14)1 l CC, W S J f -Sr l
Home Owner Address J; I I
Home Owner Telephone (&r7 ) y Z3
Present Mailing Address 1t rA) II icw�s Sf.
The current exemption of"Homeowners"was extended to include owner-occupied
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 owner acts as supervisor.
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 procedures and requireme ts,
HOMEOWNERS SIGNATURE / I
APPROVAL OF BUILDING INSPECTO L*-�z2e-��
See other side for state code
n
w p
Homeowner's Ezemation
The Code states that: "Any Homeowner performing work for which a Building Permit is
required shall be exempt from the provisions of this section(Section 109.1 —Licensing of
Construction Supervisors):provided that a Homeowner engages a person(s) for hire to do
such work, and the 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 of
Construction Supervisors, Section 2.15). This lack of awareness often results in serious
problems, particularly when the Homeowner hires unlicensed persons. In this case your
Board cannot proceed against the unlicensed person as it would with a licensed
Supervisor. The Homeowner acting as Supervisor is ultimately responsible.
To ensure that the Homeowner is fully aware of his/her responsibilities,many
communities require, as part of the Permit Application, that the Homeowner 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.
CrrY OF SALEm
' PUBLIC PROPERTY
DEPARTMENT
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