5 CYPRESS STREET - BUILDING PERMIT APP 40 P4
Plans must be filed and approved by the Inspector
prior to a permit being granted
CITY OF SALEM 3�
Noll_9,C/ Ward `!Z
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HISTORIC DISTRICT? Y N Date
IF FOR SIDING, HAS ELECTRIC 4 Home Phone 7 — 6
PERMIT BEEN OBTAINED? Y N �i��c' Bus. Phone
APPLICATION
FOR
PERMIT TO e / ( Y-r
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the
following specifications:
Owner' s name and address /J2 G _ vie n� P-,r
Architect's name
Builder's name
Location of building, No.
What is the purpose of building?
If dwelling, # of units? Material of bldng?
Will building conform to law? Asbestos?
Estimated
Estimated CostC'�D City Lic.# �/ l�State Lic.#
(V� Home Improvement License #
Signature of Applicant
SIGNED UNDER THE PENALTY OF PERJURY
DESCRIPTION OF WORK TO BE DONE
i1 0 T) rawerin, S e�v ; r-Q-,
Mail Permit to: OIL,/
L(/
No. ward
APPLICATION FOR
PERMIT TO ROOF
REROOF OR INSTALL SIDING
Location 5 C V r 2s 5 1
PERMIT GRANTED
19
Approved _
�Occ`( E it jlnvr
CITY OF SALEM
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE Z
JOB LOCATION S CS/� t <
�/ Number St a address Section of Town
"HOMEOWNER (S7 rcQ nQ r 7 Y 9-A,1�77Y 4/
Name Home phone Work phone
PRESENT MAILING ADDRESS C y p eS
Ceja
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City/Town �tate SS Zip Cod > ,
The current exemption of "homeowners" was extended to include owner-occupied
dwellings of six units or less and to allow such homeowners to engage an in-
dividual for hire who does not possess a license, rovided 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 do°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 res onsible
for all such work performed under the buildingpermit. Section 109.1 .1
The undersigned "homeowner" assumes responsibility for compliance with the State
Building code and other applicable codes, by-laws, rules 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 ocedures and requirements.
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING OFFICIAL
NOTE: Three family dwellings 35,000 cubic fee or rger, will be required
to comply with State Building Code Section 127.0, Construction Control .
HOME OWNER'S EXEMPTION
The Code states that: "Any Home Owner performing work for which a building
permit is 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
acting as supervisor is ultimately responsible.
To ensure that the Home Owner is fully aware of his/her responsibilities,
many communities 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.