28 BECKFORD STREET - BUILDING JACKET��� ����'� r� . sT
6 6 3�
Plans must be filed and approved by the Inspector
prior to a permit being granted
CITY OF SALEM
No. Ward — a
1n6 �9
HISTORIC DISTRICT? Y N _ � Date 7
1F FOR SIDING, HAS ELECTRIC '' ° Home Phone
PERMIT BEEN OBTAINED? Y N s Bus. Phone
APPLICATION
FOR
PERMIT TO
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to build according to the
following specifications:
Owner's name and address
Architect's name
Builder's name
Location of building, No.—ZZOdT
What is the purpose of building?
If dwelling, # of units? Materi 1 of bldng? /�
Will building conform to law? Asbestos? VC-D
Estimated Cost g City Lic.# �State Lic.#
Hqrke Improvement License #_1
Signature of Applicant
SIG D ND THE PENALTY OF PERJURY
DESC IPTION OF WORK TO BE DONE
C,�
Mail Permit to: }v `Ilk ( . a
a
No. d -V/` ward
APPLICATION FOR
PERMIT TO ROOF
REROOF OR INSTALL SIDING
I
n !
Location
PERMITGRANTED
kil / 19q
Approved
��
BuWft Inspe for
CITY OF SALEM
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE
JOB LOC;XON
r Tlumber Street address Section of Town
"HOMEOWNER
Name Home phone Work phone
PRESENT MAILING ADDRESS 2 CD
City/Town State Zip Code
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, 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 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 in pection procedures and requirements and that
he/she will comply with said p cedures and requirements.
HOMEOWNER'S SIGNATURE
s
APPROVAL OF BUILDING OFF/IAL
NOTE: Three family dwellings 35,000 cubic feet, or larger, 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 Ovrner
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.
Salem Fite Depan tmetrz
APPOINTMENT FOR FINAL' Fierce P�cevention Bwteau f APPOINTMENT F014-FINAL"
INSPECTION MUST E 48 La4ayette Street
MADE AT LEAST ONE WEEK INSPECTION MUST BE zo;.
Satem, Ma 01970 MADE AT LEAST O
AHEAD------------ (508) 745-7777 AHEgp NE WEEK
FIRE DEPARTMENT CERTIFICATE OF APPROVAL FOR BUILDING PERMIT
In accoAdance with .the Pnov.wton.6 o4 the Maaeachu,6ett,6 State Su.Ged in-9 Code
and the Sa.Eem F.i-ce Code, aPPt,.cation .t6 hereby made 4o-,L app-tovat o4 pPan,4
and the .i.6.6uance 04 a 04 app�tovat 4o2 a bu i ed,in9 Pe-tn,tt by the
Sae'em Fihe Department. (Re4. Section 113. 3, Ma.6.6. State SEd9. Code)
Job Location:
7?
(�
N -10
-71
Owneh./Occupant: 1 Z
�1 ink 4-i v ' 3
Eeeeth i.cat Con t,acto-c: II
�h VV h /Ns
F.Z,te Supp-te.64ton Contnacto.%: G
paA
03
T
St
gnatun,e o4
^Z
APPS-cant: Phone
Addnena o4 C.<ty 0-c
APPt,cant. Lb IYl�2 S Town:
Appaova.e date:
Ce4-tt4teate 04 appn.ova.e .w hezeby 9nanted, on appaoved ptan6 on aubm.ittae
04 p�coject data i e6, by the SaEem F.i�te Depa4,tment. AZt p.ean.6 ane app�toved
-60teEy 4oz tdentl.4teatlon 04 type and tocatLon o4 4.ite P-%Oteetion devtce6
and equipment. Att ptan,6 cute .6ubjeet to apptovat 04 any othez autho,uty
having jt4ti-bdZctlon. Upon eomp.Eetlon, the app.e.icant 0n t"ta tet(4) 6ha Z
�teque6t an tn.opec t i.on and/o-c teat o4 the 4tae pn.otec t i,on devtce.6 and
equi.pmerzt. ( " FOR ADDITIONAL REQUIREMENTS, SEE REVERSE SIDE ** )
New con6tcucti,on.
O PnOpe, ty Zocat-Lon hates no eompt-Lance with the pnov.i.6-4=4 v4
Chapter. 148, Seetlon 26 C/E, M. G. L. , aeEatl.ve to the
tn-6tatatton 04 app coved 4.i to ata'rm devtee.6. The ownet o4
this p'topenty .t,6 aequi ted to obtain eomp8-i.ance a-d a
condttton o4 obtcti.ni,ng a Su L2ding Pe-rmtt.
P'copenty location tib to eomptia.nce with the paov-i,6ton6 04
CCC Chapter 148, Section 26 C/E, M. G. L.
Exptna tion date: s
O¢4tc6a2
/ 33
Fee itce: und�t i , 500 Sq. Ft. - ` {3. 00
x3. .
I' m
FIRE DEPARTMENT CERTIFICATE OF APPROVAL FOR BUILDING PERMIT R
In compliance with the provision of Section 113.5 of the Massachusetts
State Building Code, and under guidelines agreed upon by the Salem Bldg.
Inspector and the Salem Fire Chief, the applicant for a building permit
shall obtain the Certificate of Approval (see reverse side) and stamped
plan approval from the Salem Fire Prevention Bureau.
Said application and approval is required before a building permit may be w
issued. The Massachusetts State Building Code requires complianceW
z 3
approval of the Salem Fire Department, with reference to provisions of U. m W
Articles 4 and 12 of the Building Code, the Salem Fire Code, Massachusetts n: r- oz I
General Laws, and 527 Code of Massachusetts Regulations. j F- j
f- � N
The applicant shall submit this application with three (3) sets of plans, W oz
drawn in sufficient clarity, to obtain stamped approval of the Salem Fire F- �-
Denortment, This applies for all new construction, substantial _ z W W a
alterations, change of use and/or occupancy, and any other approvals "'a. 0 �
required by the Massachusetts General Laws, and the Salem Fire Code. a ? a
Exception: Plans will not be required for structural work when the N.
proposed work to be performed under the building permit will
not, in the opinion of the Building Inspector, require a
plan to show the nature and character of the work to be
performed.
Notice: Plans are normally required for fire suppression systems,
fire alarm systems, tank installations, and Fire Code
requirements.
Under the provisions of Article 22 of the Massachusetts State Building
Code, certain proposed projects may not require submission of plans or
complete compliance with new construction requirements. In these
cases, provisions of Article 22, Appendix T, and Tables applicable
shall apply. This section shall not, however, supersede the
provisions outlined in the Salem Fire Prevention Regulations, Chapter
148, MGL, or 527 Code of Massachusetts. Regulations. . All permits for
fire code use and/or occupancy shall apply for the entire structure;
fire alarm and/or smoke detector installation shall apply to the
entire strueflirp based aper current: requirements as per Laws aid/ur
Codes, but the existing structure may comply with regulations
applicable for existing structures.
Notice: Sub-contractors may also be required to file individual
applications for a Fire Department Certificate of Approval
for the area of their work. Such sub-contractors shall file
an Application to Install with the Fire prevention Bureau
prior to commencing any work for those areas applicable.
i
I FOR F1NAL `; .
T Be
Form 81X (10/90) p1NTMENI FST B AL pp? T 014 MS SONE WEEK
APP ECt{ON MUS WEEK 1N ADE At �0
1'pPr AT LEAST �Y J � ANSD.............