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18 BAY VIEW AVE - BPA-05-255 SHED UIt1 T-BE ffL-EG-A+40 APPROVED BY T+IE MPECTOA PMOR TO A.PERNIIT BEING GRANTED CITY OF SALEM No. SS_`\\v� �:tt ..L .,\. Date ,h Ward Zoning District 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, Reroof, Install Siding, Construct Deck, 6ed 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 Name1&112�1hl'15�t/`©t1 Address & Phone e C9l 3,R) JW- 0,'] Architect's Name Address & Phone ( ) Mechanics Name E Address & Phone ( yy) What is the purpose of building? 0�C5�Cel Y1Gt1 �t9 dVl�t7�eS �aolS i S bS Material of building?—vl� & If a dwelling, for how many families? i Will building conform to law? T2 C� Asbestos? 11fb Estimated cost 2C> • City License# State License # \ Home Improvement v> Lic. I Signature of Applicant SIGNED UNDER THE PENA OF PERJURY DESCRIPTION OF WORK TO BE DONE r jj C6nSiV- 6 5 y1Cd MAIL PERMIT TO: y 14 No.� APPLICATION FOR PERMIT TO LOCATION PERMIT GRANTED 19 APR OV�D INSPECTOR OF BUILDINGS J tip CITY OF SALEM BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please Print DATE JOB LOCATION HOMEOWNER ADDRESS � a� i, HOMEOWNER C Iqq pI ce/ I l 1` b / 1 91 TELEPHONE p PRESENT MAILING ADDRESS ( !) V U f @� ! The cement exemption of"homeowners"was emended 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 act 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 to 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 to all such work performed under the building permit The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable goes by-laws,Hiles and regulations. The undersigned"homeowner"certifies that he/she understands the City of Salem Building Department minimum inspection procedures and requirements and that h/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE —4- APPROVAL OF BUILDING INSPECTOR See other side for state code HOMEOWNER'S EXEMPTION The code states that: "any homeowner performing work for which a building permit is required shall be exempt from the prrnlsions of this section(Section 109.1.1—Licensing of Construction Supervisors); Provided that is a homeowner engages a person(s)for hire to do such work,that such homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assmning the responsibilities of a supervisor(see Appendix Q,Rules and Regulations for Licensing 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 licensed Supervisor. The homeowner acting as supervisor is ultimately responsible. To ensure that the homeowner is fully aware of hi/her responsibilities,many communities recpme,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a supervisor. You may care to amend and adopt such a form/certification for use in your community. 6 U cd Cam r '�