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Permit to:
BUILDING PERMIT APPLICATION FOR:
(Circle WhW~apply) Roo(. Reroof. notall Siding, CamtrW Deck, Shed, Pool,
RWair/Replim
PLEASE FILL OUT LEMfBLY i COMPLETELY TO AVOID DELAYS IN PROCESSM
TO THE INSPECTOR OF BUILDINGS: '.
The underiy l hereby appNes for a permit to bulk! accor(6V to the fokm"
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Owners Name , 1 2 AJ v 4Z" (�
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DESCRIPTION OF WORK TO BE DONE of PERJURY
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MAIL PERMIT M.
APPLICATION FOR
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PERMIT GRANTED
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'y CITY OF SALEM9 MASSACHUSETTS
PUBLIC PROPERTY DEPARTMENT
D120 WASHINGTON STREET, 3RD FLOOR
SALEM, MASSACHUSETTS 01970
STANLEY J. USOVICZ, JR. TELEPHONE: 978-745-9595 EXT. 380
MAYOR
FAX: 978-740-9846
HOMEOWNER LICENSE EXEMPTION
Please Print,
Date t_'J pep 0 S
Job Location l�l— Gc2 ((pw-5
Home Owner Address (,
Home Owner Telephone� 7� 7t�t_t,o�
Present Mailing Address
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 Cityof Salem
BuildingDepartment
ep t minimum inspection procedures and requirements and that he/she
will comply with said procedure requirements,
HOMEOWNERS SIGNA /
APPROVAL OF BUILD INSPECTOR
See other side for state code
HOMEOWNERS EXEMPTION
The Code states that: ,Any Homeowner performing work for which a Building Permit is
ions Of this section(Section 109
required shall be exemnsing
pt from thP that a Homeowner engages a persons) for hire to
of Construction Supervisors); provided
do such work, and that such 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
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
es t the Homeowner certify that
ties, many
communities require, as a part of the Permit Application,
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.
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