15 GREENWAY RD - BUILDING INSPECTION r,
13L4'<#QSIIWT-BEffLE� APPROVED By T44E
,=P XTDI R ,PWfl TP'A.PERWT f3,ENG GRANTED
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CITY OF SALEM
No.2-1 G-ZO c>L4 Date
h
MINE WJ
Is Property Located in / Location of
the Historic District? Yes_No t/ Building 15
Is Property Located in /
the Conservation Area? Yes_No_✓
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof, Reroof, Install Siding, Construct Deck, She , 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 Name MAR-Y ZAPPA -5
Address & Phone 15
Architect's Name
Address & Phone 1
Mechanics Name 4
Address & Phone ( )
What Is the purpose of building? \;TO Q A a1
Material of building? !A)00D `*-1///trYL If a dwelling, for how many families?
Will building conform to law? YE 5 Asbestos? 8J 0
Estimated cost J I snr) City License# N A State License #
2-0 Rome Improvement
C� Lie. I
Si apf"of p Ic nt
SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
12 x 12-
MAIL PERMIT TO:
No.
APPLICATION FOR
PERMIT TO
LOCATION.
PERMIT GRANTED
9ld-91tT-5 2.0
APR ®VD
INSPECTOR OF BUILDINGS
SALEM HOSPITAL
BOOK 148, PLAN 50
"45" E DH, (FD)
18' s
06"\ o�
DH, (FD) S 4052. '17" E
o_
45'
03" E
4-1S 47 �
1v
` 66.73' �
- 1•
D (FD) Z
1947 I I I
CALC) W I LOT 61A I
LOT 0
PLAN 591 1947 � o
REC) O I PLAN 694 OF 1961 V o I
TOTAL AREA,
�
N i LEO J. HIGpN 12,059 fSF. (CALC) �
N 12, 075 f S.F. (REO PLAN 694 OF
1.
W
2 STORY W000 � / �611 ck: I
13.3" DWELLING
COR. l90AR0, MVP
(TYP.) 11
IN
P4- I I
o
l
1 r00
EN IAA Y1. w 4 ROAD
a WIDE)
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CITY OF SALEM
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please Print
JOB LOCATION I (-(�
HOMEOWNER 5R N1 L
ADDRESS
HOMEOWNER 2-79-' - 1q4
TELEPHONE
PRESENT MAILING ADDRESS
The camsnt 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 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,rules 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
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 provisions 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 assuming the responsibilities of a
supervisor(see Appendix Q,Rules and Regulations for I.iceosing 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 wvuld with
licensed Supervisor. The homeowner acting as supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of hither responsibilities,many communities require,as part
of the permit application,that the homeowner certify that he/she understands the responsibilities of a
supervisor. You may rare to amend and adopt such a form/certification for use in your community.