32 HANSON ST - BUILDING INSPECTION (3) 1
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41 T B,EWG GRANTED
,
a ±CITY OF SALEM
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No. Date+F ,
ward
\ Zoning District
Is Property Located In Location of
the Historic District? Yes—No_ Building t 3� �yQJ7c�t5yl C� l
Is Property Located in
the Coneervation Area? Yes_No
BUILDING PERMIT APPLICATION FOR:
Permit to:
(Circle whichever apply) Roof Reroof Install Siding, Construct Deck, Shed, Pool,
epair/ epace Other:.&yxtde..
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
an
Address & Phone J94 o
Architect's Name (�
Address & Phone
Mechanics Name
Address & Phone L 1
What Is the purpose of building?
Material of building? 1,t) 701 If a dwelling,for how many families? r
Will building conform to law? Asbestos?
Estimated cost 4';�O(X� City Ucense k State eena a
(� Bone Improvement
Lie. i
atu Applicant
SIGNED UNDER THE PENALTY
b OF PERJURY
DESCRIPTION OF WORK TO BE DONE
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MAIL PERMIT TO: 3g CIYI. n
01 q70
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CITY OF SALEM
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE B0
Rem /n� U1r70
roBr.GCAnoN�a
An�ss� S .
HO MOWNER 9�v
TELEPHONE _
PRESENT hfAII1NGADDRESS �o� Onl2� ( t91Cc5 x 3�a��
The current ocemption of"homeowners"was extended to include owneroewpkd dwellings of TWO
Units or less and to allow such homeowners to engage an individual for hire who does nor possess a
license,provided that the owner act as supervisor.
DEFINMON OF HOMEOWNER
or Is
Person(s)who owns a parcel of land on which heshe resides or intends to reside.on such ah thicot�md/or
intended to be,a one to two family dwelling,attached or detached structures accessory
1 to not be considered
r
farm suucnnes.A person who constructs more than one home in a two-yewperiod a
a homeowner. Such`homeowner shall,submit to the Bolding Official,on a form scaptsble to the
Building Official,that bdshe be responsible to all such work performed undo thte building pernik
.The undersigned"bomeowner"asswnes responsibility for compliance with the State Building Code and
other applicable goes by-laws,rules and regulations.
The undersigned"homeowner cw%cs that he/she urdcmands the City of Salem Building Depmvo t.
minimum inspection procedures and req ' she will comply with said proceduaa and
tequirciie>bs.
HOMEOWNER'S SIGNA
APPROVAL OF BUILDING INSPECTOR
See other side for state code
F
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 hue to do such work,that such homeowner d all act
as sup rvisor."
My 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,Seet4n
.2.14 This lade of awareness often results in serious problems,particularly when the homeowner hires
unlicensed persons. In this ease your Board cannot proceed against the unlicensed person as it would with
licensed Supcnisor. The 60mcov,•oer acting as supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of hi/her responsrbilities,many communities r MOM as pari
of the permit application,that the homeowner certify that he/she rmdcrstands the responsibilities of a
supervisor. You may care to amend and adopt such a form/certification for use in your community.
I
r_ OF SALEM. MASSACHIUSETTS
�otirvit,f r�
PUBLIC PROPERTY DEPARTMENT
�CG k
3 120 WASHINGTON STREET, 3RD FLOOR 1
'!p= $ALEM, MA 01 970 V
�r A TEL. (978)745-9595 EXT. 380
FAX (978) 740-9846
STANLEY J. USOVICZ, JR.
MAYOR
DISPOSAL OF DEBRIS AFFIDAVIT
In accordance with the provisions of MGL c 40, S34,I acknowledge that as a condition
of Building Permit# , all debris resulting from the construction activity
governed b this Building Permit shall be disposed of in a properly licensed solid-waste
g Y g sP
disposal facility,as defined by MGL nnc III, S150A. �y
The debris will be disposed of at: eQr N.S . Caro,.G
Location of Facility
ioAId,2)
gnature of Permit Applicant - Date
FULLY complete the following information:
(PLEASE PRINT
nCLEARLY)
//11
11 hl� 1.�4 cC-/{/
Nanfe of Permit Applicant
Firm Name, if any
0 oitn� ein
Address, City & State j r�SSA FL 3Yo)3
The above statute requires that debris from the demolition,renovation,rehab or other
alteration of building or structure be disposed in a properly-licensed solid-waste disposal
facility as defined by MGL cIII, S150A, and the building permits or licenses are to
indicate the location of the facility.