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15 HUBON ST - BUILDING INSPECTION -PLihM MU T-6EfiLC- APPROVED BY T44E .WSPJ:CTDB PRw TD.A.PERMIT BEING GRANTED CITY OF SALEM No. � Date 7✓� 05 Is Property Located In Location of the Historic District? Yes_No ISuilding 15— r' `'` l S y Is Property Located in the Conservation Area? Yes No X BUILDING PERMIT APPLICATION FOR: Permit to: (Circle whichever apply) Roof, Reroof, In Sidi , Construct Deck, Shed, Pool, Repair/Replac the : re lid;v- SroJe-- 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:- ( Q Owner's Name -51-6 P& �h Address & Phone 6 4-0-bM Sfi 078I 74-- 6 q 8c7 Architect's Name Npn (S- Address & Phone \ Mechanics Name /Uo n,e- C S e �� ) Address & Phone L ) What is the purpose of building? f-© Material of building? Wo 09- - If a dwelling, for how many families? / WIN building conform to law? Y e5 Asbestos? X10 Estimated cost ®O'®� City Licenser N P' State License a �— �� Hosia Imgrrover ant X Lfic. it w� ignature of Applicant SIGNED UNDER THE PENALTY OF PERJURY DESCRIPTION OF WORK TO BE DONE r -Vol Pe� e _ MAIL PERMIT TO: - t J eA-\ r\ )>f Hv2boy1 No.S :: Cj APPLICATION FOR PERMIT TO LOCATION 1�L.J'or✓1 D �� PERMIT GRANTED AlROV�D INSPECTO OF BUILDINGS l S CITY OF SALE M, :MASSACHUSETTS PUBUC PROPERTY DEPARTMENT 120 WASHINGTON STREET, 3RD FLOOR SALEM. MASSACHUSETTS 01970 STANLEY J. UsoVIC2, JIl. TELEPHONE: 978-745-9595 EXT. 380 MAYOR FAX: 978-740-9846 HOMEOWNER LICENSE EXEMPTION Please Print. Date Job Location /S k/v--bCx� Home Owner Address s® rv` Home Owner Telephone 9 $ <. 4S F>`1 Z>U Present Mailing Address:,,. , ,SbLsv�e The current exemption of"Homeowners%was extended to,include owner-occupied dwellings of two Units.or less and to allow such homeown ,to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER. : a Person(s)who owns aparcel 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 City of Salem Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING SPECTOR See ot her side for state code r HOMEOWNERS EXEMPTION The Code states that: Any Homeowner performing work for which a Building Permit is sons of this section(Section 109.1.1 —Licensing required shall be exempt from the provi of Construction Supervisors); provided that a Homeowner engages a person(s) for hire to do such work, and that such Homeowner shall act as Supervisor. lion are unaware that they are assuming the Many Homeowners who use this exemption Regulations for Licensing responsibilities of a Supervisor(see Appendix la Rules and Construction Supervisors,Section 2.15). This lack of awareness resultsthis you problems,particularly w a Homeowner person as iires unlicensed would with a licensed Board carmot pros the unlicensed p nsible. Supervisor. The Homeowner acting as supervisor is ultimately reRPo sibilities, many To ensure that the Homeowner is fully aware of hiser re the Homeowner certify that 't Application, communities require, as a p�of the Permse of this issue is a he/she understands the responsibilities of You Supervisor. am the last page t such a form currently used by several tom' You may care to amend and adopt form/certification for use in your community. y 301 zao s R� I