347 JEFFERSON AVE - BUILDING INSPECTION L
"P4JAMS 0 tJ T-BE f UED-A G APfftOVED BY T44E
W P X1_0R ,PRIDfl TD A PERMIT BEING GRANTED
CITY OF SALEM
INDI
Date
Ward
�i
� crmne�'� 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, Shed 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 L—eUL-VP 0AAQ
r
Address & Phone eri,)P (91 ) i(/ - / b"V
Architect's Name
Address & Phone ( )
Mechanics Name
Address & Phone ( )
What is the purpose of building?
Material of building? If a dwelling, for how many families?
Will building conform to law?\ Asbestos?
( Estim ed cost, C7 U City License # State ' ense #
\� f
Home Improvement
� Lic. 1
Signature of`-Applicant
!" SIGNED UNDER THE PENALTY
OF PERJURY
DESCRIPTION OF WORK TO BE DONE
=vy A(I 16L 3'�" �206� Cu_k() L,7e �rol,,.tA
MAIL PERMIT TO: c3�� _I �F)-P� J`�L AuZ✓/ l�=e
No.
APPLICATION FOR
PERMIT TO
LOCATION
PERMIT GRANTED
7f/-�/D% 19
AP OVED
INSPECTOh OF BUILDINGS
4
l
CrPY OF SALEM
BumiNG DEPAP.TMM
ii0l, •OWNERLICENSEEXEOMON
Pkam PdA
�� ell- oe
Ia�iocAnw+ C
• HOMEOWM ) r r f
ADDIRIM
o 9-7
PRESENTMAn•II'?G ADDRESS �-�
such bom
Mims on af'homeowx+s"was c=u&d m include�p.oeenpled dwclBegs dTWO
The ims a a mpg lure who don sot pawl s
Uniu a nd wallow eowres to�as individtnl .
liocuu..pmvWcd tbmthq owmct 00 as supcT+•% :
DSFI cr,ON OF HOMEOMML oa wluehthere h,eK h
Pcrsan(s)who owns a ptacel of lead an wWch hchhc raider og imcnds m reside. xy ttl auk ttse and�er
intended m bc,a am to two famUy dwelling,anadad a detached svcwa s?m➢trol be considered
farm stnxaaes.A perwn wbe constructs mme than me home in a jcbL on a�sazpobk to tha
a homeow•aa. Suds"larrxow het" shaII sUbreul to the Budding pffieuu,m mia the building perms
Buildimg Official.that bcJshe be neaponnble IQall sneh Wok pCfotared
The undersigned"homeowsxt"MUmes reaponnbMW for compliance with the State BtrD ft Code Wd
other applicable goes by-laws.►ales and njub$emt
TM t A ipxd"homeowner"artifice*A hchhe umdaswrds the Chy of Salem Bnil ft Dep wm".
minimum in =cm pmcadun s and rcgtmeutcnu and that Nshe will conq#with sald.p9mima asd
nquirmds•
HONMOWNER'S SIGNATURE
APPROVAL OF B=ING WSPECTOR
Sec otba sde for stau code
HOMEOWNER'S EXEMPTION
The code state O= "any homeowner performing-vicA fm wbicb m building permit is reyabed sh M W
ezcmgnt from the prv%idvw of this section (Section IO*.L1-Liamsimg of Construetim Superdwri)
provided that is a homeowner cngaga�person(f)for Lire to do.sucb wont.lbat such bosneowaer shall atd
as strpavit '
Many bmmeowners who use this exemption are immwanc that they are Laundmg the TespomsMa dg
supervism(am Appemdh Q,Ruks and Reguistions for I.iotosing Coostruetlom Supeav%*M Seedow
.2.25} This lack of awanncss ollat resuhs in scrims pmbkms,particularly when the bommwm bho
uniiecnsed passer. in this cast Yew Board cannot proceed agab st the miliecased pegom m It w*M wl&
licensed StrpcTisor. 71e bomcowvcr acting as supervbor is uldmat*teSEMPs 1C .
To ew me that the hanwow7m WAY Y aware of m&a r mpounbilhSa,rntroq aormamdda tsgxdm.as ps{
of the permii spok2tion•that the horwwna certify that he/she ratderstands the tesponsibllwas ate
super ism. You may care to amend and adopt mneb a fmrm/eertifiatitq foe»se is yoty ew®asdq.