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Office of the Newbury Building Inspector
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DATE:________________________________________________________
JOB LOCATION:_______________________________________________
HOMEOWNER:________________________________________________
PHONE:______________________________________________________
MAILING ADDRESS:___________________________________________
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 state, in writing, that he / she shall be responsible for all such work performed under the building code. (Section 108.3.5)
The undersigned homeowner assumes responsibility for compliance with the State Building Code and all other applicable codes, by-laws, rules and regulations and further agrees to be present on site at some point to approve construction, reconstruction, alterations, removal or demolition involving the following work:
A. Excavation
B. Foundation (pouring or other)
C. Decking
D. Rough Framing
E. Finished Framing
F. Chimneys
1. Excavation / Foundation
2. At the top of the smoke chamber and support of the flue liner
3. When erection of the chimney is complete
The undersigned homeowner certifies that he / she understands the Town of Newbury Building Department minimum inspection procedures and requirements and that he / she will comply with said procedures and requirements.
Homeowner’s signature:______________________________________________
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