DEMO DELAY APPLICATION
APPLICATION FOR WAIVER OF THE DEMOLITION DELAY ORDINANCE
Pursuant to the Historic District's Act (M.G.L. Chapter 40C) and Salem Code 2-1572, application is hereby
made for issuance of a Waiver of the Demolition Delay Ordinance for demolition as described below.
Address of Property:
Name of Record Owner (s):
Owner Mailing Address:
Original Building Construction Date, if known:
Is the property listed on the National Register of Historic Places or contributing to a NR District?
Yes No Unknown
Description of Demolition Work Proposed:
Please attach any historical data and photographs, building plans, structural reports, or other pertinent information and
submit at least a week before the scheduled meeting. Applicants who omit this information or submit their application less
than a week before the meeting date should expect to attend additional meeting(s). A site visit of the property may be
requested.
Briefly describe the extent of the demolition:
Briefly describe the reason/justification for demolition:
Briefly describe any proposal for future construction/development:
Applications must include photos of existing conditions, taken from all public ways.
Name of Applicant: Owner Contractor Tenant Other:
Tel. #: E-mail Address:
Certificate will be mailed to the owner unless otherwise indicated here:
Certificate should be mailed to: Name
Mailing address: City: State: Zip: