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Salem Historical Commission DE &120 WASHINGTON STREET,SALEM,MASSACHUSETTS 01970 COMe(T�1y
(978)619-5685 FAX(978)740-0404,
APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS
Pursuant to the Historic District's Act (M.G.L. Chapter 40C) and the Salem Historical Commission Ordinance,
application is hereby made for issuance of a Certificate of Appropriateness for:
❑ New Construction ❑ Moving ❑ Reconstruction ❑ Alteration
❑ Demolition ❑ Painting 0 Sign Other
District: ❑Derby Street ❑Lafayette Street ❑McIntire ❑Washington Square
Address of Property: -
Name of Record Owner(s):
Owner Mailing Address: , 4L -VL I cn.( c�f_ Fv{e w,',- 2 D
Description of Work Proposed
wPlease tJPe orpmv clearlf:Attacli ad&&onal sheets,as necessary:
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Name of AApplic,ant* L - M Wwner ❑Contractor ❑Tenant []Other:
Signature: .14. _ Date: S, /�-,
Tel. #: L I E-mail Address: / Od i C
Certificate will be mailed to the owner unless otherwise indicated here. /�
Certificate should be mailed to: Name L UI L,,
Mailing address: �1 _ Ci State Zip:Qj
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From Lynn Frothingham <Lynnf400@g mail.com>
Subject 2 great Photos
Date May 20, 2018 5:18:33 PM EDT
2 Attachments, 91.5 KB
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Subject, 2 great Photos
Date: 1 2018 5:15:49 PM EDT
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Lynn Frothingham <Iynnf400@g mail.com>
2 great iPhotos
May 20, 2018 5:33:13 PM EDT
2 Attachments, 86.2 KB
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