11 Warren gate design Date Stamp
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Salem Historical Commission
WASHINGTON STREET-SALEM,MASSACHUSETTS 01970 For Office Use Only
(978I 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 ❑ Sign ❑ Other
District: ❑Derby Street ❑Lafayette Street [McIntire []Washington Square
Address of Property: 11 warren st
Name of Record Owner(s): Casey Condominiums
Owner Mailing Address: 11 warren st
Description of Work Proposed
Please type or print clearly.Attach additional sheets,as necessary.
om either side of the garage to the adjacent buildings. Fence will be
tarren st). Fence will be approximately 5 feet high and painted white.
Name of Applicant: christopher nagle _ [Z Owner❑Contractor❑Tenant❑Other:
Signature: _ Date: 5/19/2018
Tel. #:781-929-3844 E-mail Address: chris@voodoosurfer.com
Certificate will be mailed to the owner unless otherwise indicated here:
Certificate should be mailed to: Name__
Mailing address:_ City: State:_Zip:
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