Loading...
158 Federal Street - C of A application - replace chapel windows FD Stamp REC ® ((�� ( MAY �..3Clleii i istoi cal COffZmissZDn,,r=, . O120WASHINGTONSTPIEET,SALEM,MASSACHUSETTS01970 COMMUNITj Only (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: 0 New Construction ❑ Moving ❑ Reconstruction 0 Alteration ❑ Demolition ❑ Painting ❑ Sign 0 Other District: ❑Derby Street ❑Lafayette Street ❑McIntire ❑Washington Square Address of Property: l.S --(!J S-,�- Name of Record Owner(s): le o rK nth AI-c !h&"o e-p sf ©< Owner Mailing Address: 6 /3 e d o 9 DR ✓e- 02,g j fir Description of Work Proposed_ Please )PC orprint clearly:Attach ad&,uonal sleets, as necessary: 1)U r(-b w�e t.Ss Tim _ /)A,-V r 1 .s r CJ P,o I(z )o,.>b/e,— �� u t`o4vZ� 1li ►✓y/ 2,CP/�c� r�,c�.r�" LvI �✓c�v ;.1S �vt ), ►`' e J y `TAQ 'fi1� ^,"►o _ P,-a,je 9 %ns„$ + // j ve 1c4eC/ V)9s 1, >�t.•/ ,t--''. nMPv I J S eh. ,r-c,�S i Name lic it: �A Q ❑Owner &Contractor ❑Tenant ❑Other: Signature: UAAWYDate: of Y Tel. #: E-mail Address: A rJ d ,ti T ,,, � Cvr�,msT, .vim/ Certificate will be mailed to the owner unless rwise fndt ated here. Certificate should be mailed to: Name 4-21 S 4 Mailing address l4!°t-I-AA44 el r,t ve City - 0: State Zip: 096-74, N - :rx—'.. - Y nt - L -- - - •ssya =v� •�j� ILL,- �i \•_ -vier w. _ .._.. Ir — II �;