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10 Summer St - C of NA application - columns and landscape timber Date Stamp t RE EIVED + i k n SE 0 5 2018 (/�J DEPT. F PLANNING & Salem isto cal Oi py�Zj�ZZSSaV�tOMMUNi Y DEVELOPMENT 120 WASHINGTON STREET,SALEM,MASSACHUSETTS 01970 For Office Use 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: ❑ New Construction 0 Moving 0 Reconstruction ❑ Alteration ❑ Demolition ❑ Painting ❑ Sign ❑ Other District: ❑Derby Street ❑Lafayette Street ❑McIntire ❑Washington Square Address of Property: 10 S y vu �c g� toe.0 L- (-(e vst c 4-- r 016 � Name of Record Owner(s): _(5 exn de-PI C L Owner Mailing Address: d �'o ?©S 1 •P J.P� y' ! Q ! ` l Description of Work Proposed Please lj pe or pruit clearlf:Attach additional sheets, as aecessarj: IZ e(p a-c- /nJ IBC r n1 b Co L u f/YI A P+ t f s,,Dpi f Q U l,^, S 67— X r S t. rfI vt -e Xo-t-Ic-e oL So, 7e'�C f/LI a v e I'a r/1 GP .j C, c/ P 7'1 vri! 6 Y' ee.S S 74r- eL•._. ,tom oe/'r f v �t- Name of Applic t 6414 d-le" ' 1 C L'n Owner ❑Contractor ❑Tenant/Other 6 R r 4 Signatur ; v Date: Tel. #: q 2.9` 92 7 E-mail Address: ;rtificate will be mailed to the owner unless otherwise indicated here: Certificate should be mailed to: Name dt�d_rz xt Y Z Ed, • �- l.- C� Mailing address: X ?aS 1 City: 'Seue� State:_Zip: o�9/S