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125 Derby St - C of NA application - paint inkind Date Stamp E C E I r AUG 3 0 2018 Salem Historical o�7`ti milssion EPT. OF PLANNING & I�w,aslii�:c,TON STREr-T,SA'_EVI NInSsr,CHUSET*s o19f0 CO MUYbTb 2k kjaV I'A (978 740-0404 APPLICATION FOR A CERTIFICATE OF NON-APPLICABILITY 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 Non-Applicability as described below for: New Construction ❑ Moving ❑ Reconstruction ❑ Alteration Demolition ❑✓ Painting ❑ Sign ❑ Other District: QDerby Street EjLafayette Street OMcIntire Washington Square Address of Property: 125 Derby Street Name of Record Owner(s): 125 Derby Street Condominium Trust Owner Mailing Address: 125 Derby Street,Salem,MA 01970 Description of Work Proposed Please type or-plint clearly.Attach additional sheets, as necessary. The work will be painting the north(Derby Street-facing) side of the building. Painting will include the siding, trim,door,and window frames. The colors will match the existing colors. Shutters will be removed as necessary for the painting itself but will be replaced without alteration after the work is done. Name of In Christian Haselgrove ©Owner�Contractor�Tenant Other: Signature Date: August 30,2018 Tel. #:978 E-mail Address:Christian@haselgrove.org Certificate will be mailed to the owner unless otherwise indicated here: Certificate should be mailed to: Name 125 Derby Stret Condominium Trust Mailing address.. Derby Street City:Salem State:MAZip:01970 ATTACHED DOCUMENTATION An application will not be considered complete unless all work items are thoroughly described and the application includes all information needed for the Commission to make a determination. Failure to submit a complete a )lication ma •result in a continuation to a future meeting. Recommended information includes: Photos of existing conditions,taken from all public ways Site plan showing location of improvements Elevation drawings of the existing conditions and proposed improvements Drawings of details and other special conditions, including profiles Description,photographs, and/or catalog cuts of proposed materials(please bring to the meeting product samples, if appropriate) Dimensions(i.e. height of fence, size of pickets and posts, etc.) Paint color samples, if applicable(no less than 2"x2") Location and size of all mechanical equipment, such as transformers,HVAC equipment, electrical service and meters, and proposed screening _ / � _ � � � r-r r��-_ � - �� ,r �_` � `- .. ��_ _ � � � - ;. a• . � - �:� - ._� - \'L� �� i�� " � r�✓� c,... ] .,S�1� �1,e � i ��J:., o.t YvSS