4 Hamilton Street - C of A application - remove vestibule door ` Date Stamp
� .� R .. 'I
K r
P 27 2019
SalejrZ 1 istor cal COjn)yllSSton OMMU DEPT;IOTY DEVELOP ENT
11 WASHINGTON STREET,SALEM,MASSACHUSETTS 0197D
{9781619 5668 FAX(978)740.040a FO!Office Use only
APPLICATION F10R A CERTIFICATE OF APPROPRIATENESS
Pursuant to the Historic Districts 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 ❑
Demolition Moving ❑ Reconstruction ❑ Alteration
0 Painting ❑ Sign
❑ Other
District: ❑)erby Street El Lafayette Street
Address of Property;
G� ❑McIntire ❑Washington Square
Name of Record Owner(s): , °S 4e'L�
Owner Mailing Address:
Descri tion of Work Pro osed
Please type or print clearly:At2acli additional sJieets,as .IecewJ3t
Auzj-�)t
a 7Jd�Yr
Name �of Applic ;`S' Ov�mer ❑Contractor ❑Tenant ❑Other:
Signaft
Date:
E-mail Address:
Certfflcate will be mailed to the owner unless otherwise itdicated he
Certificate should be mailed to: Name ��
Mailing address: G ��
�� City: _StatW4*,,ip:69Z2?�
_ ATTACHED DbC UMEN'1'A7'IUN
An application will not he considered complete unless all work items are thorou h de
includes all information needed for the Commission to make a determination.
--,. g ly scribed and the application
,,,-,.includes
to submit a com lete a lication ma result in a continuation to a tore
meedn .
Recommended information includes:
ve
Photos of existing conditions, taken from all public ways
Site plan showing location of improvements
Elevation drawings of the existing conditions and ro osed im P P provements
Drawings of details and other special conditions,including profiles
Description,photographs, and/or catalog cuts ofpropos
~-
ed 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 22'x2") -
Location and size of all mechanical equipment,such as transformers,HVAC ui
pm
electrical service and meters and
proposed screening