57 Summer Street - C of A application - paint colors Date Stamp
RECEIVED
I
JUN 2 0 2019
EPT. OF PLANNING &
Salem HLstotical Commission COMMUNITY DEVELOPMENT
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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 CRMcIntire ❑Washington Square
Address of Property: S7 9, ez 3-1- S�Wy .01 alirw _
Name of Record Owner(s): P1 U ,cq & r
Owner Mailing Address: rVA4 - rl' rwww , V ay�xy
Description of Work Protiosed
Please type or print clearly:Attach additional sheets, as necessary:
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Name of Applicant: /Ost o ®Owner❑Contractor❑Tenant❑Other:
Signature: � Date:—
Tel. #: j�12- 1,2O_3 0Y E-mail Address: ic kef IC9*p
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Certificate will he mailed to the owner unless other wl.se indicated here:
Certificate should be mailed to: Name
Mailing address: City: State:_Zip:
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 application ma,result in a continuation to a fidure meetin .
Recommended information includes:
Photos of existing conditions,taken from all public ways
Site plan showing location of improvements
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Elevation drawings of the existing conditions and proposed improvements
Drawings of details and other special conditions,including profiles
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Description,photographs, and/or catalog cuts of proposed materials (please bring to the
meeting product samples, if appropriate)
L0) Dimensions (i.e. height of fence, size of pickets and posts, etc.a
Paint color samples, if applicable(no less than 2"x2")
Location and size of all mechanical equipment, such as transformers, HVAC equipment,
N�� electrical service and meters, and proposed screening
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