89 Federal Street - C of A application - HVAC Date Stamp
` R CE1VED
APR 24 2019
Salem HistOlkal Commission
IDEJ T. O F,PLANNING,�y�,,� F.
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120 WASHWGTON STREET SALEM.MASSACHUSETTS 01970 G O M U N l Nw,4bJv
(978)619-5685 FAX(9781 740-M4
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- []Derby Street ❑Lafayette Street []McIntire [:]Washington Square
en dL-
Address of Property. ,-[ Fibkrel S
Name of Record Owner(s):
Owner Mailing Address:.
Description of Work hmposo
Please type or print demV.Anwh additional sheets,as necessary.
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Name of Applicant: q.rwe ?�( per❑Contractor❑Tenant❑Mer.
Signature.�ii Date: acm
Tel. #: -y3 g q E-mail Address: oddz .k
Certificate will be mailed to the owner unless otherwise indicated
r Certificate should be mailed to: Name�t .� fl t _
Mailing address: City: State. ip:
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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 may result in a continuation to a luture meeting
Recommended information includes:
Photos of existing conditions,taken from all public ways
Site plan showing location of improvements
0
Elevation drawings of the existing conditions and proposed improvements
Drawings of details and other special conditions,includin profiles
60 Walk 14 o(,z v/L an *ep�do
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
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