119 Federal Street - C of A application - paint colors Date Stamp
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Salem Historical Commission
D E P T O F f f &( JAe Only
120 WASHINGTON STREET.SALEM MASSACHUSETTS 01970 commudil
(9781 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 ❑ Moving ❑ Reconstruction ❑ Alteration
❑ Demolition Q Painting ❑ Sign ❑ Other
District: ❑Derby Street ❑Lafayette Street ❑✓ McIntire ❑Washington Square
Address of Property: 119 Federal St.
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Name of Record Owner(s):
Fred and Linda Lipton,Steve Duguay and Kathleen Riley
Owner Mailing Address: 117-119 Federal St Salem Ma 01970
Description of Work Proposed
Please type or print clearly.Attach additional sheets, as necessary.
Paint house original color
Paint Trim: Benjamin Moore White Dove
Paint front entryway: White Dove
Name of App ant: Fred 'pton,Steve Dug ua ✓❑Owner❑Contract/or❑Tenant❑Other:
Signature: Date: G 1 u Jl
Tel. #: -5948002,978-740-8019 E-mail Address: liptonfam@comcast net 5+0v--C n L,a�z
Certificate will be mailed to the owner unless otherwise 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 may result in a continuation to a fixture 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
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