144 Federal St C of A application for rear HVAC Date Stamp
PP 29 2019
Salem Historical Commission DE . OF P Lip N:N i f G
COMN 'IITY DEVELOPMENT
,.• ,,�. For Office Use Only
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 OLafayette Street �cIntire ❑Washington Square
Address of Property: 144 Federal Street Salem, Ma. 01970
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Name of Record Owner(s): Robert Ouellette
Owner Mailing Address: Same.
Description of Work Proposed
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Please type or pmit clearly.Attach additional sheets, as Mressary.
Name of Applicant: Robert Ouellette ✓❑Owner❑Contractor❑Tenant❑Other:
Signature: Date:04/25/2019
Tel. #: 978-836-2914 E-mail Address: robouellette@comcast.net
Certificate will be mailed to the owner unless otherwise indicated here:
Certificate should be mailed to: Name
Mailing address: City: State:_Zip:
MAP 26
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