192 Federal Street - C of A application - restore exterior and paint inkind Date Stamp
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3alem Historical Commission
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120 WASHINGTOl'a$TREE .SA;"EM.MASSAC JSF`T6 W97G For Office Use Only
{979)6;9-56 F-AX Q7&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 T Alteration
❑ Demolition ❑ Painting ❑ Sign ❑ Other
District: ❑Derby Street ❑Lafayette Street "McIntire ❑Washington Square
Address of Property: 9 )
Name of Record Owner(s): NaPtIA 1 al d P
Owner Mailing Address: -
Descri tion of Work Proposed
Please type or print clearly. Attach additional sheets, as necessary.
COJI RzPCL I P_ a_v R o 4tcl wood op- R-� p lace
Co 102-s (w d?--V i(ICY Utj 2 Q-_01 o US
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Name of Applic �Wdk%L wner❑Contractor❑Tenant❑Other:
Signature: ,Voq ci�c_ c�(�_.0✓1 Date: �I �1
Tel. #: 7a `4-7 0 E-mail Address: 0. �'Lo
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Certificate will be mailed to the owner unless otherwise indicated here:
Certificate should be mailed to: Name
Mailing address: City: State:_Zip:
Date Stamp J
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Salem is n'c issi JUL 24 2J19
120:NASFf€i`GTON STREET SA EM.M,.ASSACHUSE'.S 011970 )E T. OFc Offltd:`ems aOnly
'978 1619-.5635 FAX 59787 749-u40;4 M M
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, 5
application is hereby made for issuance of a Certificate of Non-Applicability as described below for:
❑ New Construction ❑ Moving ❑ Reconstruction ❑ Alteration
Q Demolition 0 Painting ❑ Sign ❑ Other
District: ❑Derby Street ❑Lafayette Street ✓❑McIntire ❑Washington Square
Address of Property: 192 Federal Street
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Name of Record Owner(s): Pamela Waldron
Owner Mailing Address: 192 Federal Street; Salem,MA 01970
Description of Work Proposed
Please type o.r print clearly.Attach additional sheets, as necessary
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Removal of asphalt siding, repair of all rotted wood, and painting house similar grey/white trim/light blue front
door with black on front facade inserts, side doors (2) and back door(1).
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Name f A t: Pamela ldron Owner❑Contractor❑Tenant❑Other:
Signatur • Date: 77
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Tel. #:781-526-5470 E-mail Address: paw0214@hotmail.com
Certificate will be mailed to the owner unless otherwise indicated here: /
Certificate should be mailed to: Name
Mailing address: City: State:_Zip:
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