5 Botts app for non applicability (002) Datc Stamp
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Salem Historical Commission
12o WASHINGTON STREET SALEM MASSACHUSETTS 01970 For Office Use 0n1v
(978)619-5885 FAX(978(740-0404
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
Q Demolition ❑ Painting ❑ Sign ❑ Other
District. ❑Derby Street []Lafayette Street ✓❑McIntire ❑Washington Square
Address of Property: 5 Botts Ct. Salem,NIA 01970
Name of Record Owner(s): Brendan Collins and Caroline Crandall
Owner Mailing Address: 5 Botts Ct. Salem,MA 01970
Description of Work Proposed
Please tape or print clearly.Attach additional sheets, as necessary.
We are applying for approval of non-applicability regarding an existing chimney at 5 Botts Ct. in the McIntire
District. The chimney is leaning significantly and is a hazard to our home and our neighbors'. We have had the
chimney inspected by David Riddle of 8 Points Home Inspection who has found it unsafe and in need of being
addressed immediately. The chimney is not visible from any public ways and it currently serves no working
fireplaces.
5 Botts Ct. has an additional (1) chimney which does serve a working fireplace and is visible from public ways.
We are not proposing any work to this chimney.
Name of Applicant: Brendan Collins QOwner❑Contractor❑Tenant❑Other:
Signature: Date: 11/5/2019
Tel. #:(203)209 19 E-mail Address: brendoco1112Cgmail.com
Certificate will be mailed to the owner unless otherwise indicated here:
Certificate should be mailed to: Name
Mailing address: City: State:_Zip:
ATTACHED DOCUMENTATION
Air application will not he considered complete unless all work items are thoroughlY described and the application
includes all information needed for the Commission to snake a determination.
Failure to submit a complete application may result in a continuation to a future meeting,
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
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.)
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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