15 Chestnut Street Gordon-Peter-HistoricComm-Cert-Nonapplicability-Completed-Sept-5-19Date Stamp
Salem
120 'NASH!NG'rON STRE.El, SALEM, MASSACHUSETTS Di87◊ For Office Use Only
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
Demolition
District: Ooerby Street
□ □
Moving
Painting □ □
□Lafayette Street
Reconstruction
Sign
[{]McIntire
□ [{]
Alteration
Other
□Washington Square
Address of Property: ...:.1:..:.5_.:C:..:h=.:e.=.stn=ut:...:S:...:t:..... ____________________________ _
Name of Record Owner (s): _P_et_e_r _G_or_d_o_n __________________________ _
Owner Mailing Address: 15 Chestnut St. Salem, MA 01970
Description of Work Proposed
Please type or print clearly. Atta.di additional sheets, as necessary.
Re-point chimney on West (left) side of house with historically sensible mortar.
[{]Owner0Contractor0Tenant Oother: ____ _
Signature: ----l-,/;~t.;;z:il.14,£-..'....!,!:J.,'.'..~-==--------Date: ______ _
Tel.#: 617-756-019 E-mail Address: pete-gordon@hotmail.com
Certificate will be mailed to the owner unless otherwise indicated here:
Certificate should be mailed to: Name Murray Masonry & More, Corp. ----"-----=-----'--_.___ ________________ _
Mailing address:_P_.o_._B_o_x_8_4_5_4 ______________ City: Salem State:~Zip: 01_9_71 __
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 future 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