31 Warren St - C of A application - AC UNITS behind wall �R� vmc omugi
Salem Historical Commission
For Office tlsc Only
APPLICATION FOR A CERTIFICATE OF NON-APPLICABILITY
Pursuant to the I listoric 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
_ Altcrttion
Demolition �- Pointing Sign f- Other
District: -Derby Street ' Lafayette Street L �Intire Washington Square
Address of Property: � W'�(�rLiEy 5✓ f}G/=
Name of Record Owner(s): T
Owner Mailing Address: -. 5411l,
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Description of Work Proposed
Please type or print cl •Iv. Attach additional sheets,as necess:re.
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Tl� /c/ .✓i-s ate lFQa41ER (All /4� 4
Nowc ol'Applicant: Owner .Contructor i Tenant] Other:
Signature: Date:
lei _: E-mail Address:
e rrnlii inE v ill hr mailed in the mvner unless othenvlse indicated here:
Certificate should be mailed to: Name
Mailing address: City: State:_Zip: —
ATTACHED DOCUMENTATION
An application will not be considered complete unless dLwork Items are thoroughly described and the
application includes all information needed for the Commission to make a determination.
&ffure tomb-mit a complete applicat_ ion am resuk in a co tinuation to a future mteeting
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. VAC equipment,
electrical service and meters,and proposed screening
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