49 Washington Square - C of A application - replace windows Marvin Ultimate Date Stamp
Salem Historical Commission
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 n Moving ❑ Reconstruction u Alteration
❑ Demolition ILI Painting ❑ Sign ❑ Other
District: ❑Derby Street ❑Lafayette Street ❑McIntire [Washington Square
Address of Property: yt
Name of Record Owner(s): Uf-
Owner Mailing Address: o t "V P_V Me 01q15
Description of Work Proposed
RIcasc t}l)c orprital rlead}:Adach adekiomd sht ts, as ucccssar}.
Add CL U01' w x 5U, H 3 (wlk ca�j men- Mo
\nndow vl�l
l Q dl\n�� �� irA LA C oec tUMPL K-rVlace. a,
32 , w x CPO 4W6 vm) been -t)\cad over ta)
�Cevl� Wwce.ti �'�ec pn❑'so �) .
PJ6 Ckn owning thole. v\nrdafv _62 W x ll ° +� 1n Oeccn6 00W
reCaV Y carn -IM wer -WO 4ely,
pep\af e 22 exl r� I�,\plaU.r UY_H Wlr� 00* «tw rfQ
R 11 V\II r&VV\D W\1 be. MWO n W-h o-&c 'cvi c b - ING `NC�
Name of Applicant -(\ltJ Owne Contractor❑Tenam❑Other:
Signature: hI��Date: l� 21
Tel.#: 9'�C6- tl16 - �c`.�0`lS� E-mail Address: 111Kb \fit v\r\PDPE)r±cb ,com
Cerdfacate will be mailed to the owner unless otherwise indid h ye:
Certificate should be mailed to: Name 6(AI7Urn(e �hn a'`',,,t1 ,rw�].,
Mailing address:((� � �i'I�Yf'_2_'-�' City: y r Stately'-pip: (L6I")
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 meting.
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 sin of all mechanical equipment,such as transformers,HVAC equipment,
electrical service and meters,and proposed screening
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