95 Federal St - C of NA application - paint inkind Date Stamp
-36, A.
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Salem Historical Commission
120 WASHINGTON STREET.SALEM.MASSACHUSErTS 01970 For Office Use Only
1978)619-5685 FAX t978i 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
Demolition ❑� Painting Sign Other
District: Derby Street Lafayette Street R Mclntire Washington Square
Address of Property: 95 Federal St
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Name of Record Owner(s): Jan&Bob Kendall,Denae Comrie,Mia Dellarusso,Laurie LaChapelle,David Leach
Owner Mailing Address: 95 Federal St Salem MA 01970
Description of Work Proposed
Please type or print clearly. Attach additional sheets, as necessary.
We plan to paint the north facing side of the house with custom colors previously approved(sample provided)the
last time the house was painted.
Name of Ap licant:Laurie LaChapelle �✓OwnerOContractor❑TenantQOther:
Signature: .y Date: 6-14-20
978.335.2160 ljlachapeile@comcast.net
Tel. #: E-mail Address:
Certificate will be mailed to the owner unless otherwise indicated here:
Certificate should be mailed to: Name
Mailing address: City: State:_Zip: