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28 Carlton Street
LPLANNING RE J Salem Histm cal C'o�n�nissior�oM�,�120 WASHINGTON STREET,SALEM,MASSACHUSETTS 01970 (976)619-56B5 FAX(978)740-0404 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 ❑ Moving 0 Reconstruction ❑ Alteration ❑ Demolition 0 Painting 0 Sign ❑ Other District: Derby Street ❑Lafayette Street ❑McIntire ❑Washington Square Address of Pro;)erty. 2 9 e9& L Name of Record Owner(s): PH14-/!o INN> ►'!vvl Owner Mailing Address: 5-9 rq JE: Descri tion of Work Prol2osed Please tJpe orprint clearlf:AttacL additional sleets, as necessarl: To ST(-t fC 1-7 CF Rd©f ON CA21.T0N Sy- Srt E o)- vu $ l= rrl-/!S SIDG CU9REN)TCY YAs' 3 7A6 STYc- I GJ0LcL{� 10/\>-FF%/Z rro f?,C- e /4,C,E- T(-Y ARCH) rc C T-UAL- s-r/— 41/--�16t-1 &Jr+s /9py3< < Eb 7-© GTf-bF S I D� f�A Y�! Y Yt'742 G-� f h'( S S T YE_E ;,l c3 C ©S T- / S G t1 A RA XJ 7"I' 7> (0/� L l!_ , 0 RC A1-So L. AC- /f,1 r Y (S r i K Cr SKY L ITF Wa '1-f-r AC 'T ® UYQ Name o f Appli t: ��!L/ f �� S i Owner ElContractor ❑Tenant ❑Other: Signature: - Date: Tel. #: cl "] - 7`�4f— 2 o L/ E-mail Address: —ertifecate will be mailed to the owner unless otherwise indicated here: Certificate should be mailed to: Name Mailing address: _ City: State:_Zip: 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 ai2olication mav result in a continuation to a future meeting. Recommended information includes: Photos of existing conditions, taken from all public ways L/ 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 offence, 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 ---ONO! J� Sent from my Wad M �'.t•r e y _ f i 1 hk M � � now ,�Rr+1• Jri F �a Sarah Cahill From: Crotchet Box Country Store <crotchetbox@gmail.com> Sent: Thursday,July 12,2018 9:06 AM To: Sarah Cahill Subject: 100 Derby Roof �1-06 ,M1 1