91 Federal Street CofNA application chimney Date Stamp
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Y� DEC 0 6 2016
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Saxe is o�Zca CommissionEPT, OF PLANNING&
COMMUNITY DEVELOPMENT
120 WASHINGTON STREET SALEM,MASSACHUSETTS 01970 For Office Use Onlv
;sus)81a.56as rAx(978)740•8404
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 QMclntire ❑Washington Square
Address of Property: 91 Federal St.
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Name of Record Owner(s): Connie Arlander
Owner Mailing Address: 91 Federal St.Salem,MA 01970
Description of Work Proposed
Please type or print clearly.Attach additional sheets, as necessary.
Re-point chimney- Grind masonry joints to 3/4" depth and re-point with historically sensible mortar matching
existing.
Name of Applicant:
'�Brendan Murray ❑ ❑✓Owner Contractor❑Tenant l ther:
Signature: Date:
Tel. #: E-mail Address:
978-578-0940 brendan@murraymasonry.com
Certificate will be mailed to the owner unless otherwise indicated here:
Certificate should be mailed to: Name
Mailing address: City: State:_Zip:
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