23 Warren Street application for garage reroof RECEIVED
Salem Historical Commission 22 2016
120 WASHINGTON STREET,SALEM,MASSACHUSETTS 01970 DFPT OF PLANNING &
(978)745-9595 EXT.311 FAX(978)740-0404 COMMUNITY DEVELOPMENT
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 for:
❑ Construction ❑ Moving Reconstruction ❑ Alteration
❑ Demolition ❑ Painting ❑ Sign ❑ Other
as described below.
District: Original Building Construction Date, if known:
Address of Property: 7i?J V ^GI U-l�(�P� ��^ . � (eV-A � �� -"
Name of Record Owner(s): y V L s � I 12-/ I
Description of Work Proposed:
�3 T4iZ ICI a�L iUa ���
Signature of Owner: Q� Tel. #: �
Mailing address: Z3 �a AAA—
City: c ` o
State:_ 0)