23 Warren Street application for paint colors a
Salem Historical Commissiop of 11 .
120 WASHINGTON STREET,SALEM,MASSACHUSETTS 01970 -
(978)745-9595 EXT.311 FAX(978)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 for:
❑ Construction ❑ Moving ❑ Reconstruction ❑ Alteration
❑ Demolition '13� Painting ❑ Sign ❑ Other
as described Ibelow.
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C� 1 3 0'
District: [2 `�'-C— Original Building Construction Date, if known:
Address of Property: Z V UA V-re V�
Name of Record Owner (s): jyt (JL L-e ✓14 S
Description of Work Proposed:
r- I3 Kte_�_tl;2 lualy b ye
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Signature of Owner: Tel. #: C
Mailing address:�� �1qn City: J.t Qiv State:— ip: �/ C/
CO
RECEIVED
° ? 9 2016
Salem Historical Commis�jANNINELOP MENT
120 WASHINGTON STREET,SALEM,MASSACHUSETTS 01970
(978)745-9595 EXT.311 FAX(978)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 for:
❑ Construction ❑ Moving a Reconstruction " Alteration
❑ Demolition ❑ Painting ❑ Sign ❑ Other
as described below.
District: -4'Kn V_ . Original Building Construction Date, if known: d
Address of Property: 2 �k
Name of Record Owner(s): ° " ' L-e
p Description of Work Proposed. A
Signature of Owner: Tel. #: q �1 ���� �
Mailing address: yy-d r e City: �� Stat .V I Zip: