22 Beckford St - application for repainting Date Stamp,C
ECEIVE
y r : NOV 04 2016
DEPT. OF PLANNING&
Salem Historical Commission C MMUNITY DEVELOPMEN
120 WASHINGTON STREET.SALEM.MASSACHUSETTS 01970 For Office Use Only
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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:
Ej New Construction Moving Reconstruction Fj Alteration
Demolition R] PaintingEl Sign n Other
District: ODerby Street QLafayette Street [?]McIntire QWashington Square
Address of Property: 22 Beckford Street,Salem,MA 01970
Name of Record Owner(s): Jocelyn Levin and Christopher Sallah
Owner Mailing Address: 22 Beckford Street,Salem,MA 01970
Description of Work Pro
Please type orprint clearly.Attach additional sheets,as necessary.
Repainting 3 exterior walls of house;no change to color
Name of Applicant: Jocelyn Levin _ Q✓OwnerOContractorDTenantQOther:
Q®�1 a9�M•�f Eles�
Signature: Jocelyn E. Levin _ _ Eo.� � Date: 03 November20_16
Tel.#:617-953-3224 E-mail Address: jelpepper@hotmail.com
Certificate will be mailed to the owner unless otherwise indicated here.
Certificate should be mailed to: Name
Mailing address: City: _ State:_Zip: