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Reconstruction
Sign
Date Stamp
For Office Use Onlv
Alteration
Other
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New Construction
Demolition
Moving
Painting
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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:
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flMcIntire flWashington Square
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District: loerby Street [Lafayette Street
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Address of Property; l LynnStreet
Name of Record Owner (s); Arlene O'Shea
Owner Mailing Address:1 Lynn Street, Salem MA 01970
Description of Work Proposed
PJease l77tt: or prinl cleatly. A1aclt arldilt'onal sJtce [s, as r]ecessa-rJ/.
Like-kind painting & repair exterior of brick house.
Paint doors, door surrounds, windows and bay window and shutters. Same colors: white trim and black shutters.
Repair shutters as necessary.
Name of Applicanl' Arlene O'Shea fl Owner f Contractorfl Ten ant TOther:
Tel. #: 978-744-1101 E-mail Address: arosheal@verizon.net
Certificate will be nailed to the ovtner unle,sibthenuise indicated here:
Cerlificate should be mailed 1o. yu'n. Arlene O'Shea
Mailing 3661ss5' I LYnn St City ;Salem state: Nbzip: oEZ9-
ATTACHED DOCUMENTATION
An applicationwill not be considered complete unless all work items are thoroughly described and the application
includes all information neededfor the Commission to make a determination.
Failure to submit a comnlete aonlication mqt resuh in a continuation to a-future meeting.
Recommended information includes :
Photos of existing conditions, taken tiom all public ways
Site plan showing location of improvements
Elevation drawings of the existing conditions and proposed improvements
Drawings of details and other specialconditions, including profiles
Description, photographs, and/or catalog cuts of proposed materials (please bring to the
meeting product samples, if appropriate)
Dimensions (i.e. height of fence, size of pickets and posts, etc.)
Paint color samples, if applicable (no less lhan2"x2")
Location and size of allmechanical equipment, such as transformers, HVAC equipment,
electrical service and meters, and proposed screening