376_Essex St C of NA applicationAPPLICATION 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 tire
Address of Property:
Name of Record Owner (s):
Owner Mailing Address:
Description of Work Proposed
Name of Applicant: Owner Tenant Other:
Signature: _____________________________________________ Date: ______________
Tel. #: E-mail Address:
Certificate will be mailed to the owner unless otherwise indicated here:
Certificate should be mailed to: Name
Mailing address: City: State: Zip:
Date Stamp
For Office Use Only
376 Essex St
David Askey and Shumei Yin
376 Essex St, Salem, MA 01970
David Askey
978.451.0170 dbaskey@comcast.net
In-kind replacement of deteriorated carriage house roof.
Color: charcoal
Material: 3-tab
08 Mar 2016
x
x
David Askey
ATTACHED DOCUMENTATION
An application will not be considered complete unless all work items are thoroughly described and the application
includes all information needed for the Commission to make a determination.
Failure to submit a complete application may result in a continuation to a future meeting.
Recommended information includes:
Photos of existing conditions, taken from all public ways
Site plan showing location of improvements
Elevation drawings of the existing conditions and proposed improvements
Drawings of details and other special conditions, 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.)
Location and size of all mechanical equipment, such as transformers, HVAC equipment,
electrical service and meters, and proposed screening