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5 Monroe Street application / FOffice l� 0D Salem Histm cal Commission 120 WASHINGTON STREET,SALEM,MASSACHUSETTS 01970 C' ly (9781619 5685 FAX(978)740-0404 C r _ APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS 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 Appropriateness for: New Construction ❑ Moving ❑ Reconstruction ❑ Alteration ❑ Demolition ❑ Painting 0 Sign ❑ Other District: ❑Derby Street ❑Lafayette Street fWcIntire ❑Washington Square Address of Property: S M,n„-ar- 4 ice_} �a levw Name of Record Owner(s): 13 �i o�I r Owner Mailing Address: `34:-vi c Description of Work Proposed Please lnw orxhit dead},. Attacli addiao»al sheets, as rtecessarl: CvnS{y.1� + q I�MxIY' �ru'd� t► o�sc� I�1� s�v��c.�c�r� w;1l6�e—�,odz\cd �. f +�Y.. 4' E• ` T-cl. {-}o H S L. O'n Pj r-6 W VN S`F��c�•I- o .i_7' Intl 1\ S k"'^t- t-Y-+C-r-1 0 r d o\-c�i\S and �-Ln C. s k>rl t [IN Y O L -j- - Fly pilot 4 - > tdot0:9 1 �,� �� s `�s � � ro hays d0 LA,1Jke. boor• Tint d ( r.1ls w ;i\ (ot sotnc. ,r4 $ 7MP I1j_ -cj - No �oriv�-11�1 �th cyp, F�IS o� }lac 1�tsfi�-rS , v�o �,�'tvliid cc� r%r -A ! ,v%yady 1 ah� 5% nPfi71; fin I- a I5 cs� t in c ti A 1 to S-}.rcL ke c.o ✓i� l r ns-f-S . j d L} a r'1 s -j-Ljc �kiS--f• vN c,l ```I'l� � r� ,�.ir l� ousej L WI�1C�1tDV� S C"Y-\ C4D aar SCP L�1�u bQ\t.'kS'+e-� VV u5 vJi1) Est van +�c �to�tj►"v� P�� 1'ic Lito,^a� Name of Applicant: ira a vi S k�,i *Owner ❑Contractor ❑Tenant ❑Other: Signature: Date: Tel. #:cj rl Ss , 5 b tD (o,5 tc 5 E-mail Address: 'Cloy) , In!=r r-j Certificate will be mailed to the owner unless otherwise indicated here. Certificate should be mailed to: Name Mailing address: City: State:_Zip: �y �./IT Tr.:. • r. f 7 � .ti �:°,, � �.-..a-�a...�-ate_ �tea_• rp y ab . Various Views of Full-Size Outline r- ,� ..l>_ .Zip• }� �� !' it 1 i F ' w - q '1 ` it 7i V ��. • err T7 �R M • . � . L I` y �'rS+ I • q y n WAll i Front Entryway Pilasters ppry�------ Kitchen Door Pilaster ,m • • Ab • r: `3 II . �i• i / 4 1 q!b t i �i ••L4I)� t /t Public � T Double Hung Sash - Strafford Window Manufacturing, Strafford NH. latex with galvanized Cie screws oil • EDPM Flat Roof l 1 '