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122 Derby Street - C of A - conceptual approval only Salem Historical Commission 98 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 (978) 619-5685 *CONCEPTUAL APPROVAL* CERTIFICATE OF APPROPRIATENESS It is hereby certified that the Salem Historical Commission has determined that the proposed:  Construction  Moving  Reconstruction  Alteration  Demolition  Painting  Signage √ Other work* as described below will be appropriate to the preservation of said Historic District, as per the requirements set forth in the Historic District's Act (M.G.L. Ch. 40C) and the Salem Historic Districts Ordinance. District: Derby Street Address of Property: 122 Derby Street Name of Record Owner: Robert Burkinshaw Description of Approval of Work: ▪ Conceptual approval only* of building additions per drawings and presentation materials submitted to the Commission by JFA Design Group dated 10/18/21. Detailed plans to be submitted for review and approval after zoning approval(s) granted. Upon completion of work, please notify Historical Commission staff for final review and sign-off of Certificate. Dated: November 23, 2021 SALEM HISTORICAL COMMISSION By: The homeowner has the option not to commence the work (unless it relates to resolving an outstanding violation). All work commenced must be completed within one year from this date unless otherwise indicated. THIS IS NOT A BUILDING PERMIT. Please be sure to obtain the appropriate permits from the Inspector of Buildings (or any other necessary permits or approvals) prior to commencing work.