Page 1 of 2 Description of Proposed Work (attach additional sheets if necessary): Historic District: Address of Building: Property Owner: Property Owner Address (if different): Phone Number: Email: Name of Person Filing Application (if other than owner): Email Address of Person Filing Application (if other than owner): APPLICATION FOR AN ADMINISTRATIVE CERTIFICATE OF APPROPRIATENESS (ACOA) OR A CERTIFICATE OF APPROPRIATENESS (COA) Your Signature Below Confirms Consent to the Following: 1. I understand that these materials will be archived by the Historic Preservation Program. 2. I understand it is my responsibility to inform my adjacent neighbors of my building and construction plans for this project. 3. I hereby grant permission to the County’s Historic Preservation Code Inspector to enter my property during the application and construction phases of my project. 4. I hereby grant permission to the County’s Historic Preservation Code Inspector to take photographs of my property, including the existing conditions, during the construction phase, and after the project is completed. date signature [email protected] 2314 N Kenmore Street Maywood Thomas & Christina Gelson 8-12-19 508-944-7745 Construct a 14ʼ x 28ʼ detached building for ground level in-law suite and utility storage basement. All exterior specifications (i.e. windows, doors, siding, trim, roofing, fixtures, etc.) to exactly same as main house.

APPLICATION FOR AN ADMINISTRATIVE CERTIFICATE OF ......Marvin Double Hung Wood Windows – Same as Main House 1st floor: WDH3232 (3’2 x5’1) Asek Trim – Same as Main House

Download PDF Report

Upload
others
View
1
Download
0

Embed Size (px)

Citation preview

Page 1: APPLICATION FOR AN ADMINISTRATIVE CERTIFICATE OF ......Marvin Double Hung Wood Windows – Same as Main House 1st floor: WDH3232 (3’2 x5’1) Asek Trim – Same as Main House

Page 1 of 2

Description of Proposed Work (attach additional sheets if necessary):

Historic District:

Address of Building:

Property Owner:

Property Owner Address (if different):

Phone Number:

Email:

Name of Person Filing Application (if other than owner):

Email Address of Person Filing Application (if other than owner):

APPLICATION FOR AN ADMINISTRATIVE CERTIFICATE OF APPROPRIATENESS (ACOA) OR A

CERTIFICATE OF APPROPRIATENESS (COA)

Your Signature Below Confirms Consent to the Following: 1. I understand that these materials will be archived by the Historic Preservation Program.2. I understand it is my responsibility to inform my adjacent neighbors of my building and construction plans for this project.3. I hereby grant permission to the County’s Historic Preservation Code Inspector to enter my property during the application and construction phases of my project.4. I hereby grant permission to the County’s Historic Preservation Code Inspector to take photographs of my property, including the existing conditions, during the construction phase, and after the project is completed.

date signature

[email protected]

2314 N Kenmore Street

Maywood

Thomas & Christina Gelson

8-12-19

508-944-7745

Construct a 14ʼ x 28ʼ detached building for ground level in-law suite and utility storage basement. All exterior specifications (i.e. windows, doors, siding,trim, roofing, fixtures, etc.) to exactly same as main house.