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Historic District Commission
Application For Certificate Of Approval
Complete this form and submit it to the addresss below if you
wish to make modifications that fall under the domain of the Amherst Historic District Commission
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AMHERST
VILLAGE
HISTORIC
DISTRICT
APPLICATION FOR CERTIFICATE OF APPROVAL
TO
CONSTRUCT, REPAIR, MOVE, DEMOLISH, OR CHANGE BUILDINGS, LAND OR USES
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Name of Owner/s*___________________________
Mailing Address/PO Box______________________
____________________________________
Telephone No. ______________________________
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Location of Work _____________________________
Date Building was Built (if known)________________
Map # _____________ Lot # ___________________
Application fee: Amount $_______ Check No. _______
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Check if
included |
Required Submissions (for all applications): |
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| __ |
Description of proposed work (attach
extra sheets if needed):
_____________________________
___________________________________________________________________________
___________________________________________________________________________ |
| __ |
Reasons for proposed work (attach extra
sheets if needed):
______________________________
___________________________________________________________________________ |
| __ |
Photographs
of the existing structure(s) and/or building site clearly showing
areas and elements to be
affected by the proposed work. |
| __ |
Accurate
scale drawings, renderings, or illustrations of the proposed work
that show the style, design, detailing, treatments, massing, scale,
proportions, dimensions, etc. of the proposed work. |
| __ |
description of all materials for each element of the proposed work. |
| __ |
Name,
address/PO box, and telephone number of the applicant (if different
than the owner). |
| Included |
N/A |
Other Required Submissions (as applicable): |
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| __ |
__ |
For New
construction, additions, demolition, moving of structures, site work,
change of use or fencing.
Names and addresses/PO Boxes of all abutters as defined in RSA §
672:3 and three sets of
addressed adhesive mailing labels per address, including $_____ per
abutter. |
| __ |
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New construction, additions, or exterior alterations.
Elevation scale drawings of proposed work
showing the new work and its relationship to remaining structures.
Drawings should indicate by dotted lines or other means existing
structures, features, elements, openings, detailing, etc. that will
be permanently altered or obscured as a result of the new work.
(Scale not less than 1/8" = 1'.) |
| __ |
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New construction, additions, moving of structures, site work, and
fencing. Plat or site plan showing
abutters, and the dimensions and location of the proposed building,
addition, site work, or fencing
in relation to the property line, existing structures, setback lines,
curb cuts, historic stone walls
and mature trees greater than 15" in circumference. Drawings
should indicate by dotted lines
or other means existing foundation (or footprint) that will be
permanently altered as a result of
the new work. For new construction, show location of adjacent
structures within 100' of parcel boundaries.
(Scale not less than 1" = 30'.) |
| __ |
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Windows
and Doors. Specifications of windows and doors, to include
materials, style, type of construction,
dimensions, muntin profiles (windows), and operation (windows). |
| __ |
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Restoration.
Historic references, documentation, or evidence to substantiate
restoration work. |
| __ |
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Change
of Use. Description of current and proposed use, including (for
commercial buildings) a copy
of the letter from the Planning Board granting site plan approval for
change of use. |
| __ |
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Variances.
A copy of the letter from the ZBA granting a request for a variance,
including (for commercial
buildings) approval for expansion of a non-conforming use. |
| __ |
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Special
Conditions. Describe any special conditions that you want the
Commission to consider:
______________________________________________________________________
______________________________________________________________________ |
Signature
of Owner/s* _________________________ _________________________
Date: ___________
Last Update:
