YORK HISTORIC DISTRICT COMMISSION

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Committee Members: Maine Historical Preservation Commission Kurt Hulstrom, Chairman 55 Capitol Street, State House Station 65 Scott Stevens, Vice Chairman & Secretary Augusta, ME 04333 Jon Powers Bryce Waldrop YORK HISTORIC DISTRICT COMMISSION Application for Certificate of Appropriateness Dear Applicant: A Certificate of Appropriateness from the York Historical District Commission is required for any physical changes to the exterior of a building or structure that is a historical landmark or within a historic district. This includes, but is not limited to, any addition, reconstruction, alteration, or demolition, whether or not a building permit is required. Approval is also required for any new construction on the property such as improvements in lighting, paving and curbing. It is not the purpose or desire of this Commission to discourage improvements to your property, but to ensure that its unique charter is maintained. Before filling out the application, please familiarize yourself with the Historic District Ordinance in the Town of York Zoning Ordinance. Article 12, sections 13 16 cover the application and review process. This, as well as York Design Guidelines, may be found on the Town website http://www.yorkmaine.org/. Town Hall staff in Planning and Code Enforcement can help you with the application procedure. In reviewing the proposed work on your building and/or site, the YHDC is guided by the Standards of Review as contained in 12.14 of the Zoning Ordinance and by the U.S. Secretary of the Interior s Standards for Rehabilitation and Guidelines for Rehabilitation. In the application, please include photographs of the existing condition, and descriptions and illustrations of the proposed work or demolition. These should clearly state the nature of the proposed work, and the photographs should be clearly identified. Please submit site plans, drawings or sketches, and any other material you feel will describe your project. These items will assist the Commission in understanding your proposal. In order for the application to be considered complete, you must include the original application along with 6 additional copies (with attachments) of the application. For demolition complete sections 1 and 4 only. If you have questions, please contact Catherine Harman, the Historic District Commission Assistant at (207) 363-1002, ext 6048. The completed application should be filed with the Code Enforcement Office at the Town Hall at least 14 (fourteen) days before a regular meeting of the Commission to be placed on the agenda for that meeting.

Historic District Committee Members CHAIR Kurt Hulstrom 112 York Street York, ME 03909 363-3825 hultstro8@maine.rr.com Term Expires: 06/30/2018 SECRETARY & VICE CHAIR Scott Stevens 16 Algonquin Drive Cape Neddick, ME 03902 351-5066 groundrootpres@gmail.com Term Expires: 06/30/2018 Jon Powers 15 Georgia Street York, ME 03909 jonandmichele2@gmail.com Term Expire: 6/30/2019 Bryce Waldrop 107 Cider Hill Road York, ME 039069 518-764-0062 bewaia@gmail.com Term Expire: 6/30/2019 LINDSAY ROAD REPRESENTATIVE Vacant HARBOR DISTRICT REPRESENTATIVE Vacant VILLAGE DISTRICT REPRESENTATIVE Vacant

Committee Members: Maine Historical Preservation Commission Kurt Hulstrom, Chairman 55 Capitol Street, State House Station 65 Scott Stevens, Vice Chairman & Secretary Augusta, ME 04333 Jon Powers Bryce Waldrop OFFICE USE ONLY APPROVAL /DENIAL / DATE CHAIR *See page 6 for details 1. Basic Information: Name of Applicant: YORK HISTORIC DISTRICT COMMISSION Application for Certificate of Appropriateness / Demolition Delay (For Demolition Delay, complete Sections 1 and 4 only) Address of Applicant: Contact Phone of Applicant: ( ) - Name of property owner if different from Applicant: Address of property owner if different from Applicant: Location of property: (Street Address) MAP LOT Present Use and Zoning classification: ( ) (Use) Zone Names and addresses of Abutters (attach separate sheet if necessary)

2. Specified Improvements: (Skip this section and proceed to section 4 for Demolition) Please provide detailed description of how you propose to treat or change the existing material of the building(s) or structure(s), where applicable. Some of the elements you should list below: siding, roofing, eaves, corner trim, window sash, window trim, doors and door trim porches, dormers, bay windows, etc. Attach separate sheets as needed, clearly labeled. 1. Architectural Element: Date of Element: Describe Existing Element: Describe Work and Impact on Element: 2. Architectural Element: Date of Element: Describe Existing Element: Describe Work and Impact on Element: 3. Architectural Element: Date of Element: Describe Existing Element: Describe Work and Impact on Element:

3. Major Improvements: (Skip this section and proceed to section 4 for Demolition) See section 12.12.3 for specific requirements, includes all new construction additions and site work. Please describe the proposed work and include elevations drawn to scale that illustrate architectural details and identify proposed materials, finishes and a site plan if appropriate. Describe Existing Structures, Architectural Elements and Site: Describe Work and Impact: 4. Demolition: A Certificate of Demolition is required for the demolition and also for moving of a building or structure. Attach photographs of the property and of adjacent sites if in a Historic District. Current Condition of Structure: Reason for Demolition or Moving: Does the building contribute to a historic district or landmark property? If not, please explain:

Signature of Applicant: Date: / / APPROVAL Meeting Date: Board Votes: Yes Description of Approval: / No Map / Lot: HDC Chairman DENIAL Meeting Date: Board Votes: Yes Description of Approval: / No Map / Lot: HDC Chairman