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Coa-administrative-application BOROUGH OF GETTYSBURG

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U.S.A. forms for Borough of Gettysburg

BROWSE BOROUGH OF GETTYSBURG (PA) FORMS

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Application Certificate of Appropriateness – Administrative Review
Page 1 of 3
Revised January 22, 2020
Any proposed alteration to the exterior of a building located within the limits of the Historic District, as defined by the
Gettysburg Historic District Ordinance, requires that this application be submitted and approved prior to receiving a
Building or Sign Permit. For minor projects (see Number 4, below), or replacement of materials in-kind, Certificates of
Appropriateness (COA) may be awarded by the Planning Department via administrative approval.
1. Project Site Information
Site Address Zoning District
_________________________________________________________________ ____________________
2. Applicant Information
Owner Mailing Address Zip Phone Email
_______________________ ____________________ __________ _________ __________________________
Contractor Mailing Address Zip Phone Email
Architect or Engineer Mailing Address Zip Phone Email
3. Property Type: □ Commercial □ Residential
4. Type of Work (Check all that apply) – Project must be a Sign, Banner, or Replacement in-kind.
□ Awning □ Gutters/Spouting □ Shed
□ Banner □ Lighting □ Shutters
□ Cornice □ Masonry/Brick □ Siding
□ Door □ Porch □ Sign
□ Driveway/Sidewalk □ Patio □ Stucco
□ Fence □ Railing □ Window
□ Other ______________________________________________________________________________________
OFFICE USE ONLY
Parcel #__________________________
Address: _________________________
LU - ______ - _______
COA -______-________
Date Received: ____ - ____ - ________
Application for Certificate of Appropriateness
Administrative Review
Borough of Gettysburg
LAND USE APPLICATION REQUIRED
Continued on reverse side of page.
Return to: Borough of Gettysburg Administrative Offices, 59 E. High Street, Gettysburg, PA 17325
OR
Submit electronically to Debra English, Director of Historic and Environmental Preservation at
denglish@gettysburgpa.gov
□ Completed Land Use Permit Application □ Completed COA Application □Photos and/or Samples
Application Certificate of Appropriateness – Administrative Review
Page 2 of 3
Revised January 22, 2020
5. Project Documents Required for Review
□ Color photographs of property front & side, areas of work and neighboring
properties
□ Drawings and/or architectural renderings
□ Materials samples (note current and provide proposed)
□ Sign rendering in color, with sample lettering
□ Cost Estimate
□ Certificate of Insurance
□ Detailed Scope of Work
□ Other ____________________________________________________
6. Provide a detailed description of proposed work including materials.
Provide spec sheets and drawings of windows, siding, trim, etc. Provide samples of siding and other materials.
(Use additional sheets, if needed). Provide Cost Estimate for projected work.
7. Certification
I hereby certify that the information contained herein is complete and accurate and that the work is authorized by the
owner of record of the named property. Furthermore, I agree to only complete work as presented and understand
any deviation from or addition to what is approved by the Certificate of Appropriateness constitutes a code violation.
Signature of Applicant Date
Printed Name of Applicant Phone # Email Address
This application will not be processed until all required information is submitted. HARB is a design review board only,
each project must meet all other Borough Ordinances and Building Code requirements prior to final approval.
OFFICE USE ONLY
Parcel #__________________________
Address: _________________________
LU - ______ - _______
COA -______-________
Date Received: ____ - ____ - ________
Application Certificate of Appropriateness – Administrative Review
Page 3 of 3
Revised January 22, 2020
OFFICE USE ONLY
APPROVAL DISAPPROVAL
□ Planning Administrative Approval Date: __________ □ Reason:
□ Certificate of Appropriateness Date: __________
□ Historic District Land Use-Working Permit Date: __________ □ Letter to Applicant Date: ___________
REVIEW / APPROVAL
□ Zoning Review Approval Date: ____________
□ UCC Building Permit Required (PMCA) Approval Date: ____________
OR
□ Non UCC Building Permit Required Approval Date: ___________
Issued by:______________________________________ Title:___________________________________________
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Coa-administrative-application BOROUGH OF GETTYSBURG

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Completed 12 July 2020

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