Fillable District Application Membership Application Form (Town of Mendon (MA))

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District Application Membership Application Form (Town of Mendon (MA))

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TOWN OF MENDON
HISTORIC DISTRICT COMMISSION
20 Main Street Mendon, Massachusetts 01756
Phone: (508) XXX-XXXX • Fax: (508) 478-8241 • Email: hdc@mendonma.gov
mendonma.gov/historic-district-commission
Mark Bucchino –
Chair
Deborah Flanagan
– Vice Chair
JP Parnas
– Secretary
Daniel Byer
Jane Lowell
Janice Muldoon-Moors
Ruth O’Grady
APPLICATION FOR CERTIFICATE OF
APPROPRIATNESS/HARDSHIP/NON-APPLICABILITY
Application Process:
The applicant should review the District Guidelines, and Rules and Regulations (available here:
mendonma.gov/historic-district-commission) before submitting their application. The Historic District
Commission encourages each applicant to review their application with the Chairperson before submission to
discuss the specific materials and requirements necessary to ensure an application is complete.
1. Property owner or their agent should complete this application in full and return to the Town Clerk’s
Office.
2. Within 14 days after the filing of a completed application, the Commission shall determine if proposed
work involves any exterior architectural features which are within the jurisdiction of the commission.
Please note, ALL proposed exterior work within the Historic District MUST be preceded by an
application. It is the sole purview of the Historic District Commission to determine if a proposal is
within their jurisdiction.
3. If the Commission determines the application DOES NOT fall within their jurisdiction they shall issue a
certificate of Non-Applicability. The Applicant may then bring this certificate and proceed with their
permit with the Building Department
4. If the Commission determines the application DOES fall within their jurisdiction they shall hold a public
hearing within 45 days from the date of filing of the completed application. At least 14 days prior to
the hearing, notice shall be given on the Town’s website as well as a newspaper of general circulation.
Copies of this notice will be mailed to the applicant, abutting properties within a 100 ft radius, and
additional relevant parties per the by-law.
5. Within 60 days after the date of filing of a completed application, or within such further time as the
applicant may allow in writing, the Commission shall issue a certificate of Appropriateness, Hardship or
Disapproval.
In the case of Disapproval, the Commission shall outline the reasons for such disapproval and may
include specific recommendations for changes in the proposal. If, within 14 days, the applicant files a
written modification of their application in conformity with the recommended changes of the
Commission, the Commission shall issue a certificate of appropriateness.
6. An appeals process is outlined in Section 7.13 of the by-law.
Mendon Historic District Application Revised 1/9/2020 Page 1 of 2
TOWN OF MENDON
HISTORIC DISTRICT COMMISSION
20 Main Street Mendon, Massachusetts 01756
Phone: (508) XXX-XXXX • Fax: (508) 478-8241 • Email: hdc@mendonma.gov
mendonma.gov/historic-district-commission
Mark Bucchino –
Chair
Deborah Flanagan
– Vice Chair
JP Parnas
– Secretary
Daniel Byer
Jane Lowell
Janice Muldoon-Moors
Ruth O’Grady
PROPERTY INFORMATION (SHOULD BE VERIFIED WITH ASSESSOR’S OFFICE)
Owner of Record
Property address
Parcel ID
Current Deed (Book & Page)
Year Built
Acreage
Dimensions
Property Description
Property Owner(s) Signature
APPLICANT INFORMATION
Applicant’s Name
Date
Applicant’s address
City
State
ZIP Code
Applicant email
Applicant phone#
Applicant Signature
PROPOSED WORK
Brief Description of Proposed Work
Architect and/or General Contractor (if applicable)
The following checklist is intended to provide the Commission a complete description of the proposed changes so that they may evaluate
the application prior to the hearing. All the following materials may be required for a complete submission:
___ Written description of all proposed changes.
___ Photographs of the existing structure as viewed from all public ways.
___ Photographs of the adjacent property facing the proposed changes.
*photographs may be submitted electronically to
hdc@mendonma.gov
___ Written description of materials to be used.
___ Scaled drawings, including dimensions of the existing conditions and of the proposed changes including floor plans, building
elevations, details as required and a site plan.
___ Manufacturer’s literature, photographs, samples and any other relevant materials.
___ Explanation of Hardship
(if applicable)
___ In the case of proposed demolition, the final report from the Historic Commission regarding Demolition Delay Review OR a completed
application to the Historic Commission for Demolition Delay Review
___ One printed copy of this application and all required materials. Electronic applications may be accepted at the discretion of the chair.
Completed application with all supporting materials should be submitted to the Town Clerk’s office
or may be emailed to hdc@mendonma.gov
Mendon Historic District Application Revised 1/9/2020 Page 2 of 2
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District Application Membership Application Form (Town of Mendon (MA))

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Completed 13 July 2020

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