Certificate of Appropriateness
Map __________ Lot __________
d. Removal of trim, elements, facing materials, or
B. How will the work be done:
and information concerning finishes.
repair in kind, approximating original feature
4. Please provide the following supplemental materials:
A. A description and samples of the materials which will be used. The description must include
2. Brief description of the above identified action:
3. If you checked 1a. (addition), 1b. (reconstruction), 1c. (alteration), or 1d. (removal of trim, etc.):
A. Indicate which of the following will be affected by the project:
roof exterior woodwork siding windows exterior doors other
removal of existing element/material with new kind of material
repair in kind, matching original feature
(PLEASE NOTE: THIS APPLICATION WILL NOT BE PROCESSED WITHOUT THESE MATERIALS.)
B. Photographs of the buildings marked to indicate the location of the proposed project or sign.
One of the photographs should be a photograph of the entire building.
C. A scale drawing of the project or elements to be changed. If the project is an addition or new construction, then the applicant
must submit architectural plans drawn to scale and a site plan showing the building in relation to adjacent buildings. If the project
is an improvement or change to existing exterior features, then the applicant must submit a site plan which includes the buildings
and exterior features as they now exist, adjacent buildings, and proposed alterations.
D. Sign Applications must include a scale drawing of the sign, a depiction or sample of the means of sign attachment or mounting to
Signature of Applicant/Agent Date
the building, materials, color samples, lettering samples, and finishes.
Printed Name of Applicant/Agent _____________________________________________________
i. Demolition if structure or portion of structure
Description of Applicant's Interest in Site, if not owner (e.g. lease, option, P&S Agreement):
1. Identify the action or actions requiring the Certificate of Appropriateness and/or Design Review:
Mailing Address ________________________________________________________
Phone No. _________________________________
Location of Site ________________________________________________________
Zone __________________________
Owner(s) of Site if different from Applicant _________________________________
Address _________________________________________________________________
h. Improvements to walkways, driveways, or landscape features
Design Review
Applicant _____________________________________________________________ Email _____________________________________
BANGOR HISTORIC PRESERVATION COMMISSION APPLICATION
2 COLOR COPIES OF THIS COMPLETED APPLICATION MUST BE SUBMITTED AT TIME OF APPLICATION ALONG
WITH APPROPRIATE FEE FOR REVIEW ON THE MONDAY 2 WEEKS PRECEDING THE MEETING (17 DAYS).
ONCE APPLICATION IS DEEMDED COMPLETE, AN ADDITIONAL 7 COLOR COPIES SHALL BE SUBMITTED FOR
REVIEW BY THE COMMISSION.
click to sign
signature
click to edit
![]()
