APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS TO HARRIMAN HISTORIC ZONING COMMISSION

APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS TO HARRIMAN HISTORIC ZONING COMMISSION
I (we) the undersigned do hereby make application for a Certificate of Appropriateness for the

following plans and proposals to be undertaken within the boundaries of the Historic

Preservation Zoning District pursuant to Ordinance No. 93-23-01.
Name of Applicant

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Relationship to Owner

LesseeContractorArchitectOther
Name of Owner

First NameLast Name
Owner Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Location of Property

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Type of Work (Check all that apply)

Exterior alteration or repairNew constructionDemolitionRelocation of structure
Description of Work:
Signature of Applicant

Clear
Date

MonthDayYear
Date
Check each work item for which approval is requested

Architectural feature (decorative ornamentation)Awning or canopyCurb cutDeckDoorFenceGutteringLight fitureMasonry cleaning, tuck pointing, or paintingParking lot (paving, entrance drives, landscaping)Porch (columns, cornice, trim, railings, flooring, step, trelliswork, ornamentation)Material changes (wood, brick, metal, etc.)Mechanical system unitsRetaining wallRoof (change in shape, features, materials)Satellite dishSecurity grilles on windows or doorsShuttersSidewalksSidingSignsSolar collectorsStorm windows or doorsOther
For each item checked, provide a comprehensive list and a detailed description of all work to be performed. Include relevant materials where applicable. Your submission should contain the following:
- Visual and Technical Documentation:
- Sketches, photographs, specifications, manufacturer’s illustrations, or other descriptions that clearly outline the proposed changes to the building’s exterior.
- Detailed Drawings:
For major design changes—such as modifications to roofs, facades, porches, or other prominent architectural features—detailed drawings are required.

Additional Documentation for Specific Applications:

If the application pertains to a fence, include a site plan in addition to the information required above.

Material Samples:

If material changes are proposed, provide samples to accompany your submission.
Please provide information:
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