SVHS Preservation Grant Application
Apply for the Sewickley Valley Historical Society Preservation Grant. Please complete all required fields and upload supporting documents as indicated.
Name of Historic Building / Structure / Feature
*
Full Street Address with City / State / Zip
*
Recorded Owner of Structure
*
Applicant Telephone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Applicant Street Address
Applicant City/State/Zip
Applicant Email
*
example@example.com
Historic designation status (check all that apply)
Listed on the National Register of Historic Places
Not listed but eligible for listing on the National Register of Historic Places
In an Historic District
Other historical designation (state or local, e.g. PHLF, PHMC, SVHS Preservation Award, etc.)
National Register Reference #
If in an Historic District, what district/Borough?
If other historical designation, please list
Date(s) of the construction of the building / structure / feature (including additions or renovations)
Original architect(s) if known
Describe the structure’s historical and architectural significance
*
Upload supporting historic and current photographs (at least four)
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Describe the scope of work for the proposed exterior rehabilitation or restoration
*
Upload drawings/plans of proposed work
Upload a File
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of
Contractor 1 - Name, Title and Company
*
Contractor 1 - Address
*
Contractor 1 - Telephone & Email
*
Contractor 2 - Name, Title and Company
Contractor 2 - Address
Contractor 2 - Telephone & Email
Upload contractor estimates & proposals
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Proposed construction timeline
*
Amount requested from the SVHS Preservation Grant Fund (USD)
*
If the entire project budget is beyond $5,000, explain how the applicant will fund the remaining work for completion
*
Do you have liability insurance?
*
Please Select
Yes
No
Name of Insurer
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