Historic District Commission

TOWN OF ______

HISTORIC DISTRICT COMMISSION

CERTIFICATE OF APPROPRIATENESS

Case Number: ______

Applicant: ______

Property Owner: ______

Property: ______

Plat Map: ______Lot: ______

Present zoning: ______Present use: ______

Properties in vicinity/use and zoning:

Relief requested:

The Historic District Commission received comments concerning the request at a legally noticed hearing held on ______.

Historic District Commission members present:

The following individuals spoke as representatives of the applicant/property owner:

Notice of Decision – Certificate of Appropriateness Page 2 of 4

Name of Applicant ______

Historic District Commission ______Date______

The following individuals spoke at the hearing in support of the request:

The following individuals spoke at the hearing in opposition to the request:

The following materials were entered into the record:

Findings of Fact:

Based on the following evidence which is part of the record, the Commission finds that the structure and its appurtenances do/do not have historic and architectural significance because

Notice of Decision – Certificate of Appropriateness Page 3 of 4

Name of Applicant ______

Historic District Commission Date______

2.. Based on the following evidence which is part of the record, the Board finds that the structure and its appurtenances do/do not contribute to the historical and architectural significance of the district:

3. Based on the following evidence which is part of the record the Commission finds that the general design, arrangement, texture, materials, and siting proposed in the plans are/are not appropriate to the historical and architectural significance of the structure and the district. Specifically,

· The Commission finds that the proposed work does/does not comply with Secretary of the Interior Standard No. # [quote standard] because

[Repeat findings statement for as many standards as are applicable to the specific application.]

Notice of Decision – Certificate of Appropriateness Page 4 of 4

Name of Applicant ______

Zoning Board Date______

Based on the above findings of fact, a motion was made by ______and seconded by ______to approve/deny the applicant’s request for a Certificate of Appropriateness as follows:

Approval is subject to the following conditions:

Voting in favor of the motion:

Voting against the motion:

Date of vote: ______

______

Signature of Chair Date

A party wishing to appeal this decision must do so on or before ______by ______.

This decision is valid for ______.