HomeMy Public PortalAbout59 GREAT OAK ROAD I
Ap lication #
yti R�� F�,,�� Town of Brewster I � 4 - 0� 1 - 10 I
it
o Historic District Committee CC��
2198 Main Street Fee : $ O�. J
Brewster, Massachusetts 02631- 1898
_ .`r`� = ( 508) 896-3701 Ext . 1125 Paid
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Fax ( 508) 896-8089 8 "7FCORPORAt �g building@brewster- ma . gov Email : buildin Brewster- ma . ov check #
Map 55
Lot 8 3
Certificate of Appropriateness
(Please read reverse side for requirements)
Address of Proposed Work � ��D�k Q�J ;
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Owner's Name / + �� V� Ufi�fessphone # ( ��01 Z G7 �// T
Owner's Mailing Address o4OVAORI �r k171W4 7
Agent or Contractor
���✓ �� �� Telephone #
Agent's Address ��i L ��w 4:: P7 �/f7%
Agent/Contractor E- Mail 11 n /WeeIWeew, ee%r// . e
Please check categories that apply:
Exterior Building Construction Indicate Building Type Exterior Structure
New Building ❑ House Painting ❑ Fence ❑
Addition ❑ Garage ❑ Wall ❑
Alteration ❑ Commercial ❑ Shed ❑
Other ❑ Other
Briefly describe proposed work (and complete attached Specification Sheet) :
Applicant's Signature
This Certificate is hereby Date
Signed
Ce rt, ofAppropriatenessPagel
Application #
Specification Sheet
(Please complete only those portions which apply to your application)
Foundation Type � v Amount Visible
( not to exceed 18" )
Siding Amount Visible Type
Exposure Color
Trim Size of Cornerboards IV Size of Casings ( 1xa minimum )
Rakes 11` Member 2nd Member
Depth of Overhang Color ( s )
Windows Type // Manufacturer
( Provide Spec Sheet)
Grilles or true divide Size
Color f
Skylights Type /�/ 1,4 Manufacturer
Size Color
Roof Pitch ( 7 pitch minimum ) Material
Exposure Color
Style
Fencing* Type Height
*All stockade type fencing must have "good" side
Color facing out.
Chimney Type �/ / f' Size
Color
Deck Material ��Of/ '��
G� �i'i /V Color
Color
& Railing Material 4JI 9 /d//�ff' wor Color
Shutters Material Color
Garage Doors ( s) Size of Opening A /7 Style
( Provide Spec Sheet)
Color Manufacturer - - -
Gutters Type Al Color
Over 4
Cert. ofAppropriatenessPage3
Specification Sheet — Page 2
Storm Windows Material 411� Color
—
& Door
( Provide Spec Sheet) N, /
Entry Doors Type Front
Front & Side
( Provide Spec Sheet) Side Other
Manufacturer Size
Color
Attic/Roof ( Gable Louver, Ridge Vent, Etc . ) y �
Venting
Landscaping e4ee �vY
Plans
ezz, 4t, !lire
Driveway
Type of Steps
Exterior Fuel
Tank Screening
Other
I
Cert . ofAppropriatenessPage4
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