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TOWN OF BREWSTER
OLD KING'S HIGHWAY REGIONAL HISTORIC DISTRICT
HISTORIC DISTRICT COMMITTEE
2198 MAIN STREET
BREWSTER MA 02631
PHONE:
(508) 896-3701 EXT 1125
EMAIL:
HDCMEETING BREWSTER-MA.GOV
CERTIFICATION OF APPROPRIATENESS
PLEASE READ REVERSE SIDE FOR REQUIREMENTS
NOTE: ALL FEES DOUBLED IF WORK IS STARTED BEFORE OBTAINING APPROVAL
Address of Proposed Work �j�pi I / /y S(
Owner Name
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Owner Mailing Address
Owner Email
Contractor Name
Company Name
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Contractor Address
Contractor Email
Please check the categories that apply:
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Exterior Building Construction
❑ New Building
❑ Addition
❑ Alteration
Building Type
O House
❑ Garage
O Commercial
❑ Other
Briefly describe proposed work (and complete attached specification sheet):
Contractor Phone
Exterior Building
❑ Paint
0 Solar Panels
Structure
.Fence
❑ Wall
❑ Shed
❑ Other
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Applicant Signature
This Certificate is hereby
Date
1 Page
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ADDRESS:
TOWN OF BREWSTER
OLD KING'S HIGHWAY REGIONAL HISTORIC DISTRICT
HISTORIC DISTRICT COMMITTEE
2198 MAIN STREET
BREWSTER MA 02631
PHONE:
(508) 896-3701 EX7 1125
EMAIL
HDCMEE T ING@BREWSTER-MA.GOV
SPECIFICATION SHEET
PLEASE COMPLETE ONLY THOSE PORTIONS WHICH APPLY TO YOUR APPLICATION
Foundation Type
Siding Type
Trim
Color
Amount Visible __—
(NOT TO EXCEED BETWEEN 12" OR 18")
Amount Visible
Material
Exposure
ALL WINDOWS & DOORS TO BE TRIMMED WITH ❑ 1x4 0 1X5
Size of Corner Boards Color Material
Rakes______ ___ 1St Member 2 ' Member
Depth of Overhang
Windows -MUST PROVIDE SPEC SHEET Type
Manufacturer
Grilles or True Divide Size
Skylights Type
Size
Color
Manufacturer
Roof Type
Pitch
Color
(7 PITCH MINIMUM)
Height to Ridge Style
Fencing- ALL STOCKADE TYPE FENCING MUST HAVE "GOOD" SIDE FACING OUT
Type 1/i4#. tAhef Height_' Color
Color
Chimney
Type Size Color
Material
Deck
Color Material
Railing Color Material Manufacturer
Shutters Color Material
Garage Doors- MUST PROVIDE SPEC SHEET Size of Opening Style
Material _. Color Manufacturer
Gutters Type Color Material
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TOWN OF BREWSTER
OLD KING'S HIGHWAY REGIONAL HISTORIC DISTRICT
HISTORIC DISTRICT COMMITTEE
2198 MAIN STREET
BREWSTER MA 02631
Storm Windows & Door -
MUST PROVIDE SPEC SHEET
Type Color
Entry Door (Front & Side)- MUST PROVIDE SPEC SHEET
Type Color
Attic/Roof Vent
Type (Gable Louver, Ridge Vent, etc.)
Landscaping Plans
Please describe any Landscaping Plans
Material
PHONE:
(508) 896-3701 EXT 1125
EMAIL:
HDCMEETING, BREWSTER-MA.GOV
Material
Driveway
Type
Type of Steps
Exterior Fuel Tank Screening
Other
IMPORTANT: ALL FEES DOUBLED IS WORK IS STARTED BEFORE APPROVAL.
IF CERTIFICATE IS APPROVED, APPROVAL IS SUBJECT TO THE 10 DAY APPEAL PERIOD PROVIDED
IN THE ACT.
This Certificate expires one year or upon the date of expiration of any Building Permit Issued, whichever
expiration date shall be later. You must file an extension before the expiration date.
**The Homeowner, Agent or Contractor must attend the hearing, failure to do so may result in denial of
the application*
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TOWN OF BREWSTER
OLD KING'S HIGHWAY REGIONAL HISTORIC DISTRICT
HISTORIC DISTRICT COMMITTEE
2198 MAIN STREET
BREWSTER MA 02631
WAIVER OF 45 DAY DETERMINATION
OPTIONAL
PHONE
(508) 896-3701 EXT 1125
EMAIL:
HDCMEETINGeBREWSTER-MA.GOV
The applicant/authorized agent understands and agrees that the determination of the submitted
application for a Certificate of Appropriateness may not be made within 45 days of the filing of
such application.
The applicant agrees to extend the time frame within which a determination is to be made as
required by the Old King's Highway Regional Historic District Act.
Section 9- Meetings, Hearing, Time for Making Determinations
"As soon as convenient after such public hearing; but in any event within forty five (45) days after the filing of
application, or within such further time as the applicant shall allow in writing, the committee shall make a
determination on the application." (Page 11, Old King's Highway Regional Historic District Bulletin)
Applicant understands that the review of this application will be scheduled as soon as the situation
allows.
Applicant/Authorized Agent Name
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Applicant/Authorized Agent Signature �Q /
Date 2/ '-3 Property Location R?1,./
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