2. This application is for larger-scale projects affecting historic properties that are listed on the Manhattan Register of Historic Places or in a district on the Manhattan Register of Historic Places requiring a Certificate of Appropriateness that require a Certificate of Appropriateness before the work may begin. Examples include permits for new buildings, large additions, major interior renovations, demolitions, exterior alterations, and some zoning actions.
4. Date*
   Date
5. Historic Property Address*
6. Historic District
   -- Select One --Lee Elementary NeighborhoodNot in a District
8. Applicant Information
10. First Name*
11. Last Name*
12. Company (if applicable)
14. Address*
15. City*
16. State*
17. Zip
19. Phone*
20. Email*
22. Property Owner Information
24. First Name*
25. Last Name*
26. Company (if applicable)
28. Address*
29. City*
30. State*
31. Zip
33. Phone
34. Email
36. Project Description
38. Type of Work Proposed (check all that apply)*

    1. Building Permit
    2. Demolition Permit
    3. Sign Permit

    1. Zoning Action
    2. Other Alterations
    3. N/A
40. Work Proposed (check all that apply)*

    1. Exterior Modifications
    2. Interior Modifications
    3. Signage (Removal/Replacement/Installation)
    4. Awning(s) (Removal/Replacement/Installation)
    5. Window(s) (Repair/Replacement)
    6. Facade Material Replacement
    7. Walls (Adding/Removing)
    8. Roof Repair/Replacement
    9. Floor Repair/Replacement
    10. Ceiling Repair/Replacement
    11. Foundation Work

    1. Porch Repair/Replacement/Modification
    2. HVAC Work
    3. Lighting (Installation/Repair/Replacement)
    4. Sandblasting or Chemical Treatment
    5. Construction of an Addition
    6. Excavation/Regrading
    7. Landscaping
    8. Stair Repair/Replacement
    9. Demolition
    10. Other
42. Please explain if you selected "Other"
44. Please describe in detail the project you are proposing*
46. The following questions will help determine how the proposal meets the review factors required to be assessed by the Historic Resources Board before a Certificate of Appropriateness may be issued for the project; these are the criteria on which the Historic Resources Board will determine the appropriateness project. Some questions may not be applicable depending on your project. In such case, just type "N/A"
48. 1. Will the property be used as it was historically or will be given a new use that requires minimal change to its distinctive materials, features, spaces, and spatial relationships? Explain.
50. 2. How will the historic character of the property be retained and preserved? How will the removal of distinctive materials or alteration of features, spaces, and spatial relationships that characterize the property be avoided? Explain.
52. 3. Will the property be recognizable as a physical record of its time, place, and use? Will any changes that create a false sense of historical development, such as adding conjectural features or elements from other historic properties be included? Explain.
54. 4. Are there past changes to the property that have acquired historic significance in their own right? How will they be retained and preserved?
56. 5. Are there distinctive materials, features, finishes, and construction techniques or examples of craftsmanship that characterize the property? How will they be preserved?
58. 6. Will deteriorated historic features be repaired or replaced? Which features? Where the severity of deterioration requires replacement of a distinctive feature, will the new feature match the old in design, color, texture, and, where possible, materials? Does documentary and physical evidence exist to substantiate the replacement of missing features?
60. 7. Will there be any chemical and physical treatments to historic materials? How will it be undertaken using the gentlest means possible to avoid damage to historic materials?
62. 8. Are any archaeological resources involved? Will they be protected and preserved in place? How will mitigation measures be undertaken if such resources exist or are discovered and must be disturbed?
64. 9. How will new additions, exterior alterations, or related new construction avoid the destruction of historic materials, features, and spatial relationships that characterize the property?
66. 10. How will the new work be differentiated from the old and be compatible with the historic materials, features, size, scale and proportion, and massing to protect the integrity of the property and its environment?
68. 11. How will the new additions and adjacent or related new construction be undertaken in such a manner that, if removed in the future, the essential form and integrity of the historic property and its environment would be unimpaired?
70. 12. How does the proposal comply with the applicable requirements of the ordinance designating the historic district, site, or structure and its design guidelines?
72. Photo Upload

    Please upload up to twenty high quality photos (at least 1 MB each) of the existing property, including the exterior of the property and any areas or features proposed to be modified as part of the project. If you need to submit more photos, send them as an attachment in an email to chmiel@cityofmhk.com

74. Photo 1
75. Photo 2
76. Photo 3
77. Photo 4
79. Photo 5
80. Photo 6
81. Photo 7
82. Photo 8
84. Photo 9
85. Photo 10
86. Photo 11
87. Photo 12
89. Photo 13
90. Photo 14
91. Photo 15
92. Photo 16
94. Photo 17
95. Photo 18
96. Photo 19
97. Photo 20
99. Document Upload
    Please upload any site plan drawings, sketches, sign renderings, or any other documents depicting proposed modifications to the property. PDFs are preferred. Submit up to six.
101. Document 1
102. Document 2
103. Document 3
105. Document 4
106. Document 5
107. Document 6
109. Please sign this form by entering your first and last name below

     Within two days of submission, you will be contacted via the applicant email address you provided regarding when your project can be reviewed by the Historic Resources Board. Typically, applications must be submitted as complete a minimum of 14 days prior to the 4th Monday of the month (or other scheduled meeting date) to be reviewed at that Historic Resources Board meeting. Note that more information or documentation may be requested before an application can be deemed complete. A permit cannot be issued for the project until the project is approved by the HRB and you receive a Letter of Approval from City Administration regarding its historic review.

111. First Name*
112. Last Name*
Leave This Blank:


114. 1. Receive an email copy of this form.
115. Email address

     This field is not part of the form submission.

116. Submit Submit and Print

* indicates a required field