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Proposed Scope of Work (List Each Item Separately)

(For example: 1. Replace existing front door with wood four-panel door

2. Install storm door)

________________________________________________________________________________________

Estimated Total Cost of All Work Items: _______________________________________________________

Check List: Items Submitted with This Application (No Submissions Required for Concept Reviews)

___ Plot Plan Drawings

___ Elevation Drawings

___ Photographs

___ Brochure

___ Material Sample

___ Color Sample

___ Other: ____________________________________

Application Requirements: Applicants for Concept Reviews must submit fourteen (14) copies of this completed application

form. Applicants for Administrative Reviews and Formal Reviews must submit fourteen (14) copies of this completed application,

fourteen (14) copies of blueprints, drawings, etc., one (1) set of photographs specific to the project site, and a written explanation

of the proposed scope of work. Plans must be drawn to scale. Applicants are encouraged to have their architect or contractor

present plans at HARB meetings. The building owner must attend the HARB meeting or submit a signed letter granting

permission for the proposed scope of work. A letter of authorization signed by the property owner must be submitted where an

authorized agent signs in lieu of the property owner. Applications must be complete and submitted to the Borough at least 10

business days prior to the monthly HARB meeting. HARB meetings are held on the first Tuesday of each month.

AGREEMENT

The undersigned, being the applicant who submitted the above referenced application, hereby grants to the Borough of New Hope,

without prejudice, an extension of allowable review time under the provisions of the Pennsylvania Uniform Construction Act, a further period,

starting today and ending fifteen (15) days following the date of approval by Borough Council of a Certificate of Appropriateness for one-

family and two-family dwelling units, including utility and miscellaneous use structures, and thirty (30) days following the date of approval by

Borough Council of a Certificate of Appropriateness for all other construction permits.

The purpose for this extension is to allow the New Hope Borough Historic Architectural Review Board and the Borough Council to

schedule and consider the applicant’s request for issuance of a Certificate of Appropriateness for a structure in the Historic District.

The applicant hereby acknowledges that the project address is located in the Historic District of the Borough of New Hope.

Applicant’s Name (print):

Applicant’s Signature: ___________________________

_____________________________

Date of Application: _____________________________

July 2010

Application For A Certificate Of Appropriateness Form - New Hope, Bucks County, Pennsylvania Page 2