ࡱ> egf5@ Zbjbj22 (dXX?hhhhhhh|L|?6666666^``````$7R~uhF66FFhh66F h6h6^F^&BhhB6 {PFBr0?B|B||hhhhhB06rH\666||  ||STATE OF MAINE MAINE HISTORIC PRESERVATION COMMISSION SMALL PROJECT REHABILITATION CERTIFICATION APPLICATION REQUEST FOR CERTIFICATION OF COMPLETED WORK PART 3 MHPC Office Use Only NRIS No:  Instructions: Upon completion of the rehabilitation, return this form with representative photographs of the completed work (both exterior and interior views) to the fb88 Historic Preservation Commission. If a Part 2 application has not been submitted in advance of project completion, it must accompany the Request for Certification of Completed Work. A copy of this form may be provided to fb88 Revenue Services. Type or print clearly in black ink. The decision of the Director with respect to certification is made on the basis of the descriptions in this application form. In the event of any discrepancy between the application form and other, supplementary material submitted with it (such as architectural plans, drawings and specifications), the application form shall take precedence. 1.Name of Property:  FORMTEXT       Address of Property: Street  FORMTEXT       City  FORMTEXT       County  FORMTEXT       State  FORMTEXT       Zip FORMTEXT       Is property a certified historic structure?  FORMCHECKBOX  yes  FORMCHECKBOX  noIf yes, date of certification by the Director:  FORMTEXT       or date of listing in the National Register:  FORMTEXT       2.Data on rehabilitation project:Maine Historic Preservation Commission assigned SPRCA project number:  FORMTEXT       Project starting date:  FORMTEXT       Rehabilitation work on this property was completed and the building placed in service on:  FORMTEXT       3.Owner: (space on reverse for additional owners)I hereby apply for certification of rehabilitation work described above for purposes of the State tax incentives. I certify on penalty of criminal punishment under the laws of the State of fb88 and the United States that I own the property described above, and that the information I have provided is true and accurate to the best of my knowledge and belief.Name  FORMTEXT       Signature Date:  FORMTEXT       Organization  FORMTEXT       Street  FORMTEXT       City  FORMTEXT       State  FORMTEXT       Zip  FORMTEXT       Daytime Telephone Number  FORMTEXT       MHPC Office Use OnlyThe Director of the fb88 Historic Preservation Commission has reviewed the Small Project Rehabilitation Certification Application Part 2 for the above-listed certified historic structure and has determined:  FORMCHECKBOX that the completed rehabilitation meets the Secretary of the Interiors Standards for Rehabilitation and is consistent with the historic character of the property or the district in which it is located. Effective the date indicated below, the rehabilitation of the certified historic structure is hereby designated a certified rehabilitation. A copy of this certification may be required by fb88 Revenue Services in order to claim the State tax credit. This letter of certification is to be used in conjunction with appropriate fb88 Revenue Service:;<L M Z [ \ ] j l $ & : < > ɬɬ{mX{)j2hh25>*CJUaJhh25>*CJaJ#jhh25>*CJUaJhh25CJaJhh25CJ hh2CJ hh2CJaJhh2CJhh2CJhh25CJhh25CJOJQJhh25CJhh25CJhh2OJQJ:;v_kd$$IflFLX `'T(    4 la $$Ifa$gd2 $Ifgd2 $$Ifa$gd2$a$gd2Z;<sL v9kd$$Ifl.L`'((4 la $$Ifa$gd2 $Ifgd29kd~$$Ifl)L`'((4 laL M W X Y Z [ \ XH$<<$Ifa$gd2Lkdz$$Ifl0L\ `'(4 la$ @t$If^ta$gd2 $$Ifa$gd29kd"$$IflZL`'((4 la\ ] -%$a$gd2`kd$$IflL`'(0(4 la$<<$Ifa$gd2`kd$$IfloL`'(0(4 la N P }C9kd$$Iflih'V&|4 laX$ %<$Ifa$gd2Okd$$Ifl4i0h'|V&4 laXf4$ %<$Ifa$gd2$<$Ifa$gd2> H J L N P Ƚv`S@`%jhh25>*CJUhh2CJOJQJ*jhh25>*CJUmHnHu%jhh25>*CJUhh25>*CJjhh25>*CJUhh25CJhh25CJOJQJhh2CJaJhh25>*CJaJ#jhh25>*CJUaJ.jhh25>*CJUaJmHnHu (`?rkd$$Iflj\"'N 4 laX$ @&<$Ifa$gd2$ P<$Ifa$gd2$ <$Ifa$gd2$ < ZZZZ<$Ifa$gd2 "$&68LNPZ\^fh|~2}n\nShh2CJ"jRhh25CJUjhh25CJUhh2CJOJQJ%jChh25>*CJU%jhh25>*CJUhh25CJ*jhh25>*CJUmHnHu%jWhh25>*CJUhh25>*CJjhh25>*CJU 24PRTVFH\^`jlprtHJ缰z缰gz\Nhh25CJOJQJhh2CJaJ%j) hh25>*CJUhh2CJOJQJ*jhh25>*CJUmHnHu%j:hh25>*CJUhh25>*CJjhh25>*CJUhh2CJ"jhh25CJUhh25CJjhh25CJU^prqq$ `%<$Ifa$gd2Okd$$Ifl40h'|4 laXf4$ %<$If]a$gd2$ %<$Ifa$gd2rtztQ?$ %<$Ifa$gd2Okd $$Ifl4j0h'|V&4 laXf4$<$Ifa$gd2Okd $$Ifl4i0h'|4 laXf4JL`bdnprtv㰣㰂o㰣f[hh2CJaJhh2CJ%j, hh25>*CJUhh25CJOJQJ%jY hh25>*CJUhh2CJOJQJhh25CJ*jhh25>*CJUmHnHu%j hh25>*CJUhh25>*CJjhh25>*CJU!tvvd$ %<$Ifa$gd2<kd $$Ifl4ih'V&|4 laXf4$ %<$Ifa$gd29kd $$Iflih'V&|4 laXw<kd $$Ifl4''4 laXf4$<$Ifa$gd2<kd $$Ifl4jh'V&|4 laXf4     246BDXZ\fhjlnpв}Цtвa}tTвhh2CJOJQJ%jhh25>*CJUhh2CJ*jhh25>*CJUmHnHu%j(hh25>*CJUhh25>*CJjhh25>*CJUhh25CJOJQJhh25CJhh25CJOJQJhh2CJaJhh25CJaJ 6gS>$ z%<$Ifa$gd2$ < z%<$Ifa$gd29kd $$IflIh'V&|4 laX$<$Ifa$gd2Okd] $$Ifl4q0h'|V&4 laXf46nps99kd$$Ifl;h'V&|4 laX$ %<$Ifa$gd2bkd$$Ifl4;Fh.X ' *f|    4 laXf4$  z%<$Ifa$gd2"$&(*8:NPR\^bnpܺܺܺܺ}ܺܺjܺܺ%jhh25>*CJU%jhh25>*CJU%jjhh25>*CJUhh2CJOJQJhh25CJhh25>*CJ*jhh25>*CJUmHnHujhh25>*CJU%jhh25>*CJU$(*duaM$ z%<$Ifa$gd2$ z%<$Ifa$gd2$ < z%<$Ifa$gd2OkdV$$Ifl4;0h')-|4 laXf4$ %<$Ifa$gd2$ <$Ifa$gd2ܺܺܺynbySA"jhh25CJUjhh25CJUhh25CJaJhh2CJaJhh2CJOJQJhh25CJOJQJ%jhh25>*CJUhh25CJhh2CJhh25>*CJ*jhh25>*CJUmHnHujhh25>*CJU%j?hh25>*CJUwc$ z%<$Ifa$gd2$ z%<$Ifa$gd2$ < z%<$Ifa$gd2_kd+$$Ifl;Fh.' R>|    4 laXWKK $$Ifa$gd29kd1$$Ifl''4 laX$x$Ifa$gd2_kd$$Ifl;Fh.' R>|    4 laXVVVXgOkdm$$Ifl4]0h'hV&4 laXf4$<$Ifa$gd29kd$$Ifl''4 laX,PVVVVVVVXXXXXXXXYYYYYYYYYYYY Z ZZ°ܣ——…́hwf"jhh25CJUhh25>*CJhh2CJOJQJ"jhh25CJUhh25CJhh25CJOJQJUhh25CJaJhh2CJjhh25CJU"s regulations. Questions concerning specific tax consequences or interpretation of the Internal Revenue Code or Title 36 of the Maine Revised Statutes should be addressed to Maine Revenue Services. Completed projects may be inspected by an authorized representative of the Director to determine if the work meets the  Standards for Rehabilitation. The Director reserves the right to make inspections at any time up to five years after completion of the rehabilitation and to revoke certification, if it is determined that the rehabilitation project was not undertaken as presented by the owner in the application form and supporting documentation, or the owner, upon obtaining certification, undertook unapproved further alterations as part of the rehabilitation project inconsistent with the Secretary s  Standards for Rehabilitation.  FORMCHECKBOX that the rehabilitation is not consistent with the historic character of the property or the district in which it is located and that the project does not meet the Secretary of the Interior s  Standards for Rehabilitation. A copy of this form may be provided to Maine Revenue Services.   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