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AWp HISTORIC RESOURCE INVENTORY FORM
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IDENTIFICATION
Property name(if any)
OFFICE USE ONLY
USN:
Address or Street Location 1864 Trumansburg Road (Route 96)
County Tompkins Town/City Ulysses Village/Hamlet: Jacksonville
Owner Address
Original use Single-family residence Current use Single-family residence
Architect/Builder, if known
DESCRIPTION
Date of construction, if known
Materials -- please check those materials that are visible
Exterior Walls: 13 wood clapboard ❑ wood shingle ❑ vertical boards ❑ plywood
❑ stone ❑ brick ❑ poured concrete ❑ concrete block
❑ vinyl siding ❑ aluminum siding ❑ cement -asbestos ® other: unidentified siding
Roof: [� asphalt, shingle ❑ asphalt, roll ❑ wood shingle ❑ metal ❑ slate
Foundation: ® stone ❑ brick EX poured concrete [a concrete block
Other materials and their location: See continuation sheet
Alterations, if known: See continuation sheet Date:
Condition: ❑ excellent ERgood ❑ fair ❑ deteriorated
Explain:
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Photos
Provide several clear, original photographs of the property proposed for nomination. Submitted views should
represent the property as a whole. For buildings or structures, this includes exterior and interior views, general
setting, outbuildings and landscape features.
Please staple one photograph providing a complete view of the structure or property to the front of this sheet.
Additional views should be submitted in a separate envelope or stapled to a continuation sheet.
Maps
Attach a printed or drawn map indicating the location of the property in relation to streets, intersections or other
widely recognized features so that the property can be accurately positions. Show a north arrow. Include a scale
or estimate distances where possible.
Prepared by: Katelin Olson
Telephone: 585-589-2502
Address Trumansburg, NY
Email keo249cornell.edu Date June 2014
(Continued on reverse)
Field Services Bureau • Division for Historic Preservation • New York State Office of Parks, Recreation and Historic Preservation
Peebles Island, P. 0. Box 189, Waterford, NY 12188 • www.nysparks.com/shpo • 518-237-8643