City of MedfordCommunity Preservation Act Grant Application (FY25)

City of Medford

Community Preservation Act Grant Application (FY25)

Annual Funding Round applications will be accepted July 8, 2024 - September 9, 2024 by 5pm EST.

Off-cycle applications may be eligible for consideration; reach out to Theresa Dupont at tdupont@medford-ma.gov or (781) 393-2480 to inquire about options.

If you haven't submitted an Eligibility Determination Form and received confirmation that your project is eligible for CPA funding, do not proceed with this application.

Reach out to Theresa Dupont at tdupont@medford-ma.gov or (781) 393-2480 for further direction.

Project Information

Project Name*

Project Location*

Total CPA Funding Request*

CPA Program Area*

Select or enter value

If the project is for open space or historic preservation acquisition, a Conservation Restriction (CR) or Preservation Restriction (PR) is required. For other projects in these program areas a CR or PR may be required at the discretion of the Committee. A third party holder of the CR must be identified.*

Please check off the Acknowledgement box below, to indicate that you understand this requirement.

Project Summary*

Applicant Information

Applicant Name/Primary Contact*

Co-applicant Name (if applicable)

Property Owner*

Organization (if applicable)

Mailing Address*

Phone #*

E-mail*

Project Narrative

Describe the project; include the project location and property involved.*

Why is this project needed?*

How does this project benefit the public? What population(s) will it serve? Has there been a public process, capital improvement plan, or site evaluation to document the needs or goals for this project? Mention any community support for the project.

How does the project meet the general and any category-specific priorities, as outlined in the Community Preservation Plan?*

How does the project meet the specific criteria in the Community Preservation Act Funding Allowable Uses table? Be sure to include any sustainable practices or design elements included.

Scope and Budget

Required Attachments:

1) Download and complete a CPA Budget Summary Form and attach to this application.

2) A separate, detailed line item budget with outlined tasks and deliverables must also be submitted with this application.

Total Project Cost*

Total cost to complete the project, including all non-CPA funds

CPA Funding Requests (as percentage of total project costs)*

Response must be a percentage (%)

Provide a detailed outline of the tasks that will be carried out as part of this project.*

Please indicate if some tasks will use funding from a different source.

Will the project require future phases or funding over multiple years? If so, please describe.*

If not, please enter N/A below.

Describe all successful and unsuccessful attempts to secure funding and/or in-kind contributions, donations, or volunteer labor for the project.*

Describe any cost-saving measures to be implemented.

If funding is not available to cover the full cost, can this project be phased or reduced in scale?*

Project Management

Describe the applicant*

Are they public, private non-profit, private for-profit, an individual, a partnership, or another type of entity? What is their history and background? Provide any additional relevant information.

Identify and describe the roles of all known participants, including the project manager.*

If the project involves multiple co-applicants, describe the process of coordination between co-applicants in planning for the project application, as well as how the organizations will work together to carry out the project.

Indicate who will have responsibility for managing the finances and overseeing completion of the project scope, as well as who will have responsibility for maintaining the asset after the conclusion of CPA funding. Please enter "N/A" if there are no co-applicants.

Project Feasibility

Physical improvements may be required to become ADA-compliant. If applicable, will you have an architect or similar professional on the project, to ensure compliance with ADA/MAAB Regulations? Please explain.

Historic Preservation projects will be required to follow US Secretary of Interior's Standards for historic preservation. If applicable, will you have a qualified historic preservation professional to ensure compliance? Please explain.

Feasibility Checklist

Physical improvements may require permits and approvals from other City departments and/or entities. Please consult with the Building and Engineering departments, or other applicable departments, to identify any environmental or regulatory conditions that may apply to this project.

Select any permits below that will likely be required to complete the proposed project. The CPC is providing the below information as a courtesy and does not represent a comprehensive list of required permitting and/or approvals.

Building Department

Check off any known approvals/permitting needed from the Building Department.

Select or enter value

Engineering Department

Check off any known approvals/permitting needed from the Engineering Department.

Select or enter value

Fire Department

Select or enter value

Board of Health

Select or enter value

Environmental Assessment

Acknowledge any known site condition issues

Select or enter value

Include the following attachments, if applicable and available:

ALL APPLICANTS must include a completed copy of the CPA Budget Summary Form, available for download by clicking HERE.

City government organizations or departments applying for funding must also submit a City Authorization Form, signed by the Mayor. This does NOT apply to non-government entities. The City Authorization Form is available for download by clicking HERE.

Please submit the following additional attachments, if and where relevant.

A separate, detailed line item budget with outlined tasks/deliverables
Record plans of the land
Natural resource limitations (wetlands, flood plain, etc.)
Zoning (district, dimensional and use regulations as applies to the land)
Inspection reports
Environmental assessment reports or evidence that the proposed site is free of hazardous materials, or that there is a plan for assessment and/or remediation in place
Massachusetts Historic Commission Historic inventory sheet or finding of historic significance by Medford Historic Commission
Existing conditions report
Visual materials: Photographs, renderings or design plans of the site, building, structure or other subject for which the application is made
Names and addresses of project architects, contractors, and consultants (unless undetermined for projects subject to and yet to complete the public procurement process)
Evidence that appropriate professional standards will be followed if construction, restoration or rehabilitation is proposed
Documentation that you have control over the site, such as Purchase and Sale agreement, option, or deed; or explanation of how the proposed project will proceed in the absence of site control
Letters of support sufficient to document clear endorsement by community members and groups, and, where appropriate, by municipal boards and departments
Any other information useful for the Committee in considering the project

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