2022 CPA Full Application

CITY OF MEDFORD MASSACHUSETTS COMMUNITY PRESERVATION COMMITTEE 2022 FUNDING CYCLE

Due by September 30, 2022. Prior to filling out this application, you must have submitted an Eligibility Determination Form to the Community Preservation Committee and be deemed eligible to apply.

Please note: The application form cannot be saved and returned to later. It is recommended that applicants write answers to the descriptive questions in a separate document, then copy and paste your response into the answer fields when ready to submit. For more information email Danielle Evans, Community Preservation Coordinator, devans@medford-ma.gov

Project Information

Project Name

Project Location

CPA Program Area

Applicant Information

Applicant Name/Primary Contact

Co-applicant Name (if applicable)

Property Owner

Organization (if applicable)

Mailing Address

Phone #

E-mail

Project Narrative

Project Summary:

Describe the project, including the project location and the property involved.

Why is this project needed? How does the 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? Is there community support for the project?

How does the project meet the general and category-specific priorities outlined in the Medford Community Preservation Plan, including how the project incorporates sustainable practices and design? How does the project meet the specific criteria in the Community Preservation Act Funding Allowable Uses table?

Scope and Budget

Required attachments:

Download and complete a CPA Budget Summary Form and attach to this application.
A separate detailed line item budget with outlined tasks/deliverables must also be submitted with this application.

Total CPA Funding Request

Total Project Cost

Total cost to complete the project including non-CPA funded tasks.

CPA Funding Request as % of Total Project Costs

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 answer with N/A.

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.

Will the project require funding over multiple years? If so, please provide anticipated future funding requirements.

If there is a competitive grant round, can the project be phased or reduced in scale?

Is the project going to result in a requirement for ongoing maintenance? If yes, please explain how this will be managed.

Feasibility

List and explain all further actions or steps that will be required for completion of the project, such as environmental assessments, zoning or other permits and approvals, agreement on terms of any required conservation, affordability, or historic preservation agreements, subordinated agreements, and any known or potential barriers or impediments to project implementation.

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.

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.

If the proposal entails multiple co-applicants, describe the process of coordination between coapplicants 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.

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

Demonstrate that the applicant has successfully completed projects of similar type and scale or has the ability to complete the project as proposed.

Accessibility Requirements

Describe how the project will comply with ADA/MAAB Regulations.

Include the following attachments, if applicable and available:

ALL APPLICANTS must include a completed copy of the CPA Budget Summary Form

A separate detailed line item budget with outlined tasks/deliverables

Quotes/Estimates received to support budget estimates

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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