Malden Community Preservation Committee FY24 Pre-Application Form

Please submit an electronic copy no later than 11:59 PM the second Tuesday in June via this form. Email questions to maldencpc@cityofmalden.org

PROJECT NAME*

PROJECT LOCATION/ADDRESS*

APPLICANT(S) NAME & TITLE/ORGANIZATION*

CO APPLICANT (IF APPLICABLE)

CONTACT PERSON*

First NameLast Name

MAILING ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

PHONE

EMAIL*

example@example.com

DATE

Date

Have you attended a CPA informational session in Malden or surrounding cities?*

YesNo

Have you reviewed the Malden CPC Plan?*

YesNo

Have you spoken with any boards, commissions, community organizations, or elected officials about your project?*

YesNo

Please list the boards, commissions, community organizations, or elected officials with whom you've spoken about your project

In the chart below please check all categories that apply to this project (at least one). For more detailed information on these categories, please refer to the Community Preservation Act Funding Allowable Uses" chart in the application instructions.

Note ineligible categories include:

Creation (Historic Resources)
Support (Open Space, Recreational Land, Historic Resources)

PROJECT CATEGORIES*

	Open Space	Recreational Land	Historic Resources	Community Housing
Acquisition
Creation
Preservation
Support
Rehabilitation/ Restoration

LEGAL PROPERTY OWNER OF RECORD*

Is the Applicant for this proposal the legal property owner of record?*

YesNo

Does the Applicant have site control or written consent of the property owner to submit an application? (if no, the project will be deemed ineligible for this Applicant)

YesNo

If the Applicant is not the owner but intends to submit an application, please upload written documentation that the Applicant has site control or written consent of the property owner to submit an application.

All applications for projects on City-owned property must include the City Department with Care, Custody and Control as the Applicant or the project will be deemed ineligible for this Applicant.

To determine the City Department with Care, Custody and Control of your project, please email Maria Luise, Special Assistant to the Mayor, at MLuise@cityofmalden.org, and cc maldencpc@cityofmalden.org to ensure coordination.

For the purposes of coordination, signatures by the Mayor's Office, and the Department with Care, Custody, and Control are required for all projects entailing City-owned property. After submitting this form, it will be sent to the required City Departments for signature, so applicants concerning projects on City-owned property are encouraged to submit their application well in advance of the deadline.

A signature at this stage does not indicate approval or endorsement of the project. However, the Mayor's Office or the Department with Care, Custody, and Control may deny the application or may seek additional information from the person submitting this form as a condition for their signature.

Does this project proposal entail City-owned property?*

YesNo

What is the City Department with Care, Custody and Control of the project location?

Office of Strategic Planning and Community DevelopmentDepartment of Public WorksDepartment of EngineeringOther

Have you identified other potential funding sources?*

YesNoMaybe

Please list the other potential funding sources and the status of commitment:

PROJECT DESCRIPTION: (Please describe the community needs this project is addressing and how this project aligns with CPC goals)*

PROJECT STATUS: (Please describe what level of planning, research and discussions have already been undertaken to inform this proposal)*

Signature of Applicant*

Clear

Is the resource listed on the State Register of Historic Places? (You can check designation at mhc-macris.net)

YesNo

If no, has the Malden Historical Commission determined that the resource is significant?

YesNo

Please submit documentation of State Register listing or MHS letter of determination

Malden Community Preservation Committee

Project Categories

PROPERTY OWNERSHIP

Projects on City-Owned Property

PROJECT DETAILS

FOR HISTORIC RESOURCES PROJECTS: