Grant Eligibility Questionnaire / LOI
Please answer the following questions to determine if you are eligible and ready to apply for the Cornerstones Community Partnerships / Paul Bruhn (CCP PB) grant. Some of the answers are required; some of the answers are optional.
Building/Site Name and Location
*
Building/Site Name
Location (town, county)
Project title and subtitle (only if you have these) (example - The Church of XXX: Preparing a National Registrar Nomination; School House in XXX: Updating the Plumbing; XXX Mill: Repointing exterior walls, etc.
Project Title
Project Subtitle
Name of applicant organization and Point of Contact
*
Organization
Point of Contact (first name, last name)
Email Address for Point of Contact
*
example@example.com
Phone Number for Point of Contact
*
Please enter a valid phone number.
Format: (000) 000-0000.
website (if available) for organization and/ or location
www.example.com
Address of applicant building/ site
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Address of Point of Contact
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is the applicant project in one of these 7 counties? (please check appropriate response) If your project is not in any of these counties, you are not eligible to apply to this program:
*
Colfax County
Mora County
Rio Arriba County
San Miguel County
Santa Fe County (does not include town of Santa Fe)
Taos County
Torrance County
Are you one of the following (please check appropriate response(s)):
*
Nonprofit Organization
Local Government (Certified Local Government Program (CLG), New Mexico MainStreet Organization, etc).
Tribal Entity
Religious Institution (for preservation of historic structures, not for religious programming)
Education Institution
Community-based group with ownership or long-term site control
Private property owner (if the project demonstrates community benefit)
Are you the primary owner of the building or do you have a notarized document from the primary owner authorizing the application on their behalf?
*
yes
no
CREDENTIALS (1– 2 sentences): Discuss your experience to demonstrate why you or your organization is best equipped to carry out this activity. You could mention previous grants or funding awarded, highlight information such as awards, rankings, and tangible measures that set you (and your team where applicable) apart from other applicants. Sample language: A core group of community members and leaders has formed a “Preserve this Site” committee during the last ten years and we have received funding from local businesses as well as private donations. At present, we have $10,000 in a building fund.
*
Is the property older than 50 years (built before 1976)?
*
yes
no
Does the property have historical, cultural, or architectural importance and will you be able to discuss this in your application?
*
yes
no
Will there be public use or benefit, educational value, or economic revitalization potential for the community following rehabilitation and will you be able to discuss this in your application?
*
yes
no
Is there an immediate threat to the building or the risk of loss of the historic fabric and will you be able to discuss this in your application?
*
yes
no
Do you have a realistic budget with potential funding sources or resources
*
yes
no
in process
Do you have a current scope of work (SOW)?
*
yes
no
in process
Does the SOW include any of these (please check appropriate responses):
*
Building stabilization
Improving the structural integrity of a building
Facade improvements
Roofs
Improving ADA accessibility
Electrical and Plumbing upgrades / repairs
HVAC
Historic Wood Doors and Windows (Repair / restoration is preferable to replacement of historic wood doors and windows. If replacement occurs, it is almost always best to use traditional historic materials).
Assessments and architectural/engineering planning for preservation work
Preparations for nomination to National Registrar
Is your building listed in the National Register of Historic Places? If your building is not listed in the National Register of Historic Places, do you plan to apply to the New Mexico State Historic Preservation to determine if the property is eligible (if the grant is awarded, the property must be listed in the National Register by the end of the prime grant period.)
*
yes
no
If you are awarded this grant, do you agree that all work done during the rehabilitation will meet the Secretary of the Interior’s Standards for Rehabilitation?
*
yes
no
If you are awarded this grant, are you willing to enter into a preservation easement agreement with the New Mexico Historic Preservation Division?
*
yes
no
Please upload 2 to 4 photographs (png or jpg) of exterior/interior of building/site.
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
OPTIONAL (If you can respond to this issue clearly in one or two sentences, you are likely prepared to proceed with this grant application. You do not have to respond at this point if you are not prepared). LEVEL OF URGENT NEED OR THREAT TO PROPERTY. Explain what issue you are addressing regarding your property and how the project will address an urgent need or threat to the property itself AND to the surrounding community. Note who benefits. Sample language: “I bought this property with the intention of restoring it for commercial and residential use; however, unaddressed code violations have caused the loss of potential financial backers.”
OPTIONAL ((If you can respond to this issue clearly in one or two sentences, you are likely prepared to proceed with this grant application. You do not have to respond at this point if you are not prepared) SCOPE OF WORK (1– 2 sentences): Describe what physical work will be done as part of the proposed project, and note your commitment that work will adhere to the Secretary of the Interior’s Standards for the Treatment of Historic Properties). Sample language: “My building has masonry concerns that are causing brick to deteriorate and cause safety concerns. I will hire a contractor that will adhere to NPS’s Preservation Brief# 2 ‘Repointing Mortar Joints in Historic Masonry Buildings,’ and any replacement of historic features that are beyond repair will be with in-kind materials’.”
OPTIONAL (you do not need to fill this out at this point unless you are prepared) BUDGET TABLE Please complete the table below to provide an overview of your proposed budget. This table does not automatically calculate totals.
Rows
Estimated Total Cost of:
Request from CCP PB:
Notes
Labor
Materials
Admin
Other
Total
Save
Submit Questionnaire
Should be Empty: