Sober Housing - Service Net eligibility formi /k S e rv iceU
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innovative mental health and human services
August 7, 2012
Sarah LaValley
Community Preservation Committee
City Hall, 210 Main Street, Rm. 11
Northampton, MA 01060
Re: CPC Eligibility Determination
Northampton Sober Housing
Dear Sarah:
Attached is a CPC Eligibility Determination Form for a project ServiceNet is proposing to
address the need for dedicated sober housing units in Northampton. We hope that this project
is found eligible and is successful in this round of CPC funding. ServiceNet also is applying to
MHFA's Center for Community Recovery Innovations for grant assistance for this project.
Thank you for your consideration.
Sincerely,
L Joseph P. Henefield
Director of Real Estate Development
Cc: Jay Sacchetti /ServiceNet
Seth Dunn/ServiceNet
129 King Street • Northampton, MA 01060 • 413.585.1300
www.servicenet.org • fax 413.582.4252
a United Way partner agency
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The purpose of this form is to make sure that all project applications applying for Community
- Preservation -Act fund ing -- are- eligible - for - funding.. Please refer- to- Appendix-E - -in -the
Community Preservation Plan when filling out this form. This form must be approved in
order for an application .to be accepted.
Project Title: N OM �,,
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Project Sponsor /Organization:
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Contact Name: De
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Mailing Address: Z�
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Daytime phone #: I
Fax #: �11 _� �Z ��ZSz_
E -mail address:
CPA Program Area (check those that apply):
❑ Open Space ❑ Historic Preservation
Community Housing ❑ Recreation
Project Purpose (check those that apply):
❑ Acquisition ❑ Creation ❑ Preservation
❑ Support ,Rehabilitation /Restoration
Project Summary: Please provide a brief description of the project.
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COMMUNITY PRESERVATION ELIGIBILITY
DETERMINATION FORM
For CPC Use Eligible: Not Eligible: Date: Reviewer: