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Habitat cpa Eligibility Form.pdfCOMMUNITY PRESERVATION ELIGIBILITY DETERMINATION FORM The purpose of this form is to make sure that all project applications applying for Community Preservation Act funding 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: Project Sponsor/Organization: Contact Name: Mailing Address: Daytime phone #: I Fax#: 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. For CPC Use Eligible: __ Not Eligible: __ Date: ___ _ Reviewer: ______ _ Glendale Rd Northampton Small Home Pioneer Valley Habitat for Humanity, inc Amy Landry, Director of Resource Development PO Box 60642 Florence, MA 01062 413-586-5430 Amy@pvhabitat.org We are now building the fourth home of our Glendale Rd project. The small single family home will be reserved for first-time homebuyers who earn less than 60% of the Area Median Income. A regulatory agreement has been signed by Habitat and the city of Northampton agreeing to permanentlyprotect the affordability of this unit. Habitat was selected through an RFP by the city of Northamptonto be the developer for four homes off of Glendale Rd. This two bedroom, single story home will be energy efficient. The space is designed to have a small footprint and be adaptable for someone with a wheelchair.