23. Mayor signature-Local Rapid Recovery Planning Application _ Mass.gov12/15/2020 Local Rapid Recovery Planning Application | Mass.gov
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Local Rapid Recovery Planning Application
Local Rapid Recovery Planning Application
Mass.govMass.gov
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This is the Cover Page for the Local Rapid Recovery Planning program. Please
fill it out completely. The Chief Executive Officer of the municipality or other
entity must sign the application. Please print out this page, have signed, scan
and upload signature. Please note that for applications from non-municipal
organizations, a letter of support for the application MUST be attached.
13. Application Contact Name (name of the person filling out the
application)*
Wayne
First Name
Feiden
Last Name
14. Application Contact Email *
wfeiden@northamptonma.gov
15. Application Contact Mailing Address *
210 Main St
Address Line 1
Planning & Sustainability
Address Line 2
Northampton
City
Massachusetts
State
01060
ZIP Code
15.a. Application Contact Phone *
(413) 587-1265
16. List any other contact names, email address and phone (optional)
Alan Wolf, AWolf@NorthamptonMA.gov
REQUIRED INFORMATION AND
SIGNATURE PAGE
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17. Chief Executive Officer Name *
David
First Name
Narkewicz
Last Name
18. Chief Executive Officer Email *
Mayor@NorthamptonMA.gov
19. Title of Chief Executive Officer *
Mayor
20. Chief Executive Officer Phone *
(413) 587-1249
21. Chief Executive Officer Mailing Address *
210 Main St.
Address Line 1
Address Line 2
Northampton
City
Massachusetts
State
01060
ZIP Code
22. Chief Executive Officer Certification and Signature
Please read this statement carefully. By signing, you are agreeing to its terms. I
certify that the information I have provided in this Application is true and accurate.
I understand that any misrepresentation or false information may result in the
Application being cancelled or denied, or in the termination of assistance.
__________________________________________________________________________
23. Upload Cover Page with Signature Here *
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Print this completed form, get signature, scan and upload
24. If Lead Applicant is not a municipality, you MUST submit a letter of
support from the CEO of the municipality indicating they support the
application. (optional)
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File uploads may not work on some mobile devices.
Print this completed form, get signature, scan and upload
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SUBMIT FORM
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