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0. localactionunitapp-burts meadow habitatUpdated January 2016 -1- LOCAL INITIATIVE PROGRAM APPLICATION FOR LOCAL ACTION UNITS Introduction The Local Initiative Program (LIP) is a state housing initiative administered by the Department of Housing and Community Development (DHCD) to encourage communities to produce affordable housing for low- and moderate-income households. The program provides technical and other non-financial assistance to cities or towns seeking to increase the supply of housing for households at or below 80% of the area median income. LIP-approved units are entered into the subsidized housing inventory (SHI) pursuant to Chapter 40B. Local Action Units (LAUs) are created through local municipal action other than comprehensive permits; for example, through special permits, inclusionary zoning, conveyance of public land, utilization of Community Preservation Act (CPA) funds, etc. DHCD shall certify units submitted as LAUs if they met the requirements of 760 CMR 56.00 and the LIP Guidelines, which are part of the Comprehensive Permit Guidelines and can be found on the DHCD website at www.mass.gov/dhcd. To apply, a community must submit a complete, signed copy of this application to: Department of Housing and Community Development 100 Cambridge Street, Suite 300 Boston, Massachusetts 02114 Attention: Rieko Hayashi, Program Coordinator Telephone: 617-573-1426 Email: rieko.hayashi@state.ma.us -3- Municipal Contact Information Chief Executive Officer Name David J. Narkewicz, Mayor Address 210 Main St. Northampton, MA 01060 Phone 413.587.1049 Email Mayor@NorthamptonMA.gov Town Administrator/Manager -- NOT APPLICABLE Name Address Phone Email City Planner Name Wayne Feiden, Director of Planning & Sustainability Address 210 Main St., Northampton, MA 01060 Phone 413.587.1265 Email WFeiden@NorthamptonMA.gov City/Town Counsel Name Alan Seewald Address City Solicitor, 210 Main St, Northampton, MA 01060 Phone 413.584.4455 Email ASeewald@NorthamptonMA.gov Chairman, Local Housing Partnership (if any) Name: Todd Weir Address c/o Planning, 210 Main St., Northampton, MA 01060 Phone 845.489.1506 Email Todd.Weir1@comcast.net Community Contact Person for this project Name Wayne Feiden, Director of Planning & Sustainability Address 210 Main St, Northampton, MA 01060 Phone 413.587.1265 Email WFeiden@NorthamptonMA.gov Updated January 2016 Updated January 2016 -4- The Project Developer Name Address Phone Email Is your municipality utilizing any HOME or CDBG funding for this project? Yes No Local tax rate per thousand $________ for Fiscal Year ________ Site Characteristics Project Style Total # of Units # of Units Proposed for LAU Certification Detached single-family house ________ ________ Rowhouse/townhouse ________ ________ Duplex ________ ________ Multifamily house (3+ family) ________ ________ Multifamily rental building ________ ________ Other (specify) ________ ________ Unit Composition Type of Unit: Condo Ownership Fee Simple Ownership Rental # of Units # of BRs # of Baths Gross Square Feet Livable Square Feet Proposed Sales Prices/ Rents Proposed Condo Fee Affordable: Market: Pioneer Valley Habitat for Humanity, Inc. PO Box 60642 Florence, MA 413-586-5430 megan@pvhabitat.org 16.80 2020 3 3 1 3 1.5 1 1 2 1 1 1 1,000sf 900 sf 800 sf $75/mo $75/mo $75/mo $190,000 $180,000 $170,000 Updated January 2016 -5- Please attach the following documents to your application: 1.Documentation of municipal action (e.g., copy of special permit, CPA funds, land donation, etc.) 2.Long-Term Use Restrictions (request documents before submission): For ownership projects, this is the Regulatory Agreement for Ownership Developments, redlined to reflect any proposed changes and/or the model deed rider. For rental projects, this is the Regulatory Agreement for Rental Developments, redlined to reflect any proposed changes. For HOME-funded projects, this is the HOME covenant/deed restriction. When attaching a HOME deed restriction to a unit, the universal deed rider cannot be used. 3.Documents of Project Sponsor’s (developer’s) legal existence and authority to sign the Regulatory Agreement: appropriate certificates of Organization/Registration and Good Standing from the Secretary of State’s Office mortgagee consents to the Regulatory Agreement trustee certificates or authorization for signer(s) to execute all documents 4.For Condominium Projects Only: The Condominium aster deed with schedule of undivided interest in the common areas in percentages set forth in the condominium master deed 5.For Rental Projects Only: A copy of the Local Housing Authority’s current Utility Allowances 6.Massachusetts Environmental Policy Act (MEPA) environmental notification f orm (ENF) – for new construction only (request form before submission) 7.Affirmative Fair Marketing and Lottery Plan, including: ads and flyers with HUD Equal Housing Opportunity logo informational materials for lottery applicants eligibility requirements lottery application and financial forms lottery and resident selection procedures request for local preference and demonstration of need for the preference Updated January 2016 -6-  measures to ensure affirmative fair marketing, including outreach methods and venue list  name of Lottery Agent with contact information See Section III of the Comprehensive Permit Guidelines at www.mass.gov/dhcd and search for LIP 40B Guidelines for more information. PLEASE CONTACT RIEKO HAYASHI OF OUR OFFICE AT 617-573-1426 IF YOU HAVE ANY QUESTIONS.