Somerville CPA Screening Form

CPA Screening Form

This form is recommended for all prospective CPA applicants. For community-initiated projects on City-owned property the deadline to submit this form is April 1. (No deadline applies for other types of projects.) Please include a detailed description of your idea so that we can prepare to guide you.
Project location
Which of the program areas fits the the primary purpose of the CPA funds you are requesting?

Historic PreservationOpen Space / Outdoor RecreationAffordable Housing
The Somerville Affordable Housing Trust (SAHT) distributes CPA funds for Affordable Housing. Please contact SAHT to learn how to apply for funding.

Does your project...

Rows	Yes	No	Maybe
Acquire, create, or preserve open space and natural resources?
Acquire, create, preserve, or rehabilitate land used for outdoor recreation?
Acquire, preserve, or restore a historic asset?

Does your project pertain to a physical asset such as a building, structure, land, or object?

YesNoMaybe
Would the public be able to view and/or access the asset?

YesNoMaybe
Who owns the property or asset?

I, or my organization is the sole owner.The City is the owner and the applicant.I have the owner's agreement to apply for a grant together.The property is under a condominium association.The City owns the property and we do not yet have an agreement to apply together.OtherI don't know
If your answer was “Maybe” “Other”, or “I don’t know” for any of the questions above, please contact Roberta Cameron for more information on CPA eligibility.
Project Summary*
Project Status
Questions and Barriers to Implementation
Name*
Last Name
Organization
Email*
Should be Empty: