Type of Business: ___ Sole Proprietor ___ Corporation

___ Partnership ___ Not for Profit Corporation

Development Team:

Developer Name: Address: Phone: Email:

Contractor Name: Address:

Phone: Email:

Attachment A: Provide a narrative of the development team’s experience on projects of a similar scale and nature including names and addresses of such projects. Note whether this team (architect, developer, contractor) has worked together previously, or whether this project will be their first joint endeavor.

Are you aware of any person affiliated with your organization who also shares an affiliation with Community Capital New York staff or directors? ___ No ___ Yes

If yes, please indicate name and relationship to Community Capital New York:

Newburgh Housing Remediation Fund Remediation Grant Application for Lead and Asbestos Abatement

Applicant Name:Principal Name (if different) :Address:

Phone: Email:

1 Community Capital New York 7 W. Cross Street, Hawthorne, NY 10532

914.747.8020 ext. 12

_______________________________________________________________ ________________________________________________________

_______________________________________________________________ _______________________________________________________________________________________ Cell: _______________________________ _______________________________________________________________

_______________________________________________________________ _______________________________________________________________ ________________________ Cell: _______________________________ _______________________________________________________________

_______________________________________________________________ _______________________________________________________________ ________________________ Cell: _______________________________ _______________________________________________________________

_______________________________________________________________ _______________________________________________________________ ________________________ Cell: _______________________________ _______________________________________________________________

___________________________ _________________________________

Architect Name:

Address:

Phone:

Email:

Borrower's EIN: ___________________________

Project Summary

Project Street Address: _________________________________________________________

Census Tract (6 digit) ________

Number of Units: _____________ Unit type: Rental _______Sale _______Commercial (sq ft) _______

Occupancy characteristics: Please identify the income limits you are using for eligibility in the residential units, if any. Identify the anticipated uses of any commercial space:

Uses Disbursement

2 Community Capital New York 7 W. Cross Street, Hawthorne, NY 10532

914.747.8020 ext. 12

List expenses Remediation Grant would be used for and proposed disbursement schedule:

Estimated commencement of construction: __________________________

Estimated completion of construction: __________________________

Total Estimated Project Cost: $ __________________________

Amount of Remediation Grant requested: $ __________________________

Attachment D: Project Need

• If the project is an investment property (i.e. it will not be occupied by the applicant) describe the need for the proposed development. Include market feasibility documentation to justify the project, its rent structure, occupancy and income and expense projections.

• How and when will the project be marketed?

• Does it fit within the existing demographics of the neighborhood, or is it meant to attract a new population?

Attachment E: Project Viability

• Discuss any required municipal approvals and the status of those approvals.

• Describe briefly community receptivity/opposition. (Note any opposition expressed by localofficials, citizen groups, neighbors, clergy, etc. and the steps being taken to address thisopposition. If there is no opposition, discuss the steps taken to inform the community andneighbors about the project and their reaction to it.)

Attachment F: Copies of any plans, specifications, or zoning analysis

Attachment G: Documentation of any financial commitments made to the project

Attachment H: Developer's audited financial statements from the last two years

Attachment I: Listing of Board Members & Officers (if applicable)

Attachment B: Lead/Asbestos Inspection Report.

Attachment C: Project Narrative

3 Community Capital New York 7 W. Cross Street, Hawthorne, NY 10532

914.747.8020 ext. 12

There is a limited amount of funding available for Remediation Grants. Provide a general project description with information about the significance of this structure to the overall community revitalization objectives outlined by the City of Newburgh in its Vacant Land study and why this project should receive a Remediation Grant over others that may apply. Describe the site, location, neighborhood context and demographics. Discuss other public/private investments in or near the project site. Include photographs of existing land use and conditions of the project site. A map showing the location of the site and photographs should be included.

Construction Financing

Sources: Anticipated Committed

Bank construction Loan @ _____ % for _____ years

Other Loans:

___________________ @ _____ % for _____ years

___________________ @ _____ % for _____ years

___________________ @ _____ % for _____ years

Private Developer’s Equity

Grants (specify):

__________________________________________

__________________________________________

__________________________________________

__________________________________________

Other (specify):

__________________________________________

__________________________________________

Total Construction Sources:

4 Community Capital New York 7 W. Cross Street, Hawthorne, NY 10532

914.747.8020 ext. 12

Uses:

Acquisition

Construction/Rehabilitation

Basic Construction

Contractor’s Overhead & Profit

Construction Bond/LOC

Contractor’s Contingency

Total Construction Costs

Soft Costs

Fees

Architect/Engineering

Organization Management

Developer’s Fee

Partnership Management

Construction Management

Consulting

Legal/Accounting

Insurance

Leasing

Real Property Taxes

Bridge Loans (if any)

Construction Loan Interest (if any)

Other Soft Costs (e.g. appraisal, permits, survey, filings)

Soft Cost Contingency

Total Soft Costs

Total Project Costs

5 Community Capital New York 7 W. Cross Street, Hawthorne, NY 10532

914.747.8020 ext. 12

Permanent Financing

Anticipated Committed Sources:

Bank Loan

Other Loans (specify):

Private Developer’s Equity

Grants (specify):

Other (specify)

Total Permanent Sources:

6 Community Capital New York 7 W. Cross Street, Hawthorne, NY 10532

914.747.8020 ext. 12

Operating Pro Forma

Revenue:

Gross Residential Rentals Less Vacancy Gross Commercial Rentals Less Vacancy Net Revenue

Expenses: Maintenance Utilities Marketing/Leasing Insurance R.E. Taxes Legal/Accounting Fees (indicate if paid to a project partner) Other Expenses Replacement Reserve

Total Expenses

Personnel Costs

Total Available for Debt Service

Less: Mortgage Payments Other Mortgage (Specify Other Mortgage)

7 Community Capital New York 7 W. Cross Street, Hawthorne, NY 10532

914.747.8020 ext. 12

Please email completed application to kjacobs@communitycapitalny.org. If you have questions or need assistance, contact Kim Jacobs at 914.747.8020 ext. 12

___________________________

Cash Surplus (shortfall) from operations