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New Haven Beautiful Application Available:

New Haven Beautiful Application Available

EMERGENCY REPAIR / NEW HAVEN BEAUTIFUL PROJECT APPLICATION 

Thank you for your interest in Empower New Haven’s HomePower home repair programs. We (Empower New Haven staff, Board of Directors, supporters and business partners) are extremely pleased to have this unique opportunity to help sustain homeownership in the New Haven Empowerment Zone. 

The HomePower Emergency Repair program provides loan-to-grants from $1000 to $7500 to address home repairs that affect the property’s structural integrity and/or the health and safety of its occupants. 

The HomePower New Haven Beautiful Project provides loan-to-grants from $500 to $3000 to address home repairs such as exterior painting, front yard landscaping, and façade structural maintenance.   

To take advantage of either program, please carefully read and complete the following application for the program you are applying for. Should you have any questions, please contact us at 776-2777, visit us on the Internet at www.empowernewhaven.org, or stop by our office located at 59 Elm Street Suite 410, New Haven, Connecticut 06510.

APPLICANT/PROPERTY INFORMATION

Application Date: ___ Application Number (office use only):______

Name of Applicant(s):

(First) (Middle Initial) (Last)

(First) (Middle Initial) (Last)

NAME(S) OF ALL LISTED ON PROPERTY TITLE? (Please list): 

Name of Primary Contact             Home Phone              Work or Alternate Phone

Subject Property Street Address Zip Code City Neighborhood Yr. Purchased Owner Occupied Y/N PROPERTY TYPE (please check one): ( ) Condo ( ) 1-Family ( ) 2-Family ( ) 3-Family ( ) 4-Family

SUBJECT PROPERTY RENTAL INCOME (If 2-4 Family Property):
1st Floor 2nd Floor 3rd Floor 4th Floor

Please complete the following information for each person occupying your household.

Name Relationship Age Sex Disabled (Y/N)? Full-time Student (Y/N)? Race (optional) Employer Monthly Income self M/F Y/N
M/F Y/N
M/F Y/N
M/F Y/N
M/F Y/N
M/F Y/N
M/F Y/N
M/F Y/N
ALLOWABLE REPAIRS AND IMPROVEMENTS

 Please choose one program and check the repairs you are applying for:

( ) New Haven Beautiful Project ( ) Emergency Repair Program ( ) Exterior house painting ( ) Repair leaking roof ( ) Replace damaged or missing shutters ( ) Repair damaged downspouts and/or gutters ( ) Replace damaged or missing shingles ( ) Repair hazardous electrical system(s) ( ) Repair of damaged facing and siding ( ) Repair hazardous plumbing systems(s) ( ) Repair damaged porches ( ) Repair hazardous porches ( ) General landscaping (i.e., planting grass, cutting back or removal of trees, shrub care) ( ) Repair stairs, stairwells and/or walkways (interior and/or exterior) ( ) Repair of damaged or broken windows and/or screens. ( ) Inoperable Furnace or Water Heater ( ) Repair of damaged exterior door(s) ( ) Repair inoperable fire escape(s) ( ) Cleaning of siding ( ) Repair broken windows and/or doors (including garage) ( ) Other (Please Specify): ( ) Repair hazardous and damaged drywall, flooring and ceilings ( ) Sewage and/or drainage malfunctions (interior and/or exterior) ( ) Asbestos remediation (interior and/or exterior) ( ) Other (Please Specify):

REQUIRED DOCUMENTS

  Please submit the following documents along with this application:
  1. Copy of most recent signed and dated federal tax returns including all schedules, attachments and W-2’s for each member of the owner’s household 18 years of age or older. Please check here if you did not file in the past two years ( ) Please explain: ____________.
  2. Most recent pay stub or income statement for each adult household member. If occupant is 18 years of age or older and a full-time student, a letter on school stationary verifying enrollment status must be submitted.
  3. Proof of owner occupancy – please submit two of the following ( ) Valid driver’s license or state ID
    ( ) Current voter registration documentation ( ) Current telephone bill ( ) Current cable bill ( ) Current utility bill
  4. Income verification from a federal source such as Social Security, Disability, SSI and/or TANF if applicable.
  5. Verification of current status on all mortgage loans – copy of most recent mortgage statement
  6. Most recent bank statement or copy of passbook (no more than 30 days old)
  7. Copy of Schedule A from first mortgage deed

GENERAL ELIGIBILITY REQUIREMENTS

Eligible Areas* Dixwell Dwight Fair Haven Hill Newhallville West Rock Census Tract(s): 1416 1407 1421 & 1423 1402, 1403, 1405 & 1406 1415 1413

Household Size 1 2 3 4 5 6 7 8 Upper Income Limit $56,853 $64975 $73,096 $81,218 $87,687 $94,228 $100,696 $107,237

*To find out if you live in the Empowerment Zone please call Empower New Haven at 776-2777 or check on the internet using HUD’s address locator at www.empowernewhaven.org.

CERTIFICATION, ACKNOWLDEGEMENT AND DISCLOSURE

The undersigned specifically acknowledge(s) and agrees that: (1) the loan-to-grant requested by this application will be secured by a mortgage deed on the subject property described herein, located in New Haven, Connecticut; (2) the applicant(s) is currently an owner-occupant; my/our income has been fully disclosed on the application; (3) conditions of the loan include but may not be limited to a property inspection by a licensed home inspector, verification that property and my/our household income are within HUD eligibility requirements, and verification that all property taxes are current; (4) Empower New Haven or its business partners may verify the statements made in this application at any time either directly or through a third party from any source named in this application; (5) Empower New Haven does not guarantee or warrant the quality work performed on the subject property by a contractor of my free choosing; (6) before work can begin matching funds equaling 5% of the total repair cost will be required from the applicant(s); (7) all determinations as to eligibility and acceptable repairs will be made on a case-by-case basis in accordance with the program guidelines; and, (8) that if I have applied for any HomePower repair program that there is a six (6) month waiting period before I can apply for any other HomePower repair program.

I/we certify that the information provided in this application is true and correct as of the date set forth below my/our signature(s) on this application. I/we also acknowledge my/our understanding that any intentional or negligent misrepresentation(s) of the information contained in this application may result in the denial of my/our loan-to-grant request and/or having to make full restitution to Empower New Haven for all loan advancements or expenses incurred on my/our behalf.

Signature: _________ Date: ______

Signature: _________ Date: ______ Please mail or fax the completed application and requested documentation to: Empower New Haven, Inc. 59 Elm Street New Haven, CT 06510

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