Name of  applicant_____________________________________________________
Name of business _____________________________________________________
Address of business  ___________________________________________________
Phone number _____________ Fax number _____________  E-mail address  _______ 
Type of business   _____________________________________________________
How long has the business been at the current location?  ________________________
If leased, when does your current lease   expire?______________________________________

Applicant is the ___ Property Owner ____ Business Owner  ___ Other _____________
Property owner’s name (if different from applicant)  _____________________________
Property owner’s address  ________________________________________________
Property owner’s phone  number___________________________________________
Approximate date the building was constructed.   _______________ Architectural Style _______
  Note: If you are not the property owner, please have the property owner or an authorized
representative co-sign page two of this application. 

Please describe below the proposed improvements to the property.  If for facade improvements, please indicate proposed color scheme, dimensions of signage or vendor estimates.  If you plan to use a design different from that of In-Site Architecture's design, please submit one copy of your design proposal.   All applications need two estimates on contractor letterhead. Please also provide a current photo of the area which is proposed for renovation such as the facade or the interior of the building.

If you are applying for facade improvements, please list work or improvements that  are not included on the In-Site architectural design rendering of the property.
___________________________________________________________________________________
_________________________________________________________________________________

Total proposed budget ______________________________

Proposed start date _______                 Estimated completion date_______ 

        It is expressly understood and agreed that the applicant and or building owner shall be solely responsible for all safety conditions and compliance with all safety regulations, building codes, ordinances, and other applicable regulations.
       It is expressly understood and agreed that the applicant/owner or his contractor will secure a one million dollar liabiity policy which holds harmless the Greater Warsaw Chamber of Commerce, the Warsaw Downtown Association, the Division of Housing and Community Renewal and or its agents, employees, officers and or directors liable for any property damage, personal injury or other loss relating in any way to the New York Main Street grant program.
          The applicant agrees to maintain the property and improvements, including, but not limited to, promptly removing graffiti, sweeping and shoveling in front of the property for a period of seven (7) years.  For properties receiving a facade or interior building renovation grant a lien in the form of a grant enforcement agreement will be placed upon the building by the The Greater Warsaw Chamber of Commerce to ensure the improvements are maintained for a minimum of seven years. If the property is transferred during that period, the new owner must agree to assume the responsibility of maintaining the asset or all grant funds must be returned to Housing Trust Fund Corporation (HTFC). A lien will also be placed upon residential units assisted with NYMS funds requiring the owner to keep them affordable to low-income households for at least a seven-year period. Owner/applicant agrees that he/she will maintain the integrity of the facade renovation and ensure that it is preserved for a minimum of seven years.
       Owner/applicant further agrees he/she will not make any facade changes which are inconsistent with or contrary to the Design Guidelines as incorporated into this agreement.
        The applicant/owner authorizes the Greater Warsaw Chamber of Commerce to promote an approved project, including but not limited to displaying a sign at the site, during and after construction, and using photographs and descriptions of the project in Main Street materials and press releases.The applicant/owner understands that the Greater Warsaw Chamber of Commerce reserves the right to make changes in conditions of the New York Main Street grant program as warranted.

  If applicant is not the property owner, please have the property owner or an authorized representative review and co-sign this application below. 

  ______________________                                      Date ______________
Signature of Property Owner or Representative