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HomeMy WebLinkAboutHLC February 2024 Packet*AGENDA* HISTORIC LANDMARK COMMISSION February 12, 2024 REGULAR MEETING HISTORIC LANDMARK COMMISSION Council Chambers. City Hall. 801 Main St. - 3-0,30 n. m. *AGENDA* !T61 I Wal"I I I APPROVAL OF MINUTES Approval of the minutes of the Regular Meeting held January 8, 2023. REGULAR MEETING 1) PZ2023-518:. A request for a Certificate of Appropriateness to install shutters. Applicant: David Bienvenu Location: 2621 Hazel Avenue 2) Historic District Code Enforcement Report OTHER BUSINESS 1) Minor Rehabilitation Program presentation facilitated by CDBG/Housing Manager, Jes Prince Fill 0-1 rNi I I !] ki I "To protect, enhance and perpetuate historic landmarks which represent or reflect distinctive and it elements of the City's and State'. archit tu ral, orchaeological, cultural, social, economic, ethnic ond political history and to develop appropriate settingas for such places.' Persons with disabilities who plan to attend this meeting and who may need auxiliary aids or services are requested to contact Kaltrina Minick at 409-880-3777. MINUTES* HISTORIC LANDMARK COMMISSION Januai-y 8, 2024 Council Chambers, City Hall, 801 Main Street, Beauniont, Texas A Regular Meeting of the Historic 1,andniark Commission was held on January 8, 2024 and called to order at 3:32 p.m. with the following inembers present. - Chairman Dohn LaBiche Commissioner Hester Bell Commissioner Marty Craig Commissioner Christina Crawfors *arrived at 3:50 pni/exited at 4 -41 pill Commissioner Ronald Kelley COMMISSIODer Lynda Kay Makin Commissioner Marva Provo Commissioner Janelle Templeton Commission Members absent: Commissioner John erube Commissioner 'Theresa Goodness Commissioner Thomas Sigee Also present- Elayna Luckey, Planner I Delancy Wood, Demolition Coordinator Susan Smith, Recording Secretary APPROVAL OF MINUTES Commissioner Makin moved to approve the minutes of the Regular Meeting held on December 115 2023. Commissioner Bell seconded the motion. The motion to approve carried 7:0. Commissioner Crawford not yet present. REGULAR MEETING 1) PZ2023-467: A request for a Certificate of Appropriateness to construct a new home. Applicant- Jiliverto Lopez Location.- 2241 1,1berty Avenue Mrs. Luckey presented the staff report. Jiliverto T,opez has requested a Certificate of Appropriateness for the constrUCtion of a new home to be located on the vacant lot at 2241 Liberty Avenue. Historic Landmark Comniissioii Jainiary 8, 2024 The proposed home will be approximately 1,633 sq. ft. in size. The construction methods employcd would dictate that the house is to be constructed on a slab foundation with Hardie Plank siding and the windows will be six (6) over one (1) in appearance. The roof will have a V overhang with the pitch rising six (6) inches each twelve (12) inches horizontal distance. Additionally, the roof will be 30 year architectural shingles in Shasta White. Lastly, the porch colun-in is to be a tapered craftsman style column. The front door will be a craftsman style door with a half light. The exterl'or body paint is to be Sherwin Williams Needlepoint Navy, the Cable is to be Sherwin Williams Colonial Revival Tan and the trim is to be Sherwin Williams White. Slides of the subject property were shown. Plarming staff recommended approval of the request with the following conditioDso. 1. All necessary permits and inspections are obtained through the Building Codes Department. 2. The finished floor elevation shall be 24" above the existing grade. A representative of the applicant was present. Cindy Schooling of I Homes, 11075 Eastex Freeway, Beauniont, Texas addressed the Commission. She stated that the applicant is building the home for his family and it is similar in appearance to surrounding homes. Commissioner Bell movcd to approve the request for a Certificate of Appropriateness to construct a new home, as requested in PZ2023-467, with the following conditions: 1. All necessary permits and inspections are obtained through the Building Codes Department. 2. "Fhe finished floor elevation shall be 24"' above the existing grade. Commissioner Templeton seconded the motion. A roll call vote was taken. Chairman LaBiche-Aye; Commissioner Bell -Aye; Commissioner Craig -Aye; Commissioncr Kelley -Aye; Commissioner Makin -Aye; Commissioner Provo -Aye; Commissioner Templeton. -Aye. The motion to approve the -request carried 7:0. Commissioner Crawford not yet present. 2) PZ2023-486: A rcqucst for a Certificate of Demolition to demolish a 110USe. Applicant: City of Beaumont Location: 1032 McFaddin Avenue Mrs. Luckey presented the staff report. Boyd Mier, Building Official, requests a Certificate of Demolition for the house located at 1032 McFaddin Avenue. According to the inspection report, 0 this strLICture was originally tagged on June 12, 2023. The stairs to the structurc are collapsing along with the ceiling in several rooms. There are a number of broken windows on the structure where the frames have rotted. The structure attracts transients and stray animals. 2 Historic Landmark Coinmissioii Jainiary 8, 2024 The property is listed in the 1977 SPARE Beaumont. Sur\ley and included in a local Historic Cultural Designation; however, the structure originally listed at this location was the Byrd Home, which was demolished in 2011 with approval from the Historic Landmark Commission. Tile structure there today was not included in those designations, just the land from the legal description. Based on the extensive repairs needed for this structure the Building Codes Staff is recommending a raze order and has received consent to demolish the structure by the property owner. Slides of the subject property were shown. Planning staffreeominended approval of the request. Sixteen C16 notices were sent to property owncrs within 200 feet of the subject property. ,our (4) responses were received in favor and zero (0) in opposition. Delaney Wood, Demolitioii Coordinator, discussed occupancy of the house. The property owner was not present. The public hearing oil this iten-i was opened and clo"scd without comment. Comn)Issioner Makin moved to approve the request for a Certificate of Demolition to demolish a house, as requested in PZ2023-486. Commissioner Craig seconded the motion. Discussion followed concerning historic home being demolished that could possibly be saved. A coordinated effort of the Commission, County, and City to salvage homes was suggested. The decision was made to discuss the matter further in the "Other Business" portion of the meeting. A roll call vote was taken. Chairman Lai iche-Aye; Commissioner Bell -Aye; Commissioner Craig -Aye-, Commissioner Kelley -Aye; Conviiissioner Makin -Aye- Commissioner Provo -Aye; Commissioner Templeton -Aye. The motion to approve the request carried 7:0. Commissioner Crawford not yet present. 3) PZ2023-509: A request for a Certificate of Demolition to demolish a house. Applicant: City of Beaumont Location: 2254 Liberty Avenue Mrs. Luckey presented the staff report. Boyd Meier, Building Official, requests a Certificate of Demolition for the house located at 2254 Liberty Avenue. According to the inspection report, this structure was originally tagged on February 10, 2021 after it received damage from a fire. The property owner initiated a work program oil April 3 0, 2021 at which thric they secured the property 3 Historic Landiiiark Coimnission January 8, 2024 and replaced the windows; however no additioni al work has taken place since an nspection dated October 4, 2021. The property is listed in the 1989 SPARE Beaumont Survey and was built circa 1925. Tile 0 if signi icance of the structure was listed as "The hwtw is i-e])resentatNe of tocci adcilocition of the Cr(iftsincin stide cind Qflcn-gei- inicidle-cl(iss hon7es built in Becnunont chii-ing the fir .y clecaides Qf the centnrj� Additionally, the condition at the time of recordation was listed on the SPARE Survey as "Fc1h% The house is struct-urcil1j) sound bul not pcirliculcirly ivell-t?ictinkilned Unsj)inpathetic alterations cletrice ctftoin its w4chilectitral integrity." 0 Based on the extensive repairs needed for this structure and the lack of repairs made in the past two years, the Building Codes Staff is recommending a raze order. Slides of the subject property were shown. Planning staff recommended approval of the request. Tbirty-tbree (33) notices were sent to property owners within 200 feet of the subject property. Zero response were received in favor or opposition. Delaney Wood, Demolition Coordinator, discuss occupancy of the house and apartment located on the property, unpaid property taxes, code violations, structural condition of the home, lack of communication from the property owner, the Jefferson County Sheriff delinquent tax sale, previous repairs to the home, and the demolition process. The property owner was not present. The public hearing on this item was opened. David Bradley, 2165 North Street, Beaumont, Texas addressed the Commission. He stated that the City could possibly impose liens to encourage compliance by property owners. Mr. Bradley further stated that the Jefferson County Tax Office can assist with information relating to the foreclosure process. The public hearing, on this item was closed. Commissioner Makin moved to approve the request for a Certificatc of Demolition to demolish a house, as requested in PZ2023-509. Commissioner Craig seconded the motion. Brief discussion followed regarding demolishing historic homes rather thall saving them. 4 Historic Landmark Commission Jaiwary 8, 2024 A roll call vote Nvas taken. Chairman LaBiche-Aye; Commissioner Bell -Aye; Commissioner Cralg-Aye; Coinmissloiier Crawford -Nay; Commissioner Kelley -Nay; Commissioner Makin - Aye; Commissioner Provo -Nay; Comn-iissioner Templeton -Nay. The motion tied 4:4. Chairman Laffiche decided the tie by changing his vote to "Nay." The motion to deny the request carried 5:4. 4) PZ2023-510: A reqLICSt for a Certificate of Demolition to demolish a house. Applicant: City of Beauniont. Location: 2229 Liberty Avenue Mrs. Luckey presented the staff report. Boyd Meier, Building Official, requests a Certificate of Demolition for the house located at 2229 Liberty Avenue. According to the inspection report, this structure was originally tagged on September 27, 2021 after multiple code violations were discovered. The foundation is collapsing, a ftill roof replacement will be needed, and the eaves are falling due to rot. The property is listed in the 1989 SPARE Beaumont Survey and was built circa 1915. The significance of the structure was listed as "The house is a good exany-Ve of ci local adcipcition qf the 0,aftsinan style and is ml)resenwtive ofinicIcIle c1ciss hoones built in Beauinont during the ecirly deccides o the century." !f Based on the extensive repairs needed for this structure the Building Codes Staff is reconu-rending approval of the raze order. Slides of the subject property were shown. Planning staff recommended approval of the request. Twenty- seven (27) notices were sent to property owners within 200 feet of the subject property. Zero response were received in favor or opposition. Delancy Wood, Demolition Coordinator, discussed occupancy of the house. Brief discussion followed concerning unpaid property taxes, the vehicle located oil the property, and communication with the property owner. The property owner was not present. The public hearing was opened on this item. Gloria Alvarado, 2216 Liberty, Beaumont, Texas addressed the Commission. She stated that she would like to purchase the property for use as a family home. Further discussion followed concerning the process for removal of the vehicle located on the property. 5 Historic Landmar-k Commission January 8, 2024 Barbara Wilson, 2441 Liberty Avenue, Beaun-tone, Texas addressed the Commission. She stated the property owner previously stated that he would like to sell the property and be is probably still interested in selling it. The public hearing was closed on this itein. Commissioner Templeton moved to deny the request for a Ccrtificate of Den-iolition to demolish a house, as requested in P Z2 02 3 - 5 10. Commissioner Kelley seconded the motion. A roll call vote was taken. Chairman LaBiche-Aye; Commissioner Bell -Aye; Commissioner Craig -Aye; Commissioner Crawford -Aye; Commissioner Kelley -Aye; Commissioner Makin - Aye: Commissioner Provo -Aye- Commissioner Templeton -Aye. The motion to deny the request carried 8:0. HISTORIC DISTRICT CODE ENFORCEMENT REPORT Mr. Luckey announced that Historic District Code Enforcement Report will be presented at the next scheduled meeting. OTHER BUSINESS Discussion was had regarding saving historic homes from demolition. Commissioner Templeton stated that she will speak to the City Council regarding imposing penalties to those property owners that do not respond to the Commission. She further stated that she will speak to the Jefferson County Tax Office regarding the Sheriff delinquent tax sale. Commissioner Templeton also stated that there could possibly be additional approaches taken to prevent homes from being destroyed in terins of ordinance reviSiODSand revising pro cedures/po licies. Chairman LaBiche requested that Commissioner Templeton present her findings to the Commission as a scheduled agenda item. Commissioner Crawford offered the assistance of the Beaumont Heritage Society. She also stated that the Oaks Historic District is developing a grant program for potential homeowners within the District. Brief discussion followed concerning salvaging materials from dilapidated homes, tax and/or price incentives for potential homeowners, grant opportunities for potential homeowners, and City procedures for imposing charges and fines. THERE BEING NO OTHER BUSINESS., THE MEETINGF WAS ADJOURNED AT 4:42 P.I. 101 DATE: February 12., 2024 TO: Historic Landmark Commission FROM: BaynaLucke« Planner SUBJECT: Request for a Certificate of Appropriateness to install shutters. FILE: pZ2023-518 STAFF REPORT David Bienvenu, is requesting a Certificate of Appropriateness to install shutters on the home located at 2621 Hazel Avenue. The shutters to be installed are made of vinyl, and will be black in color to match the front door. The shutters are proposed to be installed only on the front windows ofthe home. The home isnot listed |nthe SPARE Beaumont Survey, however could beconsidered asa colonial style home, making, the proposed shutters appropriate for the architecture ofthe home. Planning staff recommends approval of the request. Exhibits are attached. BEAVM►C3NT Planning & Community Development Case Type:Planning and Zoning Case Sub Type: Certificate of Appropriateness Case 4: PZ2023-518 Location: 2621 HAZEL AVE, BEAUMONT, 77702 Individuals listed on the record. - Applicant David Bienvenu 1645 Orange Street Beaumont, TX 77701 Reason for Request of a Certificate of Appropriateness Paint New Construction Demo Fene ng Miscellaneous Has request been made before? If yes, date: Notes: Case Status: REVIEW Tag Name: replace fence and add shutter Initiated On: 12/22/2023 9:20:1CAM Home Phone: 409-832-9605 Work Phone: Cell Phone: 409-832-9605 E-Mail- david.bienvenulO@gmail.com replace 6' wood privacy fence along rear yard to stop at the rear of structure. add black colonial shutters to front widnows N N N Y Y N This is not a buildxng permit, additional permits may he required for the proposed scope of work. Case Type: Planning and Zoning Page I of 1 Caro #- PZ2023-518 Printed On: 12/22/2023 EOOMAlfi ,III IF* MI 0 Premier 15" Raised Panel Shutters By Perfect Shutters, inc. * * * * * 4.8 1 910 Reviews $61.59 mar Off Open Box Price: from $22.98 You're pre -qualified!' Get the Wayfair Credit Card! CT] Free shipping OQ > 00 Home Sales Lists Account Cart RICH W[TV OPPORTUNITY �rlEA,lll�1 Ulhl�� T o R * X * A 0 S City of Beaumont Owner -Occupied Minor Rehabilitation Program Application Process Welcome — The City of Beaumont's Owner -Occupied Minor Rehabilitation Program Assistance is available to homeowners who need assistance with repairs to their principal place of residence. Senior citizens are the priority category for this program. Qualifications: Persons must be Low to Moderate Income.. (80% or below of Median Family Income) Persons must own or be in process of buying the house that they want to have rehabilitated and it must be their principal place of residence. Homeowner must have lived in the hoinc for I year prior to assistance or applying. Reguh,ements: Please fill out this entire application and return to the City of Beaumont's Housing Services Division., 801 Main Street, Suite 201, Beaumont Texas, or by mail to P. 0. Box 3827,, Beaumont, Texas 77704. All verifications inust accompany the application or the application will not be accepted. Verifications: The following verifications are required and must be current and up to date: Copy of Deed or Mortgage VeAfteation: Shows that you are the home owner or you are in the process of buying your home. Income Ve6fication: � 0 u Federal regulations require a "snapshot" of your gross income net if Yo are self- employed) and project it forward 12 months. You vAl I be asked to submit six (6) consecutive check stubs ftom any and all employment for each household membor, and any assistance payments such as Social Security, child support alimony, etc. Federal regulations rcquire that we calculate income ftom your assets, such as bank account, and add that to your income. Tax Certificate:. (City, County, School). "All of your property taxes must be paid up to date." If back taxes are owed, please provide a copy -of your payment plan from the, Jefferson County "Fax Office. Copy of Insurance Polic- .y on house. Shows current fire coverage on structure. Special Notc.-. Program Administration: The amount of assistance will not exceed $24,999 per residence. Applicant must have a current Homeowner5s Insurance policy with sufficient coverage to replace the home in case of fire. No repairs will be authorized if all required documentation and verifications are not up to date at the time of rehabilitation. The home owner is required to maintain the horne as his/her principal residence for the five-year lien period; ptoperty taxes and homcowner insurance with sufficient coverage (at a minimum, the contract amount) niust be maintained during this period. You must obtain a Tax, Certificate from Jefferson County Tax Office. All of your Propefty taxes must be paid up to date or you must have a payment plan with Jefferson County and be up to date on payments. Please note: The home owner enters into a contract with the contractor, not with the City. The City will conduct the necessary inspections and pay the contractor for repairs made as per the signed homeowner/contractor agreement. The contractor is required to extend a one-year warranty on all work. Any manufacturer warranty is in addition to the cotractorswarranty. All repairs must be made within forty-five days of signing the homeowner/contractor agreement. APPLICA:FION CENSUS TRACT AREA: APPLICATION DATE: PROJECT ADDRESS: HOUSEHOLD INFORMATION PrlmaryApplicantNanie: Current Address (Street, city, state.., zip): Phone: W) -H) Cell) Birthdate APPLICATION No.:_ Email: Social Security Number Axe you Currently employcd? Nu beer of people in your Gender (M/F) Ei YEi N nousel-101a Axe you a full-time student? Eff ii N Do you receive any other income? uY oN I OPTIONAL Federal funding agencies require the collection of ethnicity and race data to track Fair Housing performance. This information will not be used to determine housing eligibility. Etbnicity (please choose one): o Hispanic or Latino n Not Hispanic or Latino Race (please check one or M:ore of the following); Ei American Indian or Alaska Native n Asian Ei Black or Affican American ci Native Hawaiian or Other Pacific Islander EiWhite HOUSEHOLD INFOIWATION CO-ApplicantName: Current Address (street, city, state, zip): Phone: W) H. Birthdate C61) Email: Social Security Numbcr Are you Currently employed? Number of people in your Gender (M/F). Ei Yo N household Are you a full-time student? © E N Do you receive any other income? oYnN OPTIONAL: Federal funding agencies require the collection of ethnicity and race data to track, Fair Housing performance. This information will not be used to determine housing eligibility. F,thnicity (please choose one): Ei Hispanic.or Latino o Not Hispanic or Latino Race (please chcck one or more of the following); Ei American Indian or Alaska Native o Asiw-i o Black or African American u Native Hawaiian or Other Pacific Islander E]WllitC FAMILY COMPOSITION and INCOME DATA LIST ALL PERSONS LIVING IN HOUSEHOLD NAME AGE RELATIONSI-HP SOURCE OF INCOME MONTIMY INCOME TOTAL NUMBER OF DEPENDENTS TOTAL MONTI-MY INCOME TOTAL ANNUAL INCONE RICH WtT)T OF-POUTUNITY T E A * S ELIGIBILITY RE LEASE City of Beaumont Applicant Name: AP Plic a nt Acres s: instructions to Applicant: Your signature on this Eligibility 1?e1ease, and the signatures of each member of your household who is 18 years of age or older, atithorizes the, City of Beaumont to obtain information fiom a third party regarding your eligibility and continued pmlicipation in the: City of Beaumont Affordable Housing Program 0 PrivaGy Act Notice Statement: Federal program guidelines require the collection of the inforination listed in this form to determine an applicant's eligibility for programs administered by the. it of Beaumont which provides assistance with federal grant funds. This 'Information will be used to establish the level of benefits for which the applicant is eligible and to verify the accuracy of the Infoimation furnished. Information received from an applicant or as a result of verifying an applicant's eligibility may be released to appropriate Federal, State, and local agencies or, when relevant, to civil, criminal, or regulatory investigators, and to prosecutors. Failure to provide any information may result in delay or rejection of your eligibility approval. The it of Beaumont is authorized to ask for this information under the National Affordable Housing Act of 1990. Each adult member of the household must sign this Eligibility Release prior to the receipt of benefits to establish continued eligibility. NOTE: THIS GENERAL CONSENT MAY NOT BE USED TO REQUEST A COPY OF A TAX RE, TURN. If a copy of a tax return is needed, IRS Form 4506, "Request for a Copy of Tax Forin" irust be prepared and signed separately. be. e. 'pca InformaCo tion veredi: Inquiries may be -may be made about itibm8 nutWed low bythalint., P Description Verification Required Initials of -Applicants Income (all sources) X X Assets (all source.,, Child Care Expenses X Disability Assistance Expenses if applicable) X Occupancy Preference (Special Needs) (if applicable) X Medical Expenses if applicable) X Other (list) X Dependent Deduction - Full -time Student X D Disabled Household Member [] Minor Children Applicant's Authorization: I authorize the City of Boaumont to obtain information about me and my household that is pertinent to deteimining my eligibility for participation in the City of Beaumont's Affordable Housing Progra-m. I aeknowledge, that: (1) A photocopy of this for is as valid as the original; AND (2) 1 have the right to review information received using this form; AND (3) 1 have the right to a copy of Information provided to the City of Beaumont and to request correction of any information I believe to be inaccurate; AND (4) All adult household members will sign this form and cooperate with the City of Beaumont in the eligibility -verification process. WARNING: Title 18, Section 1001 of the U.S. Code states that a person is guilty of a felony for Icumvingly and willingly maldng false or fraudulent statements to any department of the United States Goyes ninent.. sign tore - Head�of Household Sifmature, — Other Adult Household Member Siffnature — Other Adult Household Member Si nature -- Other Ad -Lilt Household Member Printed Name Printed Name Printed Name Printed Name Date Date Date Date TtICTI WITH OVPOIRT ITY T Is E 0 X A Vei-ificaticin of EWLOYAM NT City of Beaumont Address: 801 Main St P 0 Box 3827 Phone: 409.880.3763 F. 409.880.3125 Email: Demetria.Lavci"ne�au�monttex A�pffi i Name: REi LE ASE: Applicant's signature her or on attached "Eligibility Release" authorizes the release and/or verification oft .e requested employment information. Signature, of Applicant Date Applicants — Do Not Fill Out The Information Requested Below. To the Employer- Federal regulations require verification of employment and income of all members of any household making application to participate in the City of Beaumont's Affordable Housing Prograin. We ask yonr cooperation in supplying this information to the City of Beawnont. The information you provide will be used only to detem-iine the eligibility status and level of benefit available to the applicant household, ation- Sala Date of last pq increase: -Base loay rate: $ WEEK / MONTH (circle one) Average number of hours workeq pe weed at basUay rate: Number of weeks worked per year: Ovel*irate $ __per hour -Expected averagc number of hours overtime to be worked per week during the next 12 months: Specify any other compensation not included above (commissions, bonuses, tips, etc.): For: $ per Is t)av received for vacation? [] Yes No If Yes, mimber Total base pay �Sa�inijg Total overtime earnings for past 12 months: $ Probability and expected date of allypy Lncrease: Does the employce have access to a retirement account? 0 Yes [I No -If Yes, what amount does he/she have access to $ Signature of Employer's Atithorized--Represent ative: F I Title: Date: Phone: TVAMEVG: Title 18, Section 1001 of the U.S. Code states that aperson isguilty of afelonyfor lawivingly tear ivillingly makingfalse orfiaudilent statentents to any deparlittent of the United States Go vernment. OWNER-- + I I MINOR RE RABILYrATION PROGRAM RFQUIRE D DOCUMENTATION CHECKLIST All of the following documents (if applicable) must be submitted with this application. Missing or incomplete Information Nvill cause your application to be delayed or possibly denied. Please include any supplemental forms for each program in which you are interested. Completed application, signed and dated, with cover page indicating theprograms to which you are A- D applying. Ei A completed Immigration Status Affidavit AND photocopy of an approved form of identification for EACH ADULT (18 years old or older) HOUSEHOLD MEMBER A signed Employer Verification forin — Do trot fill in the requested information on the bottoin haf the forin u Copies of three consecutive month's worth of your most recent pay stubs Signed Verification Forms for all other sources of income (Social Security, Social Security Disability, pension, CtC.) El Complete copics oft year of your most recent Federal tax returns, all corresponding W218 and attached schedules Ei Ifyou arinplqyed (full or part-time), submit a year-to-date profit/loss statement AND three years of federal income tax returns. Please also submit your estimate of the income you will receive for the next 12 months and an explanation as to how you came to that number. Ei Signed Asset Verification for AND copies of 6 consecutive montlis of cheeking account statements [:j A copy of your 6 most 1-ecent savings account statements, including the interest rate A copy of the most recent statement from all other assets (IRA, 401K, cash value of life insurance policy, etc.) verifying the current balance, and interest rate or atInual dividend payment A copy of your property deed F-1 A Mortgage Verification, if your home is not paid for El Obtain a Tax Certificate from Jefferson County Tax Office; all of your taxes must be paid up to date OR you El must have a Payment plan with Jefforson County and be up to date; there, is a charge for the ceilificate Copy of Homeowner's Insurance Policy (must show currcnt. fire coverage) El For applicants claiming a medical disability, submit attached Verification of Disability Special Need (certification must be rnade by someone other than the applicant(s) Ifyou currently omi a home, submit Ift recent appraisal of that home or most recent Assessor's L1 statement and your most recent mortgage statement If ;you currently mviz other realj)rqperty� such as vacant land and/or commercial property, submit a 1:1 recent appraisal or Assessor's statement and a recent mortgage statement CEWFIFICATIONS It is our policy to verify all information contained in this application. In acknowledgemont of this policy, please sign your name(s) where indicated. LVe certify the following: All the information contained and submitted in support of this application is true and complete to the best of my/our knowledge and belief. I/We are aware that any misrepresentation will result in the forfeiture of any our right to participate in any of the. City of Beaumont Affordable Housing Program and may result in legal action against me/us. Consent to Release Information: IlWe authorize representatives ftom any Of the City of Beaumont Affordable Housing Program to supply and receive information to/from all other City of Beaumont Affordable Housing Program that f/we have applied to, my/our elliployer(s), my/our financial institutions), other housing/down payment assistance programs, my/our Realtor and/or my/our Mortgage Lender to verify the information contabied in this application. TMs information includes, but is not lit-nited. to bank statements,, employment status, income, outstanding debts and other financial information. I also authorize representatives from any of the City of B eaumont Affordable Housing Program to allow inspection and reproduction of any financial records or infbimation in their possession. I/We understand that information in this application may be shared with any of our funding sources for the purpose of ineeting ftmding compliance. I/We understand that the income I/we use to qualify for a mortgage loan amount must be the, same as the income we claim in this application. I release all representatives frorn any of the City of Beaumont Affordable, Housing Program from any and all liability arising Flom release of such information. This authorization is limited solely to information requested for the processing of my application for the City of Beaumont Affordable Housing Program. If we purchase a home tinder any of the Affordable Housbig Program listed in this application, 11we will occupy the home and agree to use the home as niy/onr primary and principal residence. I widerstand that completion of this application does not guarantee that my/our eligibility for the programs ancVor that I/we will succes sftjlly purchase a home through the City of B caumont Affordable Housing Program. Signature/Date Signature/Date Equal Opportunity: hi accordance with the provisions of the Equal Oppoitunity Act and the City of Beauniont Affordable Homing Program' policies., there will be no discrimination against an applicant for these benefits on the, basis of age, sotirce of income, sex, race, marital status, sexual orientatioti, national origin, religion or handicap. If you or a member of your household is an individual with a disability, you have the right to request reasonable accoinmodation for that disability, The City of Beaumont"s Affordable Housing Program is committed to assuring that each individual has an epal opportunity to the use and enjoyment of the benefits of this program. For more information, please contact the individual progranis to which you are applying. Spanish translation is available. Confidentiality: In order to proccss an application, City of Beaumont Affordable Housing Program may supply and receive information as detailed in the "Consent to Release" clause above. Information may also be released to comply with the auditing requirernents of prograin funding sources. With these, two exceptions, all personal and identifying information on Em application reinaiiis fully confidential, INCOME, DEBT AND ASSET INFORMATION Please complete a separate Income and Asset Section for EACH individual in the household who receives income or holds assets or debts. Make copies of this part of the application if necessary. You do not need to provide employment income information for household members younger than 18. You do need to include assets hold by children, or benefit income received by children. On the following list, check YES if you receive the, particular income, and check NO if you do not receive the income. You will need to provide verification for each item checked YES. (Refer to the Requ ired Do c zip entation Ch e Mist in this packet.) A. Income Information Gross income is the combined household income, which includes, but is not limited to, job earnings, Social Security and Social Services income (for all in household), TANF,, VA benefits, unemployment income, military pay, worker's compensation payments, child support, alimony/maintenance payments, income from pensions or retirement plans, stocks, etc. Failure to report household income is considered fiand and can have serious coe+anew. Employment Income (Do not include employment income of children younger- thall A cip"ied Incom " afi&ation e f6rcl, the next 12 months as necessary) Name ofBitsiness: Applicant's Employer Anticipated Gross Annual Clarification Income for the next 12 months (as necessary) Name and address of mployer. $ Avg A hours worked per week, B 'Antleipated Gross Annual Clarification mpldycr 42 Income for the next 12 months (as necessary) Name an address iqfE n�ploy er.- $ Avg# hours worked per week. TOTAL OF ALL EMPLOYMENT INCOME Benefit Parnents Tyb.6.vfInoom lari,flssfia6n AA'E,Grxt i SecoivO 1Annua eA Peninhei)4 Ind.m"e f6f tn2oteiy( Social Security Cl E] $ Supplemental Security Income (SSI)❑ Supplemental Security Disability Income (SSDI) 1] E-] Worker's Comp/Disability pay/130nefits $ Uiemployment Insurance/Severance Pay $ Insurance Policy Payments/Annuffies E] El Pension/Retiroment Benefits Cl $ TOTAL OF ALL BENEFIT PAYMENTS Alimony and Child Support Provide a copy of the court order for each type of support and indicate whether you are actually receiving the indicated support Anticipat d I YES NO FIncome for the next 12 months as necessary) Receive? Anticipated Gross Annual clariflication e of Support Alimony[Mai.terra nce $ Child Support p$ TOTAL OF ALL ALMONY AND CEnD SUPPORT R] ElCEIVE, D Other Sources of Income th r Ret, Typ e of 0 eIn come elve. Anticipated Gross Annual Clarifleation YES NO income for the next 12 mantes (as necessary) Money or gifts regularly given by persons not living in the home/recurring cash (requires completion of Recurring Cash certification by persons who are the, source, of the cash or gifts) Lottery winnings paid iii periodic payments El El $ Rent payments you receive El $ Other Incomes (please, specify source, ex. Avon) $ Other Income (please specify source) $ TOTAL OF ALL THE, R SOURCES OF LXCOMEA $ B. Debt Do You have any dc,,bt? o Yes n No If yes, please fist below. Uilpaid Bala' Creditor's Nafiie nee C.. e Information An asset is cash or a non -cash item that can be convefted to cash. Report the following assets: Cash hold in savings accounts, Checking accounts, safe deposit boxes, homes, etc. Equity in rental property or other capital investments. Cash value of stocks., bonds, Treasury bills, certificates of deposit and money market accounts. Individual Rctirement and Keogh accoimts (even though withdrawal would result in a penalty). Retirement and pension funds. Cash value of life insurance policies available to the individual before death. Personal property held as an investment such as gems, jewelry, coin collections, antique cars, etc. Lump sum or one-time receipts, such as inheritances, capital gains, lottery wimungs, victim's restitution.5 insurance settlements and other amowits not intended as periodic payments. Mortgages or deeds of trust held by an applicant. Any real propefty. Do Not Report nccessary personal property such as clot bing, furniture, cars and vehicles specially equipped for persons with disabilities. Bank Accounts Ha've? Name of Institution Typ& of Current Balance E YS NO Account El El U Chexig $ 11 11 CheckiiiR $ $ El 0 CheAffig $ 1-1 El S 1:1 11 Savings $ 11 El Money Market $ Money Market $ El 13 Other (specify) $ TOTAL 07 ALL BANK ACCOUNT BALANCES $ Other Assets Current Cladfication Mime of x sti u TA o tm► At Value of Notes YES :. ,st — - Individual. toe B ands El 0 futaal Fends Trust Ruids ❑ ❑ Refit"emont Accounts i , M, 7 ❑ Keogh, 401 , 403B, PERA) Cash value of life. insurance -� ❑ Policy gift Money for dawn payment ❑ ❑ provide a copy offhe gift letter Estimated Proceeds front Sale of Homo Value of Other Property (please specify) Other Asset (Please specify) ❑ C� FTOTAL VALUE OF ALL OTITEi R ASSETS