RFP - Lease of 50 Mount Walley Road (Mac's Place)

REQUEST FOR PROPOSALS APPLICATION PACKET
AFFORDABLE HOUSING LOTTERY FOR
MAC'S PLACE 50 MOUNT WALLEY ROAD, WALTHAM, MA
AFFORDABLE SINGLE FAMILY HOME FOR RENT
3-Bedroom Single Family Cape, approx. 1,750 sq. ft. living space on 17,000+ sq. ft. land.
First Floor - Kitchen, Living Room, Dining Room, Bedroom, Full Bath; Second Floor - 2
Bedrooms, Full Bath; Basement - Washer & Dryer; Shed
AFFORDABLE RENT (based upon 4 person occupancy)
Three-bedroom - $2,900.00 PER MONTH (includes utility allowance)
Tenants required to pay electric (stove, a/c, lights, etc.), oil (heat), water & sewer,
cable/phone (optional).
NUMBER OF HOUSEHOLD MEMBERS
Minimum of 1 person per bedroom. Maximum household size is a family of 5.
No more than 3 unrelated people allowed.
Must be income eligible at or below the following annual gross income:
2 person household $109,000 3 person household $123,400
4 person household $137,100 5 person household $148,100
THE CITY OF WALTHAM HOUSING AND COMMUNITY DEVELOPMENT DEPARTMENT WILL BE
CONDUCTING THE FOLLOWING AS PART OF THE LOTTERY PROGRAM:
LOTTERY INFORMATIONAL MEETING: Wednesday, September 30, 2026, 7:00 PM Public
Meeting Room, Government Center, 119 School Street, Waltham
OPEN HOUSE: 50 MOUNT WALLEY RD, WALTHAM Tuesday, October 6, 2026, 5-7 PM
LOTTERY DRAWING: Thursday, October 29, 2026, 2:00 PM Public Meeting Room,
Government Center, 119 School Street, Waltham
FOR QUESTIONS CONTACT CRYSTAL PHILPOTT IN WRITING
cphilpott@city.waltham.ma.us
APPLICATIONS AND INFORMATION WILL BE AVAILABLE AT THE FOLLOWING LOCATIONS:
WALTHAM PUBLIC LIBRARY, 735 MAIN ST., WALTHAM, MA
WALTHAM HOUSING & COMMUNITY DEVELOPMENT OFFICE, 25 LEXINGTON ST., FLR 2A, WALTHAM, MA
WALTHAM HOUSING AUTHORITY, 110 POND STREET, WALTHAM, MA
CITY OF WALTHAM VETERANS' OFFICE, GOVERNMENT CENTER, 119 SCHOOL ST, WALTHAM, MA
COUNCIL ON AGING/WALTHAM SENIOR CENTER, 488 MAIN STREET, WALTHAM, MA
or on the City of Waltham website (see QR Code on page 2)
APPLICATIONS MUST BE SUBMITTED IN A SEALED ENVELOPE TO:
50 MOUNT WALLEY ROAD AFFORDABLE LOTTERY PROGRAM
CITY OF WALTHAM PURCHASING DEPARTMENT
610 MAIN STREET, WALTHAM, MA 02452
DEADLINE FOR AFFORDABLE APPLICATIONS:
OCTOBER 19, 2026 at 2PM
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WALTHAM AFFORDABLE HOUSING
MAC's PLACE
50 MOUNT WALLEY ROAD
WALTHAM, MA
LOTTERY APPLICATION*
Name________________________________ Phone #_______________________________
Address______________________________ Email _______________________@ ______________
City__________________________________ State______________ Zip__________
Date of Birth ______________ Social Security #________________ Number in Household ______
HOUSEHOLD MEMBERS**:
Please list ALL household members who will occupy the affordable home:
Name Date of Birth Social Security #
RACE (OPTIONAL): You are requested to complete the following optional section in order to assist in determining
preference. Completing this section may qualify you for additional lottery pools. (Please check all boxes that apply):
White Black/African American Hispanic/ Latino
Asian Native American/Alaskan Native Other (not white)
PETS ARE NOT PERMITTED
THIS IS A NON-SMOKING BUILDING & GROUNDS
* SEE INFORMATION SHEET B FOR INCOME ELIGIBILITY
** MINIMUM OF THREE OCCUPANTS / MAXIMUM OF FIVE OCCUPANTS
TO VIEW ONLINE OR FOR TRANSLATION:
PARA VER EN LINEA O PARA TRADUCCION:
PARA VISUALIZAR ONLINE OU PARA
TRADUCAO

Zaixian chakan huo huoqu yiwen 2

WALTHAM AFFORDABLE HOUSING
MAC's PLACE
50 MOUNT WALLEY ROAD
WALTHAM, MA
Do you currently rent? Yes No If yes, complete below:
Current Landlord
Name: ________________________________________________________________
Address: ____________________________ City ______________State ___ Zip______
Contact Name: ____________________________________ Tel. # _________________
Dates you have lived at present address? From _____________________ To: Present
Monthly Rent $_______________________ Utilities $___________________________
Previous Rental History
(this information must be completed)
1.Address: _____________________________ City _____________State _______ Zip______
Contact Name: ______________________________________ Tel. # _____________________
Dates you have lived there? From: ______________ To: _____________ Monthly Rent $ ______
2. Address: _____________________________ City _____________State _______ Zip______
Contact Name: ______________________________________ Tel. # _____________________
Dates you have lived there? From: ______________ To: _____________ Monthly Rent $ ______
Have you ever been evicted or considered for eviction proceedings? Yes No
If yes, when and please explain
_____________________________________________________________________________
________________________________________________________________________
PREFERENCE INFORMATION (you must submit proof of status with application):
A. Local Preference. Please indicate Waltham affiliation:
Current Waltham resident
Currently employed in Waltham
Parent/guardian with children attending the Waltham Public Schools
B. Veteran
Veteran Status (please check box if you are a veteran)
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WALTHAM AFFORDABLE HOUSING
MAC's PLACE
50 MOUNT WALLEY ROAD
WALTHAM, MA
Have you owned a home or joint interest in a home in the past three years?
YES _________ NO _____________
If yes, please explain
________________________________________________________________________
________________________________________________________________________
Proof of residency shall be proven by the provision of rent receipts, utility bills, or recent voter
registration listing. If a household member owns a residential property, the property must be sold
prior to leasing a home.
EMPLOYMENT STATUS: (If other adult household members are employed, please attach a
separate sheet with their current employment information.)
Applicant's Name _________________________________________________
Occupation______________________________________________________
Name & Tel. # of Present Employer__________________________________
Business Address________________________________________________
Name and Title of Supervisor_______________________________________
Annual Gross Salary______________________________________________
Co-Applicant's Name _____________________________________________
Occupation______________________________________________________
Name & Tel. # of Present Employer__________________________________
Business Address________________________________________________
Name and Title of Supervisor_______________________________________
Annual Gross Salary______________________________________________
Co-Applicant's Name _____________________________________________
Occupation______________________________________________________
Name & Tel. # of Present Employer__________________________________
Business Address________________________________________________
Name and Title of Supervisor_______________________________________
Annual Gross Salary______________________________________________
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WALTHAM AFFORDABLE HOUSING
MAC's PLACE
50 MOUNT WALLEY ROAD
WALTHAM, MA
INCOME INFORMATION:
Income information (for you and any other person occupying the home):
Supporting Documents for Qualification to verify the below will need to be provided after
the lottery (see list page 8.) Please add additional sheet(s) if more than 2 adult (18+ yrs)
applicants and/or more income/assets to report.
USE MONTHLY AMOUNTS ONLY
You Other Applicant
Salary (gross) $________________ $________________
Social Security (gross) $________________ $________________
Pension $________________ $________________
SSDI (Disability Payments) $________________ $________________
Dividends $________________ $________________
Interest $________________ $________________
Other (alimony, veterans $________________ $________________
Child support, etc.)
Other (alimony, veterans $________________ $________________
Child support, etc.)
Other (alimony, veterans $________________ $________________
Child support, etc.)
Total Monthly Income $________________ $________________
ASSETS
a. Bank Accounts
Bank Name Acct # Address Current balance
Checking _________________________________________ $____________
Checking _________________________________________ $____________
Savings __________________________________________ $____________
Savings ___________________________________________ $____________
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WALTHAM AFFORDABLE HOUSING
MAC's PLACE
50 MOUNT WALLEY ROAD
WALTHAM, MA
CD(s) _____________________________________________ $____________
Venmo/Paypal/Cash-App ______________________________ $____________
IRA(s) _____________________________________________ $____________
b. Securities (Stocks/Bonds/Mutual Funds)
Name Acct# Address Current balance
1.______________________________________________________ $____________
2. ______________________________________________________ $____________
3. ______________________________________________________ $____________
c. Real Estate
Most recent assessed value $_____________________ Mortgage Balance $________
Other Liens $_____________________
d. Life Insurance term? __________ whole life?________________
Cash Value $_____________________
e. Have you disposed of any assets for less than fair market value during the two years
preceding this application? Yes No
If yes, the date you disposed of assets_______________________. The amount you received
$___________________.
The market value of assets at the time of disposition $___________________________.
f. Have you ever been convicted of a misdemeanor within the past 5 years or a felony in the
past 10 years? No Yes
If yes, when and explain___________________________________________________
______________________________________________________________________
______________________________________________________________________
Is the crime relevant to the housing being sought?______________________________
______________________________________________________________________
______________________________________________________________________
Unless prohibited by law a criminal record will not automatically disqualify an applicant.
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WALTHAM AFFORDABLE HOUSING
MAC's PLACE
50 MOUNT WALLEY ROAD
WALTHAM, MA
PLEASE CHECK THE FOLLOWING ITEMS THAT APPLY TO YOU
_____ I/We certify that our household is ________ persons
_____ I/We certify that we qualify as eligible tenants as defined in the Lottery
Information Packet
_____ I/We certify that at least one member of the household qualifies
under the applicant preference category as defined on page 3, in the Information Packet,
if applicable.
_____ I/We certify that our household income does not exceed the
income limits provided in the Lottery Information Packet.
_____ I/We certify that I/We have read the foregoing and that the information in this
application and in support of this application is true and correct to the best of
my/our knowledge and belief. I/We understand that perjury will result in
disqualification from further consideration.
_____ I/We further understand that it is my/our responsibility to notify the Waltham
Housing Department of any change in address which would prevent delivery of any
correspondence from the Housing Department.
_____ I/We understand if I/We do not respond to correspondence, my/our application
will be removed from the Lottery List and/or wait list.
_____ I/We have read, understand, and agree the summary of lease and
sublease restrictions in the Information Packet and agree to the restrictions. I/we have
been advised that a copy of the Regulatory Agreement is available for my/our further
review from the Lottery Agent or Lottery website.
_____ I/We also understand that, if selected in the Lottery to lease a home, a full copy
of the Regulatory Agreement will be provided to you.
My/Our signature(s) below gives consent to Colette Casey-Brenner, City of Waltham Housing
and Community Development Director to verify all income. No applications will be considered
complete unless signed and dated by the Applicant/Co-Applicant. This form must be signed by
all household members age 18 years or older.
____________________________ _______________________________
Applicant Signature Co-Applicant signature
____________________________ _______________________________
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WALTHAM AFFORDABLE HOUSING
MAC's PLACE
50 MOUNT WALLEY ROAD
WALTHAM, MA
IF/WHEN SELECTED FOR LOTTERY
Supporting Documents Needed to Prove Qualification if they apply to
you and/or all household members
1. Copies of most recent eight weeks of pay stubs
2. If self-employed, include year-to-date Profit and Loss statements (2 complete
years) and last four (4) quarterly tax payment documents. Self-employed
applicants may be required to provide additional information.
3. Copies of last two years signed, filed Federal tax returns including all documents
(W-2 forms, 1099 statements, 1040, 1098, all schedules) for all adult household
members (age 18 or older).
4. Copies of last three months of all checking, savings, and asset account
statements
5. Copy(s) of Social Security Benefits Statement (Annual Determination Letter)
6. Copy(s) of Social Security Disability Benefits Statement (Annual Determination
Letter)
7. Copy(s) of Pension Statement
8. Copy(s) of Unemployment Compensation award
9. Copy(s) of alimony/child support (court order), VA benefits and/or government
assistance (this includes any benefit awards for housing subsidies)
10. Copy(s) of a utility bill proving your address if you are requesting a local preference
unit.
11. Proof of Veterans' status
12. Photo Identification - please provide proof of identification for all household
members (copy of driver's license, passport, or state ID for adults 18 years+; birth
certificate for children)
You may provide any additional information you feel is applicable to you and your
household and attach with this application for review. The City of Waltham may request
additional information necessary to make a determination of eligibility.
A description of assets is included in this application beginning on page 14. Information
on allowable assets is provided on page 13.
If selected by Lottery, the above information will be requested from you with a 1-
week deadline to provide to the Housing Office to complete processing your
application. Please do not provide documents until/unless you are requested. If
the supporting documentation is not received within deadline, you will be
determined not eligible and removed from the lottery. Full background checks are
done on each applicant, which include credit reports, references, C.O.R.I. and
S.O.R.I. checks. Your signature gives consent to the management to verify any
and all information contained in this application. Please see C.O.R.I. Policy
attached to this application.
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WALTHAM AFFORDABLE HOUSING
MAC's PLACE
50 MOUNT WALLEY ROAD
WALTHAM, MA
IT IS THE CITY OF WALTHAM'S OBLIGATION NOT TO DISCRIMINATE IN THE
SELECTION OF APPLICANTS
The City of Waltham will not discriminate in the selection of applicants on the basis of
race, color, national origin, disability, ancestry, children, familial status, genetic
information, marital status, public assistance recipiency, religion, sex, sexual orientation,
gender identity, veteran/military status, or any other basis prohibited by law.
ALL DISABLED PERSONS ARE ENTITLED TO A REASONABLE ACCOMODATION
OF THE HOUSING. SELECTED APPLICANTS WITH DISABILITIES ARE ENTITLED
TO REASONABLE ACCOMODATIONS.
ALL AFFORDABLE APPLICATIONS MUST BE
SUBMITTED TO:
APPLICATIONS MUST BE SUBMITTED
IN A SEALED ENVELOPE TO:
50 MOUNT WALLEY RD AFFORDABLE LOTTERY PROGRAM
CITY OF WALTHAM PURCHASING DEPARTMENT
610 MAIN STREET, WALTHAM, MA 02452
BY 2:00PM Monday, October 19, 2026
TO BE ENTERED IN THE LOTTERY
LATE APPLICATIONS WILL NOT BE ACCEPTED
LAST DAY FOR QUESTIONS (outside of the informational
meeting) is by October 7th by Noon and must be emailed to
cphilpott@city.waltham.ma.us
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WALTHAM AFFORDABLE HOUSING
MAC's PLACE
50 MOUNT WALLEY ROAD
WALTHAM, MA
INFORMATION PACKET
WALTHAM AFFORDABLE HOUSING LOTTERY
MAC'S PLACE
50 MOUNT WALLEY ROAD, WALTHAM, MA
This packet contains specific information on the background, eligibility
requirements, selection priority categories, application process and the
affordable rental program for Mac's Place. The developer of this project,
City of Waltham invites you to read this information and submit an
application if you think you meet the eligibility requirements. This lottery
is the first step in the application process and does not assure you are
selected for the home. If you are selected for the lottery, you must then
apply and successfully pass a background check, including but not
limited to financial eligibility and prior tenant history. The developer
reserves the right to decline to offer a home.
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