45-042 (9) 960497
FILE #
APPLICANT/CONTACT PERSON:( )4,6,t!h le -a/2ho %�TLGr
ADDRESS/PHONE: /,23 f41 � -� • •
PROPERTY LOCATION: ���� ' ��MAP PARCEL: (} � ZONE �C'� Qa-e 2
IRIS SECTION FOR-OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST •
ENCLOSED REQUIRED DATE
ZONTNG FORM FIT T,FT) OUT
Fee Paid
Rnilding Permit Filled nut _ L�
Fee Paid !X/
Type of C'nnstrnrtinn•
New C'nnctrnrtinn
_Remndeling Tnterinr
Additinn to F,Yicting
A rressnry Strnrhire
Rnildin�Plane Tnrluded•Owner/Occupant Statement nr irencp �7 1
3 Sets of Plans /Pint Plan
THE F LLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION:
l/Approved as presented/based on information presented
Denied as presented:
Special Permit and/or Site Plan Required under: §
PLANNING BOARD ZONING BOARD
Received&Recorded at Registry of Deeds Proof Enclosed
Finding Required under:§ w/ZONING BOARD OF APPEALS
Received& Recorded at Registry of Deeds Proof Enclosed
Variance Required under: § w/ZONING BOARD OF APPEALS
Received&Recorded at Registry of Deeds Proof Enclosed
Other Permits Required:
Curb Cut from DPW Water Availability Sewer Availability
Septic Approval-Bd of Health Well Water Potability-Bd Health
Permit from Conservation Co ion
%/ -5
Signature of Building Inspector Date
NOTE:lssuenee of a zoning permit does not relieve an epplioent's burden to oomply with elf
zoning requirements and obtain all required permits from the Soerd of Health, Conservation
Commission, Department of Publio Works and other applioable permit granting authorities.
i is 'nI f/j . ram-
DMCOMMONWEALTH OF MASSACHUSETTS 112
7 /3<-1-71.9--: (7'0''
JAN 2 6 DEPARTMENT OF ENVIRONMENTAL PROTECTION FL c'r•�-� �(��..c
L` WETLANDS PROTECTION ACT
DEF. 0 St M.G.L. C.131 g40 L 2 3
7 ,F c' ���dS
tini;r,.i;i, ', ; 'y° 310 CMR 10.00
•
CERTIFICATION OF EMERGENCY LOCATION OF WORK: street: in rin`j V i•C-1 0• j�S 7 r cQ • retArille r^ 1�j�
r0rA*.,
city/town: Or.,.--{-b .,Yti,r`1-ic;'•1 /1, U. , n I n tr_
1. The applicant hereby requests the Issuing Authority (Conservation
Commission or the Department of Environmental Protection) to certify the
following project as an emergency project: (describe work to be allowed, and .
attach supplemental information if more space is needed)
r e-Con 5irt- C--h4,� c'f' rt�r)t-. G-'/ c0(1 1 GY1 c. 4-0O t' 0 ofz-t t'IQ n •
Z'
2. The project is necessary for the protection of the health and safety of .
the citizens of the Commonwealth
Comlmonwealth because:- - 11047 1i r\ nick' . V) a. 4 ,- -r rct
r 4 2- k2Lc l I�h zi sa-('. o- -I-1(- Kc'i c vn of) l he rLi r,c tJ i Yl j
3. The agency (or subdivision thereof) of the Commonwealth that has ordered
the project to be performed is:
4. No work shall be allowed beyond that necessary to abate the emergency.
The date work shall be completed by: Not to exceed 30
days without written approval o he Commissioner of the Department of
Environmenta otect' n /DEP ./
-f
s gna ure of applicant) ( at )
On the basis of the above information, and after a site inspection, the
project described above (and in any supplemental information provided) is
determined to be a cer,(ti ie{d emergency pursuant to 310 CMR 10.06.
ISSUING AUTHORITY: ` J Or)/':?n' /Zr1 •
(Con ervation Commission or DEP)
BY: (P11/GIia2� i-- 1
n'i�t-,0 ,f 1_.
zf az___& ��1�/I' 4 1....-i
/'G� ZL c �. l,�-r..i,- ( r)--l��� -
Date Issued: /��li/9�
❑ (If box is checked, see attached conditions)
• (Effective 8/14/92)
GUIDELINES FOR EMERGENCY CERTIFICATIONS
The Wetlands Protection Act, M.G.L. C. 131 §40 and the
Wetlands Regulations, 310 CMR 10.00 (at 10. 06) , provide that an
Emergency Certification may be issued to permit emergency
projects without having previously filed a Notice of Intent. A
project may be granted an Emergency Certification if the
following requirements are met: •
1) The person requesting the certification must specify,
orally or in writing:
a) why the project is necessary for the protection of
the health or safety of the citizens of the
Commonwealth; and •
b) the agency or subdivision of the Commonwealth
which will perform the work or has ordered the
work to be done; and
c) describe the extent of the proposed work necessary
to abate the emergency condition.
2) The Conservation Commission or the Department of
Environmental Protection may issue an Emergency Certification
after receiving the certification request and:
a) conducting a site inspection; and
b) verifying that the proposed work is for the
protection of the health or safety of the citizens
of the Commonwealth and does not include work
beyond that necessary to abate the emergency.
The attached form may be used for this purpose.
3) When an Emergency Certification is issued, it must in
writing and should contain:
a) a description of the permitted work determined
necessary to abate the emergency; and
b) a time limitation for performance of the work, not
to exceed 30 days.
•
4) An Emergency Certification issued by a Conservation
Commission shall be signed by a majority of the
Commission. In a situation requiring immediate action,
an Emergency Certification may be signed by a single
member or agent of the Commission, if said
Certification is ratified by a majority of the members
at the next scheduled meeting of the Commission.
•
5) An Emergency Certification, when issued by a
Conservation Commission, shall immediately be sent to
•
the Department, and when issued by the Department shall
immediately be sent to the Commission.
aogoadsuI 2uzpling `oTI?qud AuoLiqud