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8 HARBOR VIEW TERRACE - ZONING RECEIVE® DEPARTMANT OF ENVIRONMENTAL PROTECTION WATERWAYS REGULATION PROGRAM JUL 1 8 2007 DEPT. OF PLANNING& Notice of License Application pursuant to M.G.L.Chapter 91COMMUNITYDEVELOPMENT Waterways License Application Number W07-2010 David Pabich NOTIFICATION DATE: July 26,2007 Public notice is hereby given notice of the application by David Pabich to maintain an existing seawall and perform beach nourishment at 8 Harbor View Terrace in the municipality of Salem in and over flowed tidelands of Salem Harbor. The proposed use of the project is to provide shoreline stabilization and is a water dependent project. The Department will consider all written comments on this Waterways application received within 30 days subsequent to the "Notification Date" . Failure of any aggrieved person or group of ten citizens or more to submit written comments to the Waterways Regulation Program by the Public Comments Deadline will result in the waiver of any right to an adjudicatory hearing in accordance with 310 CMR 9.13(4)(c). Additional information regarding this application may be obtained by contacting the Waterways Regulation Program at (617) 292-5500. Project plans and documents for this application are on file with the Waterways Regulation Program for public viewing, by appointment only, at the address below. Written comments must be addressed to: Ben Lynch, Program Chief, WRP, One Winter St., 5t" fl., Boston, MA 02108. rtcrcrtuvuw• ULCU Dn. LI /J/ r'b. 4y7 .y•'�• 1) DEE' BOOK 18625 PAGE 514 _ �t M 2) PLAN BOOK 64 PLAN 19 3 PLOT PLAN IN SALEM MASSACHUSETTS. LE BLANC HARBOR SURVEY; JAN, 18, 2006 NOTE: E NGVD LOCUS � o I rrr+r711 L4 HOF M C12: e. D > AU s� x gym , � - �. AXW ZN 1343 0S Z: ��OR 9F4rsraP�� 4``@' rr'1 N 0 �ss�oPdAL6NMAP 32 LOT 387 -xi u 10,857± S0, FT. -ren N N MAP 32 LOT 381 N N/F o - m 1n CO PETER KIRKPATRICK rFi1 W- - \ II -ar^ 409 LAFAYETTE ST. - to a M n DEED BK. 13666 PG. 415 < w � ur) > z t*1 T � x ' m X EXISTING SEAWALL ON ��'`, EXISTING SEAWALL (TO BE LICENSED), om to NEIGHBORING \ \ \ \. '., '\ \ \ w \ m PROPERTY \` `. 'AREA OF. BEACH' NOURISHMENTT,, (3500 SO. FT., 22 CU YDS.) �\ \ m � m v MHW: ,` '" \ \ PROPOSED LIMIT`OF z m0 A w 4.41 A BEACH NOURISHMENT N A --1z N) NGVDje: --4N WALL AND BEACHPROP LINE TO LOW M rrI v NOURISHMENT TO BE WATER MARK (PER DEED) LICENSED (ALL CO STRUCTURES o vii Z N ARE EXISTING) OM OD SALEM HARBOR D XX `'" E R z EXISTING SEAWALL HOR, SCALE IN FEET m � ON NEIGHBORING PROPER 0 20- 50 100 , F- •, �� z 1 IN = sD FEET SHEET 1� OF 3 Plan Accompanying Petition of David Pabich, 8 Harbor View Terrace Salem, Massachusetts .for - Existing Sea Wall and Beach Nourishment CH91 License IVI/"�JJnI..IIV:JC.GIJ, LL- LJL/'Ii.VV N F 90�.9R F$TV- SURVEY, JAN. 18, 2006 ROBERT HEISKELL Fss�ri LENG`� NOTE: ELEVATIQNS IN• NGVD' 9 HARBOR VIEW TERR. T.W:. DEECf BK 2338.7 PG. 182 + 02 A'- EXISTING POURM I A + 19.01 ' ,.—CONCRETE SEAWALL / (TO BE LICENSED) 20.91 r f ' Y ` p fl M.L.W (-4.85 { 21.45 ` � ` l f' NGVD)APPROXIM'ATEL-Y k I f 900' EASTE,f�-LY 21.27 — F 21.25 0 R ,. / B < 2 � j ' T W 8.,66 I I ; B W 3.89 `I I PROPOSED LIMI=T OF W j } 20.04 ` 1 i¢ I BEACH NOURISHMENT / WOOD I I Q � �/J DECK � � � • -I o (OVER) F m 21.86 o J fx Q cnz I a C1]< 0 o 00 z + I 8:57+ C 2 '19 1(?'46 5..15 �n B.W. HW NGVD EL. 4.41 Y � op U (n r LLJ 4 PROPOSED AREA OF 1= d cp BEACH NOURISHMENT WITH d \ "` SAND (22' CU. YDS)x N. Z Y L¢L . Q A — A PROFILE OF BEACH J Y (SEE SHEET 3 OF 3) w o o HOR. SCALE IN FEET it a 0 20 50, 100,n a 11 IN ' -= 20 FEET SHEET 2" OF 3 Plan Accomponying 'Petitiori of David Pob ch,. 8 Harbor View Terrace .A Salem, Massachusetts;" _ fora' Existing Sed Wall and Bedch STING VEGL NVILU SLUYL ( I YI") `1 PRpFILE OF BEACH NOURISHMENT JCONCRE: TIE XISTING POURED SEAWALL (4' THICK T.0 0") NOTE: M:LW. ( 4.85 NGVD) T.O.W. ELEV. 8:66 APPROXIMATELY F =5' SLOPE OF BEACH 1:1-9 900' EASTERLY B.O.W. (TOP OF EXISTING; BEACH =PROF.,ILE . FOOTING (ROCKY SAND,) M H W'E'4.41,NGVD ELEVATION: 5.02 TRANSITION 41NGVD TO T.IDALFLATS 40' �s i 67' - PROFILE A-A r NOTE: ING SLOPE (TYP): EXISTING POURED CONCRETE SEAWALL M-.L.W. (-4.85 NGVD) APPROXIMATELY _5. T O,W. ELEV. 8.66 900' EASTERLY B.0 W. (TOP OF PROFILE OF BEACH NOURISHMENT w FOOTING (4" THICK TO 0") w f ) M.H.W.: 4.41NGVD 1n IE ELEVATION: 3.89 ,_ EXISTING BEACH PROFILE " 41NGVD (ROCKY SAND:) . 35' 43, �Y2" TRANSITION TO TIDALFLATS o ,c PROFILE B-B o Jj TING VEGETATED NOTE: p s c ,, 'E (TYP): M.L.W. (-4.85 NGVD.) EXISTING POURED CONCRETE SEAWALL o� o 1 APPROXIMATELY n _5. T O.W. ELEV 8.5",7 PROFILE OF 'BEACH 'NOURISHMENT 900' 'EASTERLY > o 7 Ut � B O.W. ELEV 5;'15 (4' THICK TO- d ) R,OCKY SA ACH PROFILE o o : EXfSTING .o ` cy 1 — ( �ND) TRANSITION 1 0 V�::ALFLAT etrs M �J` a o E o 4� y < N, 4.41 `.. O t9 O N '.h 272 I Sfe � o tbin a o 38' SCALE 1 IN 10 FEET x Z' PROFILE C-C q�F w Os 20 'C� Massachusetts Department of Environmental Protection COPY Bureau of Resource Protection - Waterways Regulation Program Chapter 91 Waterways License Application ha n M T a"s"'�No PrmSimPlifed,Water-Dependent, Nonwater-Dependent,Amendment cR 9.00 ` . out A• Application Information crms on (Check one) she ocOn y the at key 'o move your Cursor-do not Name(Complete Application sections) Check One Fee SIMPLIFIED- Application# iekeythe return, pendent and �. Water-de Nonwater-dependent(A-E) C1 Residential with <4 units ' $65.00 BRP WN06a Isl'> i ❑Other $65.00 WATER-DEPENDENT• BRP W WO6b General(A-H) PQ Residential with < =crW a -Pstince 4units $175.00 BRPW01a ccmp.eting this 2PP'icabon,please ❑Other sea the $270.00 BRP WW01b nstructions•. El Extended Term --._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._..-.._.._.._.._ $2730.00 8Rp WW01c Amendment(A-H) El Residential with <4 units $85.00 BRP WWO32 ❑Other $105.00 BRP NON WgTER-DEPENDENT- WW03b Full(A-H) ❑ Residential with <4 units $545.00 BRP WWI 5a ❑Other $1635.00 BRP WWI 5b ._.._.._.._.._.._.._.._......................._.._.._.._0Extended Term _.._.._.._.._._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._ $2730.00 BRP WW15c Partial(A-H) ❑Residential with <4 units $545.00 ❑Other BRP WW14a $1635.00 BRP WW14b _.._.._.._.._.._.._.._.._.._.._.._.._.._�Extended Term ._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._ Municipal Harbor Plan (A-H) $2730.00 BRP WWI 4c ❑Residential with <4 units $545.00 BRP WW16a ❑Other $1635.00 BRP WW16b ..................... ._. _.._.._.._.._. ._.._.._..__ . ❑Extended Term _._. .._._.._.___..-__.._..___.._.._.._.._.._.._.._.._ Joint MEPA/EIR(A-H) $2730.00 BRP WW16c ❑ Residential with <4 units $545.00 BRP WWI 7a ❑Other $1635.00 BRP WW17b _.._.._................................... ❑Extended Term _.._.._.._.._ Amendment(A-H) ._.._.. W .._.._.._._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._.._ $2730.00 BRP W17c ❑Residential with <4 units $435.00 BRP WW03c ❑Other $815.00 BRP WNI03d ❑Extended Term $1090.00 BRP WW03e :,"S i,4ys.Coc-Rev. 70/02 Page i of 17 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program Chapter 91 Waterways License Application -310 CMR 9.00 Trrnsmdtal No. simplified,water-Dependent, Nonwater-Dependent,Amendment B. Applicant Information Proposed Project/Use Information 1. Applicant: l came � L �. �� �t E-mail Address Note:Pease refer Matling Address m the"instructions state, �A- '�� d�iJ6 / � //'O stars Zip code Telephone Numh_e__r Mar 2, Authorized Agent(if any): awn E-mail Address Mailing Aodrege Y awrl f� State LP Cade Telephone Number Fax Number C. Proposed Project/Use Information Property Information (all information must be provided): Owner Name(if different from applicant) Tax Assessors Map and Parcel Numbers Latitude SVeat ACdress aid CiVrown - Longitude State 2. Registered Land Yes Zip Code ❑No 3. Name Of_pe water body where the project site is located: D 4. Description of the water body in which the project site is located (check all that apply): Tvoe Nature Desi nation Z Nontidal river/stream 99-Natural Cl Area of Critical Environmental Concern ❑Flowed tidelands ❑Enlarged/dammed ❑Designated Port Area ❑Filled tidelands ❑Uncertain ❑Great Pond ❑Ocean Sanctuary Uncertain ❑ Uncertain CH9IAPP.doc•.Rev. ?0;02 Page 2 of 17 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program Chapter 91 Waterways License Application -310 CMR 9.00 Trensmittal No. Simplified,Water-Dependent, Nonwater-Dependent,Amendment C. Proposed Project/Use Information (cont.) °ziact use(s)from Protect Type Table 5. Proposed Use/Activity description on pg.2 of the - 'InsVJctlons- Comm 0 /l7 4 cc 11 }o 6. Is the project a pre-1984 existing structure AND less than 600 square feet? ❑Yes V No 7. Is the project a post-1984 existing or new structure, less than 300 square feet AND water dependent? ❑Yes ®No S. What is the estimated total cost of proposed work (including materials & labor)? $ 9. List the name&complete mailing address of each abutter(attach additional sheets, if necessary).An abutter is defined as the owner of land that shares a common boundary with the project site, as well as the owner of land that lies within 50'across a waterbody from the project. Name An �*40-" Lye O�CB.Y.c�A i►6yv S *+'e6A0-" Z.*e Name Address *A* B/ p Name Address D, Project Plans 1. I have attached plans for my project in accordance with the instructions contained in (check one): 09 Appendix A(License plan) ❑ Appendix B (Simplified License plan) ❑ Appendix C(Permit plan) 2. Other State and Local Approvals/Certifications ❑401 Water Quality Certificate Wetlands _ Dale of Issuance Ne S. FrcpWrt/ ❑Jurisdictional Determination File Number JD- ❑MEPA File Number ❑EOEA Secreta File Number Secretary certificate ❑21 E Waste Site Cleanup oats RTN Number !App.dcc•Rev. 10/02 Page 3 of 17 I Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program Chapter 91 Waterways License Application -310 CMR 9.00 71ran-SMU" Simplified,Water apendenf, Nonwater-Dependent,Amendment E. Certification All applicants, property owners and authorized agents must sign this page.All future application correspondence may be signed by the authorized agent alone. "I hereby make application for a permit or license to authorize the activities I have described herein. Upon my signature, 1 agree to allow the duty authorized representatives of the Massachusetts Department of Environmental Protection and the Massachusetts Coastal Zone Management Program to enter upon the premises of the project site at reasonable times for the purpose of inspection "I hereby certify that the information submitted in this application is true and accurate to the best of my mowled e." //J/ — v4/ �/wGf✓LD yf Appucanrs signature Date PraPertY Owners signature(if different than applicant) Date AgenCs signawre In applicable) Date APPLICANTS FILING A SIMPLIFIED APPLICATION STOP HERE Cr!51^pp.doc•.4ev. 10102 Page 4 of 17 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program Chapter 91 Waterways License Application -310 cMR 9.00 Tran8ml Water-Dependent,Nonwater-Dependent,Amendment F. Waterways Dredging Addendum 1. Provide a description of the dredging project ❑Maintenance Dredging (include last dredge date&permit no.) ❑ Improvement Dredging ?-pose of Dredging 2. What is the volume (cubic yards)of material to be dredged? 3. What method will be used to dredge? ❑Hydraulic ❑ Mechanical ❑ Other 4. Describe disposal method and provide disposal location (include separate disposal site location map) 5. Provide copy of grain size analysis. If grain size is compatible for beach nourishment purposes, the Deoartment recommends that the dredged material be used as beach nourishment for public beaches. Note: In the event beach nourishment is proposed for private property, pursuant to 310 CMR 9.40(4)(a)1, public access easements below the existing high water mark shall be secured by applicant and submitted to the Department. CH91App.doc•Rev.6/06 Page 5 of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program Chapter 91 Waterways License Application -310 CMR 9.00 Tranam tta11"° Watwr Dependent,NonwaterospendW%Amendmem G. Municipal Zoning Certificate Prosect street adtlresa waterway - C ty?owaf Description of use or change in use: /O,l-io 2if'zr. .FT . To be completed by municipal clerk or appropriate municipal official: "I hereby certify that the project described above and more fully detailed in the applicants waterways license application and plans Is not in violation of local zoning ordinances and bylaws.' /41n,„ .< J S) f� e��� Pnntetl Name of MunbipW O}ticial Date s1ratureo}Munbi Of8clel "ni'r`� v ` ` '/�f Title CdVTown CHSt Aop.doc•Rev.6/08 Page 6of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program Chapter 91 Waterways License Application -310 CMR 9.00 Water-Dependent, Nonwater-Dependent,Amendment H. Municipal Planning Board Notification Notice to Applicant: Gf/ rvsme w wppliprn Section H Should �d1Roti,�/ I.JJV� D be completed end PAO". gtr9et addreaf fir/` submitted Wong Waterway City/To Nith the onginai Description of use or change in use: wn app4cetton material. _ �4X/o � To be completed by municipal clerk or appropriate municipal official: "I hereby certify that the project described above and more fully detailed in the applicant's waterways license application and plans have been submitted by the applicant to the municipal planning board." _Lvtit.4i u�nc0.r% P d 6r M"clpal Otfblel De Si ure ofMunicipal offloial e Ciry/Town Note:Any comments, including but not limited to written comments, by the general public,applicant, municipality, and/or an interested party submitted after the close of the public comment period pertaining to this Application shall not be considered, and shall not constitute a basis for standing in any further appeal pursuant to 310 CMR 9.13(4) and/or 310 CMR 9.17. CH91 App.doc-Rev. 6106 Page 7of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program Chapter 91 Waterways License Application -310 CMR 9.00 hansmittal�"° Water-Dependent, NonwaternDependent,Amendment Appendix A: License Plan Checklist Genera) view LJ!PE or RLS, as deemed appropriate by the Department, stamped and signed, in ink, each sheet within 8 1/2 inch by 11 inch border Gf Format and dimensions conform to"Sample Plan' (attached) I,rd/Minimum letter size is 1/8 of an inch if freehand lettering, 1/10 of an inch it letter guides are used Sheet number with total number in set on each sheat ttQ Title sheet contains the following in lower left. Plans accompanying Petition of[Applicants name, 1 structures and/or fill or change in use, waterway and municipality) L� North arrow Scale is suitable to clearly show proposed structures and enough of shoreline, existing structures land roadways to define its exact location �I Scale is stated &shown by graphic bar scale on each sheet [g Initial plans may be printed on bond; final plans due before License issuance must be on 3mil Mylar. Structures and Fill All Structures and Fill shown in full BLACK lines, clearly labeling which portions are existing, which are Proposed and indicating Existing Waterways Licenses Cross Section Views show MHW and MLW*and structure finish elevations Dredge or Fill, actual cubic yardage must be stated and typical cross sections shown L]! All Structures and Fill shown in full BLACK lines, clearly labeling which portions are existing, which are Proposed and indicating Existing Waterways Licenses L"7/Cross Section Views show MHW'and MLW and structure finish elevations [�( Dredge or Fill, actual cubic yardage must be stated and typical cross sections shown LJ Actual dimensions of structures(s) and or fill and the distance which they extend beyond MHW' or OHW Change in Use of any structures on site must be stated See 310 CMR 9.02, Waterways Regulations definitions of High Water Mark, Historic High Water Mark, Historic Low Water Mark, and Low Water Mark. Note.DEP may, at its discretion, accept appropriately scaled preliminary plans in lieu of the plans described above. In general, DEP will accept preliminary plans only for non-water dependent projects and projects covered by MEPA to address site design components such as visual access, landscaping&site coverage. Anyone wishing to submit preliminary plans must obtain prior approval of the DEP Waterways Program before submitting them with their application. C491App.doc•Rev.6/06 Page 8 of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program Chapter 91 Waterways License Application 310 CMR 9.00 hansminal N"° Water-Dependent,Nonwater-Dependent,Amendment Appendix A: License Plan Checklist (cont.) Boundaries d Property lines, full black lines, , along with abutters' names and addresses Mean High Water(MHW)-or Ordinary High Water(OHW)',full black line ❑ Mean Low Water(MLW)', black dotted line, (.............) Historic MHW'or OHW(----) © Historic MLW'(... .._..� ❑ State Harbor Lines, black dot-dash line (—.—. —. _) with indication of Chapter&Act establishing them (Ch. ,Acts of) Reference datum is National Geodetic Vertical Datum (NGVD)or(NAVD). (�] Floodplain Boundaries according to most recent FEMA maps (� Proposed & Existing Easements described in metes &bounds Water- ependent Structures Distance from adjacent piers, ramps or floats (minimum distance of 25'from property line, where feasible) © Distance from nearest opposite shoreline it Distance from outside edge of any Navigable Channel Q Access stairs at MHW for lateral public passage, or 5 feet of clearance under structure at MHW. Non Water-Dependent Structures ❑ Depict extent of'Water-dependent Use Zone". See Waterways Regulations at 310 CMR 9.51-9.53 for additional standards for non water-dependent use projects. Note: Final Mylar project site plans will be required upon notice from the Department, prior to issuance of the Chapter 91 Waterways License. CH91A0p.ox•Rev.6108 Page got 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Waterways Regulation Program Chapter 91 Waterways License Application-310 CMR 9.00 rmron ftw No. Water-Dependent, Nonwater-Dependent,Amendment Appendix A: License Plan Checklist Cont. cs Registry Statement 3 D9 3112 inche 5 inches h+ Locus Map Fist Sheet Ono a. 1 „ -21/4 inches-71P Sample Plan 81/2 inches P.E. Of R.LS S+xmp �-3 3/4 inche Plan Accompanying T Petition of... DEP U5 Stamp First Sheet Only 3/4 " Border CH91 App.doc•Rev.6/06 Page 10 of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program Chapter 91 Waterways License Application -310 CMR 9.00 ifNO. Water-Dependent, Nonwater-Dependent,Amendment Appendix B: Dredging Permit Plan Checklist For projects applying for dredging permits only,enclose drawings with the General Waterways Application that include the following information: General View ❑ Submit one original of all drawings. Submit the fewest number of sheets necessary to adequately illustrate the project on 8-1/2 inch X 11 inch paper. ❑ A 1-inch margin should be left at the top edge of each drawing for purposes of reproduction and binding. A 1/2 inch margin is required in the three other edges. ❑ A complete title block on each drawing submitted should identity the project and contain:the name of the waterway, name of the applicant; number of the sheet and total number of sheets in the set; and the date the drawing was prepared. ❑ Use only dot shading, hatching, and dashed or dotted line to show or indicate particular features of the site on the drawings. ❑ If deemed appropriate by the Department, certification by the Registered Professional Engineer or Land Surveyor is included. Plan View ❑ North Arrow ❑ Locus Map ❑ Standard engineering scale. ❑ Distances from channel lines and structures If appropriate. ❑ Mean high water and mean low water shorelines (see definitions of"High Water Mark"and"Low Water Mark"at 310 CMR 9.02, C. 91 Regulations). ❑ Dimensions of area proposed to be dredged or excavated. ❑ Notation or indication of disposal site. ❑ Volume of proposed dredging or excavation. ❑ Ordinary high water, proposed drawdown level, and natural (historic) high water(for projects lowering waters of Great Ponds). Section Views ❑ Existing bottom and bank profiles. ❑ Vertical and/or horizontal scales. ❑ Proposed and existing depths relative to an indicated datum. ❑ Elevation and details of control structure (for projects lowering waters of Great Ponds). CH91 App.000•Rev.8/06 Page 11 of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program Transmittal No. Chapter 91 Waterways License Application -310 CMR 9.00 Water-Dependent,Nonwater-Dependent,Amendment Appendix C: Application Completeness Checklist Please answer all questions in the General Waterways Application form. If a question does not apply to your project write 'not applicable' (r/a) in that block. Please print or type all information provided on the form. Use black ink(blue ink or pencil are not easily reproducible,therefore, neither will be accepted). If additional space is needed, attach extra 8-1/2"x 11"sheets of paper. ❑ Proper Public Purpose: For nonwater-dependent projects, a statement must be included that explains how the project serves a proper public purpose that provides greater benefit than detriment to public rights in tidelands or great ponds and the manner in which the project meets the applicable standards. If the project is a nonwater-dependent project located in the coastal zone, the I ` statement should explain how the project complies with the standard governing consistency of the policies of the Massachusetts Coastal Zone Management Program,according to 310 CMR 9.54. If the project is located in an area covered by a Municipal Harbor Plan,the statement should describe how the project conforms to any applicable provisions of such plan pursuant to 310 CMR 9.34(2). [� Plans: Prepared in accordance with the applicable instructions contained in Appendix A-B of this application.For initial filing, meet the requirements of 310 CMR 9.11(2)(b)(3). Applicant CertfBcation:All applications must be signed by"the landowner if other than the applicant In lieu of the landowner's signature,the applicant may provide other evidence of legal authority to submit an application for the project site."If the project Is entirely on land owned by the Commonwealth (e.g. most areas below the current low water mark in tidelands and below the historic high water mark of Great Ponds),you may simply state this in lieu of the'landowner's signature". �� ❑ Municipal Zoning Certification: If required, applicants must submit a completed and signed Section E of this application by the municipal clerk or appropriate municipal official or,for the initial filing,an explanation of why the forth is not included with the initial application. if the project is a public service project subject to zoning but will not require any municipal approvals, submit a certification to that effect pursuant to 310 CMR 9.34(1). ❑ Municipal Planning Board Notification:Applicants must submit a copy of this application to the municipal planning board for the municipality where the project is located. Submittal of the NR complete application to DEP must include Section H signed by the municipal clerk, or appropriate (' municipal official for the town where the work is to be performed, except in the case of a proposed bridge, dam, or similar structure across a river, cove, or inlet, in which case it must be certified by every municipality into which the tidewater of said river,cove, or inlet extends. ❑ Final Order of Conditions: A copy of one of the following three documents is required with the filing of a General Waterways Application: (1)the Final Order of Conditions (with accompanying plan) under the Wetlands Protection Act; (2) a final Determination of Applicability under that Act w stating that an Order of Conditions is not required for the project; or(3)the Notice of Intent for the initial filing (if the project does not trigger review under MEPA. �} `❑ Massachusetts Environmental Protection Act(MEPA): MGL 30, subsections 61-61A and 301 CMR 11.00, submit as appropriate: a copy of the Environmental Notification Form (ENF)and a Certificate of the Secretary of Environmental Affairs thereon, or a copy of the final Environmental Impact Report(EIR)and Certificate of the Secretary stating that it adequately and properly complies with MEPA; and any subsequent Notice of Project change and any determination issued thereon in accordance with MEPA. For the initial filing, only a copy of the ENF and the Certificate of the Secretary thereon must be submitted. Nota: if the project is subject to MEPA,the Chapter 91 Public Notice must also be submitted to MEPA for publication in the"Environmental Monitor. MEPA filing deadlines are the 15d1 and 3e of each month. CH91 Apo.doc-Rev.6/08 Page 12 of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Waterways Regulation Program Transmittal No Chapter 91 Waterways License Application -310 CMR 9.00 Water-Dependent,Nonwater-Dependent,Amendment Appendix C: Application Completeness Checklist (cont.) 11 th ❑ Water Quality Certifleate: it applicable, pursuant to 310 CMR 9.33, is included. ❑ Other Approvals: as applicable pursuant to 310 CMR 9.33 or,for the initial filing, a list of such approvals which must be obtained. Projects involving dredging: ❑ The term"dredging"means the removal of materials including, but not limited to, rocks, bottom sediments, debris, sand, refuse, plant or animal matter, in any excavating,clearing, deepening,widening or lengthening, either permanently or temporarily, of any flowed tidelands, rivers, streams, ponds or other waters of the Commonwealth. Dredging includes and ndrsubsequ ndredging, efi refilling.Included sea completed and signed copy ofPartF of he or other dredging application. Filing your Completed General Waterways Application: ❑ For all Water-Deoendent applications—submit a completed General Waterways Application and all required documentation with a photocopyof both paymantgcheck and DElease refeP s r to t Form for Permit Application& Payment to theappropriate DEP regional office(p g• 10 of the"Instructions"for the addresses of DEP Regional Offices). ❑ For all Non Water-Deoendent applications—submit a completed General Waterways Application and all required documentation with a photocopy of both payment check and DEP's Transmittal Form for Permit Application& Payment to DEP's Boston office. N`P Department of Environmental Protection Waterways Regulation Program One Winter Street Boston, MA 02108 ❑ Application Fee Payment for ALL Waterways Aoalications: Send the appropriate Application fee' (please refer to Page 1 of the"Application"), in the form of a check or money order, along with DEP's Transmittal Form for Permit Application& Payment Department of Environmental Protection P.O. Box 4062 Boston, MA 02211 Under extreme circumstances, DEP grants extended time periods for payment of license and permit application fees. If you qualify, check the box entitles"Hardship Requestion the Transmittal Form for Permit Application& Payment. See 310 CMR 4.04(3)(c) N procedures for making a hardship request. Send hardship request and supporting documentation to the above address. NOTE: You may be subject to a double application fee if your application for Chapter 91 authorization results from an enforcement action by the Department or another agency of the Commonwealth or its subdivisions, or 0 your application seeks authorization for an existing unauthorized structure or use. Page 13 of 13 CH91 App.doc•Rev.6/06