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1 WATERS STREET - ZONING (2) 1 Commonwealth of Massachusetts For On Executive Office oJEnvironmementa!Affairs Executive Office of Environmental Affairs MEPA Office EOEA No.: MEPA Analyst: RECEIVED Environmental Phone: 617-626- JUL 13 007 Notification Form DEPT.OF PLANNING& The information requested on this form must be completed to begin MEPA Review in COMMUNITY DEVELOPMENT accordance with the provisions of the Massachusetts Environmental Policy Act, 301 CMR 11.00. Project Name: Black Cow Restaurant Street: 1 Water Street Municipality: Beverly Watershed: Atlantic Ocean Universal Tranverse Mercator Coordinates: Latitude: 42 -32'-27"N ' Longitude: 70-53'-8" W Estimated commencement date: Fall 2007 Estimated completion date: Spring 2008 Approximate cost: $2.5 million dollars Status of project design: 25 %complete Proponent: Joseph A. Leone, c/o Black Cow Restaurant Street: P. O. Box 2490 Municipality: South Hamilton State: MA Zip Code: 01982 ' Name of Contact Person From Whom Copies of this ENF May Be Obtained: William R. Bergeron, P.E. Firm/Agency: Hayes Engineering Inc. Street: 603 Salem Street Municipality: Wakefield State: MA I Zip Code: 01880 Phone: 1-781-246-2800 Fax:1-781-246-7596 Email: bbergeron@hayeseng.com ' Does this project meet or exceed a mandatory EIR threshold (see 301 CMR 11.03)? Has this project been filed with MEPA before?❑Yes E No ❑Yes (EDEA No. ) E No Has any project on this site been filed with MEPA before? ' ❑Yes (EDEA No. ) E No Is this an Expanded ENF (see 301 CMR 11.05(7)) requesting: ' a Single EIR? (see 301 CMR 11.06(8)) ❑Yes ENo a Special Review Procedure? (see 301 CMR 11.09) ❑Yes ENo a Waiver of mandatory EIR? (see 301 CMR 11.11) ❑Yes ENo a Phase I Waiver? (see 301 CMR 11.11) ❑Yes ENo Identify any financial assistance or land transfer from an agency of the Commonwealth, including the agency name and the amount of funding or land area (in acres): ' Lease from the City of Beverly. Are you requesting coordinated review with any other federal, state, regional, or local agency? EYes (Chapter 91 License & Wetlands filing with Beverly Conservation ) [:]No ' 1 1 ' List Local or Federal Permits and Approvals: Site Plan Review with Beverly Planning Board Order of Conditions from Beverly Conservation Commission Which ENF or EIR review threshold(s) does the project meet or exceed (see 301 CMR 11.03): ' ❑ Land ❑ Rare Species ® Wetlands, Waterways, & Tidelands ❑ Water ❑ Wastewater ❑ Transportation Energy El Air El Solid & Hazardous Waste EJ ACEC ❑ Regulations ❑ Historical &Archaeological Resources ' Summary of Project Size Existing Change Total State Permits & & Environmental Impacts Approvals ' ® Order of Conditions Total site acreage 0.96 ❑ Superseding Order of Conditions ' New acres of land altered 0.0 ® Chapter 91 License Acres of impervious area 0.94 0.16 0,7g ❑ 401 Water Quality Square feet of new bordering 0.0 Certification ' vegetated wetlands alteration ® MHD or MDC Access Permit Square feet of new other ❑ Water Management wetland alteration Act Permit ' Acres of new non-water ❑ New Source Approval dependent use of tidelands or 0.27 El or MWRA waterways Sewer Connection/ Extension Permit ® Other Permits Gross square footage 9,216 -332 8,884 (including Legislative — — Number of housing units Approvals)— Specify: Maximum height (in feet) 30+/- Less than 35 Less than 35 Approval in accordance ' with Article 97 Provisions TRANSPORTATION Vehicle trips per day 77 598 675 Parking spaces 44 22 66 ' Gallons/day (GPD) of water use 0 6,393 6,393 GPD water withdrawal ' GPD wastewater generation/ 0 6,393 6,393 treatment Length of water/sewer mains 1 (in miles) ' 2 1 ' CONSERVATION LAND: Will the project involve the conversion of public parkland or other Article 97 public natural resources to any purpose not in accordance with Article 97? ❑Yes (Specify ) ®No Will it involve the release of any conservation restriction, preservation restriction, agricultural preservation restriction, or watershed preservation restriction? ®Yes (Specify) [-]No It is not believed to be necessary, but the Issue is being clarified by the City of Beverly through Its Planning and Development Department and EOEA Department of Conservation and Recreation RARE SPECIES: Does the project site include Estimated Habitat of Rare Species, Vernal Pools, Priority Sites of Rare Species, or Exemplary Natural Communities? []Yes (Specify ) ®No - based on July 14, 2006 Maps ' HISTORICAL/ARCHAEOLOGICAL RESOURCES: Does the project site include any structure, site or district listed in the State Register of Historic Place or the inventory of Historic and Archaeological Assets of the Commonwealth? ' ❑Yes (Specify ) ®No If yes, does the project involve any demolition or destruction of any listed or inventoried historic or archaeological resources? ' ❑Yes (Specify. ) ®No AREAS OF CRITICAL ENVIRONMENTAL CONCERN: Is the project in or adjacent to an Area of Critical Environmental Concern? ❑Yes (Specify ) ®No- Nota listed ACEC area PROJECT DESCRIPTION: The project description should include (a) a description of the project site, (b) a description of both on-site and off-site alternatives and the impacts associated ' with each alternative, and (c) potential on-site and off-site mitigation measures for each alternative (You may attach one additional page, if necessary.) I'I The existing site consists of approximately 41 668 square feet The prior use was for a McDonalds' fast food restaurant with a drive through window. The use was terminated in 1995 and has been basically vacant since. The entire site, as shown on the attached photo shows the existing conditions. The entire site except for some foundation plantings at the building is impervious The proposed Black Cow Restaurant will revitalize the area and provide an economic benefit to the City of Beverly while enhancing the waterfront area The current parking and pavement areas on the existing pier and adiacent land area will be made available for public use and will extend the existing park area. There will be an increase of the site parking and six spaces will be set aside for DPA exclusive use. The proposed building will be located away from the existing coastal bank and will result in no resource area disturbance. The proposed new use will have minimal off-site impacts relative to traffic and utilities,and will be significantly less than the prior McDonalds' use The retention of the existing no-build condition will result in the continued decay of the structure and result in a negative impact to this gateway site and the existing park. The structure will also continue to be an economic drain to the City of Beverly as well as a potential fire hazard. The proposed redevelopment of the site will provide the City of Beverly with a positive economic benefit as well as an enhanced public open area. The reuse of the site will result in less impervious area and the Proposed improvements will incorporate enhanced stormwater treatment prior to connecting to the existina drain line. 1 3 LAND SECTION— all proponents must fill out this section 1. Thresholds/ Permits A. Does the project meet or exceed any review thresholds related to land (see 301 CMR 11.03(1) Yes X No; if yes, specify each threshold: It. Impacts and Permits A. Describe, in acres, the current and proposed character of the project site, as follows: Existing Change Total Footprint of buildings — 0.10 - 0_01 0.09 Roadways, parking, and other paved areas 0_70 - 0_16 0.54 Other altered areas (describe) 0.13 0.0 0.13 Undeveloped areas 0.03 + 0_17 0.20 ' (landscaped and open space areas) B. Has any part of the project site been in active agricultural use in the last three years? _Yes X No; if yes, how many acres of land in agricultural use (with agricultural soils)will be converted to nonagricultural use? C. Is any part of the project site currently or proposed to be in active forestry use? _Yes X No; if yes, please describe current and proposed forestry activities and indicate whether any part of the site is the subject of a DEM-approved forest management plan. 1 D. Does any part of the project involve conversion of land held for natural resources purposes in accordance with Article 97 of the Amendments to the Constitution of the Commonwealth to any purpose not in accordance with Article 97? X Yes _No; if yes, describe: 1 It is not believed to be necessarybut the issue Is being clarified by the City of Beverly through its Planning and Development Department and EDEA. Department of Conservation and Recreation E. Is any part of the project site currently subject to a conservation restriction, preservation restriction, agricultural preservation restriction or watershed preservation restriction? X Yes No; if yes, does the project involve the release or modification of such restriction? _Yes X No; if yes, describe: It is not believed to be necessary, but the issue is being clarified by the City of Beverly through its Planning and Development Department and EOEA Department of Conservation and Recreation F. Does the project require approval of a new urban redevelopment project or a fundamental change in an existing urban redevelopment project under M.G.L.c.121A? Yes X No; if yes, describe: 1 G. Does the project require approval of a new urban renewal plan or a major modification of an existing urban renewal plan under M.G.L.c.121 B?Yes _No X ; if yes, describe: H. Describe the project's stormwater impacts and, if applicable, measures that the project will take to comply with the standards found in DEP's Stormwater Management Policy. The Stormwater Management Policy will be complied with to the extent required by the Beverly Conservation Commission. I. Is the project site currently being regulated under M.G.L.c.21 E or the Massachusetts IContingency Plan? Yes _No X ; if yes,what is the Release Tracking Number(RTN)? 4 J. If the project site is within the Chicopee or Nashua watershed, is it within the Quabbin, Ware, or Wachusett subwatershed?_Yes X No; if yes, is the project site subject to regulation under the Watershed Protection Act?_Yes _No K. Describe the project's other impacts on land: The Proposed oroiect will reduce Present pavement areas enhance the open space and add a plaza for the DPA accessory uses The oroiect is in keeping with the City of Beverly's long-term reuse of this site. ' III.. Consistency A. Identify the current municipal comprehensive land use plan and the open space plan, and ' describe the consistency of the project and its impacts with that plan(s): Consistent with the City of Beverly Land Use Plan. The proposed use will enhance the waterfront area and assist with the area revitalization. B. Identify the current Regional Policy Plan of the applicable Regional Planning Agency and describe the consistency of the project and its impacts with that plan: Consistent with the City of Beverly Master Plan. The proposed use will enhance the waterfront area and assist with the area revitalization I C. Will the project require any approvals under the local zoning by-law or ordinance (i.e.text or map amendment, special permit, or variance)? Yes X No _; if yes, describe: The oroiect will require Site Plan Approval and local wetlands by-law approvals. D. Will the project require local site plan or project impact review? X Yes _No; if yes, describe: RARE SPECIES SECTION 1. Thresholds/Permits ' A. Will the project meet or exceed any review thresholds related to rare species or habitat(see 301 CMR 11.03(2))? _Yes X No; if yes, specify, in quantitative terms: B. Does the project require any state permits related to rare species or habitat? _Yes X No C. If you answered "No"to both questions A and B, proceed to the Wetlands,Waterways, and Tidelands Section. If you answered "Yes"to either question A or question B,fill out the remainder ' of the Rare Species section below. II. Impacts and Permits ' A. Does the project site fall within Priority or Estimated Habitat in the current Massachusetts Natural Heritage Atlas (attach relevant page)? _Yes No. If yes, 1. Which rare species are known to occur within the Priority or Estimated Habitat(contact: Environmental Review, Natural Heritage and Endangered Species Program, Route 135, Westborough, MA 01581, allowing 30 days for receipt of information): 2. Have you surveyed the site for rare species? _Yes_No; if yes, please include the results of your survey. 3. If your project is within Estimated Habitat, have you filed a Notice of Intent or received an Order of Conditions for this project? _Yes_No; if yes, did you send a copy of the Notice of Intent to the Natural Heritage and Endangered Species Program, in accordance with the Wetlands Protection Act regulations? —Yes_No B. Will the project "take" an endangered, threatened, and/or species of special concern in accordance with M.G.L. c.131A (see also 321 CMR 10.04)? _Yes _No; if yes, describe: 5 C. Will the project alter"significant habitat"as designated by the Massachusetts Division of Fisheries and Wildlife in accordance with M.G.L. c.1 31A(see also 321 CMR 10.30)? _Yes No; if yes, describe: D. Describe the project's other impacts on rare species including indirect impacts (for example, stormwater runoff into a wetland known to contain rare species or lighting impacts on rare moth habitat): WETLANDS. WATERWAYS, AND TIDELANDS SECTION I. Thresholds/Permits A. Will the project meet or exceed any review thresholds related to wetlands, waterways, and 1 tidelands (see 301 CMR 11.03(3))? _Yes X No; if yes, specify, in quantitative terms: B. Does the project require any state permits (or a local Order of Conditions)related to wetlands, waterways, or tidelands? X Yes _No; if yes, specify which permit: Chapter 91 License and local Order of Conditions. C. If you answered "No"to both questions A and B, proceed to the Water Supply Section. If you answered "Yes"to either question A or question B,fill out the remainder of the Wetlands, Waterways, and Tidelands Section below. II. Wetlands Impacts and Permits A. Describe any wetland resource areas currently existing on the project site and indicate them on the site plan: The proposed new building will not disturb any wetland resource areas B. Estimate the extent and type of impact that the project will have on wetland resources,and indicate whether the impacts are temporary or permanent: Coastal Wetlands Area (in square feet)or Length (in linear feet' Land Under the Ocean Designated Port Areas Parcel•41,668 sq.ft. Proposed work•11,970 sg ft Coastal Beaches Coastal Dunes Barrier Beaches Coastal Banks Rocky Intertidal Shores Salt Marshes Land Under Salt Ponds Land Containing Shellfish Fish Runs Land Subject to Coastal Storm Flowage Entire site ' Inland Wetlands Bank Bordering Vegetated Wetlands Land under Water Isolated Land Subject to Flooding Bordering Land Subject to Flooding Riverfront Area 6 ' C. Is any part of the project 1. a limited project? _Yes X No ' 2. the construction or alteration of a dam? _Yes X No; if yes, describe: 3. fill or structure in a velocity zone or regulatory floodway? _Yes X No 4. dredging or disposal of dredged material? _Yes X No; if yes, describe the volume of dredged material and the proposed disposal site: 5. a discharge to Outstanding Resource Waters? Yes X No 6. subject to a wetlands restriction order? _Yes X No; if yes, identify the area (in ' square feet): D. Does the project require a new or amended Order of Conditions under the Wetlands Protection Act(M.G.L. c.1 31A)? X Yes _No; if yes, has a Notice of Intent been filed or a local Order of 1 Conditions issued? _Yes X No; if yes, list the date and DEP file number: . Was the Order of Conditions appealed? _Yes No. Will the project require a variance from the Wetlands regulations?_Yes E. Will the project: 1. be subject to a local wetlands ordinance or bylaw? X Yes —No 2. alter any federally-protected wetlands not regulated under state or local law? Yes X No; if yes, what is the area (in s.f.)? F. Describe the project's other impacts on wetlands (including new shading of wetland areas or removal of tree canopy from forested wetlands): No further impacts. 1 III. Waterways and Tidelands Impacts and Permits A. Is any part of the project site waterways or tidelands (including filled former tidelands)that are subject to the Waterways Act, M.G.L.c.91? X Yes =No; if yes, is there a current Chapter 91 license or permit affecting the project site? X Yes No; if yes, list the date and number: License#1169 of 1889:#901 of 1982.and#4346 of 1995. B. Does the project require a new or modified license under M.G.L.c.91? X Yes _No; if yes, how many acres of the project site subject to M.G.L.c.91 will be for non-water dependent use? ICurrent 0 Change 0.27 Total 0.27 License#1169 of 1889:#901 of 1982. and#4346 of 1995. ' C. Is any part of the project: 1. a roadway, bridge, or utility line to or on a barrier beach? _Yes X No; if yes, describe: 2. dredging or disposal of dredged material? _Yes X No; if yes, volume of dredged material: 3. a solid fill, pile-supported, or bottom-anchored structure in flowed tidelands or other ' waterways? _Yes X No; if yes,what is the base area? 4. within a Designated Port Area? X Yes No D. Describe the project's other impacts on waterways and tidelands: The project will have no ' impact on waterways or tidelands. 7 1 iIV. Consistency: A. Is the project located within the Coastal Zone X Yes _No; if yes, describe the project's consistency with policies of the Office of Coastal Zone Management: The Proposed site will enhance the surface water quality from the Pavement areas as well as enhance and Provide more landscape and open space for the use of the general Public and the adjacent Park area. B. Is the project located within an area subject to a Municipal Harbor Plan? _Yes X No; if yes, identify the Municipal Harbor Plan and describe the project's consistency with that plan: WATER SUPPLY SECTION 1. Thresholds/Permits A. Will the project meet or exceed any review thresholds related to water supply(see 301 CMR 1 11.03(4))? _Yes X No; if yes, specify, in quantitative terms: B. Does the project require any state permits related to water supply? _Yes X No; if yes, specify which permit: C. If you answered "No"to both questions A and B, proceed to the Wastewater Section. If you answered "Yes"to either question A or question B, fill out the remainder of the Water Supply Section 1 below. It. Impacts and Permits A. Describe, in gallons/day,the volume and source of water use for existing and proposed activities at the project site: Existing Change Total � Withdrawal from groundwater Withdrawal from surface water Interbasin transfer Municipal or regional water supply 1 B. If the source is a municipal or regional supply, has the municipality or region indicated that there is adequate capacity in the system to accommodate the project? Yes No C. If the project involves a new or expanded withdrawal from a groundwater or surface water source, 1. have you submitted a permit application? _Yes _No; if yes, attach the application. 2. have you conducted a pump test? _Yes _No; if yes, attach the pump test report. D. What is the currently permitted withdrawal at the proposed water supply source (in gallons/day)? Will the project require an increase in that withdrawal? Yes _No ' E. Does the project site currently contain a water supply well, a drinking water treatment facility, water main, or other water supply facility, or will the project involve construction of a new facility? _Yes _No. If yes, describe existing and proposed water supply facilities at the project site: ' Water supplywell(s) (capacity, in gpd) Existino Change Total Drinking water treatment plant(capacity, in gpd) Water mains (length, in miles) 8 F. If the project involves any interbasin transfer of water, which basins are involved, what is the direction of the transfer, and is the interbasin transfer existing or proposed? G. Does the project involve 1. new water service by a state agency to a municipality or water district? _Yes _No 2. a Watershed Protection Act variance? _Yes _No; if yes, how many acres of alteration? 3. a non-bridged stream crossing 1,000 or less feet upstream of a public surface drinking water supply for purpose of forest harvesting activities? _Yes _No ' H. Describe the project's other impacts (including indirect impacts)on water resources, quality, facilities and services: III. Consistency-- Describe the project's consistency with water conservation plans or other plans to enhance water resources, quality, facilities and services: WASTEWATER SECTION 1. Thresholds/Permits ' A. Will the project meet or exceed any review thresholds related to wastewater(see 301 CMR 11.03(5))? _Yes X No; if yes, specify, in quantitative terms: ' B. Does the project require any state permits related to wastewater? _Yes X No; if yes, specify which permit: C. If you answered "No"to both questions A and B, proceed to the Transportation --Traffic Generation Section. If you answered "Yes"to either question A or question B, fill out the remainder of the Wastewater Section below. ' 11. Impacts and Permits A. Describe, in gallons/day, the volume and disposal of wastewater generation for existing and proposed activities at the project site(calculate according to 310 CMR 15.00): ' Existing Change Total Discharge to groundwater(Title 5) Discharge to groundwater(non-Title 5) ' Discharge to outstanding resource water Discharge to surface water Municipal or regional wastewater facility TOTAL B. Is there sufficient capacity in the existing collection system to accommodate the project? Yes _No; if no, describe where capacity will be found: C. Is there sufficient existing capacity at the proposed wastewater disposal facility?_Yes _No; if no, describe how capacity will be increased: ' D. Does the project site currently contain a wastewater treatment facility, sewer main, or other wastewater disposal facility, or will the project involve construction of a new facility? _Yes _No. If yes, describe as follows: ' 9 ' Wastewater treatment plant (capacity, in gpd) Existing Change Total Sewer mains (length, in miles) Title 5 systems (capacity, in gpd) E. If the project involves any interbasin transfer of wastewater,which basins are involved, what is the direction of the transfer, and is the interbasin transfer existing or proposed? F. Does the project involve new sewer service by an Agency of the Commonwealth to a municipality ' or sewer district? _Yes _No G. Is there any current or proposed facility at the project site for the storage,treatment, processing, combustion or disposal of sewage sludge, sludge ash, grit, screenings, or other sewage residual materials? _Yes _No; if yes, what is the capacity(in tons per day): Existing Change Total 1 Storage Treatment, processing Combustion Disposal H. Describe the project's other impacts (including indirect impacts)on wastewater generation and treatment facilities: ' III. Consistency-- Describe measures that the proponent will take to comply with federal, state, regional, and local plans and policies related to wastewater management: A. If the project requires a sewer extension permit, is that extension included in a comprehensive wastewater management plan? Yes _No; if yes, indicate the EOEA number for the plan and describe the relationship of the project to the plan ' TRANSPORTATION -- TRAFFIC GENERATION SECTION I. Thresholds/Permits A. Will the project meet or exceed any review thresholds related to traffic generation (see 301 CMR 11.03(6))? Yes X No; if yes, specify, in quantitative terms: ' B. Does the project require any state permits related to state-controlled roadways? X Yes No; if yes, specify which permit: Indirect Access Permit C. If you answered "No"to both questions A and B, proceed to the Roadways and Other Transportation Facilities Section. If you answered "Yes"to either question A or question B, fill out the remainder of the Traffic Generation Section below. ' II. Traffic Impacts and Permits A. Describe existing and proposed vehicular traffic generated by activities at the project site: Existing Change Total Number of parking spaces 44 22 66 Number of vehicle trips per day 77 598 675 ITE Land Use Code(s): 420. 931 and 814 10 B. What is the estimated average daily traffic on roadways serving the site? Roadway Existing Change Total 1. Rte. 1A* 31.400 +/ 598 32.000+/- 2. 3. *MHD count Salem North of Webb Street C. Describe how the project will affect transit, pedestrian and bicycle transportation facilities and services: The Proposed project will require an indirect access permit from the MHD The new restaurant 1 will generate less traffic than the prior McDonalds use The site will enhance pedestrian use and area for public viewing of the habor. III. Consistency-- Describe measures that the proponent will take to comply with municipal, regional, state, and federal plans and policies related to traffic, transit, pedestrian and bicycle transportation facilities and services: The project is in keeping with the City of Beverly's long-term efforts to enhance the area and to promote economic development for under-used City property. ' ROADWAYS AND OTHER TRANSPORTATION FACILITIES SECTION I. Thresholds A. Will the project meet or exceed any review thresholds related to roadways or other transportation facilities (see 301 CMR 11.03(6))? _Yes X No; if yes, specify, in quantitative terms: ' B. Does the project require any state permits related to roadways or other transportation facilities? _Yes X No; if yes, specify which permit: ' C. If you answered"No"to both questions A and B, proceed to the Energy Section. If you answered "Yes"to either question A or question B, fill out the remainder of the Roadways Section below. ' IL Transportation Facility Impacts A. Describe existing and proposed transportation facilities at the project site: Existing Change Total Length (in linear feet)of new or widened roadway Width (in feet)of new or widened roadway Other transportation facilities: B. Will the project involve any 1. Alteration of bank or terrain (in linear feet)? 2. Cutting of living public shade trees (number)? 3. Elimination of stone wall (in linear feet)? 1 III. Consistency --Describe the project's consistency with other federal, state, regional, and local plans and policies related to traffic, transit, pedestrian and bicycle transportation facilities and services, including consistency with the applicable regional transportation plan and the Transportation Improvements Plan (TIP), the State Bicycle Plan, and the State Pedestrian Plan: ' 11 ENERGY SECTION ' I. Thresholds I Permits A. Will the project meet or exceed any review thresholds related to energy(see 301 CMR 11.03(7))? _Yes X No; if yes, specify, in quantitative terms: B. Does the project require any state permits related to energy? _Yes X No; if yes, specify which permit: ' C. If you answered "No"to both questions A and B, proceed to the Air Quality Section. If you answered "Yes"to either question A or question B,fill out the remainder of the Energy Section below. II. Impacts and Permits A. Describe existing and proposed energy generation and transmission facilities at the project site: Existing Change Total Capacity of electric generating facility(megawatts) Length of fuel line(in miles) Length of transmission lines (in miles) Capacity of transmission lines (in kilovolts) B. If the project involves construction or expansion of an electric generating facility, what are ' 1. the facility's current and proposed fuel source(s)? 2. the facilitys current and proposed cooling source(s)? C. If the project involves construction of an electrical transmission line,will it be located on a new, ' unused, or abandoned right of way?_Yes _No; if yes, please describe: D. Describe the project's other impacts on energy facilities and services: ' III. Consistency-- Describe the project's consistency with state, municipal, regional, and federal plans and policies for enhancing energy facilities and services: ' AIR QUALITY SECTION ' I. Thresholds A. Will the project meet or exceed any review thresholds related to air quality(see 301 CMR 11.03(8))? _Yes X No; if yes, specify, in quantitative terms: B. Does the project require any state permits related to air quality? Yes X No; if yes, specify which permit: C. If you answered "No"to both questions A and B, proceed to the Solid and Hazardous Waste Section. If you answered "Yes"to either question A or question B, fill out the remainder of the Air Quality Section below. 12 i ' C. If the project will generate solid waste (for example, during demolition or construction), describe alternatives considered for re-use, recycling, and disposal: D. If the project involves demolition, do any buildings to be demolished contain asbestos? —Yes —No ' E. Describe the project's other solid and hazardous waste impacts (including indirect impacts): III. Consistency--Describe measures that the proponent will take to comply with the State Solid Waste ' Master Plan: ' HISTORICAL AND ARCHAEOLOGICAL RESOURCES SECTION I. Thresholds/ Impacts ' A. Is any part of the project site a historic structure, or a structure within a historic district, in either case listed in the State Register of Historic Places or the Inventory of Historic and Archaeological Assets of the Commonwealth? _Yes X No; if yes, does the project involve the demolition of all or any exterior part of such historic structure? —Yes _No; if yes, please describe: ' B. Is any part of the project site an archaeological site listed in the State Register of Historic Places or the Inventory of Historic and Archaeological Assets of the Commonwealth? _Yes X No; if ' yes, does the project involve the destruction of all or any part of such archaeological site? _Yes No; if yes, please describe: C. If you answered "No"to all parts of both questions A and B, proceed to the Attachments and ' Certifications Sections. If you answered "Yes"to any part of either question A or question B, fill out the remainder of the Historical and Archaeological Resources Section below. ' D. Have you consulted with the Massachusetts Historical Commission? _Yes _No; if yes, attach correspondence E. Describe and assess the project's other impacts, direct and indirect, on listed or inventoried ' historical and archaeological resources: 14 ' II. Consistency-- Describe measures that the proponent will take to comply with federal, state, regional, and local plans and policies related to preserving historical and archaeological resources: ' ATTACHMENTS: 1. Plan, at an appropriate scale, of existing conditions of the project site and its immediate context, showing all known structures, roadways and parking lots, rail rights-of-way, wetlands and water bodies, wooded areas, farmland, steep slopes, public open spaces, and major utilities. ' 2. Plan of proposed conditions upon completion of project(if construction of the project is proposed to be phased, there should be a site plan showing conditions upon the completion of each phase). 3. Original U.S.G.S. map or good quality color copy(8-%: x 11 inches or larger) indicating the project location and boundaries ' 4 List of all agencies and persons to whom the proponent circulated the ENF, in accordance with 301 CMR 11.16(2). 5. Other: ' CERTIFICATIONS: 1. The Public Notice of Environmental Review has been/will be published in the following newspaper(s) in accordance with 301 CMR 11.15(1): ' Salem Evening News July 14, 2007 (Name) (Date) ' 2. This form has been circulated to Agencies and Persons in accordance with 301 CMR 11.16(2). Date gnature of Responsible Officer Date Signature of person preparing ' or Proponent ENF(if different from above) Joseph A. Leone Peter J. Ogren, P.E. Name (print or type) Name(print or type) ' c/o Black Cow Restaurant Hayes Engineering, Inc. Firm/Agency Firm/Agency P. 0. Box 2490 603 Salem Street Street Street ' South Hamilton, MA 01982 Wakefield, MA 01880 Municipality/State/Zip Municipality/State/Zip N/A (781) 246-2800 Phone Phone ' 14 ENVIRONMENTAL NOTIFICATION FORM BLACK COW RESTAURANT 1 WATER STREET BEVERLY, MASSACHUSETTS July 2, 2007 ' CIRCULATION LIST ' * Secretary Ian A. Bowles Executive Office of Environmental Affairs Attn: MEPA Office 100 Cambridge Street, Suite 900 Original and 1 copy Boston, MA 02114 plus one copy of first three pages ' * Executive Office of Environmental Affairs Policy Director ' Undersecretary for Policy 100 Cambridge Street, Suite 900 Boston, MA 02114 1 copy ' Department of Environmental Protection Commissioner's Office ' One Winter Street Boston, MA 02108 1 copy ' DEP / Northeast Regional Office Attn: MEPA Coordinator 205B Lowell Street ' Wilmington, MA 01887 1 copy * Executive Office of Transportation (EOT) Attn: Environmental Reviewer 1 10 Park Plaza - Room 3510 Boston, MA 02116-3969 1 copy ' * Massachusetts Highway Department Public/Private Development Unit 10 Park Plaza ' Boston, MA 02116 1 copy * MHD— District 4 Attn: MEPA Coordinator 519 Appleton Street Arlington, MA 02476 1 copy ' Circulation List ENF—Black Cow Restaurant, Beverly, MA ' July 2, 2007 ' * Massachusetts Aeronautics Commission Attn: MEPA Coordinator 10 Park Plaza—Suite 3510 Boston, MA 02116 1 copy * Massachusetts Historical Commission The MA Archives Building 220 Morrissey Boulevard ' Boston, MA 02125 1 copy * Metropolitan Area Planning Council 60 Temple Place —6'" Floor Boston, MA 02111 1 copy * Beverly City Council City Hall 191 Cabot Street ' Beverly, MA 01915 1 copy * Beverly Planning Board City Hall ' 191 Cabot Street Beverly, MA 01915 1 copy ' Beverly Conservation Commission City Hall 191 Cabot Street Beverly, MA 01915 1 copy * Beverly Board of Health ' 90 Colon Street Beverly, MA 01915 1 copy * Salem City Council City Hall 93 Washington Street Salem, MA 01970 1 copy Salem Planning Board 1 Salem Green Salem, MA 01970 1 copy * Salem Conservation Commission ' City Hall 93 Washington Street Salem, MA 01970 1 copy ' Circulation List ENF—Black Cow Restaurant, Beverly, MA ' July 2, 2007 ' Salem Board of Health 9 North Street ' Beverly, MA 01970 1 copy Coastal Zone Management (CZM) ' Attn: Project Review Coordinator 251 Causeway Street, Suite 800 Boston, MA 02114 1 copy ' Division of Marine Fisheries (North Shore) Attn: Environmental Reviewer ' 30 Emerson Avenue Gloucester, MA 01930 1 copy ' Massachusetts Water Resource Authority (MWRA) Attn: MEPA Coordinator 100 First Avenue ' Charlestown Navy Yard Boston, MA 02129 1 copy M.B.T.A. ' Attn: MEPA Coordinator 10 Park Plaza—6'" Floor Boston, MA 02116-3966 1 copy 1 Commonwealth of Massachusetts Executive Office of Environmental Affairs ' MEPA Office 100 Cambridge St., Suite 900 Boston, MA 02114 Telephone 617-626-1020 The following should be completed and submitted to a local newspaper: PUBLIC NOTICE OF ENVIRONMENTAL REVIEW PROJECT: Black Cow Resta ran ' LOCATION• One Water Street, Beverly, MA 01915 ' PROPONENT: Joseph A. Leone The undersigned is submitting an Environmental Notification Form ("ENF")to the ' Secretary of Environmental Affairs on or before July 13, 2007 (date) ' This will initiate review of the above project pursuant to the Massachusetts Environmental Policy Act("MEPA",M.G.L.c. 30,s.s. 61,62 62IT). Copies of the ENF may be obtained from: ' William R. Bergeron, P.E. , at Hayes Engineering Inc 603 Salem Street, Wakefield, MA 01880 (781) 246-2800 ' (Name, address,phone number ofproponent or proponent's agent) Copies of the ENF are also being sent to the Conservation Commission and ' Planning Board of the City of Beverly (Municipality) where they may be inspected. ' The Secretary of Environmental Affairs will publish notice of the ENF in the Environmental Monitor, will receive public comments on the project for 20 days, and will then decide, within ten days, if an environmental Impact Report is needed. A site visit and consultation session on the project may also be scheduled. All persons wishing to comment on the project, or to be notified of a site visit or consultation session, should write to the Secretary of Environmental Affairs, 100 Cambridge St., Suite 900, Boston, Massachusetts 02114, Attention: MEPA Office, referencing the above project. By William R. Bergeron, P.E. , for Joseph A. Leone (Proponent) i i HAYES 'ENGINEERING INC. 603 SALEM STREET CIVIL ENGINEERING & WAKEFIELD, MA 01880 LAND SURVEYING (781 ) 246-2800 AFIAll 5aPAT jicoW. bt u • r � 4�J .meq+: 'IN G i L7 Milfro e y� � Now MINI • p � 3r VMSFf amp- em �'�,�,.. ��F��i+!►�.�� i' vii.�� .,��' � � �`�t NA UNITED STATES GEOLOGICAL SURVEY MAP VICINITY • Proposed Black Cow Restaurant #1 Water Street - Beverly, Massachusetts ,.ani•• _ �' :� � �' rc ,) ..,;�,;;,�.i... .stir. � Gi ", 'i�a+-•- - Wim. d � a ' a•�.. k , a 0 1 j sti'➢ 4^ a `� _ !'IMP11� a ,{1,� syr �• F\ 1 r ^� .� �) _ at}._ tax .•,� — !q '} -k_e•,--�} - N.,_t �x.f�7 �►♦_-raga... _. ra ' Civil Engineers 603 Salem Street Land Surveyors Hayes Engineering, Inc. Wakefield, MA 01880 Land Planners Tel: (781)246-2800 Environmental Engineers Date:June 26,2007 Fax: (781)246-7596 ' CONCEPTUAL SITEPLAN IN BE VE" Y, MA SCALENONE JUNE 28.2007 AA YESENGINEERING,INC 605 SALEMSTRE'ET �1 CIVIL ENGINEERS& WAKEFIELD,MASS 01980 ((� ' LANDSIIRWYORS TEL. (781)246-2800 S Y O BLACK MWRESTAURANT I WA TER STREET r� O I 1 I I r I � I O o = I ' o 0 0O 1 0 o LOW I'll 1 _ II II I II II II .aD.ENwA,TR d I I rL 3 0 I I I .wmvuae r n .m: �°• ry e I I SITEUSAGETABVLATIOX ma , OPEN wAiER io' I �-yyy 4166RSF. TOTALRTTEAREA ' ..'!• `q<p L'V�i I SUPPORTING SNITE F DPA AREA F R I AT Wp1FA T,39R ACTUAL BUILOINO COVERAGE OP SITE X .79—S,X44RF P ' 10,417111 4,571 S. HER USE e I AREA 5'IJ 11915. UEV LLOPMLNT Al 9T0 5 P.ACTUAL DEVELOPMENT AREA AS SHOWN 6A PARKING RPXCES TOTAL A t 4 I I I 3ESEPARRMG 11 EAETURPSTAURAHIFOR30YEA RS PlRMANENTLY OESIGNATEDFOR DPA URE ST VRAPEEEAR UE FLOORARGS 3.5 VE 6 SF OROVNDELOORLFI. OR 3.31 SM RESTAUATRORANREA2,I PATRON AREA 1,500 S.f. 997 SF VPPER LEVEL STORAGE&OFFICE) II I R.fl845P IHEALnRFA 1