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HomeMy Public PortalAboutWater Quality Certificate ApplicationFORM A WQRC-revised 03-30-10 - 1 - APPLICATION FOR A CERTIFICATE OF WATER QUALITY COMPLIANCE Brewster Zoning Bylaw 179-53 Application Fee: $100.00/Renewal $50.00 (Please Print) PROPERTY OWNER’S NAME PHONE ( ) BUSINESS NAME+OWNER _______________________________________________________________PHONE_________________________ MAILING ADDRESS E-MAIL ADDRESS________________________________________________________________ PROPERTY LOCATION: MAP: LOT: STREET ADDRESS: PLEASE PROVIDE 7 COPIES OF THIS COMPLETED APPLICATION AND ALL ATTACHED DOCUMENTS & PLANS 1. Attach minutes of Development Plan Review Committee meeting or proposed hearing date, or provide written determination of the Building and Zoning Commissioner that DPRC review is not required. 2. Attach engineered site plan(s) showing: a.) all property lines and ownership of abutting lots b.) current conditions and proposed finished grades and conditions, including all structures, fencing, signage, paved areas, parking areas (with number of parking spaces delineate) and improvements, including re-vegetation and landscaping plans. Include location of any existing and/or proposed groundwater wells and provide most recent well testing data. c.) all surface and subsurface treatments for the direction and retention of storm water and waste water, including existing or proposed drains. Provide most recent monitoring or pumping data. 3. Attach description of all activities proposed including construction and approximate timelines. If clearing and excavation are proposed, include a description of sedimentation and erosion control measures that will be taken and indicate on the current “condition plan” where such measures will be applied. 4. Describe nature of any and all proposed continuing commercial activity or activities and proposed periods and times of operation. ________________________________________________________________________________ TOWN OF BREWSTER WATER QUALITY REVIEW COMMITTEE 2198 Main Street Brewster, Massachusetts 02631-1898 (508) 896-3701 FAX (508) 896-8089 FORM A WQRC-revised 03-30-10 - 2 - ___________________________________________________________________________________________ ___________________________________________________________________________________________ 5. Describe the nature of any agricultural activity proposed, including the size of areas proposed to be cultivated and/or the number of any animals to be kept on the premises. If you have a fertilizer and Integrated Pest Management (IPM) plan, please submit a copy with this application. If you have a manure or animal waste management plan please include that with this application.___________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ 6. Provide a list of all equipment anticipated to be on site during construction. _________________________________________________________________________________________ 7. Provide a list of all equipment proposed to be stored onsite and indicate where such equipment will be stored on a “finished conditions” site plan. __________________________________________________________________________________________ 8. Provide site plan indicating internal traffic circulation pattern and the number and type of vehicle trips anticipated per day with certification of legal access 9. Provide a description of measures that will be taken to protect the premises from vandalism ___________________________________________________________________________________________ 10. If equipment is intended to be fueled on-site, indicate on the site plans where fueling is proposed to occur and describe the precautions that will be taken to prevent spills and the actions proposed in the event a spill occurs. ________________________________________________________________________________________ 11. Provide a list of all chemicals, pesticides, fuels, and other potentially toxic or hazardous materials to be used or stored on the premises in quantities greater that those associated with normal household use ________________________________________________________________________________________ 12. Provide a description of potentially toxic or hazardous wastes to be generated on site or stored on site, indicating storage containment and disposal methods. _________________________________________________________________________________________ 13. Provide a description of measures that will be taken to protect materials and storage structures from corrosion and leakage FORM A WQRC-revised 03-30-10 - 3 - __________________________________________________________________________________________ __________________________________________________________________________________________ 14. Provide a description of measures that will be taken to control and contain spills of all potentially hazardous materials including fuels. ______________________________________________________________________________________ ______________________________________________________________________________________ 15. Identify and describe any existing or proposed floor drains and dry wells. _______________________________________________________________________________________ _______________________________________________________________________________________ 16. List any non-sanitary wastewater generated at the property as a result of residential, commercial or agricultural activities conducted at the property (services, maintenance, manufacturing, processing). ________________________________________________________________________________________ 17. Provide copies of any other approvals for which you have applied, or which you have received. Signature of Applicant ______________________________________________ Printed name of Applicant Date