950 CMR: OFFICE OF THE SECRETARY OF THE COMMONWEALTH

Transcription

1 950 CMR: OFFICE OF THE SECRETARY OF THE COMMONWEALTH APPENDIX A MASSACHUSETTS HISTORICAL COMMISSION 220 MORRISSEY BOULEVARD BOSTON, MASS , FAX: PROJECT NOTIFICATION FORM Project Name: Location / Address: City / Town: Project Proponent Name: Address: City/Town/Zip/Telephone: Agency license or funding for the project (list all licenses, permits, approvals, grants or other entitlements being sought from state and federal agencies). Agency Name Type of License or funding (specify) Project Description (narrative): Does the project include demolition? If so, specify nature of demolition and describe the building(s) which are proposed for demolition. Does the project include rehabilitation of any existing buildings? If so, specify nature of rehabilitation and describe the building(s) which are proposed for rehabilitation. Does the project include new construction? If so, describe (attach plans and elevations if necessary). 5/31/96 (Effective 7/1/93) - corrected 950 CMR - 275

2 950 CMR: OFFICE OF THE SECRETARY OF THE COMMONWEALTH APPENDIX A (continued) To the best of your knowledge, are any historic or archaeological properties known to exist within the project s area of potential impact? If so, specify. What is the total acreage of the project area? Woodland acres Wetland acres Floodplain acres Open space acres Developed acres Productive Resources: Agriculture acres Forestry acres Mining/Extraction acres Total Project Acreage acres What is the acreage of the proposed new construction? acres What is the present land use of the project area? Please attach a copy of the section of the USGS quadrangle map which clearly marks the project location. This Project Notification Form has been submitted to the MHC in compliance with 950 CMR Signature of Person submitting this form: Date: Name: Address: City/Town/Zip: Telephone: REGULATORY AUTHORITY 950 CMR 71.00: M.G.L. c. 9, 26-27C as amended by St. 1988, c /1/ CMR - 276

3 MEDFIELD WALPOLE North Arrow Digital USGS Map of Medfield, MA, dated 1987, provided by the Office of Geographic and Environmental Information (MassGIS), Commonwealth of Massachusetts Executive Office of Energy and Environmental Affairs. 0 1,000 2,000 4,000 FEET ZNORTH COPYRIGHT (C) BY BEALS AND THOMAS, INC. ALL RIGHTS RESERVED Assisted Living Facility Medfield, Massachusetts LCB Senior Living 3 Edgewater Drive, Suite 101 Norwood, MA Locus Map Figure 1 Scale: 1" = 2,000' Date: 05/06/2015 Source File P032A.mxd B+T Project No B E A L S + T H O M A S

4 Civil Engineers + Landscape Architects + Land Surveyors + Planners + Environmental Specialists BEALS AND THOMAS, INC. Reservoir Corporate Center 144 Turnpike Road Southborough, Massachusetts T

5 Civil Engineers + Landscape Architects + Land Surveyors + Planners + Environmental Specialists BEALS AND THOMAS, INC. Reservoir Corporate Center 144 Turnpike Road Southborough, Massachusetts T

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7 35' - 0" 22 ELEVATION - WEST C - 30TH SCALE 12 ELEVATION - NORTH B - 30TH SCALE 11 EAST ELEVATION - PART C 21 ELEVATION - WEST B - 30TH SCALE 35' - 0" 10 ELEVATION - NORTH A 20 ELEVATION - EAST C - 30TH SCALE LCB AT MEDFIELD 361 MAIN STREET, MEDFIELD, MA P-102 ELEVATIONS 03/23/16 D E V E L O P E R : LCB SENIOR LIVING A R C H I T E C T : The Architectural Team 14106

8 221' 8" 31 ELEVATION - EAST A - 30TH 21 MAIN ENTRANCE - S-E ELEVATION - 30TH SCALE 11 SOUTH ELEVATION - PART B 30 ELEVATION - SOUTH - 30TH SCALE 20 SIDE ELEVATION AT ENTRY 10 ELEVATION - EAST-30TH LCB AT MEDFIELD 361 MAIN STREET, MEDFIELD, MA P-101 ELEVATIONS 03/23/16 D E V E L O P E R : LCB SENIOR LIVING A R C H I T E C T : The Architectural Team 14106