HomeMy WebLinkAboutChapter 91 6/30/25 L
Municipal Zoning Certificate
Massachusetts Department of Environmental Protection
Chapter 91 Waterways Water-Dependent,Nonwater Dependent,Amendment Application
Note to Permittee:This form should be submitted,with the top portion completed,to the municipal clerk or zoning
official along with the complete application and project plans.
Raymond and Harriet Fellows Revocable Trust
Name of Permittee
222 Blue Rock Road Bass River Yarmouth
Project Address Name of Waterway City/Town
Description of project and use or change in use(this field is not limited to the one line shown).
License and maintain pier,ramp and floats for private recreational access to navigable waters
To be completed by the municipal clerk or other municipal zoning official responsible for administering zoning
ordinances and by-laws.
"I hereby certify that the project described above and more fully detailed in the Permittee's Waterways License
application and plans is not in violation of local zoning ordinances and/or by-laws."
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Print Name of Mun''•. Zo in•Official Date
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Signature o e• al Title City/Town
Zoning.doc Rev_1021 Page 1 of 1