APPENDIX B

COMMONWEALTH OF MASSACHUSETTS

SECRETARY OF STATE: MASSACHUSETTS HISTORICAL COMMISSION

PERMIT APPLICATION: ARCHEOLOGICAL FIELD INVESTIGATION

A. General Information

Pursuant to M.G.L. c. 9 § 27C and according to the regulations outlined in 950 CMR 70.00, a permit to conduct a field investigation is hereby requested.

1. 1. Name
2. 2. Institution/Address
3. 3. Project Location
4. 4. Town
5. 5. Attach a copy of a U.S.G.S. quadrangle with the project area clearly marked.
6. 6. Property Owner(s)
7. 7. The applicant affirms that the owner has been notified and has agreed that the applicant may perform the proposed field investigation.

8. 8. The proposed field investigation is for a: a. Reconnaissance Survey (circle one) b. Intensive Survey

   1. c. Site Examination
   2. d. Data Recovery

B. Professional Qualifications

1. 1. Attach a personnel chart and project schedule as described in 950 CMR 70.11(2)(b).
2. 2. Include copies of curricula vitarum of key personnel (unless already on file with the State Archeologist.)

C. Research Design

1. 1. Attach a narrative description of the proposed Research Design according to the requirements of 950 CMR 70.11.
2. 2. The Applicant agrees to perform the field investigation according to the standards outlined in 950 CMR 70.13
3. 3. The Applicant agrees to submit a Summary Report, prepared according to the standards outlined in 950 CMR 70.14, by .

date

1. 4. The specimens recovered during performance of the proposed field investigation will be curated at . (M.G.L. c. 9, § 27C) curatorial facility

SIGNATURE

APPLICANT DATE

REGULATORY AUTHORITY

950 CMR 70.00: M.G.L. c. 9, § 27C.