Trial Court of Massachusetts
Land Court Department
PERMIT SESSION CIVIL COVER SHEET
V.
LOCUS ADDRESS/DESCRIPTION
PART I – THRESHOLD REQUIREMENTS FOR PERMIT SESSION
The undersigned certifies that this action is based on a claim or claims set forth in G.L. c. 185, § 3A (a) to (d), and the underlying project or
development involves:
25 or more dwelling units and / or
construction or alteration of 25,000 square feet or more of gross floor area
PART II – TYPE OF ACTION
Using the list below, place the Number “1” next to the main cause of action asserted in your complaint. Place an “X” next to each other cause
of action asserted in your complaint. Is this complaint verified?
Yes No Is there a jury claim? Yes No
Any related cases (open or closed) pending in the Land Court, any other Court Department, or Administrative Agency?
Yes No
Case No(s). _____________________________________________________________________________________________________
PSZ
AC
Appeal from Zoning/Planning Board
G.
L.
c. 40A, § 17
PSHDA
Historic Districts Act
G.
L.
c. 40C
PSZAD
Appeal from Planning Board
G.
L.
c. 41, § 81BB
PSSGZ
Smart Growth Zoning and Housing Production
G.
L.
c. 40R
PSZJA
Validity of Zoning
G.
L.
cc. 240, § 14A, 185, § 1 (j ½)
PSEXP
Expedited Permitting
G.
L.
c. 43D
PSZEN
Enforcement of Zoning
G.
L
. c. 40A, § 7
PSW
Waterways
G.
L
. c. 91
PSAHA
Affordable Housing Appeal
G. L. c. 40B, § 21
PSIFGNR
Inland Fisheries, Game and Natural Resources
G. L. c.131
PSDEM
Department of Environmental Management
G. L. c. 21
PSMESA
Massachusetts Endangered Species Act
G. L. c. 131A
PSEIP
Environmental Impact of Projects Conducted
by Agencies
G.
L.
c. 30 § 61-62H
PSBZC
St. 1956, c. 665
PSOTA
Other Claims
G. L. c. 185, § 3A sec. (b), (c) and (d)
PSSAP
State Administrative Procedure (not listed here)
PSCNC
Certiorari
PSHAC
Review by Housing Appeals Committee
G.
L.
c 40B, § 22
PSMAN
Mandamus
G.
L.
c. 249, § 5
SIGNATURE OF SELF-REPRESENTED PLAINTIFF
PART III – UNIFORM COUNSEL CERTIFICATE (SJC RULE 1:18)
I hereby certify that I have complied with requirements of Rule 5 of the Supreme Judicial Court Uniform Rules on Dispute Resolution (SJC
Rule 1:18) requiring that I provide my clients with information about court-connected dispute resolution services and discuss with them the
advantages and disadvantages of the various methods of dispute resolution.
SIGNATURE OF ATTORNEY BBO NUMBER DATE
APPROVED FOR FILING IN PERMIT SESSION
ADRCC-PS (09/2019) www.mass.gov/courts/landcourt
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