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CONSERVATION DEPARTMENT
Community Development Division
Modification to Order of Conditions
The NORTHiANDOVER CONSERVATION COMMISSION agreed to accept
Applicant: Ka^-Z w S JZt i,CC .
127,915Dte
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as a Modification to the Order of Conditions issued in File 242 .4 13 9 41dated I ?'and
recorded in Bo k# and page
Issued by the NO TH DOV CONSERVATION COMMISSION:
On this of dw? before mep sonally a e SZMo me
day month/yr
known to be the person described in and who executed the foregoing instrument and
acknowledged that he/she executed the same as his/her free act and deed.
/9 r
AP/7 40
Notary Public
=ONGE
CCHUSETTS'f .7.2009
1600 Osgood Street,North Andover,Massachusetts 01845
Phone 978.688.9530 fox 978.688.9542 Web www.townofnorthandover.com
Osgood Landing
Town of North.Andover
1600 Osgood St. U
Bldg.20,Suite 2-36 Planning Dept.
North Andover,MA 01845 jR E C w IV E D
FORM A TO
APPLICATION FOR APPROVAL NOT REQUiM SEP 25 18
DATE:
E nT}i Al""..VE''i,
]ASS £:� i $
(Stamp two (2) forms with the Town Clerk. File one (1) form with the Town Clerk and one (1) form with the
Planning Board.)
To the ALO N►NG
The undersigned, believing that the accompanying plan of property in the Town of North Andover, Massachusetts,
does not constitute a subdivision within the meaning of the Subdivision Control Law,herewith submits said plan for
a determination and endorsement that the Planning Board approval under the Subdivision Control
1
Law is not required.
1.Name of Applicant: 6 N G %4*11PU10 .. _
Address: u
2.Location and Description of Property[inclujie Asse Ma
r'
andLot and ZoningDistrict(s)]: — t -7!;
3.Deed Reference: Book 2 page ' "
or Certificate of Title: ��,+�
4.Name of Surveyor: FAf � s �.� ►
Address: (69 IA"� r
No�.T Bolt-� , NUS a t'�i
Signature of Owner(s): _ A Q4AAA s kaAz �5
Address:_C,�r-- 65 AC f V!G
Please indicate the grounds(either A,B,C or D,not combination)on which you believe your plan not to be
a subdivision.
oA Each lot on the plan meets one of the following criteria:
1. Has the frontage,lot area,and lot width required under the Zoning By-law on
✓ a) a public way,or
b) a way which the Town Clerk certifies is maintained&used as a public way,or
c) a way shown on a plan approved and endorsed by the Planning Board under the Subdivision Control
Law,recorded in Plan Book Plan ,or
d) a way in existence before the adoption of the Subdivision Control Law by the Town and which the
Board finds adequate for the way's proposed use,or
e) a way shown on a plan of a subdivision recorded at the Registry of Deeds or the Land Court prior to the
adoption of the Subdivision Control Law.
B. Each Lot has been clearly marked on the plan to be either:
a) joined to and made part of an adjacent lot,or
b) labeled"Not A Building Lot".
C. Each lot on the plan contains a building which existed prior to the adoption of the Subdivision
Control Law.
D. The plan shows an existing parcel with no new lot division(s)and has frontage on a way described
above.
Received: Town of North Andover Town Clerk(date stamp):
Signature of Town Official receiving this application:
k
t. ~
Notice to APPLICANT/TOWN CLERK of action of Planning Board on accompanying plan:
agIt3G
1. The North Andover wig Board has determined that said plan does not require approval under the
Subdivision Control Law,and the appropriate endorsement has been made upon the same.
2. The North Andover_Mvmiiag Board has determined that said plan shows a subdivision,as defined by
G.L.c.41,s. 81-L and must therefore be re-submitted to it for approval under the Subdivision Control
Law.
Very truly yours, a.
North Andover P1eaing Board
By:
Date:
[LIMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form Q — Order of Resource Area Delineation 242-1351
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
A. General Information
Important: North Andover
When filling out From: 1.Conservation Commission
forms on the
computer, use 2. This Issuance is for(check one):
only the tab key
to move your
cursor-do not a. ® Order of Resource Area Delineation Only
use the return
key.
b. ❑ Order of Resource Area Delineation Subject to Simplified Review
1. ❑ Not Subject to Stormwater Policy
2. ❑ Subject to Stormwater Policy
c. ❑ Amended Order of Resource Area Delineation
Note:
Before 3. To: Applicant:
completing this
form consult Pribhu Hingorani One Hundred Fourteen Trust
your local a. First Name b.Last Name c.Company
Conservation
Commission 51 Mount Joy Drive
regarding any d.Mailing Address
municipal bylaw Tewksbury__ MA. 01876
or ordinance' e.City/Town f.State
g.Zip Code
4. Property Owner(if different from applicant):
Sushila Lull
a. First Name b. Last Name c.Company
51 Mount Joy Drive
d. Mailing Address
_Tewksbury MA. 01876
e.City/Town f.State g.Zip Code
5. Project Location:
Berry Street/Turnpike Street North Andover
a.Street Address b.City/Town
Map 106D Parcels 44, 63, 74 &75
c.Assessors Map/Plat Number d.Parcel/Lot Number
Latitude and Longitude(note: electronic filers 42-04-22 71-04-22
will click for GIS locator): e.Latitude f. Longitude
3/10/06 �e b �i b
6. Dates: a.Date Notice of Intent filed b.Date ubli Hearing Closed c.Date6f Iss ante
7. Title and Date (or Revised Date if applicable)of Final Plans and Other Documents:
Plan for AN RAD to+s 1-N Tkrt. 1--Y Nar'fhM., )O 2k4
a.Title b.Date T
c.Title
d.Date
wpaform4b.doc•rev.06/13/05 Page 1 of 7
Massachusetts Department of.Environmental Protection
Bureau of Resource Protection - Wetlands DEP File"umber:
\ WPA Form 4B _ Order of Resource Area Delineation 242-1350
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
B. Order of Delineation
1. The Conservation Commission has determined the following (check whichever is applicable)
a. ® Accurate: The boundaries described on the referenced plan(s)above and in the Abbreviated
Notice of Resource Area Delineation are accurately drawn for the following resource area(s):
1. ® Bordering Vegetated Wetlands
2. Other Resource Area(s), specifically:
b. ❑ Modified: The boundaries described on the plan(s) referenced above, as modified by the
Conservation Commission from the plans contained in the Abbreviated Notice of Resource
Area Delineation,are accurately drawn from the following resource area(s):
1. ❑ Bordering Vegetated Wetlands
2. ❑ Other Resource Area(s), specifically:
C. ❑ Inaccurate:The boundaries described on the referenced plan(s)and in the Abbreviated
Notice of Resource Area Delineation were found to be inaccurate and cannot be confirmed
for the following resource area(s):
1. ❑ Bordering Vegetated Wetlands
2. ❑ Other Resource Area(s), specifically:
3. The boundaries were determined to be inaccurate because:
wpaform4b.doc•rev.06/13/05 Page 2 of 7
Massachusetts Department of Environmental Protection
Bureau of Resource Protection- Wetlands DEP File"umber:
WPA Form 4B — Order of Resource Area Delineation 242-1350
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
C. Simplified Buffer Zone Review
Work within the Buffer Zone pursuant to the Simplified;Review(310 CMR 10.02) requires that you
must comply with the following conditions. if your project does not meet these requirements, you are
required to either file a Determination of Applicability or Notice of Intent or take other corrective
measures as directed by the Conservation Commission.
Simplified Review Conditions:
Work conducted under Simplified Review requires the following:'
1. No work of any kind shall occur within any wetland resource areas including Riverfront Area and
Bordering Land Subject to Flooding.
2. The inner 0-to-50-foot wide area from the delineatedwetland boundary that has a Buffer Zone
shall not be disturbed by any work associated with this project, including placement of any
stormwater management components.
3. No work shall occur in the Buffer Zone bordering an Outstanding Resource Water(e.g., certified
vernal pool, public water supply reservoir or tributary), as defined in 314 CMR 4.00 or border
coastal resource areas at 310 CMR 10.25-10.35.
4. No work shall occur in the Buffer Zone adjacent to wetland resources with estimated wildlife
habitat(which is identified on the most recent Estimated Habitat Map of State-listed Rare
Wetlands Wildlife).
5. Erosion and Sedimentation controls shall be installed and maintained at the 50-foot Buffer Zone
line or limit of work(whichever is a greater distance from the resource area)to protect resource
areas during construction:
6. If the project is subject to the Massachusetts Stormwater Policy, all work shall be conducted in
conformance with an approved Stormwater Management Plan.
7. The Buffer Zone does not contain a slope greater than an average of 15%at its steepest gradient
across the 100-foot Buffer Zone.
8. The amount of new impervious surface, in combination with existing impervious surfaces, shall
not exceed 40%of the Buffer Zone between 50 and 100 feet.
9. No work is allowed,and no additional NO-1 or RDA shall be filed, for any work within the 0-to-60-
foot Buffer Zone during the three-year term of an Order associated with this application.
10. Prior to any work being undertaken pursuant to this Order, the wetlandresourceboundary shall
be flagged; all boundary delineation flagging should be maintained for the term of the Order.
11. If stormwater management structures are proposed in the Buffer Zone, the stormwater
management structures shall be maintained as required in the Stormwater Plan. Such
maintenance constitutes an ongoing condition and is not subject to further permitting
requirements.
12. If this ORAD involves work as part of a Simplified Review, the ORAD shall be recorded at the
Registry of Deeds prior to the commencement of work per the requirements of Section F.
13. Prior to proceeding with any work under Simplified Review, applicants are required to provide
written notice to the Commission one week prior to commencing any work.
14. If work authorized under Simplified Review is commenced, no work is allowed, and no additional NO[
or RDA may be filed, for any work within the 0-to-50-foot-buffer zone during the term of an ORAD
associated with this application. If work authorized under Simplified Review is not commenced,then
future NOls or RDAs may be filed for work within the 0-to-50-foot portion of the buffer zone.
-End of Conditions--
wpaform4b.doc•rev.06/13/05 Page 3 of 7
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 4B — Order of Resource Area Delineation 242-1350
Massachusetts etts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
C. Simplified Buffer Zone Review (cont.) ,.
Stormwater Applicability
1. ❑ The project is not subject to the Stormwater Policy.;
2. ❑ The project is subject to the Stormwater Policy and the Stormwater Plan included for the
project complies with all stormwater standards.
Ineligibility Determinations
Site Conditions: The applicant is not eligible for Simplified Buffer Zone review and must file a
Request for Determination of Applicability or Notice of Intent prior to any work because:
3. ❑ Work is within the Buffer Zone of a Coastal Resource Area as defined at 310 CMR 10.25-
10.35.
4. ❑ The Buffer Zone contains existing slopes greater than an average of 15%.
5. ❑ Buffer Zone contains estimated rare wildlife habitat.'
6. [:1The site borders an Outstanding Resource Water.2
Stormwater
7. ❑ The project is subject to the Stormwater Policy and the applicant has not submitted sufficient
information to demonstrate compliance with the Stormwater Management Policy. Prior to any
work, the applicant must submit plans showing compliance with the standards in the
Stormwater Policy, the location of the work,the amount of impervious surface,and the
location of erosion controls, to the Commission for its concurrence.(See instructions to
ANRAD Form 4A.)The following necessary Stormwater information was not submitted by the
applicant:
a
s. ❑ The project is subject to the Stormwater Policy but the project does not comply with one or
more of the stormwater standards(specify which standard(s) not met).
a. Standard#,
b. Standard
s. ❑ Impervious surface exceeds 40% of the area of the Buffer Zone between 50 and 100 feet
from the resource area.
1o. ❑ The applicant did not submit plans depicting adequate erosion and sedimentation controls
located at the limit of work or at least 50 feet from any resource areas,whichever will be greater.
11. ❑ Work is proposed within 50 feet of a resource area
Notice to Commission
Any applicant proposing to proceed under Simplified Buffer Zone Review, as specified in 310 CMR
10.02, must provide written notice to the Commission one week prior to any work.
1 Identified on the most recent Estimated Habitat Map of State-listed Rare Wetlands Wildlife of the Natural Heritage and Endangered
Species Program.
Certified Vernal Pools, public water supplies, or inland ACECs as identified in 314 CMR 4.00.
wpaform4b.doc•rev.06/13/05 Page 4 of 7
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form Q Order of Resource Area Delineation 242-1350
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
D. Findings
This Order of Resource Area Delineation determines that the Stormwater Plan, if applicable,and the
boundaries of those resource areas noted above, have been delineated and approved by the Commission
and are binding as to all decisions rendered pursuant to the Massachusetts Wetlands Protection Act
(M.G.L. c.131, §40)and its regulations(310 CMR 10.00). This Order does not, however,determine the
boundaries of any resource area or Buffer Zone to any resource area not specifically noted above,
regardless of whether such boundaries are contained on the plans attached to this Order or to the
Abbreviated Notice of Resource Area Delineation.
The Agent or members of the Conservation Commission and the Department of Environmental Protection
shall have the right to enter and inspect the area subject to this Order at reasonable hours to evaluate
compliance with the conditions stated in this Order, and may require the submittal of any data deemed
necessary by the Conservation Commission or Department for that evaluation.
If the Abbreviated Notice of Resource Area Delineation was filed as Simplified Review for Buffer Zone
project, the applicant has certified that any work associated with the proposed project meets all eligibility
requirements for Simplified Review listed in Section C of this Order.Any work that does not comply with
the Simplified Review requirements will require a Notice of Intent or Request for Determination of
Applicability.
The applicant is responsible for promptly requesting a Certificate of Compliance following completion of
any work allowed pursuant to a Simplified Review or no later than three years from the date of the Order
of Resource Area Delineation unless the Order is extended.
Failure to comply with the conditions of this Order is grounds for the Conservation Commission or the
Department to take enforcement action.
This Order must be signed by a majority of the Conservation Commission.The Order must be sent by
certified mail (return receipt requested)or hand delivered to the applicant. A copy also must be mailed or
hand delivered at the same time to the appropriate DEP Regional Office.
E. Appeals
The applicant,the owner,any person aggrieved by this Order,any owner oflandabutting the land subject to this
Order, or any ten residents of the city or town in which such land is located,are hereby notified of their right to
request the appropriate DEP Regional Office to issue a Superseding"Order of Resource Area Delineation.When
requested to issue a Superseding Order of Resource Area Delineation,the Department's review is limited to the
objections to the resource area delineation(s)stated in the appeal request.The request must be made by certified
mail or hand delivery to the Department,with the appropriate filing fee and a completed Request for Departmental
Action Fee Transmittal Form,as provided in 310 CMR 10.03(7)within ten business days from the date of issuance of
this Order.A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation
Commission and to the applicant,if he/she is not the appellant.Any appellants seeking to appeal the Department's
Superseding Order associated with this appeal will be required to demonstrate prior participation in the review of this
project. Previous participation in the permit proceeding means the submission of written information to the '
Conservation Commission prior to the close of the public hearing, requesting a Superseding Order or Determination,
or providing written information to the Department prior to issuance of a Superseding Order or Determination.
The request shall state clearly and concisely the objections to the Order which is being appealed and how the Order
does not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act, (M.G.L.
c. 131, §40) and is inconsistent with the wetlands regulations(310 CMR 10.00).To the extent that the Order is based
on a municipal bylaw or ordinance,and not on the Massachusetts Wetlands Protection Act or regulations,the
Department of Environmental Protection has no appellate jurisdiction
wpaform4b.doc•rev.06/13/05 Page 5 of 7
Order of Resource Area Delineation
Berry Street&Turnpike Street
DEP Fide #242-1350
Facts &Findings:
Jurisdictional wetland resource areas on the subject property include the following:
❖ Bordering Vegetated Wetlands(BVWs)associated with an intermittent stream;
❖ Isolated Lands Subject to Flooding (ILSF);
❖ Isolated Vegetative Wetlands (IVWs)jurisdictional under the North Andover Wetlands
Protection Bylaw (greater than 1,000 s.f.)and which may be federally jurisdictional
(greater than 5,000 s.f.);
❖ Two (2)Vernal Pools (not certified)/Ephemeral Pools(North Andover Wetlands
Protection Bylaw)
The associated 25' No-Disturbance Zone,50' No-Construction Zone, and 100'buffer zones
were not depicted on the approved plans, therefore not approved under this filing.
The aforementioned jurisdictional resource areas on the site were thoroughly reviewed by
the Conservation Administrator and by Mark West of West Environmental. Plans were
revised based upon these field reviews and discussions and were submitted to the North
Andover Conservation Commission(NACC)for review and approval. As such,the NACC
formally approved the boundaries of all jurisdictional wetland resource areas at their
meeting of May 10, 2006, accepting the final revised plan
In addition, the applicant has agreed to formally certify the two (2)vernal/ephemeral pools
on the site with the Natural Heritage and Endangered SpeciesProgram and shall do so
following this approval. Further, the applicant shall duly submit all associated permits with
the Army Corps of Engineers to determine jurisdiction of any federally regulated resource
areas. Any findings issued by the Army Corps of Engineers shall be submitted to the NACC
upon issuance.
Record Documents:
➢ Abbreviated Notice of Resource Area Delineation,received March 10, 2006;
➢ Plan entitled "Plan for ANRAD Lots 1-N Thru 4-N North Andover, MA". Prepared by
Patrick C. Garner Co.,Inc, dated March 8,2006,last revised May 10,2006. Stamped &
signed by Patrick C. Garner, P.L.S;
➢ Memorandum from Mark West of West Environmental dated May 10, 2006;
➢ Letter from Patrick Garner dated May 10,2006.
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File"umber:
WPA Form Q — Order of Resource Area Delineation 242-1350
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
F. Signatures and Notary Acknowledgement 57
Please indicate the number of bers who will sign this form:
1.Number of Signers
Signature of ConsN io mis ' n Member 1/Si re of nserva ion Commission Member
Signa r o Conservatio omm io Member Signature of Conservation Commission Member
Signat of C rise Co ission Member Signature of Conservation Commission Member
Sign ure o e do o mission Member
This Order is valid for three years from the date of issuance.
This Order is issued to the applicant and the property owner(if different)as follows:
❑ by hand delivery on [ by certified mail, return receipt requested on
512-5 6
Date Date
Notary Acknowledgement
Commonwealth of Massachusetts County of Essex North
-t'l,t
On this Day of Month Year
Before me, the undersigned Notary Public, 6C'4 MA—'Tse .
personally appeared Name of Document Signer
proved to me through satisfactory evidence of identification,which was/were
Massachusetts License
Description of evidence of identification
to be the person whose name is signed on the preceding or attached document,and acknowledged
to me that he/she signed it voluntarily for its stated purpose.
As member of CityRown North Andover - Conservation Commission
rlflMl�r� '
DONNA M.WEDGE
NOTARY PUBLIC Signature of Nota Public
COMMONWEALTH Of MASSACHUSETTS g Notary _
My Comm.Expkw Aug.7,2009
Printed Name of Vary Public
Place notary seal and/or any stamp above e I7 0106'T
My Commission xpires(Date)
This Order is issued to the applicant as follows:
wpaform4b.doc•rev.06/13/05 Page 6 of 7
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 4B - Order of Resource Area Delineation 242-1350
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
G. Recording Information
If this Order is issued for purposes of Resource Area Delineation only, this Order should NOT be
recorded.
If this Order of Resource Area Delineation is issued as part of a Simplified Review,this Order must be
recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the
chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in
the Registry's Grantor Index under the name of the owner of the land subject to the Order. In the case of
registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner of the
land subject to the Order of Conditions. The recording information on Page 6 of this form shall be
submitted to the Conservation Commission listed below.
North Andover
Conservation Commission
Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission.
---------------------------------------------------------------------------------------------------------------------------
To:
North Andover
Conservation Commission
Please be advised that the Order of Conditions for the Project at:
242-1350
Project Location DEP File Number
Has been recorded at the Registry of Deeds of
County Book Page
for:
Property Owner
and has been noted in the chain of title of the affected property in:
Book Page
In accordance with the Order of Conditions issued on:
Date
If recorded land, the instrument number identifying this transaction is:
instrument Number
If registered land, the document number identifying this transaction is
Document Number
Signature of Applicant
wpaformft.doc-rev.06/13/05 Page 7 of 7
L1Massachusetts Department of Environmental Protection
Bureau of Resource Protection Wetlands
1 DEP Regional Addresses
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Mail transmittal forms and DEP payments,payable to:
Commonwealth of Massachusetts
Department of Environmental Protection
Box 4062
Boston, MA 02211
DEP Western Region Adams Colrain Hampden Monroe Pittsfield Tyringham
436 Dwight Street Agawam Conway Hancock Montague Plainfield Wales
g Alford Cummington Hatfield Monterey Richmond Ware
Suite 402 Amherst Dalton Hawley Montgomery Rowe Warwick
Springfield,MA 01103 Ashfield Deerfield Heath Monson Russell Washington
Phone:413 784-1100 Becket Easthampton Hinsdale Mount Washington Sandisfield Wendell
Belchertown East Longmeadow Holland New Ashford Savoy Westfield
Fax:413-784-1149 Bernardston Egremont Holyoke New Marlborough Sheffield Westhampton
Blandford Erving Huntington New Salem Shelburne West Springfield
Brimfield Florida Lanesborough North Adams Shutesbury West Stockbridge ,
Buckland Gill Lee Northampton Southampton Whately
Charlemont Goshen - Lenox Northfield South Hadley Wilbraham
Cheshire Granby Leverett Orange Southwick Williamsburg
Chester Granville Leyden Otis Springfield Williamstown
Chesterfield Great Barrington Longmeadow Palmer Stockbridge Windsor
Chicopee Greenfield Ludlow Pelham Sunderland Worthington
Clarksburg Hadley Middlefield Peru Tolland
DEP Central Region Acton Charlton Hopkinton Millbury Rutland Uxbridge
627 Main Street Ashburnham Clinton Hubbardston Millville Shirley Warren
Ashby Devens Hudson New Braintree Shrewsbury Webster
Worcester,MA 01605 Athol Douglas Holliston NorthboroughSouthborough Westborough
Phone: 508-792-7650 Auburn Dudley Lancaster Northbridge Southbridge West Boylston
Fax:508-792-7621 Ayer Dunstable Leicester North Brookfield Spencer West Brookfield
Barre East Brookfield Leominster Oakham Sterling Westford
TDD:508-767-2788 Bellingham Fitchburg Littleton Oxford Stow Westminster
Berlin Gardner Lunenburg Paxton Sturbridge Winchendon
Blackstone Grafton Marlborough Pepperell Sutton Worcester
Bolton Groton Maynard Petersham Templeton
Boxborough Harvard Medway Phillipston Townsend
Boylston Hardwick Mendon Princeton Tyngsborough
Brookfield Holden Milford Royatston Upton
Hopedale
DEP Southeast Region Abington Dartmouth Freetown Mattapoisett Provincetown Tisbury
20 Riverside Drive Acushnet Dennis Gosnold Middleborough Raynham Truro
Aquinnah Dighton Halifax Nantucket Rehoboth Wareham
Lakeville, MA 02347 Attleboro Duxbury Hanover New Bedford Rochester Wellfleet
Phone:508-946-2700 Avon Eastham Hanson North Attleborough Rockland West Bridgewater
Fax:508 947-6557 Barnstable East Bridgewater Harwich Norton Sandwich Westport
Berkley Easton Kingston Norwell Scituate West Tisbury
TDD:508-946-2795 Boume Edgartown Lakeville Oak Bluffs Seekonk Whitman
Brewster Fairhaven Mansfield Orleans Sharon Wrentham
Bridgewater Fall River Marion Pembroke Somerset Yarmouth
Brockton Falmouth Marshfield Plainville Stoughton
Carver Foxborough Mashpee Plymouth Swansea
Chatham Franklin Plympton Taunton
Chilmark
DEP Northeast Region Amesbury Chelmsford Hingham Merrimac Quincy Wakefield
One Winter Street Andover Chelsea Holbrook Methuen Randolph Walpole
Arlington Cohasset Hull Middleton Reading Waltham
Boston, MA 02108 Ashland Concord Ipswich Millis Revere Watertown
Phone:617-654-6500 Bedford Danvers Lawrence Milton Rockport Wayland
Fax: 617-556-1049 Belmont Dedham Lexington Nahant Rowley Wellesley
Beverly Dover Lincoln Natick Salem Wenham
TDD:617-574-6868 Billerica Dracut Lowell Needham Salisbury West Newbury'
Boston Essex Lynn Newbury Saugus Weston
Boxford Everett Lynnfield Newburyport Sherborn Westwood
Braintree Framingham Malden Newton Somerville Weymouth
Brookline Georgetown Manchester-By-The-Sea Norfolk Stoneham Wilmington
Burlington Gloucester Marblehead North Andover Sudbury Winchester
Cambridge Groveland Medfield North Reading Swampscott Winthrop
Canton Hamilton Medford Norwood Tewksbury Woburn
Carlisle Haverhill Melrose Peabody Topsfield
Wpaform4b.doc•rev.11/22/00 Page lot 1
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
Request for Departmental Action Fee Transmittal Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. Request Information
Important:
When filling out 1. Person or party making request(if appropriate, name the citizen group's representative):
forms on the
computer, use Name
only the tab
key to move
your cursor- Mailing Address
do not use the
return key. City/Town State Zip Code
Phone Number Fax Number(if applicable)
Project Location
retrsn
Mailing Address
City/Town State Zip Code
2. Applicant(as shown on Notice of Intent(Form 3),Abbreviated Notice of Resource Area Delineation
(Form 4A); or Request for Determination of Applicability(Form 1)):
Name
Mailing Address
City/Town State Zip Code
Phone Number Fax Number(if applicable)
3. DEP File Number:
B. Instructions
1. When the Departmental action request is for(check one):
❑ Superseding Order of Conditions -
❑ Superseding Determination of Applicability
❑ Superseding Order of Resource Area Delineation
Send this form and check or money order for$100.00(single family house projects)or$200(all other projects),
payable to the Commonwealth of Massachusetts to:
Department of Environmental Protection
Box 4062
Boston, MA 02211
Wpaform4b.doc-rev.10104 Page 1 of 2
J
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
Request for Departmental Action Fee Transmittal Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Instructions (cont.)
2. On a separate sheet attached to this form,state clearly and concisely the objections to the
Determination or Order which is being appealed. To the extent that the Determination or Order is
based on a municipal bylaw,and not on the Massachusetts Wetlands Protection Act or regulations,
the Department has no appellate jurisdiction.
3. Send a copy of this form and a copy of the check or money order with the Request for a Superseding
Determination or Order by certified mail or hand delivery to the appropriate DEP Regional Office.
4. A copy of the request shall at the same time be sent by certified mail or hand delivery to the
Conservation Commission and to the applicant, if he/she is not the appellant.
Wpaform4b.doc•rev.10104 Page 2 of 2
� STREET VARIABLE R /w
(� BERr\ Y
FERN ST. N� `�7 ��•
174.95 -�
FRONTAGE TOTAL=174.95
v J / — —25' FRONT SETBACK — `\
Q /•� � \ \ SITE
u +A � �
\ L 0 T 3N — A .
q.g.59 _.•_ --- IAL
RTE. 114
FRONTAGE_ f X25 F� 1 .0 AC.
off,
P (> 32,700 SF UPLAND) \soy, SCALE 1" = 1500'
�, LOT 2 N — A �� ti °�� \���� LOCUS
— >>•a�� �\ \9c� THIS PLAN HAS BEEN PREPARED IN CONFORMITY
\ 1 .0 AC;. + / �' �>.•� � \ �\ WITH THE RULES& REGULATIONS OF THE
>,�• ��� REGISTRARS OF DEEDS IN THE COMMONWEALTH OF
— �� 32,700 SF UPLAND) \ \ MASSACHUSETTS, AND IN COMPLIANCE WITH THE
�r L.0 T 1 N A\ °� r \ RULES& REGULATIONS FOR THE PRACTICE OF LAND
SURVEYING IN THE COMMONWEALTH OF
�NE \ MASSACHUSETTS.THIS DECLARATION IS INTENDED
TO MEET THE REQUIREMENTS OF THE REGISTRY OF
°'� / (> 32,700 SF UP D) �� o�-°�
\ --\, DEEDS AND IS NOT A CERTIFICATION OF THE TITLE
OR OWNERSHIP OF THE LAND SHOWN HEREON.
/A°�P/ _�� �� \� 31, N/F RITA HOUGHTON
' 2.47 p6 E
11-0,11 563-1= / ,PATRICK C. GARNER, PLS
p6 EZONE - /---- FOR REGISTRY USE ONLY
/ �. �• VILLAGE RESIDENT_t _,....•� ��
ZONE \ Q
/ / / / / / �� `...,. • ...•—- BUS • �\ \ � TECHNICAL NOTES:
omwSUBDIVISION
--�- J Z' � \ ya. APPROVAL UNDER
CONTROL LAW NOT REQUIRED.
..................... `� `so• APPROVAL BY THE NORTH WETLANDS SHOWN WERE
ANDOVER ZONING BOARD OFAPPEALS ACTING AS APPROVED BY CONCOM IN
MAY 2006,
�. / Vtk 11,0,111 / \ PLANNING BOARD N ITS
E PROTECT-ED UNRDER THE
7 �2� °�� / so\ CAPACITY AS THE COMPRE- STATE WET-LANDS
HENSIVE PERMIT GRANTING PROTECTION ACT.
AUTHORITY UNDER GLC 408,
AT A MEETING ON IT LOTS 1-N THRU 3-N TO
PWAS LAN VOTED TO APPROVE THIS BE SERVED BY TOWN
6� \ UN SEWER & BY INDIVIDUAL
0" p ��61 WELLS.
/ O����, / / 5�.� / \ tn� ------------------ ALL PROPERTY LINES ARE
BOUNDED BY STONE WALLS.
/ �-� �O �O THE OVERALL BOUNDARY
2� FOR THESE LOTS IS FROM
A "PLAN OF LAND IN
NORTH ANDOVER, MA"
/ — -' A. ZONE
/ / / ` _ 7 ------------ ----- DATED SEPT 25 1985 BY
i1�CNASSE SAID PLANE S ENG.,
/ G
_____ RECORDED IN THE N.
--------------
DISTRICT ESSEX COUNTY
/ �✓
- 5•�p'05"E REGISTRY AS PLAN #
/ S 2•r �'y� //i ,,. �/ 56 455. 8
� 10143.
FOR TITLE REFERENCE, SEE
DEED BOOK 2108, P. 244.
°Fug' ' ' ZONING WITHIN OVERALL
�� ^'%: '. PARCEL IS EITHER VILLAGE
P/ \ y PATRICK, RESIDENTIAL OR BUSINESS
GARNER
DISTRICT 4 (SEE PLAN)No Ko�l .
ALL ZONE LINES SHOWN
ST_ �o
,' y.• ARE APPROXIMATE &
off• SCALED FROM TOWN
ZONING MAP.
LOT 4N — A N/F FOUR H COMPANY LLC THIS PLAN REVISES A
Q \ PRIOR ANR PLAN FOR THE
ON \
� � Z 10.6 AC. + /— \ SITE By
• S pISTR�C \ R• APPROVED IBYFTHE
j51NE5 \
ZONE \ \ (> 2 AC. UPLAND) � ,
� �Os�>>4 PLANNING BOARD & DATED
RES�DEN11 A JLY 1995.
"i XISTING BLDG.
\ 0 STS • E TOWN ASSESSOR DATA: OWNER/APPLICANT:
I. ONE HUNDRED FOURTEEN TRUST
PG
V' \
\--\ Q I Sp sp � LOT S/ LOT 2N-A 106D-74 51 MOUNT JOY DR.' ;�1►'' \ F S �� LOT 3N-A 1060-44 TEWKSBURY, MA 01876
Q ' FT\ s
\ e /� O/ LOT 4N-A 106D-
63
GARAGE T
>>,� sT� �--��\ PATRICK C. GARNER CO. , INC.
#low
\ tiF
/��ti CTA HYDROLOGY . RIVER ANALYSIS . WETLAND SCIENCE
` . — — — — — — � tip• . `
EXIST. HOUSE � ? ti� - - - _ . _. - - - - - - - - - - - - - -- - - - - � s>ssi SOIL EVALUATION . LAND SURVEYING . PLANNING
r` 50' FRONT SETBACK •oA� 109 WHITNEY STREET
NORTHBOROUGH, MASS. 01532
rn m
0
'ODTOTAL FRONTAGE = 688.31' 508.393.3200 www.patrickgarner.com
' R = 4840.0' '•h�
S55'17'29"E M L - 247.48'
2
APPROVAL NOT REQUIRED PLAN
ROUTE 114 80 ) R /W— � LOTS 1 N-A THRU 4N-A
NORTH ANDOVER, MASS.
COPYRIGHT PATRICK C. GARNER, 2007 SCALE, 1' = 50 FT.
DATEt SEPT 24, 2007 PROJECT No,
REVISIONS, SHEET 1
—25 0
OF
GRAPHIC SCALE 1