HomeMy WebLinkAboutMiscellaneous - 1812 TURNPIKE STREET 4/30/2018 (4)Town of North Andover
Office of the Conservation Department
Community Development and Services Division
27 Charles Street
Alison McKay North Andover, Massachusetts 01845
Interim Conservation Administrator
March 8, 2004
Jean Proulx
1812 Turnpike Street
North Andover, MA 01845
VIA Certified Mail # 70031010 0001 0781 7372
Telephone (978) 688-9530
Fax(978)688-9542
RE: Enforcement Order- DEP File # 242-1090,1812 Turnpike Street, N. Andover, MA
Violation of the MA Wetlands Protection Act (M.G.L c.131, s.40) and the North
Andover Wetlands Protection Bylaw (c. 178 of the Code of North Andover).
Dear Jean Proulx:
On February 14, 2004, this Department observed work occurring at the above referenced
property, in violation of the Order of Conditions for the property, as well as the MA Wetlands
Protection Act and the Town of North Andover's Wetlands Protection Bylaw. The subject
"work" consisted of a bobcat being used in an attempt to reduce flooding from recent rains and
thawing. This bobcat was crossing the stream on the property, pushing water around on the site
and attempting to redefine the stream channel to accommodate more water. While you do have a
permit to perform activities on this site, the "work" described above was not part of the approved
work and may have potentially disturbed the intermittent stream as well as other portions of the
100' Buffer Zone and possibly even the wetland located on the adjacent site. Furthermore, this
Department has not received the required associated bond for the project, recording information
from the Registry of Deeds, or a Pre -Construction request to make sure all of the Pre -
Construction requirements outlined in the Order of Conditions have been met. As a result, no
work within the 100' Buffer Zone to the intermittent stream should be occurring on this property
and permission to commence work was never granted by the North Andover Conservation
Commission. All work within jurisdictional areas must stop immediately and the following must
be adhered to (refer to attached Enforcement Order):
L Temporarily stabilize all disturbed areas within NACC jurisdiction with hay mulch by no
later than Monday, March IS, 2004. Additional site stabilization methods may be
required as determined by the NACC or its designated agent. If such additional methods
are required, they shall be implemented immediately.
2. Submit a report to the NACC prepared by a qualified Wetland Scientist describing any
work that has occurred within the 100' Buffer Zone. This report needs to outline work
performed as described above as well as any other work (including the placement of
structures if within jurisdictional areas) that has occurred on the property. This report will
BOARD OF APPEALiS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
also address impacts to the intermittent stream, associated Bordering Vegetated Wetland
(BVW), associated Buffer Zones, and impacts to the wetland on the adjacent property.
This report will also propose restoration to all impacted areas. This report must be
submitted by no later than Friday, March 19, 2004.
3. Comply with all pre -construction conditions as required in the Order of Conditions by no
later than Friday, March 26, 2004
Please refer to the attached Enforcement Order requiring you to cease and desist all activities
within NACC jurisdiction with the exception of completing the temporary stabilization by no later
than Monday, March 15, 2004. The Enforcement Order also mandates the submittal of a report
prepared by a qualified Wetland Scientist by no later than Friday, March 19, 2004.
Also, please find a Violation Notice in the amount of $300. Please be aware that the NACC
reserves the right to impose additional fines at any time in accordance with M.G.L. c. 40, s.21 and
the Town of North Andover's Wetlands Protection Bylaw, Section 178.10. Also, be aware that
each day or portion thereof during which a violation continues shall constitute a separate offense;
if more than one, each condition violated shall constitute a separate offense. Failure to comply
with this Order and the deadlines referenced herein will result in the issuance of additional
penalties. This Enforcement Order shall become effective upon receipt.
A list of Wetland Consultants has been included for your convenience.
Your anticipated cooperation is appreciated.
Since ly,
Alison McKay
Interim Conservatio dministrator
Cc: NACC
Heidi Griffin, Director, Community Development and Services
Julie Parrino, Town Planner
Robert Nicetta, Building Commissioner
Micheal McGuire, Building Inspector
DEP Northeast Region
File
P
Massachusetts Department of Environmental Protection
DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 9A - Enforcement Order 242-1090
LlMassachusetts Wetlands Protection Act M.G. L. c. 131, §40 Provided by DEP
Property Owner (if different)
A. Violation Information
Important:
When filling out
This Enforcement Order is issued by:
forms on the
North Andover 3/8/2004
computer, use
only the tab
Conservation Commission (Issuing Authority) Date
key to move
To:
your cursor -
Parcel/Lot Number
do not use the
Jean Proulx
return key.
Name of Violator
1812 Turnpike Street
Address
1. Location of Violation:
»
same
Property Owner (if different)
1812 Turnpike Street
Street Address
North Andover
01845
City/Town
Zip Code
160D
46
Assessors Map/Plat Number
Parcel/Lot Number
2. Extent and Type of Activity:
See attached correspondence dated March 8, 2004
B. Findings
The Issuing Authority has determined that the activity described above is in violation of the Wetlands
Protection Act (M.G.L. c. 131, § 40) and its Regulations (310 CMR 10.00), because:
❑ the activity has been/is being conducted without a valid Order of Conditions.
® the activity has been/is being conducted in violation of the Order of Conditions issued to:
Jean Proulx
10/24/2001
Name Dated
242-1090 36,37,38,40,42,44
File Number Condition number(s)
wpaform9a.doc • rev. 12/15/00 Page 1 of 3
Massachusetts Department of Environmental Protection
DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 9A — Enforcement Order 242-1090
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
B. Findings (cont.)
® Other (specify):
Refer to attached correspondence dated 3/8/2004
C. Order
The issuing authority hereby orders the following (check all that apply):
® The property owner, his agents, permittees, and all others shall immediately cease and desist
from the further activity affecting the Buffer Zone and/or wetland resource areas on this property.
❑ Wetland alterations resulting from said activity should be corrected and the site returned to its
original condition.
❑ Complete the attached Notice of Intent. The completed application and plans for all proposed
work as required by the Act and Regulations shall be filed with the Issuing Authority on or before
Date
No further work shall be performed until a public hearing has been held and an Order of Conditions
has been issued to regulate said work.
® The property owner shall take the following action to prevent further violations of the Act:
temporarily stabilize all exposed areas within jurisdiction by 3/15/2004, submit report prepared by a
qualified Wetland Scientist by 3/19/2004. See attached correspondence dated 3/8/2004.
Failure to comply with this Order may constitute grounds for additional legal action. Massachusetts
General Laws Chapter 131, Section 40 provides: "Whoever violates any provision of this section (a)
shall be punished by a fine of not more than twenty-five thousand dollars or by imprisonment for not
more than two years, or both, such fine and imprisonment; or (b) shall be subject to a civil penalty not
to exceed twenty-five thousand dollars for each violation". Each day or portion thereof of continuing
violation shall constitute a separate offense.
wpaform9a.doc • rev. 12115100 Page 2 of 3
Massachusetts Department of Environmental. Protection
DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 9A - Enforcement Order 242-1090
LlMassachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
D. Appeals/Signatures
An Enforcement Order issued by a Conservation Commission cannot be appealed to the Department of
Environmental Protection, but may be filed in'Superior Court.
Questions regarding this Enforcement Order should be directed to:
Alison McKay, Interim Conservation Administrator
Name
978-688-9530
Phone Number
Monday through Friday, 8:30am-4:30pm
Hours/Days Available
Issued by:
North Andover
Conservation Commission
In a situation regarding immediate action, an Enforcement Order may be signed by a single member or
agent of the Commission and ratified by majority of the members at the next scheduled meeting of the
Commission.
Signatur
Signature of delivery person or certified mail number
wpaformga.doc - rev. 12/15/00 Page 3 of 3
TOWN OF NORTH ANDOVER
NOTICE OF VIOLATION OF WETLAND BYLAW
0157
DATE OF THIS NOTICE o o 7
NAME OF OFFENDER .-p �LC
ADDRESS OF ��NDER ,
{{ u r ( �-
CkTY, STATE. ZIP ^ COPE BIRTH OF OFFENDEf
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REGISTRATION NUMBER
OFFENSE: r
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W�'iKin fur 1<S LTiyne�4 Resov.f,_C "eet.S cy
TIME AND DATE OF VIOLATION
(A.M.) (P.M.) ON kc tq 20 a t
LOCATION OF VIOLATION
AT a Ti c rn I %e. 5+/M
SIGN A QF ENFORCI PE
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Fy�RCING DEPARTMPT
Lie -.95ew✓`-v"
I HEREBY ACKNOWLEDGE REC T OF THE FOREGOING CITATION
_x
lonable, to obtain signature of offender. Date Mailed
I Citation mailed to offender
'
THE FINE FOR THIS NON -CRIMINAL OFFENSE IS $ y
YOU HAVE THE FOLLOWING ALTERNATIVES WITH REGARD TO
DISPOSITION OF THIS MATTER.
(1) You may elect to pay the above fine, either by appearing in person
between 8:30 A.M. and 4:30 P.M.,'Monday through Friday, legal holidays
excepted, before: The Conservation Office. 27 Charles Street, North
Andover, MA 01845 OR by mailing a check, money order or postal note to
the Conservation Office WITHIN TWENTY-ONE (21) DAYS OF THE DATE
OF THIS NOTICE. This will operate as a final disposition of the matter, will
no resulting criminal record.
(2) If you desire to contest this matter in a non -criminal proceeding, yo
may do so by making a written request, and enclosing a copy of this citatil
WITHIN TWENTY-ONE (21) DAYS OF THE DATE OF THIS NOTICE TO:
The Clerk -Magistrate, Lawrence District Court
380 Common St., Lawrence, MA 01840
ATTN: 21D non -criminal
(3) If you tail to pay the above fine or to appear as specified, a crimina
complaint may be issued against you.
❑ A. I HEREBY ELECT the first option above, confess to the offense
charged, and enclose payment in the amount of $
❑ B. I HEREBY REQUEST a non -criminal hearing on this matter.
Signature
WHITE: OFFENDER'S COPY YELLOW: CONSERVATION COPY
PINK: POLICE COPY GOLD: COURT COPY
Important:
When filling out
forms on the
computer, use
only the tab key
to move your
cursor - do not
use the return
key.
Note:
Before
completing this
form consult
yourlocal
Conservation
Commission
regarding any
municipal bylaw
or ordinance.
Massachusetts Department of Environmental Protection
DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form Q — Order of Resource Area Delineation 242-1370
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
A. General Information
North Andover
From: 1. Conservation Commission
2. This Issuance is for (check one)
a. ® Order of Resource Area Delineation Only
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
3. To: Applicant:
Gino Fodera
a. First Name b. Last Name
325 North Main Street # 15-B
d. Mailing Address
Middleton
e. City/Town
4. Property Owner (if different from applicant):
Jean Proulx
a. First Name b. Last Name
One Elm Square
d. Mailing Address
Andover
e. City/Town
5. Project Location:
1812 Turnpike Street
a. Street Address
Map 106D
c. Assessors Map/Plat Number
Latitude and Longitude (note: electronic filers
will click for GIS locator):
F Dates' 9/1/06
7
KAA
c. Company
0_1949
g. Zip Code
c/o Andy Caffrey, Caffrey & Caffrey
c. Company
MA. 01810
f. State
North Andover
b. City/Town
Parcels 46 & 47
d. Parcel/Lot Number
e. Latitude
g. Zip Code
f. Longitude
a. Date Notice of Intent filed b. Date Public Hearing Closed c. Date of Issuance
Title and Date (or Revised Date if applicable) of Final Plans and Other Documents:
Site Development Permit Plan 6/9/2006
a. Title b. Date
c. Title
d. Date
wpaform4b.doc • rev. 06/13/05 Page 1 of 7
Massachusetts Department of Environmental Protection
DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form Q — Order of Resource Area Delineation 242-1370
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. 9 Other Resource Area(s), specifically:
t c,4eA u-);
►got ro.'J� w
o+
r -i.
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 Number:
WPA Form 4B — Order of Resource Area Delineation 242-1370
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 delineated wetland 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 NOI or RDA shall be filed, for any work within the 0 -to -50 -
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 wetland resource boundary 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 NOI
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
Ll'Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 4B — Order of Resource Area Delineation 242-1370
Massachusetts 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. ❑ The site borders an Outstanding Resource Water.'
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.
10. ❑ 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.
' 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
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
il WPA Form Q - Order of Resource Area Delineation 242-1370
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 a 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 of land abutting.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. 06113105 Page 5 of 7
Massachusetts Department of Environmental Protection
DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 4B — Order of Resource Area Delineation 242-1370
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
F. Signatures and Notary Acknowledgement �•-
Please indicate the nu ers who will sign this form: T
1. Number of Signers
Signa a of Conservation Commi on Member J Signa o C �'NN 'on ommission Member
Signature of Conservation Commis ion Member Si re of Conservation Commission Member
Signature of Conservation Commission Member Signature of Conservation Commission Member
Signature of Conservation Commission 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
Date Date
Notary Acknowledgement
Commonwealth of Massachusetts County of
On this a?
Dayof
Before me, the undersigned Notary Public,
personally appeared
Essex North
sr'O"be, 0,1006
Montt Year
Sc-o+M aSs ¢_
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 North Andover
City/Town
Place notary seal and/or any stamp above
This Order is issued to the applicant as follows:
Conservation Commission
In 64"1 1— -/Yl • vIJ _
S nature of Notary Public
D0,717 '4 01
Printed Name of Notary Public
My Commis(sion Upires (Date
fl9C�1� i
DONNA M. WEDGE
NOTARY PUBLIC
COMMONWEALTH OF MASSACHUSETTS
My Comm. Expires Aug -7,2009
wpaform4b.doc • rev. 06/13/05
Page 6 of 7
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form Q — Order of Resource Area Delineation
242-1370
(1 Massachusetts Wetlands Protection Act M.G.L. c. 131 §40 Provided by DEP
U. Kecording 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
k,unservanon Lommission
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:
Project Location
Has been recorded at the Registry of Deeds of:
County
for:
Property Owner
242-1370
DEP File Number
Book Page
and has been noted in the chain of title of the affected property in:
Book
In accordance with the Order of Conditions issued on:
Page
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
wpaform4b.doc•rev. 06/13/05
Page 7 of 7
Massachusetts Department of Environmental Protection
'
Bureau of Resource Protection -Wetlands
DEP Regional Addresses
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Charlton
Hopkinton
Mail transmittal forms and DEP payments, payable to:
Rutland
Uxbridge
627 Main Street
Commonwealth of Massachusetts
Clinton
Hubbardston
Millville
Department of Environmental Protection
Warren
Ashby
Box 4062
Hudson
New Braintree
Shrewsbury
Boston, MA 02211
Worcester, MA 01605
Athol
Douglas
DEP Western Region Adams Colrain Hampden
Monroe
Pittsfield
Tyringham
436 Dwight Street Agawam Conway Hancock
Montague
Plainfield
Wales
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
Northborough
Southborough
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
Weymouth
Boxborough
Harvard
Medway
Phillipston
Townsend
Wilmington
Boylston
Hardwick
Mendon
Princeton
Tyngsborough
Winchester
Brookfield
Holden
Milford
Royalston
Upton
Winthrop
Canton
Hopedale
Medford
Norwood
Tewksbury
Woburn
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
Bourne
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 1of 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
forms on the
computer, use
only the tab
key to move
your cursor -
do not use the
return key.
VQ
ietrm
Person or party making request (if appropriate, name the citizen group's representative):
Name
Mailing Address
City/Town
Phone Number
Project Location
Mailing Address
State
Fax Number (if applicable)
Zip Code
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
Phone Number
3. DEP File Number:
B. Instructions
1. When the Departmental action request is for (check one):
❑ Superseding Order of Conditions
❑ Superseding Determination of Applicability
State
Fax Number (if applicable)
Zip Code
❑ 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. 10/04 Page 1 of 2
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. 10/04 Page 2 of 2