HomeMy WebLinkAboutMiscellaneous - 1951 Turnpike Street5
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CONSERVATION DEPARTMENT
Community Development Division
NEGATIVE DETERMINATION OF APPLICABILITY
SPECIAL CONDITIONS
Harold Parker Bay Circuit Trail Boardwalk,North Andover
15 public hearing, the North Andover Conservation f n�ro°nm�Y 160linearfoot
to
At the June 14, 20 plicabilityforconstructionthepp
within Harold Parker State Forest.The new
issue a Negative Determinate Ve etaped Wetland (BVW)within
boardwalk to span Bordering g
boardwalk will improve safety by replacing the existing access over an uneven stone wall.
Friends of North Andover Trails
Applicant: P.O.Box 212
North Andover,MA 01845
Owner: Commonwealth of Massachusetts
Department of Conservation and Recreation
1951 Turnpike Street
North Andover,MA 01845
Stephen David,Park Supervisor
Record Documents: Request ination of ApplicabilityIncluding Project&Work
Descrifor Determption,Waiver Request Form,and p
Submitted:June 10,2015
Plans Titled: Exhibit B:Plan—Bay circuit Trail Boardwalk Proposal,
Exhibit C:Drawing of Boardwalk (2 pages)
SPECIAL CONDITIONS:
•'• ervation Department of the start of work.
The applicant shall notify the Cons
• tin accordance with the work description
Dur Construction
•'• All work shall be conducted using hand tools and equpmen
• thin the wetland resource area.
referenced herein.There shall be no cutting of wood wi
Post Construction
.•. hall be contacted to conduct
lesion of all requirements,the Conservation Department s
Upon com p
a final site inspection.
16M C)sgood Sheet,$Wilding 20,Suite 2-36,North over,Massachusetts 01845
Phone 978.688.9530 Fag 978.588.9542
Web:http.//www.townornorihaaaDvrscom/Pages'int'`adoverMA--Consesvatian'indes
y � i
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. General Information
important: From:
When filling out
forms on the North Andover
computer, use Conservation Commission
only the tab Property Owner(if different from applicant):
key to move To: Applicant
your cursor- Commonwealth of Massachusetts
do not use the Friends of North Andover Trails Name
return key. Name 1951 Turnpike Street
PO Box 212 Mailing Address
Mailing Address 01845 North Andover MA 01845
North Andover MA State Zip Code
City/Town State Zip Code City/Town
1. Title and Date (or Revised Date if applicable)of Final Plans and Other Documents:
Exhibit B: Plan- Ba June 10, 2015 Circuit Trail Boardwalk Proposal Date
Title
Date
Title
Date
Title
2. Date Request Filed:
June 10, 2015
B. Determination
Pursuant to the authority of M.G.L. c. 131, § 40, the Conservation Commission considered your
Request for Determination of Applicability, with its supporting documentation, and made the following
Determination.
Project Description (if applicable):
Installation of a boardwalk on the Bay Circuit Trail within Bordering Vegetated Wetland.
Project Location:
North Andover
Harold Parker State Forest City/Town
Street Address Lot 44
Map 108C Parcel/Lot Number
Assessors Map/Plat Number
Page 1 of 5
wpaform2.doc•Determination of Applicability•rev.12/14
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Determination (cont.)
The following Determination(s) is/are applicable to the proposed site and/or project relative to the Wetlands
Protection Act and regulations:
Positive Determination
Note:No work within the jurisdiction of the Wetlands
of Intent or Abbreviated Notice of Intent)olr Order of
rder° d
Conditions (Issued following submittal of a has been receive
Resource Area Delineation (issuedfollowing
Commission on oal of r the Department o ed Review Environmental Protection).
from the issuing authority(i.e.,
F11. The area described on the referenced an (qui s a the filing on area f ect a Nofi a of Intentnder the Act.
Removing,filling,dredging, or altering of the
reas described on
e referenced
❑ 2a.The boundary delineations of the follolarea boundaries confirmed n thishDetermination are
are
confirmed as accurate.Therefore,the resource
binding as to all decisions rendered pursuant to the ation s v►alldnds Protection Act and its regulations regarding
such boundaries for as long as this Dete
ed by
❑ 2b. The boundaries of resource areas listed a contained on plans not latta hed t ithDeDete oination or
regardless of whether such boundaries are
to the Request for Determination.
thin
an area
ect to
❑ 3. The work described on referenced oplenf II, dredgecorlalterthst sent(s) is ires Therefore, said work
protection under the Act and will remove,
requires the filing of a Notice of Intent.
in the
uffer Zone
❑ 4.The wont described on referenced planand
. Therer'ore,(said Wiork requBes the filing of swill
l
alter an Area subject to protection under the Aci
Notice of Intent or ANRAD Simplified Review(if work is limited to the Buffer Zone).
❑ 5. The area and/or work described on referenced plan(s)and document(s) is subject to review
and approval by:
Name of Municipality
Pursuant to the following municipal wetland ordinance or bylaw:
Ordinance or Bylaw Citation
Name
Page 2 of 5
wpafo
doc•Determination of Applicability
.rev.12/14
rm2
Massachusetts Department of Environmental Protection
Bureau of iResource Protection -Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Determination (cont.)
❑ 6. The following area and/or work, if any, is subject to a municipal ordinance or bylaw but not
subject to the Massachusetts Wetlands Protection Act:
❑ 7. If a Notice of Intent is filed for the work in the Riverfront Area described on referenced plan(s)
and document(s), which includes all or part of the work described in the Request, the applicant
must consider the following alternatives. (Refer to the wetland regulations at 10.58(4)c. for more
information about the scope of alternatives requirements):
❑ Alternatives limited to the lot on which the project is located.
❑ Alternatives limited to the lot on which the project is located, the subdivided lots, and any
adjacent lots formerly or presently owned by the same owner.
❑ Alternatives limited to the original parcel on which the project is located, the subdivided
parcels, any adjacent parcels, and any other land which can reasonably be obtained within
the municipality.
❑ Alternatives extend to any sites which can reasonably be obtained within the appropriate
region of the state.
Negative Determination
Note: No further action under the Wetlands Protection Act is required by the applicant. However, if the
Department is requested to issue a Superseding Determination of Applicability, work may not proceed
on this project unless the Department fails to act on such request within 35 days of the date the
request is post-marked for certified mail or hand delivered to the Department. Work may then proceed
at the owner's risk only upon notice to the Department and to the Conservation Commission.
Requirements for requests for Superseding Determinations are listed at the end of this document.
❑ 1. The area described in the Request is not an area subject to protection under the Act or the
Buffer Zone.
® 2. The work described in the Request is within an area subject to protection under the Act, but will
not remove, fill, dredge, or alter that area. Therefore, said work does not require the filing of a
Notice of Intent.
❑ 3. The work described in the Request is within the Buffer Zone, as defined in the regulations, but
will not alter an Area subject to protection under the Act. Therefore, said work does not require
the filing of a Notice of Intent, subject to the following conditions(if any).
❑ 4. The work described in the Request is not within an Area subject to protection under the Act
(including the Buffer Zone). Therefore, said work does not require the filing of a Notice of Intent,
unless and until said work alters an Area subject to protection under the Act.
wpaform2.doc•Determination of Applicability•rev.12/14 Page 3 of 5
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
f WPA ForM 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Determination (cont.)
❑ 5. The area described in the Request is subject to protection under the Act. Since the work
described therein meets the requirements for the following exemption, as specified in the Act and
the regulations, no Notice of Intent is required:
Exempt Activity(site applicable statuatory/regulatory provisions)
6. The area and/or work d scribed in the Request is not subject to review and approval by:
N me of Municipality
Pursuant to a municipal wetlands ordinance or bylaw.
Chapter 178
North Andover Conservation Commission Ordinance or Bylaw citation
Name
C. Authorization
This Determination is issued to the applicant and delivered as follows:
❑ by hand delivery on by certified mail, return receipt requested on
Date
Date
This Determination is valid for three years from the date of issuance (except Determinations for
Vegetation Management Plans which are valid for the duration of the Plan). This Determination does not
relieve the applicant from complying with all other applicable federal, state, or local statutes, ordinances,
bylaws, or regulations.
ority of the Conservation Commission. A copy must be sent to
This Determination must be signed by a maj
the appropriate DEP Regional Office (see
hft ://www.mass. ov/eea/a encies/massde /about/contacts/find-the-massde -re ional-office-for- our-
city-or-town.html) and the property owner(if different from the applicant).
Signatures:
Date
Page 4 of 5
wpaform2.doc•Determination of Applicability•rev.12114
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
WPA Form 2 — Determination of Applic0bility
Massachusetts Wetlands Protection Act M.G.L. c. 131, §4
D. Appeals
ation, any owner of land abutting the land
The applicant, owner, any person aggrieved by this Determin
upon which the proposed work is to be done, or any ten reoents of the city or riate Departmenttof Environmental h land is
p
located, are hereby notified of their right to request t e pp Applicability.
Protection Regional Office (see htt -11www.mass. ov/esale a Supersedingncies/massderrminationcoflApp the- y.
massde -re Tonal-office-for- our-cit -or-town.htmh to ro riate filing
The request must be made by certified nest for Departmail or hand mental Action Fee Transmittalepartment, with tFor) as provided of the
ery to th
fee and Fee Transmittal Form (see Request � Determination. A copy
310 CMR 10.03(7)within ten business days from the date of issuance oft is
request shall at the same time be sent by certified mailor
hanues d de it erystato tearlyhe oand concisely�he fission
q appellant.The q
and to the applicant if he/she is not the app
objections to the Determination which is being appealed.To the extent that the Determination is based on
a municipal ordinance or bylaw and not on the Massachuutrts sW Hands Protection Act or regulations, the
Department of Environmental Protection has no appellateJ
Page 5 of 5
,.,nafnrm2.doc•Determination of Applicability•rev.12114
Massachusetts Department of Environmental Protection
DEP File Number:
ILI Bureau of Resource Protection -Wetlands
Request for Departmental Action Fee
Transmittal Form Provided by DEP
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. Request Information
1. Location of Project
a.Street Address b.City/Town,Zip
c.Check number d.Fee amount
Important:
When filling 2 Person or party making request(if appropriate, name the citizen group's representative):
out forms on
the computer, Name
use only the
tab key to Mailing Address
move your
cursor-do City/Town State Zip Code
not use the
return key. Phone Number Fax Number(if applicable)
3. Applicant(as shown on Determination of Applicability(Form 2), Order of Resource Area Delineation
(Form 4B), Order of Conditions (Form 5), Restoration Order of Conditions (Form 5A), or Notice of
Non-Significance(Form 6)):
Name
Mailing Address
City/Town State Zip Code
Phone Number Fax Number(if applicable)
4. DEP File Number:
B. Instructions
1. When the Departmental action request is for(check one):
❑ Superseding Order of Conditions—Fee: $120.00(single family house projects)or$245(all other
projects)
❑ Superseding Determination of Applicability—Fee: $120
❑ Superseding Order of Resource Area Delineation—Fee: $120
Send this form and check or money order, payable to the Commonwealth of Massachusetts, to:
Department of Environmental Protection
Box 4062
Boston, MA 02211
woaform2.doc•Reauest for Departmental Action Fee Transmittal Form•rev.12/15 Pana 1�r 9
Massachusetts Department of'Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
Request for Departmental Action Fee
Provided by DEP
Transmittal f=orm
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 (see http://www.mass.gov/eea/aQencies/massdep/about/contacts/).
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.
The Commonwealth of Massachusetts _4 /t
t. = Executive Office of Health and Human Sej
Department of Public Health !Z z,,b► ��
Bureau of Environmental Health
Community Sanitation Program
g y 5 Randolph Street 9j.14r'e ss 7
Canton MA 02021 r
DEVAL L.PATRICK ' (7�� I £Lr,�t�t2✓'
GOVERNOR Telephone: 781 828-7910
JOHN W.POLANOWICZ Facsimile: 781828-7703
SECRETARY
CHERYL BARTLETT,RN Marian.Robertson@state.ma.us
COMMISSIONER
August 1, 2013
Samantha Overton,Deputy Director
MassParks
Department of Conservation and Recreation
251 Causeway Street, Suite 600
Boston,MA 0211.4 (electronic copy)
Re: Facility Inspection—Harold Parker State Forest,North Andover
Dear Ms. Overton:
In accordance with M.G.L. c. 1.11, §§ 3 and 127A as well as Massachusetts Department of:Public Health (Department)
Regulations 105 CMR 440.000: Minimum Standards for Developed Family Type Camp Grounds(State Sanitary Code,
Chapter VI),and 105 CMR 445.000: Minimum Standards for Bathing Beaches (State Sanitary Code, Chapter VII); I
conducted an inspection of Harold Parker State Forest on July 1.2,2013, at 1:10 p.m. accompanied by Paul Halfmann
of the Community Sanitation Program.Violations noted during the inspection are listed below:
HEALTH AND SAFETY VIOLATIONS
(* indicates conditions documented on previous inspection reports)
Contact Station
Bathroom
No Violations Noted
Lorraine Park Campground
Dumping Station
No Violations Noted
Campground Swimming Area
No Violations Noted
Camp Sites
105 CMR 440.07(4) Water Supply: Missing backflow preventer on water spigot at camp.site# 7 and 307
Dumpsters
Front Dumpster
No Violations Noted
Dumpster Near Camp Site#17
105 CMR 440.11(2)* Refuse Storage and Disposal: Dumpster lids left open
440-13-DCR-North Andover-Harold Parker State Forest-Report 8-1-13 Page l of 4
4
Dumpster Near Camp Site #59
105 CMR 440.11(2)* Refuse Storage and Disposal: Dumpster lids left open
105 CMR 440.11(1) Refuse Storage and Disposal: Refuse over flowing from the receptacles
Dumpster Near Camp Site # 113
105 CMR 440.11(2)* Refuse Storage and Disposal: Dumpster lids left open
Comfort Station 1
2 Compartment Sink
No Violations Noted
Men's Room
No Violations Noted
Women's Room
105 CMR 440.08(2)* Toilet Facilities: No soap at handwashing sinks
105 CMR 440.08(2) Toilet Facilities: Hand dryer damaged and not working
105 CMR 440.09(5) Lavatories and Showers: Lavatory not maintained in a clean and sanitary condition,
excessive amounts of dead bugs in one light shield
Comfort Station 2
Exterior
1.05 CMR 440.03(1) Housing: Wall shingles rotting at bottom of building
Men's Room
105 CMR 440.08(2) Toilet Facilities: Left sink cold faucet loose
105 CMR 440.08(2) Toilet Facilities: Left sink rusted
105 CMR 440.08(2)* Toilet Facilities: Wall damaged behind toilet in toilet stall # 3
105 CMR 440.09(5)* Lavatories and Showers: Shower not maintained in a clean and sanitary condition,
excessive amounts of dead bugs in the light shield above shower# 3
105 CMR 440.09(5) Lavatories and Showers: Left door casing damaged
Women's Room
105 CMR 440.08(2)* Toilet:Facilities: Outer door not weather tight
105 CMR 440.08(2)* Toilet Facilities: Sinks damaged,rusted
105 CMR 440.08(2)* Toilet Facilities: Ceiling paint peeling
105 CMR 440.09(5)* Lavatories and Showers: Shower wall tiles damaged in all showers
105 CMR 440.08(2)* Toilet Facilities: Screen not tight fitting
105 CMR 440.09(5) Lavatories and Showers: Lights not secure above showers
105 CMR 440.09(5) Lavatories and Showers: Wash basins not maintained in good working order,hot
water temperature measured 135°F
Comfort Station 3
Exterior
No Violations Noted
Men's Room
105 CMR 440.08(2) Toilet Facilities: No paper towels provided
Women's Room
105 CMR 440.08(2) Toilet Facilities:No paper towels provided
Play Ground
No Violations Noted
440-13-DCR-North Andover-Harold Parker State Forest-Report 8-1-1.3 Page 2 of 4
Comfort Station 4
Exterior
No Violations Noted
2 Compartment Sink
No Violations Noted
Men's Room
105 CMR 440.08(2)* Toilet Facilities: Screen door damaged
105 CMR 440.08(2) Toilet Facilities: Left window screen damaged
105 CMR 440.09(5) Lavatories and Showers: Lights not secure above all showers
105 CMR 440.09(5) Lavatories and Showers: Shower not maintained in a clean and sanitary condition,
excessive amounts of dead bugs in the light shields
1.05 CMR 440.09(5) Lavatories and Showers: Lavatory not maintained in a clean and sanitary condition,
wall tiles missing in toilet stall #2
105 CMR 440.08(2) Toilet Facilities: Sinks rusted
105 CMR 440.09(5) Lavatories and Showers: Shower not maintained in a clean and sanitary condition,
grout missing in shower#2 and 3
Women's Room
105 CMR 440.07(4)* Water Supply: Missing backflow preventer on sink faucet
105 CMR 440.09(5) Lavatories and Showers: Wash basins not maintained in a clean and sanitary
condition,sink# 2 and 3 rusted
1.05 CMR 440.09(5) Lavatories and Showers: Shower wall tiles damaged in all showers
105 CMR 440.09(5) Lavatories and Showers: Light shield over toilets not secured properly
Frye Pond—Beach Area
No Violations Noted
Observations and Recommendations
1. The Department recommends that all female bathroom stalls be equipped with trash receptacles for feminine
hygiene products.
2. Hot water temperature measured 135°F in handwash sinks at Comfort Station 2 in women's bathroom. Hot
water temperature range for handwash sinks is 1 l 0°F to 1300F.
3. The lights were off in the Female Bathroom in Comfort Station # 3 at the time of inspection.
This facility does not comply with the Department's Regulations cited above. To review the specific regulatory
requirements or download a copy of 1.05 CMR 440.000,please visit our website at wNNNv.mass.gov/dpli/dcs and click
on "Family-Type Campgrounds"(available in both PDF and RTF formats).
To review the Beach Regulations or download a copy,please visit the Beaches website at w,NNw.inass.gov/dph/beaches
and click on "Minimum Standards for Bathing Beaches, State Sanitary Code"(available in both PDF and RTF
formats).
440-13-DCR-North Andover-Harold Parker State Forest-Report 8-1-13 Page 3 of 4
Q
This inspection report is signed and certified under the pains and penalties of perjury.
Sincerely,
1_ft�
Marian Robertson
Environmental Health Inspector, CSP,BEH
cc: Suzanne K. Condon,Associate Commissioner,Director, BEH
Steven Hughes,Director, CSP,BEH
Susan Sawyer, RSLREHS,Health Director,North Andover Board of Health
Priscilla Geigis, Director,MassParks,DCR (electronic copy)
Gary Briere,Assistant Director for Recreation,MassParks,DCR (electronic copy)
Anita Wysocki,Camping Program Coordinator,MassParks, DCR (electronic copy)
Ruth Teixeira,Director of Park Improvement, :DCR (electronic copy)
Susan F. Hamilton,Regional Director,DCR (electronic copy)
Thomas M. Walsh,District Manager,DCR (electronic copy)
Steve David, Supervisor, .DCR (electronic copy)
440-13-DCR-North Andover-Harold Parker State Forest-Report 8-1-13 Page 4 of 4
1 n
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SACHU`+�
CONSERVATION DEPARTMENT
Community Development Division
NEGATIVE DETERMINATION OF APPLICABILITY
SPECIAL CONDITIONS
Harold Parker State Forest, North Andover
At the March 14, 2012 public hearing the North Andover Conservation Commission (NACC)voted to issue a
Negative Determination of Applicability for demolition of an existing wood bridge and replacement with a new
wood bridge in the same footprint. The bridge is located on an existing fire road known as Mason Road at the
spillway on Sutton Pond. All work will be completed by hand. Work shall comply with the following:
Applicant: Harold Parker State Forest Commonwealth of MA D.C.R.
1951 Turnpike Road
North Andover,MA 01845
Record Documents: Form 1: Request for Determination of Applicability,received February 21, 2012
Including Maps,Bridge Detail and Photographs
Prepared by Steve David, Forest and Park Supervisor III
Construction Conditions
•3 The applicant shall place erosion controls (as approved by the Conservation Department) on either side of the
bridge where the land slopes down to the stream.
❖ Prior to work commencing on the site, the applicant shall contact the Conservation Department for a pre-
construction meeting with the applicant and to inspect the erosion control.
❖ Excess material and construction debris shall be properly disposed of offsite. Stockpiled material shall be placed
in a truck or under tarps.
Post Construction
❖ Immediately following completion of the work and prior to the removal of erosion controls, any disturbed areas
will be permanently stabilized against erosion by loaming and seeding.
❖ Upon completion of all requirements, the Conservation Department shall be contacted to conduct a final site
inspection. With the permission of the Conservation Department, erosion controls shall be removed.
1600 Osgood Street,Building 20,Suite 2-36,North Andover,Massachusetts 01845
Phone 978.688.9530 Fax 978.688.9542
Web:http://xvww.townofnorthandover.com/Pages/NAndovetAIA_Conservation/index
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
NAPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. General Information
Important:
When filling out From:
forms on the North Andover
computer, use Conservation Commission
only the tab
key to move To: Applicant Property Owner(if different from applicant):
your cursor-
do not use the Harold Parker State Forest Commonwealth of MA
return key. D. C. R. Name
1951 Turnpike Street
Mailing Address Mailing Address
North Andover MA 01845
City/Town State Zip Code City/Town State Zip Code
1. Title and Date(or Revised Date if applicable) of Final Plans and Other Documents:
RDA(including Form 1, Maps, Bridge detail and Photographs) February 21, 2012
Title Date
Title Date
Title Date
2. Date Request Filed:
February 21, 2012
B. Determination
Pursuant to the authority of M.G.L. c. 131, §40, the Conservation Commission considered your
Request for Determination of Applicability, with its supporting documentation, and made the following
Determination.
Project Description (if applicable):
Replacment-in-kind of the Stearn's Pond Fire Road bridge within Riverfront and the Buffer Zone to
Bordering Vegetated Wetland.
Project Location:
Harold Parker State Forest Commonwealth of MA North Andover
D. C. R. City/Town
Map 108C Parcel 41
Assessors Map/Plat Number Parcel/Lot Number
wpaform2.doc-Determination of Applicability-rev.10/6/04 Page 1 of 5
Y
5
Massachusetts Department of Environmental Protection
ILIBureau of Resource Protection -Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Determination (cont.)
The following Determination(s) is/are applicable to the proposed site and/or project relative to the Wetlands
Protection Act and regulations:
Positive Determination
Note: No work within the jurisdiction of the Wetlands Protection Act may proceed until a final Order of
Conditions (issued following submittal of a Notice of Intent or Abbreviated Notice of Intent) or Order of
Resource Area Delineation (issued following submittal of Simplified Review ANRAD) has been received
from the issuing authority(i.e., Conservation Commission or the Department of Environmental Protection).
❑ 1. The area described on the referenced plan(s)is an area subject to protection under the Act.
Removing,filling, dredging, or altering of the area requires the filing of a Notice of Intent.
❑ 2a.The boundary delineations of the following resource areas described on the referenced plan(s)are
confirmed as accurate.Therefore,the resource area boundaries confirmed in this Determination are
binding as to all decisions rendered pursuant to the Wetlands Protection Act and its regulations regarding
such boundaries for as long as this Determination is valid.
❑ 2b. The boundaries of resource areas listed below are not confirmed by this Determination,
regardless of whether such boundaries are contained on the plans attached to this Determination or
to the Request for Determination.
❑ 3. The work described on referenced plan(s)and document(s) is within an area subject to
protection under the Act and will remove, fill, dredge, or alter that area. Therefore, said work
requires the filing of a Notice of Intent.
❑ 4. The work described on referenced plan(s)and document(s) is within the Buffer Zone and will
alter an Area subject to protection under the Act. Therefore, said work requires the filing of a
Notice of Intent or ANRAD Simplified Review(if work is limited to the Buffer Zone).
❑ 5. The area and/or work described on referenced plan(s)and document(s) is subject to review
and approval by:
Name of Municipality
Pursuant to the following municipal wetland ordinance or bylaw:
Name Ordinance or Bylaw Citation
wpaform2.doc•Determination of Applicability•rev.10/6/04 Page 2 of 5
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Determination (cont.)
❑ 6. The following area and/or work, if any, is subject to a municipal ordinance or bylaw but not
subject to the Massachusetts Wetlands Protection Act:
❑ 7. If a Notice of Intent is filed for the work in the Riverfront Area described on referenced plan(s)
and document(s), which includes all or part of the work described in the Request, the applicant
must consider the following alternatives. (Refer to the wetland regulations at 10.58(4)c. for more
information about the scope of alternatives requirements):
❑ Alternatives limited to the lot on which the project is located.
❑ Alternatives limited to the lot on which the project is located, the subdivided lots, and any
adjacent lots formerly or presently owned by the same owner.
❑ Alternatives limited to the original parcel on which the project is located, the subdivided
parcels, any adjacent parcels, and any other land which can reasonably be obtained within
the municipality.
❑ Alternatives extend to any sites which can reasonably be obtained within the appropriate
region of the state.
Negative Determination
Note: No further action under the Wetlands Protection Act is required by the applicant. However, if the
Department is requested to issue a Superseding Determination of Applicability, work may not proceed
on this project unless the Department fails to act on such request within 35 days of the date the
request is post-marked for certified mail or hand delivered to the Department. Work may then proceed
at the owner's risk only upon notice to the Department and to the Conservation Commission.
Requirements for requests for Superseding Determinations are listed at the end of this document.
❑ 1. The area described in the Request is not an area subject to protection under the Act or the
Buffer Zone.
❑ 2. The work described in the Request is within an area subject to protection under the Act, but will
not remove, fill, dredge, or alter that area. Therefore, said work does not require the filing of a
Notice of Intent.
® 3. The work described in the Request is within the Buffer Zone, as defined in the regulations, but
will not alter an Area subject to protection under the Act. Therefore, said work does not require
the filing of a Notice of Intent, subject to the following conditions (if any).
See attached conditions
❑ 4. The work described in the Request is not within an Area subject to protection under the Act
(including the Buffer Zone). Therefore, said work does not require the filing of a Notice of Intent,
unless and until said work alters an Area subject to protection under the Act.
wpaform2.doc•Determination of Applicability•rev.10/6/04 Page 3 of 5
Massachusetts Department of Environmental Protection
ILIBureau of Resource Protection -Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Determination (cont.)
❑ 5. The area described in the Request is subject to protection under the Act. Since the work
described therein meets the requirements for the following exemption, as specified in the Act and
the regulations, no Notice of Intent is required:
Exempt Activity(site applicable statuatory/regulatory provisions)
❑ 6. The area and/or work described in the Request is not subject to review and approval by:
Name of Municipality
Pursuant to a municipal wetlands ordinance or bylaw.
North Andover Wetlands Protection Bylaw Chapter 178
Name Ordinance or Bylaw Citation
C. Authorization
This Determination is issued to the applicant and delivered as follows:
❑ by hand delivery on M by certified mail, return receipt requested on
3 I�.
Date Date
This Determination is valid for three years from the date of issuance(except Determinations for
Vegetation Management Plans which are valid for the duration of the Plan). This Determination does not
relieve the applicant from complying with all other applicable federal, state, or local statutes, ordinances,
bylaws, or regulations.
This Determination must be signed by a majority of the Conservation Commission. A copy must be sent to
the appropriate DEP Regional Office (see http://www.mass.gov/dep/about/re.qion.findyour.htm)and the
property owner(if different from the applicant).
Signatures:k";
al I �
Date
wpaform2.doc•Determination of Applicability•rev.10/6/04 Page 4 of 5
Massachusetts Department of Environmental Protection
ILIBureau of Resource Protection -Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
D. Appeals
The applicant, owner, any person aggrieved by this Determination, any owner of land abutting the land
upon which the proposed work is to be done, 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 Department of Environmental
Protection Regional Office(see http://www.mass.gov/dep/about/region.findyour.htm) to issue a
Superseding Determination of Applicability. The request must be made by certified mail or hand delivery
to the Department, with the appropriate filing fee and Fee Transmittal Form (see 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 Determination. 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. The request shall state clearly and concisely the objections to the Determination which is being
appealed. To the extent that the Determination is based on a municipal ordinance or bylaw and not on the
Massachusetts Wetlands Protection Act or regulations, the Department of Environmental Protection has
no appellate jurisdiction.
wpaform2.doc•Determination of Applicability•rev.10/6/04 Page 5 of 5
ILIMassachusetts 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
ras Phone Number Fax Number(if applicable)
17 Project Location
Mailing Address
Cityrrown 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 ($100 for individual single family homes with associated
structures; $200 for all other projects)
❑ Superseding Determination of Applicability($100)
❑ Superseding Order of Resource Area Delineation ($100)
Send this form and check or money order for the appropriate amount, payable to the Commonwealth of
Massachusetts to:
Department of Environmental Protection
Box 4062
Boston, MA 02211
wpaform2.doc•Request for Departmental Action Fee Transmittal Form•rev.10/6/04 Page 1 of 2
r
LlMassachusetts 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(see
http://www.mass.gov/dep/about/region/findyour.htm).
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.
wpaform2.doc•Request for Departmental Action Fee Transmittal Form•rev.10/6/04 Page 2 of 2
� r
f t4ORYt9
O �t�eo
,646 0
O s
%rep
CONSERVATION DEPARTMENT
Community Development Division
NEGATIVE DETERMINATION OF APPLICABILITY
SPECIAL CONDITIONS
NSNEMBA 2009 Project, Harold Parker State Forest North Andover
Project, ,
At the January 13, 2010 public hearing, the North Andover Conservation Commission (NACC)
voted to issue a Negative Determination of Applicability for the construction of three (3) bog
bridges across wet sections of an existing trail to access a proposed new trail. The bridges are
proposed within Bordering Vegetated Wetland (BVW). All materials will be carried in and installed
by hand. The project also includes the construction of approximately 2,3001.f. of new trail with
minimal disturbance to vegetation and soils (nothing over 4"in diameter to be cut). The trail will
cross one narrow intermittent stream. The crossing will require minimal rock armoring. Portions of
the trail are within the 100-foot buffer zone to BVW. Signage directing trail users will also be
installed.This application is to specifically permit a new trail within Harold Parker State Forest and
does not permit the prior construction or use of other trails within the forest system.The approved
new trail is designated by a dashed yellow line on the proposed plan referenced below.
Applicant: North Shore New England Mountain Bike Association (NSNEMBA)
3 Boston Road
Newbury,MA 01951
Property Owner: The Commonwealth of Massachusetts
Harold Parker State Forest
C/O Steve David, Supervisor
1951 Turnpike Street, Route 114
North Andover,MA 01845
Record Documents: Request for Determination of Applicability
Prepared by: Dan Streeter,NSNEMBA (Trails Project Coordinator)
Dated: December 2, 2009
Site plans entitled, "NSNEMBA 2009 Project" 2 pages
Prepared by: NSNEMBA
Dated: December 2, 2009
Other Record Documents: Typical Boardwalk Section Diagrams
Dated: December 2, 2009
Prepared by: NSNEMBA
1600 Osgood Street,Building 20,Suite 2-36,North Andover,Massachusetts 01843
Phone 978.688.9530 Fax 978.688.9542
Web:http://vw-w.townofnorthandover.com/Pages/NAndoverMA—Consenation/index
r �
Prior to Construction
The applicant shall inform the Conservation Department a minimum of 48 hours prior to the
start of work.
During Construction
All work shall be conducted using hand tools and equipment.
•3 Access to Harold Parker for proposed construction shall be from Middleton Road. Materials
shall be carried into construction locations by hand.
Proper construction practices shall be utilized and the boardwalks constructed as shown in the
referenced boardwalk details.
Limited cutting of vegetation is permitted with nothing over 4"in diameter to be removed. All
cut vegetation shall be left in place or dispersed off the proposed trail outside of resource areas.
Y from private
Signage shall be installed clearly marking the new trail and directing trail users awa
•
property. Signage marking the edge of Harold Parker State Forest shall also be installed. Trail
markers shall be installed with the approval of the Conservation Department.
Post Construction
•o Once the site is adequately stabilized, the Conservation Department shall be contacted to
conduct a final site inspection.
1600 Osgood Street,Building 20,Suite 2-36,North Andover,'Massachusetts 01845
Phone 978.688.9530 Fax 978.688.9542
Web:http:/%u-w-xv.townotnortliandover.com/Pages/NAndoverliA—Conservation/index
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. General Information
Important:
When filling out From:
forms on the North Andover
computer, use Conservation Commission
only the tab
key to move To: Applicant Property Owner(if different from applicant):
your cursor-
do not use the New England Mountain Bike Association Commonwealth
return key. Name Name
3 Boston Road 1951 Turnpike Street, Rte. 114
� Mailing Address Mailing Address
Newbury MA 01951 North Andover MA 01845
City/Town State Zip Code City/Town State Zip Code
reran
1. Title and Date (or Revised Date if applicable) of Final Plans and Other Documents:
NSNEMBA 2009 Project 12/2/09
Title Date
Title Date
Title Date
2. Date Request Filed:
12/4/09
B. Determination
Pursuant to the authority of M.G.L. c. 131, §40, the Conservation Commission considered your
Request for Determination of Applicability, with its supporting documentation, and made the following
Determination.
Project Description (if applicable):
Construction of a loop trail within Harold Parker State Forest. The proposed trail is within the Buffer
Zone to Bordering Vegetated Wetland (BVW) and includies a crossing of an intermittent stream with the
use of rock armoring. The proposal also includes the installation of three (3) bog bridges (12', 20'and 16')
on an existing trail used to access the new trail. The bridges will be constructed in seasonally wet BVW
areas. Signage will be installed to keep users on the existing trails stem
Project Location:
Middleton Street North Andover
Street Address City/Town
Map 109 Parcels 33, 25, 26
Assessors Map/Plat Number Parcel/Lot Number
wpaform2.doc-Determination of Applicability-rev.10/6/04 Page 1 of 5
Y
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Determination (cont.)
The following Determination(s) is/are applicable to the proposed site and/or project relative to the Wetlands
Protection Act and regulations:
Positive Determination
Note: No work within the jurisdiction of the Wetlands Protection Act may proceed until a final Order of
Conditions (issued following submittal of a Notice of Intent or Abbreviated Notice of Intent) or Order of
Resource Area Delineation (issued following submittal of Simplified Review ANRAD) has been received
from the issuing authority(i.e., Conservation Commission or the Department of Environmental Protection).
❑ 1. The area described on the referenced plan(s) is an area subject to protection under the Act.
Removing,filling, dredging, or altering of the area requires the filing of a Notice of Intent.
❑ 2a. The boundary delineations of the following resource areas described on the referenced plan(s)are
confirmed as accurate. Therefore, the resource area boundaries confirmed in this Determination are
binding as to all decisions rendered pursuant to the Wetlands Protection Act and its regulations regarding
such boundaries for as long as this Determination is valid.
❑ 2b. The boundaries of resource areas listed below are not confirmed by this Determination,
regardless of whether such boundaries are contained on the plans attached to this Determination or
to the Request for Determination.
❑ 3. The work described on referenced plan(s) and document(s) is within an area subject to
protection under the Act and will remove, fill, dredge, or alter that area. Therefore, said work
requires the filing of a Notice of Intent.
❑ 4. The work described on referenced plan(s) and document(s) is within the Buffer Zone and will
alter an Area subject to protection under the Act. Therefore, said work requires the filing of a
Notice of Intent or ANRAD Simplified Review(if work is limited to the Buffer Zone).
❑ 5. The area and/or work described on referenced plan(s) and document(s) is subject to review
and approval by:
Name of Municipality
Pursuant to the following municipal wetland ordinance or bylaw:
Name Ordinance or Bylaw Citation
wpaform2.doc-Determination of Applicability-rev.10/6/04 Page 2 of 5
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Determination (cont.)
❑ 6. The following area and/or work, if any, is subject to a municipal ordinance or bylaw but not
subject to the Massachusetts Wetlands Protection Act:
❑ 7. If a Notice of Intent is filed for the work in the Riverfront Area described on referenced plan(s)
and document(s), which includes all or part of the work described in the Request, the applicant
must consider the following alternatives. (Refer to the wetland regulations at 10.58(4)c. for more
information about the scope of alternatives requirements):
❑ Alternatives limited to the lot on which the project is located.
❑ Alternatives limited to the lot on which the project is located, the subdivided lots, and any
adjacent lots formerly or presently owned by the same owner.
❑ Alternatives limited to the original parcel on which the project is located, the subdivided
parcels, any adjacent parcels, and any other land which can reasonably be obtained within
the municipality.
❑ Alternatives extend to any sites which can reasonably be obtained within the appropriate
region of the state.
Negative Determination
Note: No further action under the Wetlands Protection Act is required by the applicant. However, if the
Department is requested to issue a Superseding Determination of Applicability, work may not proceed
on this project unless the Department fails to act on such request within 35 days of the date the
request is post-marked for certified mail or hand delivered to the Department. Work may then proceed
at the owner's risk only upon notice to the Department and to the Conservation Commission.
Requirements for requests for Superseding Determinations are listed at the end of this document.
❑ 1. The area described in the Request is not an area subject to protection under the Act or the
Buffer Zone.
® 2. The work described in the Request is within an area subject to protection under the Act, but will
not remove, fill, dredge, or alter that area. Therefore, said work does not require the filing of a
Notice of Intent.
® 3. The work described in the Request is within the Buffer Zone, as defined in the regulations, but
will not alter an Area subject to protection under the Act. Therefore, said work does not require
the filing of a Notice of Intent, subject to the following conditions (if any).
See attached conditions
❑ 4. The work described in the Request is not within an Area subject to protection under the Act
(including the Buffer Zone). Therefore, said work does not require the filing of a Notice of Intent,
unless and until said work alters an Area subject to protection under the Act.
wpaform2.doc-Determination of Applicability•rev.10/6/04 Page 3 of 5
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Determination (cont.)
❑ 5. The area described in the Request is subject to protection under the Act. Since the work
described therein meets the requirements for the following exemption, as specified in the Act and
the regulations, no Notice of Intent is required:
Exempt Activity(site applicable statuatory/regulatory provisions)
❑ 6. The area and/or work described in the Request is not subject to review and approval by:
Name of Municipality
Pursuant to a municipal wetlands ordinance or bylaw.
North Andover Wetlands Protection Bylaw Chapter 178
Name Ordinance or Bylaw Citation
C. Authorization
This Determination is issued to the applicant and delivered as follows:
❑ by hand delivery on V by certified mail, return receipt requested on
Date ///f/ v
Date
This Determination is valid for three years from the date of issuance (except Determinations for
Vegetation Management Plans which are valid for the duration of the Plan). This Determination does not
relieve the applicant from complying with all other applicable federal, state, or local statutes, ordinances,
bylaws, or regulations.
This Determination must be signed by a majority of the Conservation Commission. A copy must be sent
to the appropriate DEP Regional Office (see http://www.mass.gov/dep/about/region.findyour.htm) and the
property owner(if different from the applicant).
Signatures:
17 /tet
JC �
Date
wpaform2.doc•Determination of Applicability•rev.1016/04 Page 4 of 5
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
D. Appeals
The applicant, owner, any person aggrieved by this Determination, any owner of land abutting the land
upon which the proposed work is to be done, 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 Department of Environmental
Protection Regional Office (see http://www.mass.gov/dep/about/region.findyour.htm)to issue a
Superseding Determination of Applicability. The request must be made by certified mail or hand delivery
to the Department, with the appropriate filing fee and Fee Transmittal Form (see 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 Determination. 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. The request shall state clearly and concisely the objections to the Determination which is being
appealed. To the extent that the Determination is based on a municipal ordinance or bylaw and not on the
Massachusetts Wetlands Protection Act or regulations, the Department of Environmental Protection has
no appellate jurisdiction.
wpaform2.doc•Determination of Applicability•rev.10/6/04 Page 5 of 5
LlMassachusetts 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
QPhone Number Fax Number(if applicable)
Project Location
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 ($100 for individual single family homes with associated
structures; $200 for all other projects)
❑ Superseding Determination of Applicability ($100)
❑ Superseding Order of Resource Area Delineation ($100)
Send this form and check or money order for the appropriate amount, payable to the Commonwealth of
Massachusetts to:
Department of Environmental Protection
Box 4062
Boston, MA 02211
-wpaform2.doc•Request for Departmental Action Fee Transmittal Form•rev.10/6/04 Page 1 of 2
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
Request for Departmental Action Fee Transmittal Form
L) I 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(see
hftp://www.mass.gov/dep/about/region/findvour.htm).
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.
wpaform2.doc•Request for Departmental Action Fee Transmittal Form•rev.10/6/04 Page 2 of 2
Commonwealth of Massachusetts Form 4--System Pumping RecB d
Massachusetts
System Pumping Record
System Owner System Location
�C1.Cc,�G c'u_Cj ec 5-':itu worQ:t purC t.- St .if
195: Tutt tike tRoaG
iortri Ance7veL, i , 5
,`J'ra) -f,gf, 41
�.a[,.,tl �,UY ._:r rr-tf,.;t
Type: Emergent Routine
Cesspool: No Yes Septic Tank: No Yes��
Date of Pumping: (� Quantity Pumped f�r�Gallons
System Pumped By: Wind River Environmental,LLC Permit 4
RECEIVED
Contents Transferred to:
JUL -- l ?OiU
TOWN OF NORTH 0 llmm�
HEALTH DEPARTMENT
Contents Disposed at:
6;LeSD
Date: Pumper Signatur .
Condition of System/Other Comments
® Nnted on recycled paper Dep Approved Form-12/07/95
R
APPLICATION FOR*DAY EXTENSION PERMIT
d'
Pursuant to the provisions of M.G.L. c. 131, s. 80A and 321 CMR 2.08, I herebyapply for a Od y
extension permit to continue to alleviate an exist' PP y y
existing threat to human health and safety as determined by
my local Board of Health.
Name: 74:' Date:
Address:
Town:
Zip Code:
Daytime Tel. # Evening Tel. #
Agent Name(if applicable): J c '
Agent Tel. # �
r
nt Location(if different than
Type of Complain •Please provide a detailed description of the threat to public health and safety.
Under M.G.L. c. 131, s. 80A,an extension permit authorizes the applicant or his duly au horized agent to
remedy the threat to human health and safety by one or more of the following option (a) a use of
conibear or box or cage-type traps for the taking of beaver or muskrat, subject to re ons;(b)the
breaching of dams, dikes,bogs or berms; and/or(c)employing any non-lethal management of water-flow
devices.
Applicant Signator : Date
r
Board of Health Official Signature: Date: /r r
Please attach a copy of the Board of Health site visit report (if applicable), a copy of the 10-
day emergency permit and any consent forms. If options B and/or C are employed, attach a
copy of the Emergency Certification from the Conservation Commission.
C Wy Documents\Animal\2001\BEAVER FORMS OCT 2001\Application for 30Day Extension Permit.doe
_ r _
10/24/2011 08:23 FAX
A 1004
lb-DAY EMER11X.11IC'y BEAVER OR MUSKRAT PERMIT
_r T
Name: Mass,Dgpt.of Conservation&Recreation/Harold Parker State Forest Permit No.
Address: 1951 Tyrnnike Road,North Andovcr MA 01845
Authorized Agent Name(if applicable):_PatrMustoe 1 lnteerated Wildlife Lontrol
Complaint Location:Harald Parker Road FIarold darker State Forest,North.Andover,MA_,�,!
In accordance with and pursuant to provisions contained in chapter 131 of the Massachusetts
General taws section 40, $OA and 3?l Code of MtisMachusetts Regulation 2.08 and 10.00
(Wetlands Protection Act),the perrniuce(s)above named may immediately remedy the threat to
human health and safety by one or more of the following options:
(a he use of conibear or box or cage-tyric traps for the taking of beaver or muskrat,
subject to the regulations promulgated by the Division of Fisheries and Wildlife(see --'
back) '
(b) the breaching of clams,dikes,bogs or berms,so-called*
(c) employing any non-lethal management or water-flow devices*
*If the pennittcc chooses option(s)b and/or i;,he/she must appear before the local conservation
commission to obtain an ernergenc^y certification regarding specifications for brcaeh size and/or watcr-
ftow device:installation in accordance to M.G.L.c. 131,s.40(Wetlands Protection Act),
The Hoard of Health has determined that said bcaver or muskrat problem poses a threat tQ public
health and safety as stated in M.G.L.x.131, s.80A.
Specify: Heaver dwnming of a culvert is causing dw-aking flooding of the public road o j�,,,,,..,
daily basis.
Board of Health Official Name:
Board of Health Official Signature: &a Date: G''
Tltc above signature validat Zt6 permit for 10 eonsee tilve days from the date shown for
option(a) only. If the permittee chooses options(b)and/or(c),he/she must retunt to the Board
of Health for a final signature atter obtaining an emergency certification from the conservation
commission.
W24/2011 08:23 FAX
APPLICATION FOR 10-DAY EMERGENCY BE,AVEU OR MUSKRAT PERMIT
TO BE FILLED OUT BY APPLICANT Fee(if applicable):$
Name:Mass.Dept. of Conservation&Recreation/Ilarold Parker Mate forest Date: 10/21/1 l
Address: 1951 'Turnpike Road
Town: North Andover. MA `Lip Code:
Telephone: Steve David (978)686-3341 or(617)'719-4216
Agent Name: Pat_Mustoe/Integrated Wildlife Control Tel, # (413)626,683$ _
(if applicable)
complaint location:,11laroid Parker Road,Harold Barker State Forest,l Orth Andover
Is the problem entirely on your property? Yes: „X__ No:...,_,_ Don't Knew:
Note: If the problem does not occur entirely on the applicant's property,consent
forms from ail other property owners must be obtaincd.
Type of Complaint:Provide a detailed description of the parecived threat to public health and
safety
13eavers are damming at a road culvert and caging damaging flooding;;of the Public road on a
daily-basis.
Under IvI.Cr.L.e. 131,s. $OA,an emergency permit authorizes the applicant or hitiduly authorized agent
to in,tnedistcly remedy the threat to hunnan health and safety by one or more of the following options; (a)
tine use of conibear or box or cage-.type traps for the taking of beaver or muskrat,subject to regulations;
(b)the broaching of dams,dikes,bogs or berivis;and/or(c)employing atny non-lethal management of
water-flow devices, The emergency permit will be,gond for 10 days from the date of issue.
Signature ofApplicant; aW_1-_11,,,___„_. Date:_ go -a?I-- 1!_
NOTE.Options(b)and/or(c)above require applicant to get conservation commission approval prior to
such work in accordance with the wetlands protection act.
10/24"/2011 08:22 FAX
Integrated Wildlife Control
Fax
Pam Ruth Callahan Ta% North Andover Board of Health
Fax: (413)203-1926 Pages: 4
PimneA (413)588.4890 Detke: 10/01110
Rea Tellular:(413)626-0838 CC:
❑Urgent 0 For Review ❑Please Comment 0 Please Reply D Please Recycle
• Comments;
Attached please find a copy of an email that was sent last week seeking a beaver
permit for Mess, Dept,of Conservation&Recreation:'Harold Parker State Forest.
They are having a very hand time with road flooding and we need to get them some
help as soon as possible.
Thank-you.
002
�aiz4izai> 08:23 FAX Page 1 of I
Subj: Beaver Permit Request
Date: 10121/20116:36:18 A.M. Eastern Daylight Time
From: MRCALLNaol.comNi
To. ssawyerCcr�t�iv nQfnorthandoyer.com
Dear Ms. Sawyer,
On behalf of Mass. Dept. of Conservation and Recreation/Harold Parker State Forest, I am requesting
that a beaver permit be issued for a site along Harald Parker Road in North Andover. Beavers there are
aggressively damming at a road culvert causing damaging flooding to the public road on a daily basis.
I have included a permit request as well as a permit for your signature. Upon your approval please fax
or email the permit to me at(413)203-1826 or eailsh2QQQQiaol.%m.
Please do not hesitate to contact me if you have any question;:or require any further information.
Thank you very much for your assistance in this matter.
Sincerely,
Ruth
Don LaFountain/Ruth Callahan
integrated Wildlife Control
PO Sox 60169
Florence, MA 01062.0169
Phone: (413) 586-0890
Fax (413)203-1826
Email: callah20DO@aol.com
Monday, October 24,2011 AOL, M R CA.LLHN