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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 Robert & Tracey Drouin
return key. Name Name
33 Sullivan Street
r� 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:
Plan of Land (sketch) 7/6/1993
Title
Date
Title --
Date
Title
Date
2. Date Request Filed:
11/6/09
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):
Placement of fill and boulder wall to level back yard for construction of play area and swing set within
the Buffer Zone to Bordering Vegetated Wetland. Work was done prior to Conservation Commission
Project Location:
33 Sullivan Street
Street Address
Nap 107B
Assessors Map/Plat Number
North Andover
City/Town
Parcel 99
Parcel/Lot Number
wpaform2.doc • Determination of Applicability • rev. 10/6/04 Page 1 of 5
Ll'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 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
Ll'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).
❑ 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
Name
C. Authorization
Chapter 178
Ordinance or Bylaw Citation
This Determination is issued to the applicant and delivered as follows:
❑ by hand delivery on oy 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.
This Determination must be signed by a majority of the Conservation Commission. A copy must be sent
to the appropriate DEP Regional Office (see hftp://www.mass.gov/dep/about/region.findvour.htm) and the
property owner (if different from the. applicant).
Signatures:
Date r ---r
wpaform2.doc • Determination of Applicability • rev. 10/6/04 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.qov/dep/about/region.findvour.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
Ll'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
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
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.
Cityfrown State Zip Code
VQ
_
Phone Number Fax Number (if applicable)IL
ff
renen
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
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.qov/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