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10 -DAY EMERGENCY BEAVER OR MUSKRAT PERMIT
Name: Permit No.
Address: W e 1C&' Ull(c ) rc"i -
Authorized Agent Name (if applicable):
Complaint Location:
In accordance with and pursuant to provisions contained in chapter 131 of the Massachusetts General
Laws section 40, 80A and 321 Code of Massachusetts Regulation 2.08 and 10.00
(Wetlands Protection Act), the permittee(s) above named may immediately remedy the threat to
human health and safety by one or more of the following options:
(a) the use of conibear or box or cage -type 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 dams, dikes, bogs or berms, so-called*
(c) employing any non -lethal management of water -flow devices*
*In cases where option(s) b and/or c are specified, the applicant must appear before the local
conservation commission to obtain an emergency certification regarding specifications for breach
size and/or water -flow device installation in accordance to M.G.L. c. 131, s. 40 (Wetlands Protection
Act)
The Board of Health has determined that said beaver or muskrat problem poses a threat to public
health or safety as stated in M. G.L. c. 131, s. 80A.
Specify:
Board of Health Official Name:
Board of Health Official Signature:
Date: 4 Z t
The above signature validates this permit for 10 consecutive days from the date shown for
option (a) only. If the permittee chooses options (b) and/or (c), he/she must return to the
Board of Health for a final signature after obtaining an emergency certification from the
conservation commission.
Please attach the emergency certification to this permit and return to the Board of Health for
final approval.
(See Back)
C:\My Documents\Animal\2001\BEAVER FORMS OCT 2001 \1 ODay Emergency Permit.doc
This permit is valid for 10 consecutive days from the date of the final Board of Health
signature.
Board of Health Official Name:
Board of Health Official Signature:
Start Date: End Date: Ext:
This permit does not allow permittee(s) or their authorized agent to trespass on private
property.
This permit or a copy thereof shall be carried on the person of any individual exercising the
authority thereof and shall be shown upon request if challenged by any local or state law
enforcement officer empowered to enforce the provisions of M.G.L. c. 131.
Massachusetts Division of Fisheries and Wildlife trapping regulations
Permittee(s) may destroy problem furbearing mammals (named above) by means of a body
gripping trap or by means of a box or cage type trap including Hancock or Bailey traps for
catching beaver. The pan of Hancock and Bailey traps must be submerged in water. Problem
furbearing mammals that are captured alive shall be disposed of by destruction in a humane
manner. Body gripping traps with a jaw spread not less than 4 inches and not greater than 7
inches or body gripping traps with a jaw spread not less than 6 inches and not exceeding 10
inches for the trapping of beaver only, may be used if such traps are completely submerged in
water. The placement of traps in reference to the proximity of the beaver lodge or beaver dam is
unrestricted, but the disturbance or destruction of the beaver lodge or beaver dam is strictly
prohibited unless otherwise authorized..
Permittee(s) taking problem furbearing mammals, on the property of another, by means of a
trap shall possess a valid Massachusetts trapping license and traps shall be registered
according to M. G.L. c. 131, s. 80.
Said problem furbearing mammals (named above), their carcasses or parts thereof may be
retained by the permittee, sold, bartered, or exchanged for consideration during the open
regulated harvest season for that species. Sealing of beaver pelts is required. Disposition of all
carcasses obtained from the incidental capture of furbearing mammals not authorized by this
permit must be surrendered to the District Wildlife Manager of the Division of Fisheries and
Wildlife having -jurisdiction in the town where the furbearing mammal was taken.
CAMy Documents\Animal\2001\BEAVER FORMS OCT 2001\10Day Emergency Permit.doc
APPLICATION FOR 10—DAY EMERGENCY PERMIT TO MANAGE
BEAVER OR MUSKRAT THREAT
TO BE FILLED OUT BY APPLICANT Fee (if applicable): $
Name: Date:
Address:
Town: A�n/ Aa, Zip Code: l �V S
Daytime Tel. # f Evening Tel. #
Agent Name:
(if applicable)
Complaint Location} //
Z��7, �" Z,/4
Tel. #
Is the problem entirely on your. property? Yes: No: Don't Know:
Note: If the problem does not occur entirely on the applicant's property, consent forms from all
other property owners must be obtained.
Complaint Condition: Check appropriate box and provide a detailed description of the perceived threat
to public health and safety
❑ Flooding of drinking water well
❑ Flooding of septic system or sewer
❑ Flooding of public or private way or driveway
❑ Flooding of a utility structure such as an electrical or communications facility
0 Flooding of a building
❑ Flooding poses imminent threat of substantial property damage
;7 Flooding which prevents normal agricultural use of land
ikf Other condition
�^ r
Under M.G.L. c. 131, s. 80A, an emergency permit authorizes the applicant or his duly authorized agent
to immediately remedy the threat to human health and safety by one or more of the following options: (a)
the use of conibear or box or cage -type traps for the taking of beaver or muskrat, subject to regulations;
(b) the breaching of dams, dikes, bogs or berms; and/or (c) employing any non -lethal management of
water -flow devices. The emergency permit will be good for 10 days from the date of issue.
I certify the above information is true and correct to the best of my knowledge
s� J
Signature of Applicant: ! Date:
THIS SECTION IS FOR COMPLETION BY NORTH ANDOVER HEALTH AND CONSERVATION DEPARTMENTS
Site visit by Health: Date
Approved Permit #
Permit Denied
Date
Inspector name:
Start Date End Date
Director Signature
Site visit by Conservation: Date Inspector name:
Conservation Commission Application Required: Yes
Findings & recommendations:
No
Ext. Date
Note: Options (b) and/or (c) above require applicant to get North Andover Conservation Commission
approval prior to such work in accordance with the Wetlands Protection Act.