HomeMy WebLinkAboutApplication - 95 OLYMPIC LANE 8/22/2012 AJO 2 7 2012
NORTH AN
DOVER
L NSERVAT
IONCOMM
8/22/12
North Andover Conservation Commission
North Andover Town Hall
120 Main Street
North Andover, MA 01845
Dear North Andover Conservation Commission:
Goddard Consulting, LLC is pleased to submit this Notice of Intent (NOI) on behalf of the
applicant, Michelle Verminski, for the addition to a single family home including the construction
of a deck and the replacement of a septic tank within the Buffer Zone to a BVW.
Nine copies of the NOI application are enclosed. The titles of all the documents enclosed are as
follows:
• NOI (WPA Form 3)Application Form
• NOI Wetland Fee Transmittal Form and Copy of Fee Checks
• Affidavit of Service,Abutters List, Notification to Abutters
• USGS Map
• Proposed Addition.Atlas Land Surveying, Inc. 8/06/12
• Plan Showing Septic Tank Replacement. Merrimack Engineering Services. 7/26/12
Project Description
The scope of the project is the construction of an addition to a single family home including the
construction of a deck. In order to do this the Septic Tank needs to be relocated and will be
replaced as part of the relocation.All construction will be on a pre-existing lawn which is located
within the 100' Buffer Zone, except for a new septic pipe which will be connected to the existing
S.A.S.which is in the 50' No Disturb Zone. However,with proper erosion control barriers in place
there will be no effect on the wetlands. We would also like to note that the tree line is adjacent
with the wetland boundary.
Also, the property is located within the estimated habitat for rare wetland wildlife, however, it is
exempt from MESA review because the project is an addition to a single family home within the
area of an existing lawn with no expansion of such lawn.
If there are any questions concerning this submission,please do not hesitate to contact us.
Sincerely,
Goddard Consulting, LLC
by
fl �
. � 1
Scott G Goddard, PWS
Professional Wetland Scientist
cc:
• Michelle Verminski, 95 Olympic Lane, North Andover, MA 01854
• Wetlands Division, DEP-NERO, 205B Lowell Street,Wilmington, MA 01887
2
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SACHUS
APPLICATION CHECKLIST- Notice of Intent
General Requirements- Wetland Protection ByLazv:
Please check the following boxes indicating that you have read&now understand the applicable rule and/or
regulation:
ASection 178.2(page 2) -This section identifies the Town's wetland resource areas.
Section 178.4(page 3) -This section pertains to permit application types. (Note:All applications shall be
accepted as complete before all permits,variances,and approvals required by the Bylaws of the Town
with respect to the proposed activity,at the time of such Notice,have been applied for or obtained").
Section 178.5(page 4) -This section pertains to public hearings and the burden of proof placed on an
applicant.
Section 178.8(page 7) -This section pertains to responsibility for compliance.
General Requirements- Wetland Protection Regulations
Section 1.0. (page 1) -This section pertains to general provisions
11y, Nine (9) copies of the Notice of Intent, plans and appurtenant data(including 2 original stamped and
signed plans) must be delivered by hand,or by certified mail,and received by the NACC office at least
nine (9)business days prior to the scheduled hearing.
LAList of Abutters within 300' of the parcel(s) where work is proposed as certified by the Town Assessor's
Office. (NOTE: This certified list shall not be more than 30 days old at the time of filing.)
Notification made to abutters by certified mail not less than seven(7)calendar days prior to the public
hearing and proof of mailing presented at that hearing in the form of"white slips" or signed "green cards."
Notification of public hearing made in the Lawrence Eagle Tribune at the applicant's expense not less than
seven (7) calendar days prior to the public hearing.
"North Andover Riverfront Maps" (Appendix B)examined to determine if activity or resource area is
located within the designated 200-foot Riverfront Area.
The most recent"Estimated Habitat of Rare Wetlands Wildlife Map &Certified Vernal Pools" map
published by NHESP has been reviewed.
tA State Filing Fee sent to the DEP Lock Box. Town portion of state filing fee and the local Wetland Bylaw fee
has been included with this application(Section 1.4).
81/2" x 11" copy of the portion of the USGS topographic map depicting the project location has been
included with this application.
A written narrative description of the proposed project and potential impacts to all wetland resource areas
1 has been included.
Effective 10/11/06 1
❑ A description of observed valuable and/or unique wildlife habitat characteristics has been included.
Where applicable,a"Wildlife Habitat Evaluation" performed by a qualified Wetland/Wildlife Biologist
has been incl. (Section 6.2).
All resource area flags and associated numbering are present and easily readable in the field as of the
date of this application.
L71,'�A Waiver Request Form (Appendix D),if applicable.
An Alternatives Analysis (Section 5.0),if applicable.
Storntzvater Management Regtirements(Section 7.0):
The project is in compliance with the"Nine (9) North Andover/State Stormwater Standards."
The "DEP Stormwater Management Form" has been submitted with the Notice of Intent and
signed/stamped accordingly (Appendix H).
Hydrologic/hydraulic calculations showing the full flow capacity and velocity of all water courses,open
and only sometimes closed channels,and storm drains flowing into, on and out of the parcel, including
engineering calculations for compensatory flood storage areas have been incl. (Refer to Section 7.0).
Erosion &Sedimentation Control Requirements (Section 4.3)
PLNarrative erosion control plan and/or report provided for any proposed alteration of wetland resource
areas,including the buffer zone.
Construction schedule and sequence provided for any work within a wetland resource area including
specifications for temporary and permanent ground cover.
Plan Requirements(Section 4.3)
A title that includes the name of the project, location and names of the person(s) preparing the drawings
and the date prepared including any revision dates.
Drawings must be stamped and signed by a Registered Professional Civil Engineer of the Commonwealth
&/or Registered Professional Land Surveyor of the Commonwealth (whichever is applicable).
All existing condition plans shall include, at a minimum, the following information
yNAll wetland resource areas within 100' of the proposed work and within 200' of Riverfront Area,
delineated by a professional wetland scientist not more than 3 years from the application submission
date. n �a
• Delineated by: Cr,�\ Cio�,�
e� A on (date): d
OR
• Formally approved delineation on (date): DEP File #
All property boundaries,existing lot lines and abutters from most recent information available at the
Assessor's Office.
"Watershed Protection District Boundaries",surface water supplies, wells,and septic systems within 100'
of proposed work.
Existing contours at not less than 2'intervals and datum source.
Effective 10/11/06 2
❑ All existing natural and man-made features including tree lines,rock outcrops,stone walls, fence lines,cart
roads, foot paths, overhead and underground utilities and drainage structures. If`e_ I nt, µcif cicen 41,
Elevations of all natural and man-made drainage structures, waterways, and wetlands. �cE1ana i�;;�1�1Yy
�a 100-year flood elevations of all natural and/or man-made waterways and waterbodies as determined by
FEMA or engineering calculations.
Subdivision plans shall be submitted at an appropriate scale to accurately depict existing and proposed
conditions (typ.1" = 40'). Individual parcels of land within the Subdivision and under the Wetlands
Protection Act and North Andover Bylaw shall be submitted at an appropriate scale (typ.1" = 20').
All developed condition plaits shall include,at a minimum, the following information(p. 24):
Location of proposed work.
All proposed man-made features including roads, driveways, parking areas, structures,buildings,
overhead and underground utilities.
Subsurface sewage disposal systems.
Proposed grading and changes in elevation depicted with 2' contours and spot grades.
All surface and subsurface drainage structures including the location,cross section, slope and surface
treatment of all drainage channels.
The inverts,slope,pipe materials,catch basins,manholes,and end treatment of all storm drains
discharging within 100' of any wetland resource area.
Location and detail of all temporary erosion control devices, diversions, terraces,silt fences,hay bales
barriers, sedimentation basins,and soil stockpile locations on the project site.
Location and nature of all proposed alterations to wetland resour reas.
Date: 5 0/V;2
------------------------- ------------------------------- _Signature of Applicant or Applicant's epr sentative
- - (TOWN USE ONLY)
❑ COMPLETE APPLICATION- It appears as though your application meets minimum submittal
requirements,as such, a public hearing will be scheduled before the NACC within 21 days upon receipt of
this application.
❑ INCOMPLETE APPLICATION-The following sections of the Wetland Protection Bylaw&/or
Regulations have not been complied with and as a result this Department is rejecting this incomplete
application w/in two (2)business days from the date of receipt (Section 178.4 North Andover Wetland
Protection Bylaw). You may pick up this application and supporting plans at the Conservation Office and
re-file a complete Notice of Intent.
Wetland Bylaw -Section(s):
Wetland Regulations- Section(s):
Signature of Agent: Date:
Effective 10/11/06 3
1
Massachusetts Department of Environmental Protection Provided by MassDEP:
�B/u�reau of Resource Protection -Wetlands MassDEP File Number
Y Y Form 3 ® Notice of I Cite (r, `} ( 1 1�( [`; current Transaction Number
Massachusetts Wetlands Protection Act M.G. c.L1 , - r ' rth Andover
and North Andover Wetlands Protection Byla . } ,_ i yrrown
Important` A. General Information .",)u L ` LUIL
When filling out
forms on the NORTH ANDOVER
computer, use 1. Project Location (Note: electronic filers will click o ' ):
only the tab key
to move your 95 Olympic Lane North Andover 01845
cursor-do not a.Street Address b.City/Town c.Zip Code
use the return
key. Latitude and Longitude: 42.64198°N 71.05203°W
d.Latitude e.Longitude
Q 106.B 33A
f.Assessors Map/Plat Number g. Parcel/Lot Number
2. Applicant:
Michelle Verminski
a.First Name b. Last Name
Note:
Before c.Organization
completing this 95 Olympic Lane
form consult
your local d.Street Address
Conservation North Andover MA 0845
Commission e.City/Town f.State g.Zip Code
regarding any
municipal bylaw 978-208-8711 michelle @verminski.com
or ordinance. h. Phone Number i. Fax Number j.Email Address
3. Property owner(required if different from applicant): ❑ Check if more than one owner
a.First Name b. Last Name
c.Organization
d.Street Address
e.City/Town f.State g.Zip Code
h. Phone Number i. Fax Number j. Email address
4. Representative (if any):
Scott Goddard, PWS
a.First Name b. Last Name
Goddard Consulting, LLC
c.Company
14 Wilson Rodad
d.Street Address
Northborough MA 01532
e.City/Town f.State g.Zip Code
508-525-0726 goddardconsulting @yahoo.com
h.Phone Number i. Fax Number j.Email address
5. Total WPA Fee Paid (from NOI Wetland Fee Transmittal Form):
$110 + $110 Bylaw Fee $42.50 $67.50 + $110 Bylaw Fee
a.Total Fee Paid b.State Fee Paid c.City/Town Fee Paid
wpaform3.doc-rev. 11/16/09 Page 1 of 8
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection -Wetlands MassDEP File Number
WPA Form 3 ® Notice of Intent
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 North Andover
and North Andover Wetlands Protection Bylaws City/Town
A. General Information (continued)
6. General Project Description:
Addition to a single family home, including construction of a deck& the relocation of the septic tank
7a. Project Type Checklist:
1. ® Single Family Home 2. ❑ Residential Subdivision
3. ❑ Limited Project Driveway Crossing 4. ❑ Commercial/Industrial
5. ❑ Dock/Pier 6. ❑ Utilities
7. ❑ Coastal Engineering Structure 8. ❑ Agriculture (e.g., cranberries, forestry)
9. ❑ Transportation 10. ❑ Other
7b. Is any portion of the proposed activity eligible to be treated as a limited project subject to 310 CMR
10.24 (coastal) or 310 CMR 10.53 (inland)?
1. ❑ Yes ® No If yes, describe which limited project applies to this project:
2.Limited Project
8. Property recorded at the Registry of Deeds for:
Essex
a.County b.Certificate#(if registered land)
10653 155
c. Book d. Page Number
B. Buffer Zone & Resource Area Impacts (temporary & permanents
1. ® Buffer Zone Only—Check if the project is located only in the Buffer Zone of a Bordering
Vegetated Wetland, Inland Bank, or Coastal Resource Area.
2. ❑ Inland Resource Areas (see 310 CMR 10.54-10.58; if not applicable, go to Section B.3,
Coastal Resource Areas).
Check all that apply below. Attach narrative and any supporting documentation describing how the
project will meet all performance standards for each of the resource areas altered, including standards
requiring consideration of alternative project design or location.
Resource Area Size of Proposed Alteration Proposed Replacement(if any)
For all projects
affecting other a F-1 Bank Resource Areas, 1. linear feet 2.linear feet
please attach a b. El Bordering Vegetated
narrative Wetland 1.square feet 2.square feet
explaining how
the resource
area was c. ❑ Land Under 1.square feet 2.square feet
delineated. Waterbodies and
Waterways 3.cubic yards dredged
wpaform3.doc•rev. 11/16/99 Page 2 of 8
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands
MassDEP File Number
'f WPA Form 3 ® Notice of Intent
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 North Andover
and North Andover Wetlands Protection Bylaws City/Town
B. Buffer Zone & Resource Area Impacts (temporary & permanent) (cont'd)
Resource Area Size of Proposed Alteration Proposed Replacement(if any
d. ❑ Bordering Land
Subject to Flooding 1.square feet 2.square feet
3.cubic feet of flood storage lost 4.cubic feet replaced
e. ❑ Isolated Land
Subject to Flooding 1.square feet
2.cubic feet of flood storage lost 3.cubic feet replaced
f. ❑ Riverfront Area 1. Name of Waterway(if available)
2.Width of Riverfront Area (check one):
❑ 25 ft. - Designated Densely Developed Areas only
❑ 100 ft. - New agricultural projects only
❑ 200 ft. -All other projects
3. Total area of Riverfront Area on the site of the proposed project: square feet
4. Proposed alteration of the Riverfront Area
a.total square feet b.square feet within 100 ft. c.square feet between 100 ft.and 200 ft.
5. Has an alternatives analysis been done and is it attached to this NOI? ❑ Yes❑ No
6.Was the lot where the activity is proposed created prior to August 1, 1996? ❑ Yes❑ No
3. ❑ Coastal Resource Areas: (See 310 CMR 10.25-10.35)
Check all that apply below. Attach narrative and supporting documentation describing how the project
will meet all performance standards for each of the resource areas altered, including standards
requiring consideration of alternative project design or location.
Online Users:
Include your Resource Area Size of Proposed Alteration Proposed Replacement(if any)
document
transaction a. ❑ Designated Port Areas Indicate size under Land Under the Ocean, below
number
(provided on your
receipt page) b. ❑ Land Under the Ocean
with all 1.square feet
supplementary
information you 2.cubic yards dredged
submit to the
Department. c. ❑ Barrier Beach Indicate size under Coastal Beaches and/or Coastal Dunes below
d. ❑ Coastal Beaches 1.square feet 2.cubic yards beach nourishment
e. ❑ Coastal Dunes 1.square feet 2.cubic yards dune nourishment
wpaform3.doc•rev. 11/16/09 Page 3 of 8
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands MassDEP File Number
WPA Form 3 ® Notice of Intent
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 North Andover
and North Andover Wetlands Protection Bylaws City/Town
B. Buffer Zone & Resource Area Impacts (temporary & permanent) (cont'd)
Size of Proposed Alteration Proposed Replacement(if any)
f. ❑ Coastal Banks 1.linear feet
g. ❑ Rocky Intertidal
Shores 1.square feet
h. ❑ Salt Marshes 1.square feet 2. sq ft restoration, rehab.,creation
i. ❑ Land Under Salt
Ponds 1.square feet
2.cubic yards dredged
j. ❑ Land Containing
Shellfish 1.square feet
k. ❑ Fish Runs Indicate size under Coastal Banks, inland Bank, Land Under the
Ocean, and/or inland Land Under Waterbodies and Waterways,
above
1.cubic yards dredged
I. ❑ Land Subject to
Coastal Storm Flowage 1.square feet
4. ❑ Restoration/Enhancement
If the project is for the purpose of restoring or enhancing a wetland resource area in addition to the
square footage that has been entered in Section B.2.b or B.3.h above, please enter the additional
amount here.
a.square feet of BVW b.square feet of Salt Marsh
5. ❑ Project Involves Stream Crossings
a. number of new stream crossings b.number of replacement stream crossings
C. Other Applicable Standards and Requirements
Streamlined Massachusetts Endangered Species Act/Wetlands Protection Act Review
1. Is any portion of the proposed project located in Estimated Habitat of Rare Wildlife as indicated on
the most recent Estimated Habitat Map of State-Listed Rare Wetland Wildlife published by the Natural
Heritage and Endangered Species Program (NHESP)?To view habitat maps, see the Massachusetts
Natural Heritage Atlas or go to
http://www.mass.gov/dfwele/dfw/nhesp/requlatory review/priority habitat/online viewer htm.
a. ® Yes ❑ No If yes, include proof of mailing or hand delivery of NOI to:
Natural Heritage and Endangered Species Program
Division of Fisheries and Wildlife
2008 Route 135, North Drive
b. Date of map Westborough, MA 01581
wpaform3.doc•rev. 11/16/09 Page 4 of 8
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands MassDEP File Number
WPA Form Notice of Intent
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 North Andover
and North Andover Wetlands Protection Bylaws City/Town
C. Other Applicable Standards and Requirements (cont'd)
If yes, the project is also subject to Massachusetts Endangered Species Act(MESA) review(321
CMR 10.18). To qualify for a streamlined, 30-day, MESA/Wetlands Protection Act review, please
complete Section C.1..C, and include requested materials with this Notice of Intent(NOI); OR complete
Section C.1.d, if applicable. If MESA supplemental information is not included with the NOI, by
completing Section 1 of this form, the NHESP will require a separate MESA filing which may take up
to 90 days to review(unless noted exceptions in Section 2 apply, see below).
1. c. Submit Supplemental Information for Endangered Species Review"
1. ❑ Percentage/acreage of property to be altered:
(a)within wetland Resource Area percentage/acreage
(b) outside Resource Area percentage/acreage
2. ❑ Assessor's Map or right-of-way plan of site
3. ❑ Project plans for entire project site, including wetland resource areas and areas outside of
wetlands jurisdiction, showing existing and proposed conditions, existing and proposed
tree/vegetation clearing line, and clearly demarcated limits of work**"
(a)❑ Project description (including description of impacts outside of wetland resource area &
buffer zone)
(b) ❑ Photographs representative of the site
(c)❑ MESA filing fee (fee information available at:
http://www.mass.gov/dfwele/dfw/nhesp/re uq Iatory review/mesa/mesa fee schedule.htm).
Make check payable to"Commonwealth of Massachusetts- NHESP" and mail to
NHESP at above address
Projects altering 10 or more acres of land, also submit:
(d)❑ Vegetation cover type map of site
(e)❑ Project plans showing Priority & Estimated Habitat boundaries
d. OR Check One of the Following
1. ® Project is exempt from MESA review.
Attach applicant letter indicating which MESA exemption applies. (See 321 CMR 10.14,
http://www.mass.gov/dfwele/dfw/nhesp/regulatory review/mesa/mesa exemptions.htm;
the NOI must still be sent to NHESP if the project is within estimated habitat pursuant to
310 CMR 10.37 and 10.59.)
2. ❑ Separate MESA review ongoing. a. NHESP Tracking# b. Date submitted to NHESP
` Some projects not in Estimated Habitat may be located in Priority Habitat,and require NHESP review(see
http://www.mass.gov/dfwele/dfw/nhesp/nhesi3.htm, regulatory review tab). Priority Habitat includes habitat for state-listed plants and
strictly upland species not protected by the Wetlands Protection Act.
" MFSA nroiects my not he segmented (321 CMR 10.161.The annlicant must disclose full development olans even if such plans are
not required as part of the Notice of Intent process.
wpaform3.doc-rev. 11/16/09 Page 5 of 8
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands MassDEP File Number
WPA Form 3 ® Notice of Intent
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 North Andover
and North Andover Wetlands Protection Bylaws City/Town
C. Other Applicable Standards and Requirements (cont'd)
3. ❑ Separate MESA review completed.
Include copy of NHESP"no Take" determination or valid Conservation & Management
Permit with approved plan.
2. For coastal projects only, is any portion of the proposed project located below the mean high water
line or in a fish run?
a. ® Not applicable—project is in inland resource area only
b. ❑ Yes ❑ No If yes, include proof of mailing or hand delivery of NOI to either:
South Shore-Cohasset to Rhode North Shore- Hull to New Hampshire:
Island, and the Cape& Islands:
Division of Marine Fisheries- Division of Marine Fisheries-
Southeast Marine Fisheries Station North Shore Office
Attn: Environmental Reviewer Attn: Environmental Reviewer
1213 Purchase Street—3rd Floor 30 Emerson Avenue
New Bedford, MA 02740-6694 Gloucester,MA 01930
Also if yes, the project may require a Chapter 91 license. For coastal towns in the Northeast Region,
please contact MassDEP's Boston Office. For coastal towns in the Southeast Region, please contact
MassDEP's Southeast Regional Office.
3. Is any portion of the proposed project within an Area of Critical Environmental Concern (ACEC)?
Online Users: a. F1 Yes ® No If yes, provide name of ACEC (see instructions to WPA Form 3 or MassDEP
Include your Website for ACEC locations). Note: electronic filers click on Website.
document
transaction b.ACEC
number
(provided on your 4. Is any portion of the proposed project within an area designated as an Outstanding Resource Water
receipt page) (ORW) as designated in the Massachusetts Surface Water Quality Standards, 314 CMR 4.00?
with all
supplementary a. ❑ Yes ® No
information you
submit to the 5. Is any portion of the site subject to a Wetlands Restriction Order under the Inland Wetlands
Department. Restriction Act(M.G.L. c. 131, §40A) or the Coastal Wetlands Restriction Act(M.G.L. c. 130, § 105)?
a. ❑ Yes ® No
6. Is this project subject to provisions of the MassDEP Stormwater Management Standards?
a. ❑ Yes. Attach a copy of the Stormwater Report as required by the Stormwater Management
Standards per 310 CMR 10.05(6)(k)-(q) and check if:
1. ❑ Applying for Low Impact Development(LID) site design credits (as described in
Stormwater Management Handbook Vol. 2, Chapter 3)
2. ❑ A portion of the site constitutes redevelopment
3. ❑ Proprietary BMPs are included in the Stormwater Management System.
b.® No. Check why the project is exempt:
1. ® Single-family house
wpaform3.doc•rev. 11/16/09 Page 6 of 8
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands MassDEP File Number
WPA Form 3 ® Notice of Intent
LA
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 North Andover
and North Andover Wetlands Protection Bylaws Cityfrown
C. Other Applicable Standards and Requirements (cont'd)
2.❑ Emergency road repair
3.❑ Small Residential Subdivision (less than or equal to 4 single-family houses or less than or
equal to 4 units in multi-family housing project)with no discharge to Critical Areas.
D. Additional Information
Applicants must include the following with this Notice of Intent(NOI). See instructions for details.
Online Users: Attach the document transaction number(provided on your receipt page)for any of the
following information you submit to the Department.
1. 0 USGS or other map of the area (along with a narrative description, if necessary) containing
sufficient information for the Conservation Commission and the Department to locate the site.
(Electronic filers may omit this item.)
2. ® Plans identifying the location of proposed activities (including activities proposed to serve as a
Bordering Vegetated Wetland [BVW] replication area or other mitigating measure) relative to
the boundaries of each affected resource area.
3. ® Identify the method for BVW and other resource area boundary delineations (MassDEP BVW
Field Data Form(s), Determination of Applicability, Order of Resource Area Delineation, etc.),
and attach documentation of the methodology.
4. ® List the titles and dates for all plans and other materials submitted with this NOI.
Proposed Addition
a. Plan Title
Atlas Land Surveying, Inc. Todd P. Chapin
b. Prepared By c.Signed and Stamped by
8/6/12 1"-40'
d. Final Revision Date e. Scale
Plan Showing Septic Tank Replacement 7-26-12
f.Additional Plan or Document Title g.Date
5. ❑ If there is more than one property owner, please attach a list of these property owners not
listed on this form.
6.❑ Attach proof of mailing for Natural Heritage and Endangered Species Program, if needed.
7. ❑ Attach proof of mailing for Massachusetts Division of Marine Fisheries, if needed.
8. ® Attach NOI Wetland Fee Transmittal Form
9. ❑ Attach Stormwater Report, if needed.
wpaform3.doc-rev. 11/16/09 Page 7 of 8
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands MassDEP File Number
® Notice of Intent
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Document Transaction Number
City/Town
E. Fees
1. ❑ Fee Exempt: No filing fee shall be assessed for projects of any city, town, county, or district of
the Commonwealth, federally recognized Indian tribe housing authority, municipal housing
authority, or the Massachusetts Bay Transportation Authority.
Applicants must submit the following information(in addition to pages 1 and 2 of the NOI Wetland Fee
Transmittal Form)to confirm fee payment:
M� -� a-Iq� 2A ( 0
2.Municipal Check Number 37(thec ate
g-nV 115 1)
4.State Check Number 5.Check date r
6.Payor name on check:First Name 7.Payor name on n - �check:Last Name
F. Signatures and Submittal Requirements
I hereby certify under the penalties of perjury that the foregoing Notice of Intent and accompanying plans,
documents, and supporting data are true and complete to the best of my knowledge. I understand that
the Conservation Commission will place notification of this Notice in a local newspaper at the expense of
the applicant in accordance with the wetlands regulations, 310 CMR 10.05(5)(a).
I further certify under penalties of perjury that all abutters were notified of this application, pursuant to the
requirements of M.G.L. c. 131, §40. Notice must be made by Certificate of Mailing or in writing by hand
delivery or certified mail (return receipt requested) to all abutters within 100 feet of the property line of the
project location.
� atu` �
1.�i r of Applicant 2.Date
zw,, G C/�Clc
AS 4 o Pr rty Owhe (if different) 4.D e
5.S' a es alive(if a 6.JlDfiate
For Conservation Commission:
Two copies of the completed Notice of Intent(Form 3), including supporting plans and documents, two
copies of the NOI Wetland Fee Transmittal Form, and the city/town fee payment, to the Conservation
Commission by certified mail or hand delivery.
For MassDEP:
One copy of the completed Notice of Intent(Form 3), including supporting plans and documents, one
copy of the NO1 Wetland Fee Transmittal Form, and a copy of the state fee payment to the MassDEP
Regional Office(see Instructions) by certified mail or hand delivery.
Other:
If the applicant has checked the"yes" box in any part of Section C, Item 3, above, refer to that section
and the Instructions for additional submittal requirements.
The original and copies must be sent simultaneously. Failure by the applicant to send copies in a
timely manner may result in dismissal of the Notice of Intent.
wpaform3.doc•rev.11/16/09 Page 8 of 8
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
NOI Wetland Fee Transmittal Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Important:When A. Applicant Information
filling out forms
on the computer, 1. Applicant:
use only the tab
key to move your Michelle Verminski
cursor-do not a. First Name b. Last Name
use the return
key.
c.Organization
rQ 95 Olympic Lane
d. Mailing Address
North Andover MA 01845
reNn e. City/Town f. State g. Zip Code
979-208-8711 michelle@verminski.com
h. Phone Number i. Fax Number j.Email Address
2. Property Owner (if different):
a. First Name b. Last Name
c.Organization
d. Mailing Address
e.City/Town f. State g. Zip Code
h. Phone Number i.Fax Number j.Email Address
3. Project Location:
95 Olympic Lane North Andover
a.Street Address b. City/Town
To calculate B. Fees
filing fees, refer
to the category The fee should be calculated using the following six-step process and worksheet. Please see
fee list and g g p p
examples in the Instructions before filling out worksheet.
instructions for
filling out WPA Step 1/Type of Activity: Describe each type of activity that will occur in wetland resource area and
Form 3(Notice of
Intent). buffer zone.
Step 2/Number of Activities: Identify the number of each type of activity.
Step 3/Individual Activity Fee: Identify each activity fee from the six project categories listed in the
instructions.
Step 4/Subtotal Activity Fee: Multiply the number of activities (identified in Step 2) times the fee per
category (identified in Step 3) to reach a subtotal fee amount. Note: If any of these activities are in a
Riverfront Area in addition to another Resource Area or the Buffer Zone, the fee per activity should be
multiplied by 1.5 and then added to the subtotal amount.
Step 5/Total Project Fee: Determine the total project fee by adding the subtotal amounts from Step 4.
Step 6/Fee Payments: To calculate the state share of the fee, divide the total fee in half and subtract
$12.50. To calculate the city/town share of the fee, divide the total fee in half and add $12.50.
Wpaform3.doc•Wetland Fee Transmittal Form•rev.2/21/08 Page 1 of 2
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
NOI Wetland Fee Transmittal Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Fees (continued)
Step 1/Type of Activity Step 2 1Number Step Step 4/Subtotal Activity
of Activities 3/individual Fee
Activity Fee
Category 1a 1 $110 $110
North Andover Bylaw Fee 1 $110 $110
Step 5/Total Project Fee: $110+$110 Bylaw
Step 6/Fee Payments:
Total Project Fee: $110+$110 Bylaw
a.Total Fee from Step 5
State share of filing Fee: $42.50
b. 1/2 Total Fee less$12.50
City/Town share of filling Fee: $67.50+$110 Bylaw
c. 1/2 Total Fee plus$12.50
C. Submittal Requirements
a.) Complete pages 1 and 2 and send with a check or money order for the state share of the fee, payable to
the Commonwealth of Massachusetts.
Department of Environmental Protection
Box 4062
Boston, MA 02211
b.) To the Conservation Commission: Send the Notice of Intent or Abbreviated Notice of Intent; a copy of
this form; and the city/town fee payment.
To MassDEP Regional Office (see Instructions): Send a copy of the Notice of Intent or Abbreviated Notice of
Intent;a copy of this form; and a copy of the state fee payment. (E-filers of Notices of Intent may submit these
electronically.)
WpafonnIdoc•Wetland Fee Transmittal Form•rev.2/21108 Page 2 of 2
MATTHEW D.VERMINSKI r i-fT A 114 2587
MICHELLE A.VERMINSKI s F , �� 1 68.7269/2560
95 OLYMPIC LANE Ot
NORTH ANDOVER,MA 01846 15 Qd'
DATE
THE RDER OF: 1�( I �R r 50
JIM U4,0 9�XL / v DOLLARS
E•TRADE Bank.A6J gton.VA
Il
FOR: '---
0® 2560 ? 269 0e 2006 28 36 30u5 258 ?
MATTHEW D.VERMINSKI ADE 2588
MICHELLE A.VERMINSKI I M I 68.7269/2560
95 OLYMPIC LANE �` of
NORTH ANDOVER,MA 01845
w
DATE
PAY TO
THE ORDER OF: ,✓V " "J I s ��• �v
DOLLARS
osuus o°
_
E•TRADEB Arlington.VA
AZN''FOR:
0: 2560 ? 269 0® 2006 2a36301I' 2588
s E`):7RAD 2589
MATTHEW D.VERMINSKI '' F I N A sil C I A L
MICHELLE A.VERMINSKI �, 68-7269/2560
95 OLYMPIC LANE r of
NORTH ANDOVER,MA 01845
D//0. 00 ATE
PAY TO � y V $
THE ORDER OF: V (/!� `
9ecni.r
DOLLARS
E•TRADE Bank,Arlington,VA
FOR: L//
I® 2560 ? 269 P, 2006 28 36 300 2 5j3 9
AFFIDAVIT OF SERVICE
Under the Massachusetts Wetlands Protection Act
And the North Andover Wetlands Protection Bylaw
I, Joshua Johansen hereby certify under the pains and penalties of perjury
that on August 22, 20121 gave notification to abutters in Compliance with
the second paragraph of Massachusetts General Law Chapter 131, Section
40, and the DEP Guide to Abutter Notification dating April, 8, 1994 in
connection with the following matter:
A Notice of Intent was filed under the Massachusetts Wetlands Protection
Act and North Andover Wetlands Protection Bylaw by Michelle Verminski
with the North Andover Conservation Commission on August 22, 2012 for
property located on 95 Olympic Lane.
The form of the notification, and the list of abutters to whom it was given,
and their addresses, are attached to this Affidavit of Service.
J'
(/km J
,Y V
( ame) ( ate)
Abutter to Abutter( ) Building Dept. ( ) Conservation ( ) Zoning ( )
REQUIREMENT: h1G1.40A,Section 11 states in part Tarties in Interest as used in this chapter shall mean the petitioner,
abutters,owners of fand directly oppositeon any public or private way,and abutters to abutters within
three hundred(300)feet of the property line of the petitioner as they appear on the most recent applicable
tax Iist,not withstanding that the land of any such owner is located In another city or town,the planning
board of the city o town,and the planning board of every abutting city or town.'
Sublect Propsrty:
MAP PARCEL Name Address
106.13 138 Matthew Vweminski 95 Olympic Lane North Andover,MA 01845
Abutters Properties
Map Parcel Name Address
106.13 12 Jonathan Heydenreich 1907 Salem Street North Andover,MA 01845
106.B 13 Michael Cammarata 1925 Salem Street North Andover,MA 01845
106.13 22 Paul Hudson 1850 Salem Street North Andover,MA 01845
106.13 60 P.Roy 1895 Salem Street North Andover,MA 01845
106.13 63 James Fay 10 Campbell Road North Andover,MA 01845
106.13 71 Kenneth Roy 1 Campbell Road North Andover,MA 01845
106.13 112 David Nichols 62 Olympic Lane North Andover,MA 01845
106.13 113 John Mahoney 76 Olympic Lane North Andover,MA 01845
106.13 114 Frederick Kulik 8 Laconia Circle North Andover,MA 01845
106.13 115 Gray Rich 20 Laconia Circle North Andover,MA 01845
1063 119 Ronald Goodwin 9 Laconia Circle North Andover,MA 01845
1063 120 Derrick Kittler 7 Laconia Circle North Andover,MA 01845
106.13 121 Robert Harrison 110 Olympic Lane North Andover,MA 01845
106.13 122 John Haroian 122 Olympic Lane North Andover,MA 01845
106.B 135 Anthony Festa 127 Olympic Lane North Andover,MA 01845
106.13 136 John Cox 115 Olympic Lane North Andover,MA 01845
106.13 137 Bradley Wyard 107 Olympic Lane North Andover,MA 01845
106.8 139 Christopher Golini 83 Olympic Lane North Andover,MA 01845
106.13 140 Christopher Hanle 71 Olympic Lane North Andover,MA 01845
1063 141 Howard Reeve III 57 Olympic Lane North Andover,MA 01845
106.8 142 Joseph Wescott 37 Olympic Lane North Andover,MA 01845
106.13 143 Domenic Terranova 19 Olympic Lane North Andover,MA 01845
106.8 144 Gary Mucica 7 Olympic Lane North Andover,MA 01845
Date 8/20/2012
Yhis certifies that the names appearing on the Page 1 of 1
records of the Assessors Office as of
Certified by: _Date ���
r
X sc
8/22/12
Re: Notification of Abutters
95 Olympic Lane
Dear Abutter:
Enclosed please find a Notification to Abutters form to inform you of a public hearing that will be
held by the Town of North Andover Conservation Commission under the MA Wetland Protection
Act. The subject of the hearing is the construction of an addition to a single family home on 95
Olympic Lane in North Andover, MA.
Should you have any questions relative to this project, feel free to contact Goddard Consulting at
508-525-0726 or the Town of North Andover Conservation Commission at 978-688-9530.
Lastly, if you are receiving this notice, there is a high likelihood that your property also may
contain wetland resource areas, be with 100 feet of wetlands, or be within 200 feet to a regulated
stream. If so, activity on your property may be subject to similar permitting requirements.
Goddard Consulting is well experienced in the nuances of this town and is fully capable to assist
you. If you are considering a project on your property, please contact us for all your wetland
consulting and permitting needs.
Very truly yours,
GODDARD CONSULTING, LLC
by
Scott Goddard, Manager & PWS
Notification to Abutters Under the
Massachusetts Wetlands Protection Act
and North Andover Wetlands Protection Bylaw
In accordance with the second paragraph of Massachusetts General Laws Chapter 131,
Section 40 you are hereby notified of the following.
A. The name of the applicant is: Michelle Verminski.
B. The applicant has filed a Notice of Intent (NOI) with the Conservation Commission for
the municipality of North Andover, MA seeking to alter Areas Subject to Protection
under the Wetlands Protection Act (General Laws Chapter 131, Section 40) and the
Needham Wetlands Protection Bylaw.
C. The project scope is: Addition to a single family home.
D. The address of the lot where the activity is proposed is: 95 Olympic Lane.
E. Copies of the NOI may be examined at Town Hall between the hours of 8 and 4:30 on
the following days of the week: M, W, Th., and between 8 and 6 on T, and 8 and 12 on
F. For more information, call (978) 688-9530.
F. Copies of the NOI may be obtained for a reasonable fee from the applicant's
representative, by calling(508) 525-0726 between the hours of 10 and 3 on the following
days of the week: M, T, W, Th., F.
G. Information regarding the date, time, and place of the public hearing may be obtained
from North Andover Conservation Commission by calling(978) 688-9530.
NOTE: Notice of the public hearing, including its date, time, and place, will be published at
least five (5) days in advance in the Lawrence Eagle Tribune. It will be held at 7:00 p.m. on
Sept. 12th at the Town Hall, 120 Main Street,2ND Floor Meeting Room, North Andover,
MA 01845
NOTE: Notice of the public hearing, including the date, time, and place, will be posted in the
City or Town Hall not less than forty-eight (48) hours in advance.
Note: You also may contact your local Conservation Commission or the nearest Department of
Environmental Protection Regional Office for more information about this application or the
Wetlands Protection Act. To contact DEP, call:
❑ Central Region: (508) 792-7650 ® Northeast Region: (978) 694-3200
❑ Southeast Region: (508) 946-2700 ❑ Western Region: (413) 784-1100
,� .���',s ..� ��� '�"' yy� ,.fir' � � ':""tv rya.�yy `� � .r� � r' ✓
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r
8/22/12
Mrs. Michelle Verminski
95 Olympic Lane
North Andover, MA 01845
Re: Wetland Border Report
95 Olympic Lane, North Andover, MA
On June 27, 2012 the wetland resource area was delineated on 95 Olympic Lane in North
Andover, MA. The wetland border was flagged using the criteria in the most recent edition of MA
Wetland Protection Act (WPA) and Regulations 310 CMR 10.00 et al as well. Hydric soil
indicators,vegetational changes, hydrological indicators,and topography were all considered for
delineation purposes. The Bordering Vegetated Wetland (BVW) flags are blue and the MAHW
flags are Pink and are denoted with SGG#.
The parcel contains a perenial stream, Boston Brook,to the rear. The delineation, therefore,
combines Bank, River front area and BVW wetland resource areas. Typical vegetation includes
Red Maple, Royal Fern, New York Fern, Poison Ivy, Hickory, Ink Berry,White Pine,Jack-in-the-
Pulpit,American Elm, Speckled Alder,Arrowwood,Sensitive Fern,Yew, Spice Bush, Sweet
Pepperbush, Cinnamon Fern, Norway Maple, skunk Cabbage,and European Buckthorn.
Flag SGG #5 was documented using MA DEP Data Sheets,and those sheets are attached.
According to the 2008 MA Natural Heritage Atlas,this site is located within an Estimated Habitat
of Rare Wildlife,but is not mapped for certified or potential vernal pools. If there are any
questions concerning this report or for assistance with permitting, please do not hesitate to
contact me.
Very truly yours,
GODDARD CONSULTING, LLC
by
Scott Goddard, Manager&PWS
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