HomeMy WebLinkAboutMiscellaneous - 49 GARNET CIRCLE eZoning Bylaw Review Form
Town Of North Andover Building Department
1600 Osgood St. Bldg 20 Suite 2-36
North Andover, MA. 01845
Phone 978-688-9545 Fax 978-688-9542
Street: 49 Gannet Circle ----
Me Lot: 109/66
A lican t: Rebecca and Scott D'Entremont - __
oast: 1 coAugnst
18 ruct a farmers Porch in the front entrance
Date: ust 2010
Please be advised that after review of your Application and Plans that your Application is
DENIED for the following Zoning Bylaw reasons:
Zonin VR
Item Notes
A Lot Area neat Notes
1 Lot area Insufficient F Frontage
2 Lot Area Preexistin 1 Fronts a Insufficient
3 Lot Area Com lies X 2 Fronts a Com lies
4 Insufficient Information 3 Preexistin fronts e
B Use 4 Insufficient Information x
1 Allowed 5 No access over Frontage
2 Not Allowed X G Contiguous Building Area
3 Use Preexistin 1 Insufficieni a
4 S ecial Permit Re uired 2 Com lies
5 Insufficient Information 3 Preexistin CBA X
C Setback 4 Insufficient Information
1 All setbacks com I H Building Height
2 Front Insufficient 1 Hall ht Exceeds Maximum
3 Left Side Insufficient X 2 Com lies
4 Ri ht Side Insufficient 3 Preexistin Hell ht X
5 Rear Insufficient 4 Insufficient Information
6 Preexistin setback s I Building Coverage
7 Insufficient Information 1 Covera a exceeds maximum
D Watershed 2 Covera a Com lies X
1 Not in Watershed 3 Coverage Preexisting
2 In Watershed 4 Insufficient Information
3 Lot rior to 10/24/94 J Sign
4 Zone to be Determined 1 Si n not allowed
5 Insufficient Information 2 Si n Com lies N/A
E Historic District 3 Insufficient Information
1 In District review re uired K Parking
2 Not in district 1 More Parkin Re uired
3 Insufficient Information 2 Parkin Com lies x
3 Insufficient Infonna[ion
4 Pre-existin Parkin
Remed for the above is checked below.
Item* S tial Permits PI nnin Board
Site Plan Review S ecial Permit item# Variance
Access other than Fronts e S tial Permit C 2 Setback Variance
Fronts a 5rce tion Lot S ecial Permit Parkin Variance
Common Drivewa S
it Permit Lot Area Variance
Con re ate Housin S tial Permit Hei ht Vanance
Continuing Care Retirement Special Permit Variance for Si n
Intlependent Elders Housin SS a W Pemtlts Zonin Board
La a Estate Condo S tial Pennital Permit Spacial Permit Non-Conforl Use ZBA
Plannetl Develo merit Distad S ecial Permit Eanh Removal S tial Permit ZBA
Plannetl Real S tial Permit S ectal Permit Use not Listed but Similar
R-6 Density Special Permit S ectal Permit for siren
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NOTE: ALL PROPOSED-WORK WILL BE PERFORMED IN
ACCORDANCE WITH THE MASSACHUSETTS STATE BUILDING CODE
PROPOSED PORCH ENGINEER:
SIDE ELEVATION ANTHONY R. GOUVEIA. P.E.
LOT AO FOREST VIEW ESTATES PREP
NORTH ANDOVER. MI agEO BY: ERIC OIVIRG IL IO
SCALE: N.t.S. DATE: 9/tT/10
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LOCUS I"NOP i V r1 f I/ --
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1. WETLANDS EW SUFI FROM DEFl MHF SUB0INMS PLAN
FOR FOREST NEW RECORDED
I BY NNF DESIGN CONSULTANTS
DATED 9-22-97 RECORDED IN ENORD AS PLAN n3362LOT 39 ] ® N
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NORTH ANDOVER ZONING -._,_ _ 1 �' 20.0'
BOARD OF APPEALS
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OWNER OF RECORDIAPPLICANT u �
SCOTT h REBECCA D'ENTRIDUMT
49 CARNET CIRCLE
NORTH ANDOVER, MA DIMS
COMM OF MASS
DEED REFERENCE MAP HOBO LOT u
DEED BOOK 9149 PAGE 180 DATED 10-28-2004 177.71 ACRES
SITE ADDRESS ABU
49 GARNET CIRCLE BRIAN t KRISTEN DEE 6 GARNET ORCLE MAP 10 C L0
ROBERT! DONNA D'AMBRO90 35 GANNET ORCLE MAP
ASSESSORS REFERENCEPNASANNA A A11141 MAINNAR b GARNET DRCLE MAP
STONER M. WANDRA A USHA PRMASH 41 CARNET ORCLE MAP 10
ASSESSORS MAP 109 PARCEL 66 Z MEIESCIUC MOW 6: .DVCE SHAW W GARNET CROS MM 109 LOT
COMM. OF MASS DEPARTMENT OF ENNRMMENTAL MANN
PUN REFERENCE N&3" 100 CAMBRIDGE ST BOSTON, MA OR202 MAP 1060 L(
LOT ENIM�PIH x3382 SHEET ESTATES ZONE VILLAGE DISTRIC
OA'ES51� 2ONINGSUMMARY-
U REQUIRED EXISTING
DEED RESTRICTIONS [LW-0.
T MEA: tt,roO SF! 15,564 SF.
PROTECTIVE COVENANTS BOON 5942 PACE 282 EET FRONTAGC
EASEMENT R RESTRICTIONS BOO( ]lu PAGE 295 WT YARD SETBACK: 25•
FOREST NEW HOMEOWNERS ASSOCIATION BY- E YARD SETBACK' 15' 191,
ORDER OF CONDITIONS 53]5 PAGE za AND BOOK 54]9 PAGE 151 291 291 CNOGNSETBAO(:ComACE 36'PEWC TO FOREST NEW SMID,11 N
Abutter to Abutter( ) Building Dept ( ) Conservation ( X ) Zonin
9 ( )
Town of North
Abutters Listing
REQUIREMENT. yon 40A,section tf aymem
petl"parties In Interest as ucad N Ible,a ¢Fall Tears the on
a0uPounds,owners M hand directly Panel any Public or ptivNa way,andnd dhunere to abutters
Mon.
Nree hundred(30,IV I the property IIne OIM1e pNNona as I1e1 appearon the most recent epplloble
has IIV,not withstanding that he land of such owwr Is located In mother city or town,the planning
bond a In.city w town,end the planning beartl of every agent"city or town:
Subject Property,
MAP PARCEL Name
to 66Scod D'Enfromonl AdAdddress
Abutters Pro rt' 49 Gamef Circle,North Andover,MA 01845
Mae Paine/ Name
107.B 171 Forest View Home Owners 49
108.0 49 Gamet Circle,Nodh Andover,MA 01845
64 Paul Burke
109 33325 Barry Sheld,
Commonwealth of Massachusetts 100 Cambridge Street, ostton MA 02202 5
109 65 John Shaw
41 Garret Circe,North Antlover,MA 01845
109 67 Chandra Pmkash
109 68 41 Circle,North Andover,MA 01645
Robert O'Ambrosio 149 Bridges Lane,North Andover,MA 01845
This certifies that the names appearing on the
records of the Assessors
�4 MOD as of
Certified by.
Date /Ov7a
e
Zoning Bylaw Review Form
Town Of North Andover Building Department
1600 Osgood St. Bldg 20 Suite 2-36
North Andover, MA. 01845
Phone 978-688-9545 Fax 978-688-9542
Street: 49 Garnet Circle
Ma /Lot: 109166
Applicant: Rebecca and Scott D'Entremont
Request: To construct a fanners porch in the front entrance
Date: 18 August 2010
Please be advised that after review of your Application and Plans that your Application is
DENIED for the following Zoning Bylaw reasons:
Zoning VR
Item Notes Item Notes
A Lot Area F Frontage
1 Lot area Insufficient 1 Frontage Insufficient
2 Lot Area Preexisting X 2 Frontage Complies
3 Lot Area Complies 3 Preexisting frontage X
4 Insufficient Information 4 Insufficient Information
B Use 5 No access over Frontage
1 Allowed X G Contiguous Building Area
2 Not Allowed 1 I Insufficient Area
3 Use Preexistinq 2 Com lies X
4 Special Permit Required 3 Preexisting CBA
5 Insufficient Information 4 Insufficient Information
C Setback H Building Height
1 All setbacks comply I Height Exceeds Maximum
2 Front Insufficient X 2 Complies X
3 Left Side Insufficient 3 Preexisting Height
4 Right Side Insufficient 4 Insufficient Information
5 Rear Insufficient I Building Coverage
6 Preexisting setbacks 1 Coverage exceeds maximum
7 Insufficient Information 2 Coverage Complies X
D Watershed 3 Coverage Preexisting
1 Not in Watershed 4 Insufficient Information
2 In Watershed j Sign
3 Lot prior to 10/24/94 1 Sin not allowed N/A
4 Zone to be Determined 2 Sin Complies
5 Insufficient Information 3 Insufficient Information
E Historic District K Parking
1In Dishid review re uired 1 More Parkin Required
2 Not in district 2 FawIng Complies X
3 Insufficient Information 1 3 1 Insufficient Information
4 1 Pre-existing Parkin
Remedy for the above is checked below.
Item# Special Permits Planning Board Item# Variance
Site Plan Review Special Permit C•2 Setback Variance
Access other than Fronta e Special Permit Parking Variance
Frontage Exception Lot Special Permit Lot Area Variance
Common Driveway Special Permit Height Variance
Congregate Housing Special Pemnit Variance for Sign
Continuing Care Retirement Special Permit Special Permits Zoning Board
Independent Elderly Housing Special Permit Special Permit Non-Conforming Use ZBA
Lame Estate Condo Special Permit Earth Removal Special Permit ZBA
Planned Development District Special Permit Special Permit Use not Listed but Similar
Planned Residential Special Permit I Iermit for Si n
Plan Review Narrative
The following narrative is provided to further explain the reasons for DENIAL for the
APPLICATION for the property indicated on the reverse side:
Item Reasons for
Reference
Section 7.3 Construct a Farmers porch, in the required front yard. Required is 25'
Table 2 and the proposed is 23' Variance .
9.1 & Special permit required
9,2 Alteration or Extension
Referred To: Health
Fire
Town of North Andover
ZONING BOARD OF APPEALS ,`'-
Albert P.Mani III,Esq.Cham
Elim P.Mclntym,Vw-fhxm oarH
Rkhard J.Byers,Esq.Cs,a
Uavd S.Breese,Esq.
Vait
Richard M 1pp htcourt
U.Ippo0a
AoodmrMadua t a
Thomas olito
Michael R Iiporto
'rs�nNez! "I'ouxi Clak'l imr Scnvp
This is to oetafy that Wi rdy(20)dere
have elapsed from date of decision,flied
without filin8 of an ep I ��0
Date_ �
Any appeal shall be filed within(20) Notice of Decision Joyce A. -a
days after the date of filing of this Year 2010 Town Gerk
notice in the office ofthe Town Clerk,
per Mass.Gen.L.ch.40A,§17 Property at: 49 Garnet Circle,North Andover,MA
NAME:Rebecca and Scott D'Entremont HEARING(S): Sep 21,2010
ADDRESS: 49 Garnet Circle (Map 109,Parcel PETITION: 2010-012A
66),North Andover,MA 01845
The North Andover Board of Appeals held a public hearing at The Senior Center, at 120R Main Street,
North Andover,MA on Tuesday, September 21,2010 at 7:30 PM on the application of Rebecca and Scott
D'Entremont at 49 Garnet Circle (Map 109, Parcel 66), North Andover, MA 01845. Petitioner is
requesting a Special Permit from 9.1 and 9.2(non conforming uses/alteration or extension)of the Zoning
Bylaw to construct a Farmer's Porch in the front yard in the VR Zoning District.
Legal notices were sent to all the certified abutters provided by the Town of North Andover,Assessors
Office,and were published in the Eagle-Tribune,a newspaper of general circulation in the Town of North
Andover,on September 7 and September 14 2010.
The following voting members were present: Albert P.Manzi 111,Richard J.Byers and Richard M.
Vaillancourt.The following Associate members were present: Thomas Ippolito and Michael Liporto
Upon a motion by Richard M.Vaillancourt and 2nd by Richard J. Byers the Board voted to GRANT a
Special Permit to allow from Sections 9.1 and 9.2 of the Zoning Bylaws for Non-Conforming Uses and
Alteration or Extensions to the existing dwelling as submitted to the Board subject to the following
conditions:
1. A letter of approval from Conservation Commission.
2. Letter of approval from the Homeowners' Association.
3. Letter from the Town Planner,Judy Tymon on behalf of the Planning Board stating the
Petitioner's request does not conflict with special permit for definitive subdivision of the subject
property.
The following members voted in favor to GRANT a Special Permit with the stated conditions: Albert P.
Manzi 111,Richard J.Byers, Richard M.Vaillancourt, Thomas Ippolito and Michael Liporto.
The petition was unanimously approved.
The Board finds that this use, as developed by the building and site plans, will not adversely affect the
neighborhood. There will be no nuisance or serious hazard to vehicles or pedestrians since there are
provisions for the required off-street parking. Adequate and appropriate facilities are provided to the
existing residential dwelling and for the front yard where the Farmer's Porch will be constructed. The
Board finds that the Farmer's porch will not be substantially detrimental to the existing single-family
��_///��� ^
Page 1 of
dwelling and to the neighborhood and that this use, of a Farmer's Porch will be in harmony with the
neighborhood and general purpose and intent of this Bylaw.
Special Permit: 49 Garnet Circle (Map 109,Parcel 66),North Andover,MA 01845
Section 9.1 and 9.2 of the Zoning Bylaw in order to build a Farmer's
Porch in a VR Zoning District.
Plan(s)Title: 1) "Plot Plan of Land"dated August 16 2010 containing one(1)sheet.
Prepared by Maruhionda&Associates, L.P.MA
"Proposed Addition"containing three(3)sheets;proposed porch,
first floor plan with proposed porch,and side elevation of proposed
porch.Plans dated August 17,2010 and prepared by Eric
Divir ilio: and Engineer:AnthonyR.Gouveia.PE.
Voting in favor: Albert P.Manzi III_,Richard J. Byers, Richard M.Vaillancourt,
Thomas Ippolitty and Michael Li orto
Voting in the Negative: I N/A
The Board finds that the applicant has satisfied the provisions of Section 9.1 and 9.2 of the Zoning Bylaw
to construct a Farmer's Porch at front of home for 49 Garnet Circle (Map 109,Parcel 66),in a VR
Zoning District.
Notes:
1. This decision shall not be in effect until a copy of this decision is recorded at the Essex County Registry of Deeds,
Northern District at the applicant's expense.
2. The granting of the Special Penning as requested by the applicant does not necessarily ensure the granting of a building
permit as the applicant must abide by all applicable local,state,and federal building codes and regulations,prior to the
issuance of a building permit as required by the Inspector of Buildings.
3. If the rights authorized by the Special Permit are not exercised within two(2)years of the data of the gran,it shall lapse,
and may be re-established only after notice,and a new hewing.
Andover Zonhig Board o Appeals
s
Aert P.Manzi IB,Esq.,Chairman
Ellen P. McIntyre, Vice Chairman
Richard J.Byers,Esq.,Clerk
Daniel S Braese
Richard M.Vaillancourt
Decision 2010-012A
Page 2 of 2
r
O p
F y
Y "
33ACHa5
CONSERVATION DEPARTMENT
Community Development Division
NEGATIVE DETERMINATION OF APPLICABILITY
SPECIAL CONDITIONS
49 Garnet Circle,North Andover
At the September 13,2010 public heating,the North Andover Conservation Commission(NACC)
voted to issue a Negative Determination of Applicability for the construction of a 34'x 8'farmer's
porch on 12" footings.This work will be conducted in the Buffet Zone to Bordering Vegetated
Weiland(BV W).The closest point of work to the BV W is approximately 80-feet
Applicant Scott and Rebecca D'Enttemont
49 Garnet Circle
- North Andover,MA 01845
Record Documents: Request for Determination of Project Description
RDA Dated 8/24/10 and Received 8/26/10
Record Plans: Plan of Land
Date: 8-13-10
Pre-Construction
•3 The applicant shall install wetland markets at the 25-foot No-Disturb Zone every 25-feet(where
they do not already exist)up-gradient of the Bordering Vegetated Wetland Location of the
markers shall be approved by the Conservation Department at the Pre-construction meeting.
Markets are available from the Conservation Department($3 square/$2 round—one square to
every 3 round required).
•8 Fsosions controls shall be installed according to the approved plan referenced herein.
S Prior to the shut of construction,the applicant shall contact the Conservation Department to
schedule a preconstntction meeting with the applicant and the contractor.
D-- CM don
J Excess material and construction debris shall be properly disposed of off site and stockpiled
• material shall be stored in accordance with the approved plan. ...
1600 Osgood Stmt.Building 20,Suite 2-36,North Andover,Massachusetts 01845
Phone 978.688.9530 Fax 978.688.9542
Web:http://cow wv ofnorthandover.corn/Pagcs/NAndoverMA-Coosa tion/index
4• Any changes to the approved plan require the approval of the Conservation Commission.
Post Constnution
4- Immediately following completion of the work,any disturbed areas shall be permanently
stabilized against erosion. If weather conditions do not permit the establishment of vegetative
cover through seeding,jute matting or other stabilization material shall be used.
3 Upon completion of all requirements,the Conservation Department shall be contacted to
conduct a final site inspection.
1600 Osgood Street.Budding 20,Suite 2-36,North Andover,Massachusetts 01845
Phone 978.688.9530 Fax 978.688.9542
Web:http://w .wo o&orffimdov .com/Pages/NAndovedAA_Cmsemation/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: From:
When filling out
tonna on the North Andover
computer,use Conservation Commission
only the tab
key to move To: Applicant Property Owner(if different from applicant):
yourcursor-
donot use the Scott&Rebecca D' Entremont
return key. Name Name
�Iy II
� 49 Garnet Circle Mailing Address
_I� Mailing Address
North Andover MA 01845
Cityrtown Slate Zip Cade City?own - Slate Zip Code
�a 1. Title and Date(or Revised Date if applicable)of Final Plans and Other Documents:
RDA Plan of Land 8113/10
Ingle Data
Title
TRIe Date
2. Date Request Filed:
8/26/10
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 farmer's porch within the Buffer Zone to Bordering Vegetated Wetland
Project Location:
49 Garnet Circle North Andover
.strearAVi?es -_. _--_ __--- --.--_ _ - -Ckyrro ------
Map 109 Parcel 66
Assessors Map/Plat Number ParrsVLot Number
vp�ma.mc•oerenw�enmmoacrouiM•m.tamma sew t as
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 Determinationroceed until a foal Order of
Note: No work within the jurisdiction of the Wetlands Protection Act may p
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).
is an
ect to
Removing,fil1. The l g,dredging, orea described raltering n the fof thearea requires the filing of a Noprotection
ce of Intent. the Act
❑ 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 fling 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 fling 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($)is subject to review
and approval by:
Name of Municipality
Pursuant to the following municipal wetland ordinance or bylaw:
Name
Pe 2d5
wporm2doc'Cd ,naliondApficebPM'tm'.ids'o<
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.)
❑ 8.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 Rlverfront 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 altematives. (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 descObed
rea
❑ not remove,fill, or altethe r that area.withinquest is Thereforsubject tprotection tt will
Therefore, saidworke
does not the filing 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 des not require the filing of a Notice of Intent,
- - - - -- unless and until said workallers an Area-subject-to-protection under the Act. - — - - -
ayeads
wpffiorm2tlocOerermirarbnd PypliceEiliry•rev.lareroa
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(sib applicable statualory/regulatory provlslons)
❑ 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. Chapter 17a
North Andover Wetlands Protection B law oNinance or Bylaw cnaaon
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
44J'V
Date
Date
This Determination is valid for three years from the date of issuance(except Determinations for
relieve tlhe applicant from ement comply nans ich are valid for the duration of the Plan).This g With all other applicable federal, state, or local statutes, ordinances,
ination
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 htt /Iwww mass cov/deo/about/recion findVour_htm)and the
property owner(if different from the applicant).
Signatures:
r
P
_ D
Data pyv LR5
„yeranna.aoc oorwmu,eum a rod�nuiro•,�.�oamt
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 htto 11www.mass.gov/deo/abouUrecion 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.
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ElMassachusetts 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: 1. Person ora man reappropriate, name the citizen group's representative):
When filling out party request
(qg p
forms on the
computer,use Name
only the tab
key to move
your cursor-
Meiling Address
do not use the
return key. Cityrrown State Zip Code
VIAI Phone Number Fax Number(if applicable)
I�V Project Location
r
Mailing Address
City?own 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
Cityfrown state Zip Code
Phone Number Fax Number(g 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 Comrrronwealth of
Massachusetts to:
Department of Environmental Protection
Box 4062
BostonrMA02217 -
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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 Orderwhich 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
hfto://www.mass.gov/der)/abouVregion/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.
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