Request for Determination of Applicability (002).doc
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 1- Request for Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Northamptons
City/Town
A. General Information
Important:
When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key.
1. Applicant:
Jeffrey
Name
jeff@marneyelectric.com
E-Mail Address
Marney / 660 Riverside drive LLC
Mailing Address
61 briar hill Rd
City/Town
Ma,
State
01096
Zip Code
Williamsburg
Phone Number
Fax Number (if applicable)
2. Representative (if any):
Firm
Contact Name
E-Mail Address
Mailing Address
City/Town
State
Zip Code
Phone Number
Fax Number (if applicable)
B. Determinations
1. I request the
Northampton
Conservation Commission
make the following determination(s). Check any that apply:
a. whether the area depicted on plan(s) and/or map(s) referenced below is an area subject to jurisdiction of the Wetlands Protection Act.
b. whether the boundaries of resource area(s) depicted on plan(s) and/or map(s) referenced below are accurately delineated.
c. whether the work depicted on plan(s) referenced below is subject to the Wetlands Protection Act.
d. whether the area and/or work depicted on plan(s) referenced below is subject to the jurisdiction of any municipal wetlands ordinance or bylaw of:
City Of Northampton Ma.
Name of Municipality
e. whether the following scope of alternatives is adequate for work in the Riverfront Area as depicted on referenced plan(s).
C. Project Description
1. a. Project Location (use maps and plans to identify the location of the area subject to this request):
660 Riverside Drive
Street Address
Florence
City/Town
23c
Assessors Map/Plat Number
037
Parcel/Lot Number
b. Area Description (use additional paper, if necessary):
Perimeter of existing building and rear parking lot
c. Plan and/or Map Reference(s):
Map No. 23c Lot No. 037
Title
5/29/19
Date
Title
Date
Title
Date
2. a. Work Description (use additional paper and/or provide plan(s) of work, if necessary):
Install perimeter drain of existing building to deter water from entering the building. Install dry well. stockpile gravell and fill during excavation period. Install silt fence
C. Project Description (cont.)
b. Identify provisions of the Wetlands Protection Act or regulations which may exempt the applicant from having to file a Notice of Intent for all or part of the described work (use
additional paper, if necessary).
3. a. If this application is a Request for Determination of Scope of Alternatives for work in the Riverfront Area, indicate the one classification below that best describes the project.
Single family house on a lot recorded on or before 8/1/96
Single family house on a lot recorded after 8/1/96
Expansion of an existing structure on a lot recorded after 8/1/96
Project, other than a single family house or public project, where the applicant owned the lot before 8/7/96
New agriculture or aquaculture project
Public project where funds were appropriated prior to 8/7/96
Project on a lot shown on an approved, definitive subdivision plan where there is a recorded deed restriction limiting total alteration of the Riverfront Area for the entire subdivision
Residential subdivision; institutional, industrial, or commercial project
Municipal project
District, county, state, or federal government project
Project required to evaluate off-site alternatives in more than one municipality in an Environmental Impact Report under MEPA or in an alternatives analysis pursuant to an application
for a 404 permit from the U.S. Army Corps of Engineers or 401 Water Quality Certification from the Department of Environmental Protection.
b. Provide evidence (e.g., record of date subdivision lot was recorded) supporting the classification above (use additional paper and/or attach appropriate documents, if necessary.)
D. Signatures and Submittal Requirements
I hereby certify under the penalties of perjury that the foregoing Request for Determination of Applicability and accompanying plans, documents, and supporting data are true and complete
to the best of my knowledge.
I further certify that the property owner, if different from the applicant, and the appropriate DEP Regional Office were sent a complete copy of this Request (including all appropriate
documentation) simultaneously with the submittal of this Request to the Conservation Commission.
Failure by the applicant to send copies in a timely manner may result in dismissal of the Request for Determination of Applicability.
Name and address of the property owner:
Jeffrey marney
Name
61 Briar hill Rd
Mailing Address
Williamsburg
City/Town
Ma.
State
01096
Zip Code
Signatures:
I also understand that notification of this Request will be placed in a local newspaper at my expense
in accordance with Section 10.05(3)(b)(1) of the Wetlands Protection Act regulations.
Signature of Applicant
5/29/19
Date
Signature of Representative (if any)
Date