30D-016 278 Burts Pit Road-demolition Request for Determination-2021wpaform1.doc • rev. 7/27/2020
WPA Form 1 – Request for Determination of Applicability • Page 1 of 4
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
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:
City of Northampton
Name
wfeiden@orthamptonMA.gov
E-Mail Address
210 Main St, Planning
Mailing Address
Northampton
City/Town
MA
State
01060
Zip Code
413-587-1265
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:
Name of Municipality
e. whether the following scope of alternatives is adequate for work in the Riverfront Area as
depicted on referenced plan(s).
wpaform1.doc • rev. 7/27/2020
WPA Form 1 – Request for Determination of Applicability • Page 2 of 4
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
City/Town
C. Project Description
1. a. Project Location (use maps and plans to identify the location of the area subject to this request):
278 Burts Pit Road
Street Address
Florence
City/Town
30D
Assessors Map/Plat Number
016-001
Parcel/Lot Number
b. Area Description (use additional paper, if necessary):
Building lot currently containing a house and garage
c. Plan and/or Map Reference(s):
Topographic Plan of Land in Northampton, MA, surveyed for Northampton
Housing Authority (annotations added)
12/3/2008
Revised 3/8/2021
Title
Date
Title
Date
2. a. Work Description (use additional paper and/or provide plan(s) of work, if necessary):
Demolition of buildings and structures
wpaform1.doc • rev. 7/27/2020
WPA Form 1 – Request for Determination of Applicability • Page 3 of 4
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
City/Town
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).
Project has no adverse impact on resource area
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.)
wpaform1.doc • rev. 7/27/2020 WPA Form 1 – Request for Determination of Applicability • Page 4 of 4
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
City/Town
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:
City of Northampton, in the care and custody of Planning & Sustainability
Name
210 Main Street, Planning & Sustainability
Mailing Address
Northampton
City/Town
MA
State
01060
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
3/8/2021
Date
Signature of Representative (if any) Date
so
04
1
0
0
a
I
I
1
I
1
1
11
1
o
1
f
Z
N
I_,_
I
II °
0
Y ;
o
co
o-
J
1
W
Z
r
3z
ti4
1
Lj0
oOm
N
1
4
N
I
W
11
1
WV)
1
03
00
1
N
I
c5
0
N
Z
IlMz
NN
6ik111a
j
f
t
1
z
il,
k
c
fi\\
I-\
A—:
All
1
I,y1
f
1
1 '
r
cl
i
etiN
e
1
1
l
U
offta
a/
259
o
i
J
am
rr
l
0.
7
i
J
1
i
z/
1
z
1
h
1
1
l
1
ti-
C /
13,
in
1
Z
t
i
1
i
1
I
I•
4
I
a:
V
I
1
mot
Q
t
1 !
I
o
c
4
W
Q
Z
ji
W
1
O
1
1
I
Ct
C(
01N -
c "
c
L°
1
t
1
1 •
1
m
Oz
E
w
sue
E
1
T
1
le
r\
5
1
1
a
z
d
Fc,
2
X
X
X
UZ
e
t
11
Z
6
ge
U
I
r
1
S30 °
06'22 ''
W
x
X \--
X --\
X
x
x
x
L=
11
1
I
1
0coN
CONC
WALK
11
1
1
1
1
1
1
1
11
o
U
1
1I
1
1
1\
QDQ
U
CI
qt
5.
05'
169.
38'
1
W .
Z0
1
I—
d7
ZO
Q
Z
W
O
O
1
OCO w1-WLL'0z0U
A
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
t
1
1
1
1
1
1
i1
PI
Ix
i.
1
I
1
I
I
I
I
x
1
I
1
1
1
1
1
1
1
x
I
1
1
1
1
1 \
I
It
1
1
1
1 \
x
1
1
4-
11'
1
1
tY
Z
11
1
1
1
1
x
1
Z
1
W/u/
I
1
trit, 1, :
1
I
a
x
x
x
x
1
x
x`
X
I
1
1
1
1
1,
1
1
1
1
1
1
1
1
1
1
1
I
1
a
I
I
I
l
1
o
1
1'
I
N
1
I
1
1
1
Q
I
1
1
1
1
i
I
1
1
1
I
1
1
N
1
1
j
1
1
1
1 -
A
1
1
11
1
f
J
1
1
1
V
A
1
1
11
1
A
x
t ;
111.
44*
1
1
1
1
N
Li
i
I
kI \
N
N
N
1
N
N
ZQ
x
69.
38
x
x
N
N
N
1
x
t
x
x
x
x
A1
7 °
nn
rn»r
Z
w
o
Q
Q
1
Q_
O
j
K
W
v)
2
in
Lu
J
N
L
W 'i
ZO
Q
In0
0
w
0
Z (
0 (
f)
o .
c
v)
cn
C
0
It
z
2OOV
O
ct
ZQF =
o
Nitj
0LU3
Z
N 0
Li
U
i-
CCOJ>
Z -
1
Q
v)
CC
Z
Q
O
p
v) (
f)
4
Z
Q
t—
U
Lf
p
V)
0Z
00
0
Uw
c
Q
C
J
W
0
1---
w
Jo
v1-
C)
1N7 (
3
Q
N
1—
Z
I
0
03
R:(
I)
0
f=
O
Qmi
ti
wo
0
C
pol
C6
1m
U
Z
jLu
0
w
0
LULb
0 (
l
Q
Q
L.
CrWQ
Q
Z
Z=
ZO
W
W
5
NZ
c
LlJzz
R
Et
k-
r>
O
Q °
z
Z
I
c
Z
0Z
t
c
N&)c
a.
0
N)
4
o
1
Lu1
1
1
1
LLI
ozLL0za_z
O
0
a.
Oo
QZO
0IIU
z0J
0
0CD
0
PI
o
O
L
zzZ
O
73
1
11
0
w
Q
0
0OCLoWQOcGo
LiLid
Cr)
LiCC
CC
a.