474 LAFAYETTE STREET - CONSERVATION COMMISSION 474 LafayetteSStreet
,
s®
Farm 2 - oEOE File No. -
,,;� (To be provided by DEOE)
( commonwealth ciy/Town
1 of Massachusetts
Applicant
. i
Determination'of Applicability
Massachusetts Wetlands Protection Act, G.L c. 131, §40
From Salem- Cons rwntion rnm r Issuing Authority
To 'FfFred J. Harney Jr. same_
(Name of person making request) (Name of property owner)
Address 474 Lafayette Streat Address
This determination is issued and delivered as follows:
❑ by hand delivery to person making request on (date)
Iff by certified mail,return receipt requested on (date)
.Pursuant to the authority of G.L C. 131, §40, the 3a i am r �n Ces sn�s s'en
has considered your request for a Determination of Applicability and its supporting documentation,and has
made the following determination(check whichever is applicable):
This Determination is positive:
1. ❑ The area described below,which includes alVpart of the.area described in your request,is an Area .
Subject to Protection Under the Act Therefore, any removing,filling, dredging or altering of that
area requires the filing of a Notice of Intent
2. .❑ The work described below, which includes alVpart of the work described in your request,is within
an Area Subject to Protection Under the Act and will remove,fill,dredge or after that area.There-
fore, said work requires the filing of a Notice of Intent.
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3. ❑ The work described below,which includes ail/part of'the work described in your request;is.within
the Buffer Zone as defined in the regulations, and will alter an Area Subject to Protection Under
the Act.Therefore,said wo,k requires the filing of a Notice of Intent.
This Determination is negative: 1.
.1. ❑ The area described in your request is not an Area Subject to Protection Under the Act
2. The work described in your request is within an Area Subject to Protection Under the Act,but will
not remove, fill, dredge,or after that area.Therefore, said work does not require the filing of a
Notice of Intent.
3. ❑ The work described in your request is within the Buffer Zone,as defined inthe 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.
4. b The area described in your request is Subject to Protection Under the Act,but 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:
Issued by q AT.FM Conservation Commission.
Signature(s)
This Determination must be signed by a majority of the Conservation Commission.
On this ill day of MA3r 19 97 before me
personally appeared Fred J. Harnev , to me known to be the
person described in, and who executed, the foregoing ins ent, and acknowledged that he/she executed
th as his/�reeacand aged.
A-lam
Notary Public y commissi expires
This Detennination does not relieve the applicant from complying with all other applicable federal,state or local statutes,ordinances,
bylaws or regulations.This Determination shall be valid for three years form the dale of issuance.
f The applicant,the 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:own in which such land is located,are hereby notified of their right to request the
Department of Environmental Quality Engineering to issue a Superseding Determination of Applicability,providing the request is made
by certified mail or hand delivery to the Oeoartment within ten 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 cehvery to the Conservation Commission and the applicant.
2-2A
so
Farm 2
DECE File No.
(To be provided by DERE)
Commonwealth C;ryiTo n
-may of Massachusetts AppIrant
Determination*of Applicability
Massachusetts Wetlands Protection Act, G.L c. 131, §40
From Salem Conservation Commission Issuing Authority
To 7 ,,Xred J. Harney Jr. same
(Name of person making request) (Name of property owner.)*
Address 474 '.afavette StrPpr Address
This determination is issued and delivered as follows:
rJ by hand delivery to person making request on (date)
Iff by certified mail,return receipt requested on (date)
Pursuant to the authority of G.L c. 131, §40,the 5 A 1 PM c n Csmm'a s'ea
has considered your request for a Determination of Applicability and its supporting documentation,and has
made the following determination(check whichever is applicable):
This Determination is positive:
1. 0 The area described below, which includes alVpart of the.area described in your request, is an Area
Subject to Protoution Under the Act.Therefore, any removing,filling, dredging or altering of that
area requires the filing of a Notice of Intent.
2. .❑ The work described below, which includes all/part of the work described in your request,is within
an Area Subject to Protection Under the Act and will remove,fill,dredge or alter that area There
fore, said work requires the filing of a Notice of Intent.
2-1
3. ❑ The work described below,which includes all/part of the work described inyour request;is'within
the Buffer Zone as defined in the regulations, and will alter an Area Subject to Protection Under
the Act.Therefore, said work requires the firing of a Notice of Intent.
This Determination is negative:
.1. ❑ The area described in your request is not an Area Subject to Protection Under the Act '
2. 0 The work described in your request is within an Area Subject to Protection Under the Act, but will
not remove, fill, dredge,or alter that area.Therefore, said work does not require the filing of a
Notice of Intent..
3. ❑ The work described in your 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.
4. ❑ The area described in your request is Subject to Protection Under the Act,but 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:
Issued by Conservation Commission .
Signature(s)
r
This Determination must be signed by a majority of the Conservation Commission.
On this t i day of MA" 19 u7 before me .
personally appeared Fred J. Harnev to me known to be the
person described in, and who executed, the foregoing ins ent,and acknowledged that he/she executed
thL;(!ss/�itree actan d dQed.
Notary Public commissi expires
This Deterrnination does not relieve the applicant from complying with all other applicable federal•state or local statutes,ordinances.
bylaws or regulations.This Determination shall be valid for three years forrn the date of issuance.
The applicant,the 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 len residents of the city or:gwn in which such land is located,are hereby notified of their right to request the
Department of Environmental Quality Engineering to issue a Superseding Determination of Applicability,providing the request is made
by certified mail or hand delivery to the Department wimin ten 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 celwery to the Conservation Commission and the applicant.
2.2A
I
s®
Form 2
DEOE Fite No. 1 _
(To be provided by DERE)
( commonwealth city/Tow"
- of Massachusetts Applc< _
Determination'of Applicability
Massachusetts Wetlands Protection Act, G.L c. 131, §40
From Salem- Cons ervAtion Commiggion Issuing Authority
To °17f-Fred J. Harney Jr, same
(Name of person making request) (Name of property owner)
Address 474 Lafayette Straet Address
This determination is issued and delivered as follows:
❑ by hand delivery to person making request on (date)
(5 by certified mail,return receipt requested on (date)
Pursuant to the authority of G.L c. 131, §40,the 9w nn Ceminss;en
has considered your request for a Determination of Applicability and its supporting documentation,and has
made the following determination(check whichever is applicable):
This Determination is positive:
1, ❑ The area described below, which includes all1part of the area described in your request,is an Area
Subject to Protection Under the Act.Therefore,any removing,filling, dredging or altering of that
area requires the filing of a Notice of Intent
2, ❑ The work described below, which includes all/part of the work described in your request,is within
an Area Subject to Protection Under the Act and will remove,fill, dredge or alter that area.There-
fore, said work requires the filing of a Notice of Intent.
2-1
it -
1 Si
3. ❑ The work described below,which includes all/part of the work described in your request;is.within
the Buffer Zone as defined in the regulations, and will alter an Area Subject to Protection Under
the Act.Therefore,said work requires the firing of a Notice of Intent.
This Determination is negative:
.1. ❑ The area described in your request is not an Area Subject to Protection Under the Act. '
2. CK7 The work described in your request is within an Area Subject to Protection Under the Act, but will
not remove, fill, dredge,.or alter that area.Therefore, said work does not require the filing of a
Notice of Intent.
3. ❑ The work described in your 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
fling of a Notice of Intent
4. d The area described in your request is Subject to Protection Under the Act,but 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:
Issued by Consefvabon Commission .
Signature(s)
aw •�2
This Determination must be signed by a majority of the Conservation Commission.
On this i day of Mnv 19 97 before me
personally appeared Fred J. Harney to me known to be the
person described in, and who executed, the foregoing ins ent, and acknowledged that he/she executed
th/ his/ er gree zc and dged.
r
Notary Public y commiss' expires
This Det_errnin ition does not relieve the applicant from complying with all other applicable federal,state or local statutes,ordinances,
uy-laws or regulations.This Determination shall be valid for three years forth the dale of issuance. -
The applicant,the owner,any person aggrieved by ms 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:own in which such land is located,are hereby notified of their right to request the
Department of Environmental Quality Engineering to,ssue a superseding Determination of Applicability,providing the request is made
by cer8fied mail or hand delivery to the Deoanment wimin ten 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 the applicant.
2.2A
78
Form 1 _ 4EOE Foe No.
i
(To be provided by OEOE) '
,
- - City/Town
Commonwealth
of Massachusetts Appf rant
.1
Request for a Determination of Applicability
Massachusetts Wetlands Protection Act, G.LL/c..j131, §40
1. I,the undersigned,hereby request that the
Conservation Commission make a determination as to whether the area,described below,or work to be
performed on said area,also described below,is subject to the jurisdiction of the Wetlands Protection
Act,G.L c. 131, 140.
2. The area is described as follows.(Use maps or plans, if necessary,to provide a description and the
location of the area subject to this request.)
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3. The work in said area is described below.(Use additional paper,H necessary,to describe the
proposed work.)
S� s1 S 17 ✓L
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4. The owner(s)of the area if not the person making this request,has been given written notification of this
request on CN < jc (date)
i
The name(s)and address(es)of the owner(s):
da, 7 cy
5. I have filed a complete copy of this request with the appropriate regional office of the Massachusetts
Department of Environmental Cluality Engineering on (date)
Northeast Southeast-
323
t S coruµd N wJeA T- Lakeville Hospital
Woburn,MA 01801 hoc Lakeville,MA 02346
Central Western P
75 Grove Street Public Health Center
Worcester,MA 01605 University of Massachusetts
Amherst,MA 01003
6. 1 understand that notification of this request will be placed in a local newspaper at my expense in accor-
dance with Section 10.05(3)(b) 1 of the regulations by the Conservation Commission and that I will be
billed accordingly.
..-� Name
Signature U
Address 4-7 - r l C f - Tel.
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