Sovereign Way Beaver CulvertMassachusetts Department of Environmental Protection
Bureau of Resource Protection Wetlands
WPA Emergency Certification Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. Emergency Information
Important: Issuance From:
When filling out
forms on the
computer, use 1. Site Location:
only the tab
key to move 2
your cursor
do not use the
return key.
WPA Emergency Certification
Rev. 01/31/0
Reason for Emerge
4. Public a.ency to perforr
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5. Date of Site Visit:
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6. Work to be alto, ed
Issuing Author' IA (kir)
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3. Applicant to perform work:
work or public agency .rdering the w'rk to be performed:
11C._
Start Date:
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May not include work beyond that necessary to abate the emergency.
B. Signatures
Certified to be an Emergency by this Issuing Authority.
Signat
E d Date
srat) &03
than 30 days from start date or 60 days in the
case o an Immediate Response Action approved by
DEP to address an oiVhazardous material release.
A copy of this form must be provided to the appropriate DEP Regional Office.
Page 1 of 2
WPA Emergency Certification
Rev. 0
Massachusetts Department of Environmental Protection
Bureau of Resource Protection Wetlands
WPA Emergency Certification Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. General Conditions
1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory
measures, shall be deemed cause to revoke or modify this Emergency Certification or subject to
enforcement action.
2. This Emergency Certification does not grant any property rights or any exclusive privileges; it does not
authorize any injury to private property or invasion of property rights.
3. This Emergency Certification does not relieve the applicant or any other person of the necessity of
complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations.
4. Any work conducted beyond that described above, and any work conducted beyond that necessary to
abate the emergency, shall require the filing of a Notice of Intent.
5. The Agent or members of the Conservation Commission and the Department of Environmental
Protection shall have the right to enter and inspect the area subject to this Emergency Certification at
reasonable hours to evaluate compliance with this Certification, and may require the submittal of any
data deemed necessary by the Conservation Commission or the Department for that evaluation.
6. This Emergency Certification shall apply to any contractor or any other person performing work
authorized under this Certification.
7. No work may be authorized beyond 30 days from the date of this certification without written approval
of the Department.
D. Special Conditions
E. Appeals
The Department may, on its own motion or at the request of any person, review: an emergency
certification issued by a conservation commission and any work permitted thereunder; a denial by a
conservation commission of a request for emergency certification; or the failure by a conservation
commission to act within 24 hours of a request for emergency certification. Such review shall not
operate to stay the work permitted by the emergency certification unless the Department specifically so
orders. The Department's review shall be conducted within seven days of: issuance by a conservation
commission of the emergency certification; denial by a conservation commission of the emergency
certification; or failure by a conservation commission to act within 24 hours of a request for emergency
certification. If certification was improperly granted, or the work allowed thereunder is excessive or not
required to protect the health and safety of citizens of the Commonwealth, the Department may revoke
the emergency certification, condition the work permitted thereunder, or take such other action as it
deems appropriate.
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APPLICATION FOR 10-DAY EMERGENCY BEAVER OR MUSKRAT PERMIT
TO BE FILLED OUT BY Lt-)A-7 Fee (if applicable):
Name 0 e ✓'c' .ty I h w y t O 4 1CfPL41 r em' Jc Date:
Address:(. Q £,J: L i p 1F ear C-. c v, A/
Town: F/o ►��.�P
Daytime Tel. °Z i' `s
Agent Name: J e.a. ye-v. n j•
(if applicable) 1,4 Ca- j I w 4
Complaint Location:
Zip Code: D1 2 Y
Evening TeL
L e Tel. 3) 5 1 6 4/ 7_1_
cell C L0 3) 6 °l .5 0 Y' Y
(..t7a
Is the problem entirely on your property? Yes: Z/ No: Don't Know:
Note: If the problem does not occur entirely on the applicant's property, consent
forms from all other property owners must be obtained
Type of Complaint Provide a detailed description of the perceived threat to public health and
safely
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P
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such work in accordance with the wetlands protection act.
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Under M.G.I.. c. 131, s. 80A, an emergency permit authorizes the applicant or his duly authorized agent
to immediately remedy the threat to human health and safely by one or more of the following options: (a)
the use of conibear or box or cage -type traps for the taking of beaver or muskrat, subject to negations;
(b) the breaching of dams, dikes, bogs or berms; and/or (c) employing any non lethal management of
water -flow devices. The emergency permit will be good for 10 days from the date of issue.
NOTE: Options (b) and/or (c) above require applicant to get conservation commission approval prior to
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