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(n I O 0 V) 0 +00 1+00 2 +00 3 +00 4 +00 5 +00 6 +00 7 +00 8 +00 9 +00 10 +00 11+00 Ti CONS ultilly Eli illeers 53 Southampton Road Westfield, Massachusetts (413) 562 -1600 www.tighebond.com - Massachusetts Highway Department District 2 Sewer Service Northampton & Hatfield, Massachusetts Mark I Date IDescription PROJECT NO VV3597 -1 -02 FILE: EXSITE (PROFILE) DRAWN BY. LPT CHECKED. DRP APPROVED BY JOR PROFILES SCALE. HORIZ. 1 " =40', VERT. 1 " =4' SHEET 2 4 • SILT FENCE I i�l I I I I I V I I I V I I I Illl II / Ii i WORK AREA PROTECTED IIIIIII STAKED AREA STRAW BALES I I i I I II /� FLOW I SET 4" INTO GROUND TOP OF I I I II III / GROUND / I I �I I II C F 11 PLAN EXISTING SUBGRADE TYPICAL SECTION CATCH BASIN NOTE: (2) WOOD STAKES MINIMUM PER HAYBALE. STEEL DOWELS SHALL BE UTILIZED WHERE WOOD STAKES CAN NOT BE DRIVEN INTO GROUND. STANDARD DETAIL CATCH BASIN INLET EROSION CONTROL TIGHE do BOND INC., CONSULTING ENGINEERS WESTFIELD, MASSACHUSETTS CBERC OCD`. • l � 1 - = l �- o •�. aveI Prts r -ST ' T F I E L «'eat Hat vid SITE LOCATION�� 14 , 9 Holy Tr,>17ty I , p4a9elTits Canary Island I - - j Hebrew; j, Cems• a _RIvt;H Y 0 C 1 Quancv G �- FI A D L E Y NUNEY POT PQ] ROAD ' r J ROAD ,HON.EY CEMETERY INTERCHANGE o CIRCLES INDICATE 500 -FOOT AND 1/2 -MILE RADII. 0 / BASED ON USGS TOPOGRAPHIC MAP FOR FIGURE 1 EASTHAMPTON, MA QUADRANGLE USGS SITE LOCUS REVISED 1979 MASSACHUSETTS HIGHWAY DEPT 10 -FOOT CONTOUR INTERVAL N 6W:'� SEWER SERVICE PROJECT NORTHAMPTON, MASSACHUSETTS ■ MASS. W F ' Tighe &Bond SCALE: 1:25000 AUGUST 2004 W 3597.apr OHO 51 'te c 5 1 SITE LOCATION C7 r - ION f `4 ROAD NO ;..,.. .. e J -., L 'I�NEPON 47 1 F mo I, 1 . �. WELT HA 1 I 1 W3597.apr - � L ;` ° Hc3NEY P q1 /1 . BASED ON MassGIS MAP - FEBRUARY 2002. CIRCLES INDICATE 500 -FOOT AND 1/2 -MILE RADII. ...; Non Potential Drinking Water Source Area: Medium Yield Public Surface Water Supply (PSWS) C Community Public Water Supply- Surface Water FIGURE 2 VAW Non Potenh Drinking Water Source Area High Yield Potentially Productive Medium Yield Aquifer C Community Public Water Supply - Groundwater # Non - Community Non - Transient Public Water Supply M G I S MAPPING MAMM Potento y Product— High Yield Aquifer 0 EPA Designated Sole Source Aquifer Non - Community Transient Public Water Supply ass © DEP Approved Wellhead Protection Area (Zone2) NHESP 2003 Massachusetts Certified Vernal Pools DEP Interim Wellhead protection Area WPA I 0 ( ) Mufti -Lane Highway, NOT Limited Access Limited ese PuPublicOt Surface Water Supply Protection Area (Zone A) er Numbered h Other Numbered Hgway Highway MASSACHUSETTS HIGHWAY DEPT 4:14r Lake, Pond, Stream or other Fresh Water Feature "`-" Sall Feature T* " Bay Estuary Major Road - Connector Min street R oad SEWER SERVICE PROJECT or other Water Tra or Trail N �T= urWery F Water Non-Forested Welland � ' Boundary NORTHAMPTON, MASSACHUSETTS it h Sett Water Wetland I- -F -1 rei Than NHESP 2003 Priority Habitats for Stele - Protected - Ct Powedins W E Rare Spaces and Estimated Habitats for Rare Wildlife' Protected and Recreational Ope S �� Pipeline Rivers and Streams A queduct Areas of Cntical Environmental Concern (ACEC) Major Drainage Basin Tighe &Bond Solid Waste Landfill S ub Drainage Basin S USG' Quadrangle Boundary NHESP 2003 E,it ed HHabitats lv Pere 0160, `a US 1n M MA Wetwft P—lim A,t —(3110 CMR 10) Messx�useth En�angereC Specws Act SCALE: 1:25000 AUGUST 2004 47 1 F mo I, 1 . �. WELT HA 1 I 1 W3597.apr • SECTION 1 INTRODUCTION Tighe &Bond This Notice of Intent (NOI) is being submitted on behalf of the Massachusetts Highway Department (MHD) for the Sewer Service Project. The proposed project involves the construction of a 2" low pressure sewer service connection to an existing sanitary sewer stub along Routes 5 &10. A Site Locus (Figure 1) and Massachusetts Geographic Information Systems (MassGIS) Map (Figure 2), which illustrate the project area and surrounding physical and environmental features, are provided in Appendix B. 1.1 PURPOSE AND NEED The objective of the proposed project is to provide sewer service to the presently un- sewered MHD District 2 Headquarters Building. This includes the construction of an 1,100 -foot low pressure sewer service to the property. The proposed project will provide positive benefits by providing sewer service to collect and transmit facility wastewater to a central treatment facility, thus eliminating nuisance conditions due to ground and surface water contamination associated with the aging existing on -site wastewater disposal system. Due to problems associated with this system, a stub for the MHD property was installed during a recent sewer system expansion on Routes 5 &10. Notice of Intent - Massachusetts Highway Department Sewer Connection 1 -1 • SECTION 2 EXISTING ENVIRONMENT Tighe &Bond 2.1 SITE DESCRIPTION The project site is located at the MHD facility on the east side of North King Street in Northampton, Massachusetts. Paved access to the site is available from North King Street. The project site consists of the MHD District 2 facility building, paved parking and maintained lawn areas as well as the existing right -of -way along the east shoulder of Routes 5 &10 between the south access drive for the MHD facility and the Longview RV Super Store. These features are shown on the Site Plan provided in Appendix C of this NOI. 2.2 RESOURCE AREAS 2.2.1 Methodology Resource areas on the project site were delineated by Tighe & Bond on July 23, 2004. The guidelines established by MADEP for BVW (1995) and in the regulations (310 CMR 10.00) were employed. Resources are marked in the field by sequentially numbered pink stake flags. The flags marking the resource area are included on the attached Site Plan provided in Appendix B of this NOI. The Site Plan should be referenced for location information for the resource areas described below. 2.2.2 Resource Area - BVW There are several areas of bordering vegetated wetland (BVW) located in the proximity of the project boundaries. These areas consist of changes in vegetation consistent with a change in topography which slopes up to the adjacent lawn area that MHD regularly mows. The upland vegetation consists of maintained lawn areas and, in some areas, red oak (Quercus rubra), Douglas fir (Pseudotsuga menziseii), eastern white pine (Pinus strobus), and Multiflora Rose (Rosa multiflora). The dominant wetland vegetation consists primarily of cattails (Typha sp. ), wool grass (Scirpus cyperinus), arrow - leaved tearthumb (Polygonum sagittatum) and sedge species (Carex sp. ). A copy of the DEP Bordering Vegetated Wetland (310 CMR 10.55) Delineation Field Data Forms for this site are provided in Appendix E of this NOI. The project is not located within these resource areas. There are two (2) BVW resource areas that were observed on the opposite (west) side of North King Street from the proposed sewer service. These areas, and the 100 -foot Buffer Zone associated with them, are illustrated on the Site Plan. Again, the project is not located within these resource areas. Notice of Intent - Massachusetts Highway Department Sewer Connection 2 -1 • SECTION 2 EXISTING ENVIRONMENT Tighe &Bond 2.2.2.1 100 -foot BVW Buffer Zone Portions of the proposed project are located within the 100 -foot Buffer Zone of the resource areas discussed in Section 2.2.2. However minimal disturbance of the Buffer Zone will occur as a result of the proposed project due to the use of "trenchless" technology. Notice of Intent - Massachusetts Highway Department Sewer Connection 2 -2 SECTION 3 PROJECT DESCRIPTION Tighe &Bond This sewer service project includes a "trenchless" technology construction method referred to as "horizontal directional drilling" (HDD), whereby the need for open -cut excavation methods is reduced significantly. Approximately 1,100 linear feet (If) of 2- inch diameter high density polyethylene (HDPE) low pressure sewer service pipe will be installed to connect the MHD facility to the existing sewer service located on Routes 5 &10. Roughly 15 linear feet of 4 -inch diameter sanitary sewer gravity service and a grinder pump will also be installed as part of this project. The proposed grinder pump and gravity sewer building connection will be constructed to the south of the paved parking area adjacent to the MHD building (see Site Plan). The proposed 2" low pressure sewer pipe will then travel to the north and west towards the Longview RV Super Store on Route 5 &10, where it will connect to an existing gravity sewer collector system that was designed to accommodate this proposed project. 3.1 PROJECT CONSTRUCTION SEQUENCE The following sections detail the sequence of proposed construction events and describe each of these steps. 3.1.1 Siltation Control Installation The proposed siltation controls consist of siltation fence installed in conjunction with a haybale barrier to provide additional support and to further define the limits of the resource and proposed work areas. Given the low level of impact associated with trenchless technology and the nature of the project area, erosion is not considered a potential hazard. Siltation controls will be installed prior to the commencement of access pit construction and horizontal directional drilling at this site and maintained throughout construction activities. The locations of these controls are illustrated on the Site Plan provided in Appendix C of this NOI. Additionally, catch basin inlet sedimentation controls will be installed at all catch basins located in close proximity to the staging areas and construction access pits. These catch basins discharge to the nearby resource area. A detail of this control is provided in Appendix C of this NOI. 3.1.2 Staging Area Preparation — A staging area of approximately 35 feet by 100 feet is proposed near the access pit adjacent to the proposed grinder pump. This area will be used for equipment staging and material storage during the preparation and construction phases of the proposed project. This area is located within 10 feet of the resource area boundary, however, the haybale siltation fence barrier will be erected between the limits of work and the Notice of Intent - Massachusetts Highway Department Sewer Connection 3 -1 i SECTION 3 PROJECT DESCRIPTION Tighe &Bond Finally, when the newly installed sewer service system has been installed, tested, and connected, the existing on -site wastewater disposal system will be decommissioned. In the event that any areas are disturbed by the proposed activities, they will be restored to their original grade with vegetative support material and the specified seed mixture and erosion control measures will be installed. Notice of Intent - Massachusetts Highway Department Sewer Connection 3 -3 � r� v� Massachusetts Wartment of Environmental Prot6,.ion Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. V Q A. General Information Northampton Conservation Commission From: 1. Conservation Commission DEP File Number: 246 -545 IV�III' III I I�I��P� 8k: 8076Pg: 123 Page: 1 of 8 Recorded: 1112312004 12:51 PM 2. This issuance is for (check one): ® Order of Conditions ❑ Amended Order of Conditions 3. To: Applicant: Albert a. First Name 811 North King Street d. Mailing Address Northampton e. City/Town 4. Property Owner (if different from applicant): Stegemann Massachusetts Highway Department b. Last Name c. Company MA f. State a. First Name b. Last Name c. Company d. Mailing Address e. City/Town 5. Project Location: 811 North King Street a. Street Address 8 c. Assessors Map /Plat Number Latitude and Longitude, if known (note: electronic filers will click for GIS locator) f. State Northampton b. City/Town 11 d. Parcel /Lot Number e. Latitude 01060 g. Zip Code g. Zip Code f. Longitude 6. Property recorded at the Registry of Deeds for (attach additional information if more than one parcel): Hampshire a. County b. Certificate (f registered land) c. Book d. Page August 19, 2004 September 9, 2004 September 28, 2004 7. Dates: a. Date Notice of Intent Filed b. Date Public Hearing Closed c. Date of Issuance 8. Final Approved Plans and Other Documents (attach additional plan or document references as needed): "Massachusetts Highway Department District 2 Sewer Service, Sanitary Site Plan" a. Plan Title Tighe &Bond b. Prepared By c. Signed and Stamped by d. Final Revision Date f. Additional Plan or Document Title 9. Total WPA Fee Paid: _ exempt a. Total Fee Paid 1 " =40' e. Scale g. Date b. State Fee Paid c. City/Town Fee Paid wpaform5.doc • rev. 9/28/04 Page 1 of 8 Massachusetts9partment of Environmental Prot6 Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Number: 246 -545 B. Findings 1. Findings pursuant to the Massachusetts Wetlands Protection Act: Following the review of the above - referenced Notice of Intent and based on the information provided in this application and presented at the public hearing, this Commission finds that the areas in which work is proposed is significant to the following interests of the Wetlands Protection Act. Check all that apply: a. ® Public Water Supply b. ❑ Land Containing Shellfish c. ® Prevention of Pollution d. ® Private Water Supply e. ❑ Fisheries f. ® Protection of Wildlife Habitat g. ® Groundwater Supply h. ® Storm Damage Prevention i. ® Flood Control 2. This Commission hereby finds the project, as proposed, is: (check one of the following boxes) Approved subject to: ® the following conditions which are necessary in accordance with the performance standards set forth in the wetlands regulations. This Commission orders that all work shall be performed in accordance with the Notice of Intent referenced above, the following General Conditions, and any other special conditions attached to this Order. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, these conditions shall control. Denied because: ❑ the proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations. Therefore, work on this project may not go forward unless and until a new Notice of Intent is submitted which provides measures which are adequate to protect these interests, and a final Order of Conditions is issued. A description of the performance standards which the proposed work cannot meet is attached to this Order. ❑ the information submitted by the applicant is not sufficient to describe the site, the work, or the effect of the work on the interests identified in the Wetlands Protection Act. Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides sufficient information and includes measures which are adequate to protect the Act's interests, and a final Order of Conditions is issued. A description of the specific information which is lacking and why it is necessary is attached to this Order as per 310 CMR 10.05(6)(c). Inland Resource Area Impacts: Check all that apply below. (For Approvals Only) wpaform5.doc • rev. 9128104 Permitted Proposed Permitted Alteration Replacement Replacement b. linear feet c. linear feet d. linear feet b. square feet c. square feet d. square feet b. square feet c. square feet d. square feet I. Uu.yU ulCUy CU Page 2 of 8 Proposed Resource Area Alteration 3. ❑ Bank a. linear feet 4. ❑ Bordering Vegetated Wetland a. square feet 5. ❑ Land Under a. square feet Waterbodies and Waterways e. cu.yd dredged wpaform5.doc • rev. 9128104 Permitted Proposed Permitted Alteration Replacement Replacement b. linear feet c. linear feet d. linear feet b. square feet c. square feet d. square feet b. square feet c. square feet d. square feet I. Uu.yU ulCUy CU Page 2 of 8 Ll Massachusettsepartment of Environmental Prot&.,Lion Bureau of Resource Protection - Wetlands l� WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Number: 246 -545 B. Findings (cont.) Barrier Beaches Indicate size under Coastal Beaches and /or Coastal Dunes below 12. ❑ Coastal Beaches Proposed Permitted Proposed Resource Area Alteration Alteration Replacement 6. ❑ Bordering Land Subject a. linear feet b. linear feet 15. ❑ to Flooding a. square feet b. square feet c. square feet Cubic Feet Flood a. square feet b. square feet 16. ❑ Storage e. cubic feet f. cubic feet g. cubic feet 7. ❑ Isolated Land Subject _ to Flooding a. square feet b. square feet Cubic Feet Flood Storage c. cubic feet d. cubic feet e. cubic feet 8. ❑ Riverfront area a. total sq. feet b. total sq. feet Sq ft within 100 ft c. square feet d. square feet Sq ft between 100 -200 ft e. square feet f. square feet Coastal Resource Area Impacts: Check all that apply below. (For Approvals Only) 9. ❑ Designated Port Indicate size under Land Under the Ocean, below Areas 1o. ❑ Land Under the Ocean a. square feet b. square feet Permitted Replacement d. square feet h. cubic feet f. cubic feet 11. ❑ Barrier Beaches Indicate size under Coastal Beaches and /or Coastal Dunes below 12. ❑ Coastal Beaches a. square feet b. square feet c. c/y nourishmt. d. c/y nourishmt. 13. ❑ Coastal Dunes a. square feet b. square feet c. c/y nourishmt. d. c/y nourishmt 14. ❑ Coastal Banks a. linear feet b. linear feet 15. ❑ Rocky Intertidal Shores a. square feet b. square feet 16. ❑ Salt Marshes a. square feet b. square feet c. square feet d. square feet 17. ❑ Land Under Salt _ Ponds a. square feet b. square feet 18. ❑ Land Containing Shellfish a. square feet b. square feet c. square feet d. square feet 19. ❑ Fish Runs Indicate size under Coastal Banks, inland Bank, Land Under the Ocean, and /or inland Land Under Waterbodies and Waterways, above a. cu.yd dredged b. cu.yd dredged 20. ❑ Land Subject to Coastal Storm Flowage a. square feet b. square feet wpaform5.doc • rev. 9128104 Page 3 of 8 �� 11® Massachusettstpartment of Environmental Prot&.,,ion Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Number: 246 -545 C. General Conditions Under Massachusetts Wetlands Protection Act (only applicable to approved projects) 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 Order. 2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. 4. The work authorized hereunder shall be completed within three years from the date of this Order unless either of the following apply: a. the work is a maintenance dredging project as provided for in the Act; or b, the time for completion has been extended to a specified date more than three years, but less than five years, from the date of issuance. If this Order is intended to be valid for more than three years, the extension date and the special circumstances warranting the extended time period are set forth as a special condition in this Order. 5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. Any fill used in connection with this project shall be clean fill. Any fill shall contain no trash, refuse, rubbish, or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles, or parts of any of the foregoing. 7. This Order is not final until all administrative appeal periods from this Order have elapsed, or if such an appeal has been taken, until all proceedings before the Department have been completed. 8. No work shall be undertaken until the Order has become final and then has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done. In the case of the registered land, the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done. The recording information shall be submitted to this Conservation Commission on the form at the end of this Order, which form must be stamped by the Registry of Deeds, prior to the commencement of work. 9. A sign shall be displayed at the site not less then two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection" [or, "MA DEP "] "File Number 246 -545 wpaform5.doc • rev. 9128104 Page 4 of 8 Massachusetts *partment of Environmental Prot&,...ion DEP File Number: Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions 246 -545 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 C. General Conditions Under Massachusetts Wetlands Protection Act 10. Where the Department of Environmental Protection is requested to issue a Superseding Order, the Conservation Commission shall be a party to all agency proceedings and hearings before DEP. 11. Upon completion of the work described herein, the applicant shall submit a Request for Certificate of Compliance (WPA Form 8A) to the Conservation Commission, 12. The work shall conform to the plans and special conditions referenced in this order. 13. Any change to the plans identified in Condition #12 above shall require the applicant to inquire of the Conservation Commission in writing whether the change is significant enough to require the filing of a new Notice of Intent. 14. 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 Order at reasonable hours to evaluate compliance with the conditions stated in this Order, and may require the submittal of any data deemed necessary by the Conservation Commission or Department for that evaluation. 15. This Order of Conditions shall apply to any successor in interest or successor in control of the property subject to this Order and to any contractor or other person performing work conditioned by this Order. 16. Prior to the start of work, and if the project involves work adjacent to a Bordering Vegetated Wetland, the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden stakes or flagging. Once in place, the wetland boundary markers shall be maintained until a Certificate of Compliance has been issued by the Conservation Commission. 17. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully stabilized with vegetation or other means. At no time shall sediments be deposited in a wetland or water body. During construction, the applicant or his /her designee shall inspect the erosion controls on a daily basis and shall remove accumulated sediments as needed. The applicant shall immediately control any erosion problems that occur at the site and shall also immediately notify the Conservation Commission, which reserves the right to require additional erosion and /or damage prevention controls it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of work line has been approved by this Order. Special Conditions: If you need more space for additional conditions, - - - - - select box to attach a text document ❑ wpaform5.doc • rev 9128104 Page 5 of 8 �� 11® Massachusettswartment of Environmental Prote� ion DEP File Number: Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions 246 -545 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 D. Findings Under Municipal Wetlands Bylaw or Ordinance 1. Furthermore, the Northampton hereby finds (check one that applies): Conservation Commission 2. ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw specifically: a. Municipal Ordinance or Bylaw b. Citation Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides measures which are adequate to meet these standards, and a final Order of Conditions is issued. 3. ❑ that the following additional conditions are necessary to comply with a municipal ordinance or bylaw: a. Municipal Ordinance or Bylaw b. Citation The Commission orders that all work shall be performed in accordance with the following conditions and with the Notice of Intent referenced above. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, the conditions shall control. If you need more The special conditions relating to municipal ordinance or bylaw are as follows: space for additional conditions, select box to attach a text document ❑ E. Issuance Sig This Order is valid for three years, unless otherwise specified as a special condition pursuant to General Conditions #4, from the date of issuance. September 28 2004 _ 1. Date of issuance Please indicate the number of members who will sign this form: This Order must be signed by a majority of the Conservation Commission. 2. Number of signers The Order must be mailed by certified mail (return receipt requested) or hand delivered to the applicant. A copy also must be mailed or hand delivered a the same time to the appropriate Department of Environmental Protection Regional Office, in t filing electronically (see Appendix A), and the property owner, if different frorp-aWlicant. _ i a re wpaform5 doc • rev. 9/23/04 Page 6 of 8 Massachusettse6artment of Environmental Protc- ..ion Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Number: 246 -545 E. Issuance (cont.) Notary Acknowledgement Commonwealth of Massachusetts County of Hampshire Twenty -third September 2004 On this Day � Month Year Before me, the undersigned Notary Public, personally appeared John Body Name of Document Signer proved to me through satisfactory evidence of identification, which was /were Personal knowledge Description of evidence of identification to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he /she signed it voluntarily for its stated purpose. As member of Northampton _. Conservation Commission City/Town 0 6 ii - w V I V! notary seal and /or any stamp above 1 . S tary ure of No Public ria McPherson This Order is issued to the applicant as follows: ❑ by hand delivery on D F. Appeals Printed Name of Notary Public September 4, 2009 My Commission Expires (Date) ® by certified mail, return receipt requested, on September 28, 2004 Date The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject to this Order, 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 DEP Regional Office to issue a Superseding Order of Conditions. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and a completed Appendix E: Request of Departmental Action Fee Transmittal Form, as provided in 310 CMR 10.03(7) within ten business days from the date of issuance of this Order. 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 Order which is being appealed and how the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act, (M.G.L. c. 131, § 40) and is inconsistent with the wetlands regulations (310 CMR 10.00). To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. wpaform5.doc • rev. 9128/04 Page 7 of 8 Massachusetts4ppartment of Environmental Prote .,lion Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Number: 246 -545 G. Recording Information This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions. The recording information on Page 7 of this form shall be submitted to the Conservation Commission listed below. Northampton Conservation Commission Conservation Commission Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission. To: Conservation Commission Please be advised that the Order of Conditions for the Project at: Project Location DEP File Number Has been recorded at the Registry of Deeds of: County Book Page fo r: Property Owner and has been noted in the chain of title of the affected property in Book Page In accordance with the Order of Conditions issued on: Date If recorded land, the instrument number identifying this transaction is: Instrument Number If registered land, the document number identifying this transaction is: Document Number Signature of Applicant wpaform5.doc • rev. 9128104 ATTEST: HAMPSHIRE, Pa 8 of 8 MARIANNE L. DONOHUE O MMONWEALTH OF MA SSACHUS - i, ITS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION WESTERN REGIONAL OFFICE 436 Dwight Street • Springfield, Massachusetts 01103 • (413) 784 -1100 • FAX (413) 784 -1149 MITT ROMNEY ELLEN ROY HERZFELDER Governor Secretary KERRY HEALEY ROBERT W. GOLLEDGE, Jr. Lieutenant Governor Commissioner RE: NOTIFICATION OF WETLANDS PROTECTION ACT FILE NUMBER DATE: August 31, 2004 MUNICIPALITY: NORTHAMPTON The Department of Environmental Protection has received a Notice of Intent filed in accordance with the Wetlands Protection Act (MGL c. 131, § 40): APPLICANT: ALBERT STEGEMANN OWNER: SAME MHD 811 NORTH KING STREET NORTHAMPTON, MA 01060 PROJECT LOCATION: NORTH KING STREET IF CHECKED, THE FOLLOWING ITEM(S) APPLY TO THIS NOTICE OF INTENT: A. 0 This project has been assigned the following file #: 246 -545 Although a file number is being issued, please note the following: Based upon information provided within the Notice of Intent, it appears that this proposal is restricted to work within the 100 -foot Buffer Zone to jurisdictional resource areas [see 310 CMR 10.04 Buffer Zone Adequate erosion and sedimentation controls are required for projects of this nature. If applicable, the Department's Stormwater Management Policy must be complied with. If any new information indicating that jurisdictional resource areas will be altered is presented to the issuing authority, the Department should be simultaneously notified, at which time the Department would reserve the right to make additional comments as necessary, as it does whenever additional information is submitted. The conservation commission should correctly cite relevant plans in the Order of Conditions. Copies of final supplemental information generated during and after the Public Hearing and local review of this project should be forwarded to both the conservation commission and the Department's Western Regional Office. ISSUANCE OF A FILE NUMBER INDICATES ONLY COMPLETENESS OF SUBMITTAL, NOT APPROVAL OF APPLICATION For more information please contact: Dave Foulis, Wetlands Program @ 413- 755 -2154 xc: Conservation Commission ❑MA Natural Heritage and Endangered Species Program Property Owner as listed in Notice of Intent ❑US Army Corps of Engineers Representative as listed in Notice of Intent ❑DEP- Waterways Regulation Program ❑Other: This information is available in alternate format. Call Donald A DEP on the World Wide We 0 Printed on i5 CooRlInator at 617 -556 -1057. TDD Setvide - 1 - 800.29 &2207. tt www.mass.gov /dep ecycle Paper - I al(A Wmp UT�.i�`h,i'1�li�___. _3 Jighe&Bond Consulting Engineers Environmental Specialists W- 3597 -1 -04 August 16, 2004 Conservation Commission City of Northampton Town Hall 210 Main Street Northampton, MA 01060 Re: Notice of Intent Massachusetts Highway Department - District 2 Sewer Service Project Northampton, Massachusetts Dear Members of the Commission: On behalf of the Massachusetts Highway Department (MHD), and in accordance with the Massachusetts Wetlands Protection Act and the Northampton Wetlands Protection Ordinance (Section 24), we are hereby providing you with two (2) copies of this NOI. The proposed project involves a sewer service to the MHD District 2 facility headquarters on North King Street. This project involves the construction of a 1,100 linear foot section of 2" low pressure sanitary sewer service pipe from an existing sewer stub in Routes 5 &10. A recent sewer extension project on Routes 5 &10 provided sewerage capacity for this proposed sewer service connection. Sections of the proposed work are within buffer zone areas, but no work will occur within the resource areas themselves. In order to limit potential impacts to the resource areas, trenchless construction methods have been incorporated into the design. Where excavation work is required, erosion control measures have been incorporated to mitigate potential adverse impacts to resource areas. This project will eliminate severe nuisance conditions and potential adverse public health problems associated with the existing aged on -site wastewater disposal system. In addition, the proposed project will improve groundwater and surface water quality in the resource areas adjacent to the existing on -site wastewater disposal system. 53 Southampton Road, Westfield, MA 01085 Tel. 413 -562 -1600 Fax 413 - 562 -5317 Offices: Bellows Falls, VT, Middletown, CT. Norwalk, CT, Pocasset, MA and Worcester, MA Original printed on recycled paper. �� II■1 • Tighe &Bond Consulting Engineers Environmental Specialists As required in Section A of WPA Form 3, the book and page reference for the project site will be provided prior to the public hearing for this submittal once historical research to locate this information is completed. Should you have any questions or comments regarding this submittal, please do not hesitate to contact Melissa Parsons at (413) 572 -3224 or myself at (413) 572 -3278. Very truly yours, TIGHE & BOND, INC. David R. Prickett JAW \W3597 \N0I \C0VER LETTER.DOC Enclosures Copy: MA DEP (WERO) - Division of Wetlands & Waterways Steve Doyle - MHD District 2 Paul Gibavic - Warner Bros. Inc. -2- Original printed on recycled paper. � II■1 • TABLE OF CONTENTS Tighe &Bond COVER LETTER WPA FORM 3 — NOTICE OF INTENT LIST OF APPENDICES APPENDIX A — PROJECT NARRATIVE STANDARD DETAIL: CATCHBASIN INLET EROSION CONTROL I SECTION 1 INTRODUCTION 1.1 Purpose and Need ............................. ............................... 1 -1 SECTION 2 EXISTING ENVIRONMENT 2.1 Site Description .................................. ............................... 2 -1 2.2 Resource Areas ................................. ............................... 2 -1 2.2.1 Methodology ............................... ............................2 -1 2.2.2 Resource Area - BVW ............. ............................... 2 -1 SECTION 3 PROJECT DESCRIPTION 3.1 Project Construction Sequence .......... ............................... 3 -1 3.1.1 Siltation Control Installation ..... ............................... 3 -1 3.1.2 Staging Area Preparation ........ ............................... 3 -1 3.1.3 Access Pit Construction .......... ............................... 3 -2 3.1.4 Sewer Service Installation ....... ............................... 3 -2 SECTION 4 MITIGATION MEASURES 4.1 Mitigation Guidelines .......................... ............................... 4 -1 APPENDIX B — FIGURES FIGURE 1 — USGS SITE LOCUS FIGURE 2 — MASSGIS MAP APPENDIX C — PROJECT PLANS SANITARY SITE PLAN SHEET _ PROFILES SHEET STANDARD DETAIL: SILT FENCE /HAYBALE BARRIER STANDARD DETAIL: CATCHBASIN INLET EROSION CONTROL • TABLE OF CONTENTS Tighe &Bond _ APPENDIX D - SITE PHOTOGRAPHS APPENDIX E - ABUTTERS INFORMATION LIST OF ABUTTERS ABUTTER NOTIFICATION FORM APPENDIX F - DELINEATION DATA FORMS • WPA Form 3 - Notice of Intent - Massachuset s Department of Environmental ental Pr62ectlon Bureau of Resource Protection - Wetlands Ll WPA Form 3 — Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DER P►. Veneral Information 1. Project Location (Note: electronic filers will click on button for GIS locator): North King Street Northampton 01060 a. Street Address b. City/Town C. Zip Code Latitude and Longitude, if Known: 41:21:46 - 72:38:15 d. Latitude e. Longitude Map 8 Lot 11 f. Assessors Map /Plat Number g. Parcel /Lot Number Important: When filling out 2. Applicant: forms on the Albert Stegemannn computer, use Massachusetts Highway Department only the tab a. First Name b. Last Name c. Company key to move 811 North King Street your cursor - d. Mailing Address do not use the Northampton MA 01060 return key. e. City/Town f. State g. Zip Code (413) 585 -9567 (413) 584 -8194 N/A 7a6 h. Phone Number i. Fax Number j. Email address 3. Property owner (if different from applicant): ❑ Check if more than one owner (Same) _ a. First Name b. Last Name c. Company d. Mailing Address Note: Before e. City/Town f. State g. Zip Code completing this form consult h. Phone Number i. Fax Number j. Email address your local _ Conservation 4 • Representative (if any): Commission Tighe & Bond, Inc. regarding any a Firm _ municipal bylaw Dave or ordinance. Prickett b. Contact Person First Name C. Contact Person Last Name 53 Southampton Road _ d. Mailing Address Westfield MA 01085 e. City/Town f. State g. Zip Code 413 - 572 -3278 413- 562 -5317 drprickett@tighebond.com El Select h. Phone Number i. Fax Number i. Email address if you want to see 5. Total WPA Fee Paid (from Appendix A, Wetland Fee Transmittal Form): _ Wetland Fee Fee exempt. Transmittal Form. a. Total Fee Paid b. State Fee Paid c. City/Town Fee Paid 6. General Project Description: Construct low pressure sewer service connection to the MHD facility from an existing sewer stub on Routes 5/10 (via directional drilling). Some sections of the proposed work are in the 100 -foot Buffer Zone of a Borderin Vegetated Wetland. wpaform3.doc • rev. 06/03 Page 1 of 8 Massachuset s Department of Environmental Protection Bureau of Resource Protection - Wetlands i WPA Form 3 — Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. General Information (continued) 7. Project Type Checklist: a. ❑ Single Family Home b. ❑ Residential Subdivision c. ❑ Limited Project Driveway Crossing d. ❑ Commercial /Industrial e. ❑ Dock/Pier f. ® Utilities g. ❑ Coastal Engineering Structure h. ❑ Agriculture — cranberries, forestry i. ❑ Transportation i. ❑ Other 8. Property recorded at the Registry of Deeds for: Hampshire a. County b. Book C. Page Number Provided by QEP DEP Fil$ hlut bof — Document Transaction Number Northampton City/Town o. certificate # (if registered land) 9. Buffer Zone Only Is the project located only in the Buffer Zone of a bordering vegetated wetland, inland bank, or coastal bank, coastal beach, coastal dune, or salt marsh? a. ® Yes If yes, skip to Section C. b. ❑ No If no, check the resource areas to be affected by this project, directly below. wpaform3.doc • rev. 06/03 Page 2 of 8 Ilr — _ MassachusetDepartment of Environmental Pr ProvidedbybEP: erection Bureau of Resource Protection - Wetlands DEP M twti ft e PA Form 3 — Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Document Transaction Number Northampton City/Town - B. Resource Area Effects 1. Inland Resource Areas Check all that apply below. Attach narrative and any supporting documentation describing how the project will meet all performance standards for each of the resource areas altered, including standards requiring consideration of alternative project design or location. Online Users: Include your Resource Area Size of Proposed Alteration Proposed Replacement (if any) document transaction a. ❑ Bank 1. linear feet 2. linear feet number b. ❑ Bordering Vegetated (provided on your receipt Wetland 1. square feet 2. square feet page) with all c. ❑ Land Under supplementary 1. sq uare feet Waterbodies and q 2. square feet information you Waterways submit to the 3. cubic yards dredged d ❑ Bordering Land Department. Subject to Flooding 1. s quare feet 1 9 q 2. square feet 3. cubic feet of flood storage lost 4. cubic feet of flood storage replaced e. ❑ Isolated Land Subject to Flooding 1. square feet 2. cubic feet of flood storage lost 3. cubic feet of flood storage replaced f. ❑ Riverfront area 1. Name of Waterway (if available): 2. Width of Riverfront Area (check one): ❑ 25 ft. - Designated Densely Developed Areas only ❑ 100 ft. - New agricultural projects only ❑ 200 ft. - All other projects 3. Total area of Riverfront Area on the site of the proposed project: Square Feet 4. Proposed alteration of the Riverfront Area: a. Total Square Feet b. Square Feet within 100 ft. c. Square Feet between 100 ft. and 200 ft. 5. Has an alternatives analysis been done and is it attached to this NO[? ❑ Yes ❑ No 6. Was the lot where the activity is proposed created prior to August 1, 1996? ❑ Yes ❑ No wpaform3.doc • rev. 06/03 Page 3 of 8 I� Ll Massachusetts Department of Envir onmental Provided q DEP. p ronmental Protection � Bureau of Resource Protection - Wetlands aEP J- '1 Dumber WPA Form 3 — Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Docum tham pransactiort Number Nor _ City/Town B. Resource Area Effects (continued) 2. Coastal Resource Areas: Check all that apply below. Attach narrative and supporting documentation describing how the project will meet all performance standards for each of the resource areas altered, including — standards requiring consideration of alternative project design or location. Online Users: Include your R Resource Area Size of Proposed Alteration Proposed Replacement (if any) document transaction a. ❑ Designated Port Areas Indicate size under Land Under the Ocean, below number (provided on b. ❑ Land Under the Ocean your receipt 1. Square feet page) with all supplementary 2. Cubic yards dredged _ information you c. r Barrier Beach Indicate size under Coastal Beaches and /or Coastal Dunes submit to the below Department. d. ❑ Coastal Beaches 1. Square feet 2. Cubic yards beach nourishment e. ❑ Coastal Dunes 1. Square feet q 2. Cubic yards dune nourishment f. ❑ Coastal Banks 1. Linear feet g. ❑ Rocky Intertidal Shores 1. Square feet h. ❑ Salt Marshes 1. Square feet 2. Sq ft restoration, rehab., or creation i. ❑ Land Under Salt Ponds 1. Square feet 2. Cubic yards dredged j. ❑ Land Containing Shellfish 1. Square feet 2. Square feet restoration, rehab. k. ❑ Fish Runs Indicate size under Coastal Banks, inland Bank, Land Under the Ocean, and /or inland Land Under Waterbodies and Waterways, above 1. Cubic yards dredged i. r Land Subject to Coastal Storm Flowage 1. Square feet I Limited Project: Is any portion of the proposed activity eligible to be treated as a limited project subject to 310 CMR 10.24 or 310 CMR 10.53? a. ❑ Yes ❑ No If yes, describe which limited project applies to this project: b. Limited Project wpaform3.doc • rev. 06/03 Page 4 of 8 d. ❑ Direct observation For all projects affecting other Resource Areas, please attach a narrative explaining how the resource area was delineated. e. ❑ Hydric soil indicators f. ❑ Credible evidence of conditions prior to disturbance Li. Uther Applicable Standards and Requirements 1. Is any portion of the proposed project located in estimated habitat as indicated on the most recent Estimated Habitat Map of State - Listed Rare Wetland Wildlife published by the Natural Heritage and Endangered Species Program? a. ❑ Yes ® No If yes, include proof of mailing or hand delivery of NOI to: Natural Heritage and Endangered Species Program Division of Fisheries and Wildlife Route 135, North Drive Westborough, MA 01581 July 1, 2003 b. Date of Map 2. For coastal projects only, is any portion of the proposed project located below the mean high water line or in a fish run? ❑ Yes ❑ No If yes, include proof of mailing or hand delivery of NOI to: Massachusetts Division of Marine Fisheries 251 Causeway Street, Suite 400 Boston, MA 02114 ® Not applicable — project is in inland resource area only wpaform3.doc • rev. 06/03 Page 5 of 8 — Massachusetts Department of Enviro nmental Pravidecla, .DER p onmental Pro�ectlon � Bureau of Resource Protection - Wetlands 6EP!fr11e7N4 her WPA Form 3 — Notice of Intent 3 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 r4curentTraact► °rF Number Northampton City/Town - C. Bordering Vegetated Wetland Delineation Methodology Check all methods used to delineate the Bordering Vegetated Wetland (BVW) boundary: Online Users: 1. ❑ Final Order of Resource Area Delineation issued by Conservation Commission or DEP Include your (attached) document — transaction 2. ® DEP BVW Field Data Form (attached) number (provided on 3. ❑ Final Determination of Applicability issued by Conservation Commission or DEP (attached) your receipt page) with all 4. ❑ Other Methods for Determining the BVW Boundary (attach documentation): supplementary information you a. ❑ 50% or more wetland indicator plants - submit to the Department. b. ❑ Saturated /inundated conditions exist c. ❑ Groundwater indicators d. ❑ Direct observation For all projects affecting other Resource Areas, please attach a narrative explaining how the resource area was delineated. e. ❑ Hydric soil indicators f. ❑ Credible evidence of conditions prior to disturbance Li. Uther Applicable Standards and Requirements 1. Is any portion of the proposed project located in estimated habitat as indicated on the most recent Estimated Habitat Map of State - Listed Rare Wetland Wildlife published by the Natural Heritage and Endangered Species Program? a. ❑ Yes ® No If yes, include proof of mailing or hand delivery of NOI to: Natural Heritage and Endangered Species Program Division of Fisheries and Wildlife Route 135, North Drive Westborough, MA 01581 July 1, 2003 b. Date of Map 2. For coastal projects only, is any portion of the proposed project located below the mean high water line or in a fish run? ❑ Yes ❑ No If yes, include proof of mailing or hand delivery of NOI to: Massachusetts Division of Marine Fisheries 251 Causeway Street, Suite 400 Boston, MA 02114 ® Not applicable — project is in inland resource area only wpaform3.doc • rev. 06/03 Page 5 of 8 Massachusetts Department of Environmental Protection Provided by DEP:' Bureau of Resource Protection - Wetlands DEP File Number 1 WPA Form 3 — Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 N o or r tham t ham pransactfon Number N City/Town - D. Other Applicable Standards and Requirements (continued) 3. Is any portion of the proposed project within an Area of Critical Environmental Concern (ACEC)? a. ❑ Yes ® No If yes, provide name of ACEC (see instructions to WPA Form 3 or DEP Website for ACEC locations). Note: electronic filers click on Website. b. ACEC Online Users: 4. Is any portion of the site subject to a Wetlands Restriction Order under the Inland Wetlands Include your Restriction Act (M.G.L. c. 131, § 40A) or the Coastal Wetlands Restriction Act (M.G.L. c. 130, § 105)? document transaction a. ❑ Yes ® No number (provided on your receipt 5 Is any activity within any Resource Area or Buffer Zone exempt from performance standards of the page) with all wetlands regulations, 310 CMR 10.00. supplementary information you a. ❑ Yes ® No If yes, describe which exemption applies to this project: submit to the Department. b. Exemption 6. Is this project subject to the DEP Stormwater Policy? a. ❑ Yes ® No b. If yes, stormwater management measures are required. Applicants should complete Appendix B: Stormwater Management Form and submit it with this form. c. If no, explain why the project is exempt: No new discharges will be constructed as part of this project and no impervious area will be added as a result of construction. E. Additional Information Applicants must include the following with this Notice of Intent (NOI). See instructions for details. Online Users: Attach the document transaction number (provided on your receipt page) for any of the following information you submit to the Department. 1.0 USGS or other map of the area (along with a narrative description, if necessary) containing sufficient information for the Conservation Commission and the Department to locate the site. (Electronic filers may omit this item.) 2. ® Plans identifying the location of proposed activities (including activities proposed to serve as a Bordering Vegetated Wetland [BVW] replication area or other mitigating measure) relative to the boundaries of each affected resource area. wpaform3.doc -rev 06/03 Page 6 of 8 — Massachusett• Department of Environmental Prolfection Provided by DE Bureau of Resource Protection - Wetlands DEP''File Number _ WPA Form 3 — Notice of Intent _ Doct�menf Transaction Number' Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Northampton City/Town E. Additional Information (continued) 3. ® Other material identifying and explaining the determination of resource area boundaries shown on plans (e.g., a DEP BVW Field Data Form). Online Users: Include your 4. ® List the titles and dates for all plans and other materials submitted with this NOI. document 5. ❑ If there is more than one property owner, please attach a list of these property owners not transaction listed on this form. number (provided on 6. ❑ Attach proof of mailing for Natural Heritage and Endangered Species Program, if needed. your receipt page) with all 7• ❑ Attach proof of mailing for Massachusetts Division of Marine Fisheries, if needed. supplementary information you s. ® Attach Appendix A, see next page. submit to the Department. s. ® Attach Appendix B, if needed. F. Fees The fees for work proposed under each Notice of Intent must be calculated and submitted to the Conservation Commission and the Department (see Instructions and Appendix B. Wetland Fee Transmittal Form). No fee shall be assessed for projects of the federal government, the Department, or cities and towns of the Commonwealth. Applicants must submit the following information (in addition to pages 1 and 2 of Appendix B) to confirm fee payment: This project is fee exempt. 1. Municipal Check Number 3. State Check Number 5. Payor name on check: First Name 2. Check date 4. Check date 6. Payor name on check: Last Name wpaform3.doc • rev. 06/03 Page 7 of 8 r Department of Environmental Protection Provided by DEP: rce Protection - Wetlands DEP File Number orm 3 — Notice of Intent M um ;tts Wetlands Protection Act M.G.L. c. 131, §40 N City/Town pi—gnat—ure—sand Submittal Requirements an in I hereby certify under the penalties of perjury that the for Notice of Intent knowledgepl understand plans, documents, and supporting data are true and complete to the best of my news paper at the that the Conservation Commissiodna i Ce P with the not No etlands regulat ons, 310 l ocal CMR 10.05(5)(a). expense of the applicant in acco ere notified of this application, pursuant to the � I further certify under penalties of p e r jury that all abutters w Notice must be made in writing by hand delivery or certified mail requirements of M.G.L. c. 131, § line of the roject location. P (return receipt requested) to all abutters j100 feet of the property t.� (je K Date Department) Signature of Applicant ( Massachusetts Highway Date �Signature of Property O ner 'f di rent), Date natur f Representative (if an (David Prickett, Tighe & Bond, Inc.) For Conservation Commission: ment s upporting plans and documents; two must be sent to the Conservation Two copies of the completed Notice of Intent (Form 3), including copies of pages 1 and 2 of Appendix B; and the c ity/town /twn fee ay Commission by certified mail or hand delivery. For DEP: porting plans and documents; one _ One copy of the completed Notice of Intent (Form 3), including su p payment must be sent to the DEP copy of pages 1 and 2 of Appendix B; and a copy of the state feepay submit these Regional Office (see Instructions) by certified mail or hand delivery. (E- filers may electronically.) Other: art of Section D, Item 3, above, refer to that section If the applicant has checked the "yes" box in an y p and the Instructions for additional submittal requirements. The original and copies must be sent simultaneously. Failure by the applicant to send copies in a timely manner may result in dismissal of the Notice of Intent. Page 8 of 8 wpaform3.doc • rev. 06/03 cur