23B-011 Determination of Applicability, Northampton PediatricsLIMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Title Date
2. Date Request Filed:
November 16. 2010
B. Determination
Pursuant to the authority of M.G.L. c. 131, § 40, the Conservation Commission considered your
Request for Determination of Applicability, with its supporting documentation, and made the following
Determination.
Project Description (if applicable):
Construction of a 218 sf building addition an relocation of walkway and landing in the 100 foot buffer
zone to BVW
Project Location:
193 Locust Street
Street Address
23B
Northampton
City/Town
011
wpaform2.doc • Determination of Applicability • rev. 1016/04 Page 1 of 5
A. General Information
Important:
When filling out
From:
forms on the
Northampton
computer, use
Conservation Commission
only the tab
key to move
To: Applicant
Property Owner (if different from applicant):
your cursor -
do not use the
Northampton Area Pediatrics c/o Kim Hayes
Same
return key.
Name
Name
193 Locust Street
Mailing Address
Mailing Address
Northampton MA 01060
City/Town State Zip Code
City/Town State Zip Code
1: Title and Date (or Revised Date if applicable) of Final Plans and Other Documents:
Site Plan for New Building Addition and Interior Renovations 11/16/2010
Title
Date
Title
Date
Title Date
2. Date Request Filed:
November 16. 2010
B. Determination
Pursuant to the authority of M.G.L. c. 131, § 40, the Conservation Commission considered your
Request for Determination of Applicability, with its supporting documentation, and made the following
Determination.
Project Description (if applicable):
Construction of a 218 sf building addition an relocation of walkway and landing in the 100 foot buffer
zone to BVW
Project Location:
193 Locust Street
Street Address
23B
Northampton
City/Town
011
wpaform2.doc • Determination of Applicability • rev. 1016/04 Page 1 of 5
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L.. c. 131, §40
B. Determination (cont.)
The following Determination(s) is/are applicable to the proposed site and/or project relative to the Wetlands
Protection Act and regulations:
Positive Determination
Note: No work within the jurisdiction of the Wetlands Protection Act may proceed until a final Order of
Conditions (issued following submittal of a Notice of Intent or Abbreviated Notice of Intent) or Order of
Resource Area Delineation (issued following submittal of Simplified Review ANRAD) has been received
from the issuing authority (i.e., Conservation Commission or the Department of Environmental Protection).
❑ 1. The area described on the referenced plan(s) is on area subject to protection under the Act.
Removing, filling, dredging, or altering of the area requires the filing of a Notice of Intent.
❑ 2a. The boundary delineations of the following resource areas described on the referenced plan(s) are
confirmed as accurate. Therefore, the resource area boundaries confirmed in this Determination are
binding as to all decisions rendered pursuant to the Wetlands Protection Act and its regulations regarding
such boundaries for as long as this Determination is valid..
® 2b. The boundaries of resource areas listed below are not confirmed by this. Determination,
regardless of whether such boundaries are contained on the plans attached to this Determination or
to the Request for Determination
❑ 3. The work described on referenced plan(s) and document(s) is within an area subject to
protection under the Act and will remove, fill, dredge, or alter that area. Therefore, said work
requires the filing of a Notice of Intent.
❑ 4. The work described on referenced plan(s) and document(s) is within the Buffer Zone and will
alter an Area subject to protection under the Act. Therefore, said work requires the filing of a
Notice of Intent or ANRAD Simplified Review (if work is limited to the Buffer Zone).
❑ 5. The area and/or work described on referenced plan(s) and document(s) is subject to review
and approval by:
Name of Municipality
Pursuant to the following municipal wetland ordinance or bylaw:
Name
Ordinance or Bylaw Citation
wpaform2 doc • Determination of Applicability • rev. 10/6/04 Page 2 of 5
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 2 ® Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Determination (cont.)
❑ 6. The following area and/or work, if any, is subject to a municipal ordinance or bylaw but not
subject to the Massachusetts Wetlands Protection Act:
❑ 7. If a Notice of Intent is filed for the work in the Riverfront Area described on referenced plan(s)
and document(s), which includes all or part of the work described in the Request, the applicant
must consider the following alternatives. (Refer to the wetland regulations at 10.58(4)c. for more
information about the scope of alternatives requirements):
❑ Alternatives limited to the lot on which the project is located.
❑ Alternatives limited to the lot on which the project is located, the subdivided lots, and any
adjacent lots formerly or presently owned by the same owner.
n❑Alternatives limited to the original parcel on which the project is located, the subdivided
❑ Alternatives limited to the original parcel on which the project is located, the subdivided
parcels, any adjacent parcels, and any other land which can reasonably be obtained within
the municipality.
❑ Alternatives extend to any sites which can reasonably be obtained within the appropriate
region of the state.
Negative Determination
Note No further action under the Wetlands Protection Act is required by the applicant. However, if the
Department is requested to issue a Superseding Determination of Applicability, work may not proceed
on this project unless the Department fails to act on such request within 35 days of the date the
request is post -marked for certified mail or hand delivered to the Department. Work may then proceed
at the owner's risk only upon notice to the Department and to the Conservation Commission.
Requirements for requests for Superseding Determinations are listed at the end of this document.
❑ 1. The area described in the Request is not an area subject to protection under the Act or the
Buffer Zone.
❑ 2. The work described in the 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 the 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, subject to the following conditions (if any).
Please see Attachment A
❑ 4. The work described in the Request is not within an Area subject to protection under the Act
(including the Buffer Zone). Therefore, said work does not require the filing of a Notice of Intent,
unless and until said work alters an Area subject to protection under the Act.
wpeform2.doc • Determination of Applicability • rev. 10/6/04 Page 3 of 5
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Determination (cont.)
❑ 5. The area described in the Request is subject to protection under the Act. 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:
Exempt Activity (site applicable statuatory/regulatory provisions)
❑ 6. The area and/or work described in the Request is not subject to review and approval by:
Name of Municipality
Pursuant to a municipal wetlands ordinance or bylaw.
Name Ordinance or Bylaw Citation
C. Authorization.
This Determination is issued to the applicant and delivered as follows:
❑ by hand delivery on by certified mail, return receipt requested on
Date at
This Determination is valid for three years from the date of issuance (except Determinations for
Vegetation Management Plans which are valid for the duration of the Plan). This Determination does not
relieve the applicant from complying with all other applicable federal, state, or local statutes, ordinances,
bylaws, or regulations.
This Determination must be signed by a majority of the Conservation Commission. A copy must be sent to
the appropriate DEP Regional Office (see http://www.mass.gov/dep/about/re.ion.findyour.htm) and the
property owner (if different from the applicant).
January 13, 2011
wpaform2.doc • Determination of Applicability • rev. 10/6/04 Page 4 of 5
LIMassachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
D. Appeals
The applicant, 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 town in which such land is
located, are hereby notified of their right to request the appropriate Department of Environmental
Protection Regional Office (see http://www.mass.gov/dep/about/region.findyour.htm) to issue a
Superseding Determination of Applicability. The request must be made by certified mail or hand delivery
to the Department, with the appropriate filing fee and Fee Transmittal Form (see Request for
Departmental Action Fee Transmittal Form) as provided in 310 CMR 10.03(7) within ten business 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 to the applicant if he/she is not the
appellant. The request shall state clearly and concisely the objections to the Determination which is being
appealed. To the extent that the Determination is based on a municipal ordinance or bylaw and not on the
Massachusetts Wetlands Protection Act or regulations, the Department of Environmental Protection has
no appellate jurisdiction.
wpaform2.doc • Determination of Applicability • rev. 10/6/04 Page 5 of 5
"ATTACHMENT A"
1. Prior to the initiation of any work, the applicant/owner shall submit a letter of
understanding to the Commission stating that he/she has received, read, understands and
shall comply with these conditions. The applicant, and, his or her contractor, foreman
and/or construction manager shall sign the letter of understanding.
2. Prior to the initiation of any work, the applicant shall submit to the Commission a
sequencing plan for construction, and erosion and sedimentation control installation.
Prior to the start of any site work, excavation or construction, a pre -construction conference
shall be held on the site, between the contractor conducting the work, the site/project
engineer, the applicant, and a member or agent of the Conservation Commission, in order
to ensure that the requirements of this Order are understood by all parties. Prior to the pre -
construction meeting, all erosion control devices must be installed.
4. All required permits must be obtained from applicable federal, state and local agencies and
departments prior to the start of any project.
5. A copy of these conditions and associated plans shall remain on site during all construction
and/or building activities. The project manager and all equipment operators shall be
familiar with the approved plans, and shall be informed of their location on the site. This
location shall be accessible to all contractors whenever work is occurring on site.
6. All revised plans shall be approved by the Conservation Commission and incorporated into
the permit by reference and shall be followed during the course of construction.
7. The areas of construction shall remain in a stable condition at -the close of each construction
day. Erosion control measures shall be inspected at this time, and maintained or reinforced
as necessary. All such devices shall be inspected, cleaned or replaced during construction
and shall remain in place until such time as stabilization of all areas that may impact
resource areas is permanent. These devices shall also be inspected to assure that the
maximum control has been provided. Any entrapped silt shall be removed to an area
outside the buffer zone and resource areas, and maintained or reinforced. as necessary.
Erosion controls shall be inspected after every rainfall to assure that maximum control has
been provided.
8. An adequate stockpile of erosion control materials shall be on site at all times for
emergency or routine replacement and shall include materials to repair or replace silt
fences, straw bales, erosion control blankets,. riprap, filter berms or other devices planned
for use during construction.
9. Soils exposed for periods greater than two months shall be stabilized with erosion control
blankets and netting, a covering of straw mulch, or a temporary cover of rye or other grass
to prevent erosion and sedimentation. Drainage ditches shall be stabilized and seeded with
a native perennial grass mixture. Any stabilization materials such as jute netting shall be
firmly anchored to prevent them from being washed from slopes by rain or flooding.
Preference should be given to biodegradable materials.
10. All disturbed areas shall be graded, loamed and seeded, or stabilized with erosion control
blankets or netting, and a covering of straw mulch prior to November 30, of each year. No
disturbed areas or stockpiled materials will be left unprotected or without erosion control
after this date.
11. No disposal of soils or other materials shall be allowed within: a 100 -year floodplain; 40
feet of the 100 -year floodplain elevation; any wetland; or any area within 100 -feet of a
wetland, unless such areas are specifically approved by the Commission, in accordance
with 310 CMR 10. 00, and City of Northampton Ordinances - Chapter 337.
® 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:
Northampton Wetland Ordinance
_.
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.tloo Rage I of 4
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
Northampton
.-
WPA Form 1 Request for Determination of Applicability City/Town
Massachusetts Wetlands Protection Act M.G.L. c.
131, §40
eneralInformation
Important:
When filling out
1. Applicant:
forms on the
Hayes
Northampton Area Pediatrics c/o Kim-
khayes@llqpe�ds.com
computer, use
-
Nam - —...._ _ . _
Name
— —------ .-..
E -Mail Address
only the tab key
to move your
193 Locust Street
_ --_
cursor - do not
Mailing Address
use the return
Northampton
MA 01060
key.
Cityfrown
State Zip Code
413 584-8708
413 584-1714
rm
Phone Number
Fax Number (if applicable)
2. Representative (if any):
Herita e Surve s, Inc.
Firm
Mark P. Reed
markka herita eg surveys.com
_ — ---- -
Contact Name
E -Mail Address
241 CollegeHighway & Clark Street, P.O.ox 1
--- -- -
_—
Mailing Address
Southampton
MA _ _ 01073 _
CitylTown
State Zip Code
X41 1527 -3600_
-
Phone Number
Fax Number (if applicable)
B. Determinations
1. I request the Northampton make the following
determination(s). Check any that apply:
Conservation Commission
® 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:
Northampton Wetland Ordinance
_.
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.tloo Rage I of 4
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands Northampton
City/Town
WPA Form 1- Request for Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. Project Description
1. a. Project Location (use maps and plans to identify the location of the area subject to this request):
193 Locust Street Northampton _
Street Address City/Town
23B 011
Assessors Map/Plat Number Parcel/Lot Number
b. Area Description (use additional paper, if necessary):
The existinc,�site,contains pediatric and dental offices.
c. Plan and/or Map Reference(s):
Site Plan for New Building -- . - g Addition and Interior Renovations 11/16/10
....--- — --
Title Date
Title Date
Title Date
2. a. Work Description (use additional paper and/or provide plan(s) of work, if necessary):
The proposed work involves the construction of a 218 square foot office addition for Northampton
Area Pediatrics. The proposed single story addition will be located on the north side of the existing 2001
building addition. (See DEP File No. 246-470 for 2000 Notice of Intent filing for 2001 addition) Also
proposed is the relocation of the existing walkway and new stairway and landing_
wpaformi.doo Page 2 of 4
011 Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands Northampton
WPA Form 1- Request for Determination of Applicability City%Town
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
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.)
wpaformt Aoc Page 3 of 4
L "IMP" Massachusetts Department of •r Protection
Bureau of Resource Protection - Wetlands Northampton_
•F. y. Request for of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
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:
193 Locust Street Associates LLP (Northampton Area Pedia4rics cJo Kime�
Name
193 Locust Street
Mailing Address
Northampton
City/Town
MA 01060
State Zip Code
Signatures:
I also understand that notification of this Request will be placed in a local newspaper at my expense
in accorc�ae wi h ection 10.05(3)(b)(1) of the Wetlands Protection Act regulations.
Sign ure of Ap lica t Date
r
Signature of Representative (if any) D e
wraformi.tloc Page 4 of 4
HERITA6E, SURVEYS, INC.
Professional Surveyors and Engineers
241 College Hwy & Clark St, P O Box I
Southampton, Massachusetts 01073-0001
Bruce A. Coombs, President Telephone (413) 527-3600
Professional Surveyor, MA, CT & VT Facsimile (413) 527-8280
E-mail: brace@heritagesurveys.com Website: heritagesurveys.com
November 16, 2010
Northampton Conservation Commission
City of Northampton
City Hall - 210 Main Street
Northampton MA 01060
RE: Request for Determination of Applicability
Northampton Area Pediatrics
193 Locust Street, Northampton, MA
Northampton Assessor's Map 23B Parcel 011
HSI Job #3960-101026
Dear Commission Members:
Please find enclosed nine (9) copies of a Request for Determination of Applicability (WPA Form 1)
as per the Massachusetts Wetlands Protection Act, G. L. c. 131 s40 and the Northampton Wetland
Ordinance, relative to the proposed 218 square foot office addition for Northampton Area Pediatrics.
The Request for Determination of Applicability package also includes the following items:
1. Nine (9) prints of plan entitled, "Site Plan for New Building Addition and Interior Renovations,
Prepared for Northampton Area Pediatrics, LLP, dated November 16, 2010.
2. Nine (9) prints of 11" x 17" plans prepared by Mark O Gelotte Architect, SK 1, dated October 20,
2010, SK 2 & SK 3, dated October 8, 2010.
3. Nine (9) copies of Maps (Orthophoto, Orthophoto with NHESP overlay, Orthophoto with DEP
Wetland overlay and Topographical).
4. Nine (9) copies site pictures with description, dated November 10, 2010.
5. A check in the amount of $125.00, addressed to the City of Northampton & copy of check.
6. A check in the amount of $45.00, addressed to the Daily Hampshire Gazette & copy of check.
We would appreciate your directing any correspondence regarding the above referenced filing to
Northampton Area Pediatrics, c/o Kim Hayes, 193 Locust Street, Northampton, MA 01060 (413) 584-
8708, with copies of the same to Heritage Surveys, Inc.
Sincerely,
CC: DEP Western Regional Office
Northampton Area Pediatrics
HERITAEiE SURVEYS, INC..,
Professional Surveyors and Engineers
241 College Hwy & Clark St, P O Box I
Southampton, Massachusetts 01073-0001
Bruce A. Coombs, President
Professional Surveyor, MA, CT & VT
E-mail: brute@heritagesurveys.com
November 16, 2010
DEP Western Regional Office
State House West, 4th Floor
436 Dwight Street
Springfield, MA 01103
RE: Request for Determination of Applicability
Northampton Area Pediatrics
193 Locust Street, Northampton, MA
Northampton Assessor's Map 23B Parcel 011
HSI Job #3960-101026
Dear Sir/ Madam:
Telephone (413) 527-3600
Facsimile (413) 527-8280
Website: heritagesurveys.com
Please find enclosed one (1) copy of a Request for Determination of Applicability (WPA Form 1) as
per the Massachusetts Wetlands Protection Act, G. L. c. 131 s40 and the Northampton Wetland Ordinance,
relative to the proposed 218 square foot office addition and 120 square foot interior renovation.
The Request for Determination of Applicability package also includes the following items:
1. One (1) print of plan entitled, "Site Plan for New Building Addition and Interior Renovations,
Prepared for Northampton Area Pediatrics, LLP, dated November 16, 2010,
2. One (1) print of 11" x 17" plans prepared by Mark O Gelotte Architect, SK 1, dated October 20,
2010, SK 2 & SK 3, dated October 8, 2010.
3. One (1) copy of Maps (Orthophoto, Orthophoto with NHESP overlay, Orthophoto with DEP
Wetland overlay and Topographical).
4. One (1) copy of Site Pictures with description, dated November 10, 2010.
5. A copy of a check in the amount of $125.00, addressed to the City of Northampton.
6. A copy of a check in the amount of $45.00, addressed to the Daily Hampshire Gazette.
We would appreciate your directing any correspondence regarding the above referenced filing to
Northampton Area Pediatrics, c/o Kim Hayes, 193 Locust Street, Northampton, MA 01060 (413) 584-
8708, with copies of the same to Heritage Surveys, Inc.
Sincerely,
Mark P. Reed
CC: Northampton Conservation Commission
Northampton Area Pediatrics
® 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:
Northampton Wetland Ordinance
_.
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.tloo Rage I of 4
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
Northampton
.-
WPA Form 1 Request for Determination of Applicability City/Town
Massachusetts Wetlands Protection Act M.G.L. c.
131, §40
eneralInformation
Important:
When filling out
1. Applicant:
forms on the
Hayes
Northampton Area Pediatrics c/o Kim-
khayes@llqpe�ds.com
computer, use
-
Nam - —...._ _ . _
Name
— —------ .-..
E -Mail Address
only the tab key
to move your
193 Locust Street
_ --_
cursor - do not
Mailing Address
use the return
Northampton
MA 01060
key.
Cityfrown
State Zip Code
413 584-8708
413 584-1714
rm
Phone Number
Fax Number (if applicable)
2. Representative (if any):
Herita e Surve s, Inc.
Firm
Mark P. Reed
markka herita eg surveys.com
_ — ---- -
Contact Name
E -Mail Address
241 CollegeHighway & Clark Street, P.O.ox 1
--- -- -
_—
Mailing Address
Southampton
MA _ _ 01073 _
CitylTown
State Zip Code
X41 1527 -3600_
-
Phone Number
Fax Number (if applicable)
B. Determinations
1. I request the Northampton make the following
determination(s). Check any that apply:
Conservation Commission
® 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:
Northampton Wetland Ordinance
_.
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.tloo Rage I of 4
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands Northampton
City/Town
WPA Form 1- Request for Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. Project Description
1. a. Project Location (use maps and plans to identify the location of the area subject to this request):
193 Locust Street Northampton _
Street Address City/Town
23B 011
Assessors Map/Plat Number Parcel/Lot Number
b. Area Description (use additional paper, if necessary):
The existinc,�site,contains pediatric and dental offices.
c. Plan and/or Map Reference(s):
Site Plan for New Building -- . - g Addition and Interior Renovations 11/16/10
....--- — --
Title Date
Title Date
Title Date
2. a. Work Description (use additional paper and/or provide plan(s) of work, if necessary):
The proposed work involves the construction of a 218 square foot office addition for Northampton
Area Pediatrics. The proposed single story addition will be located on the north side of the existing 2001
building addition. (See DEP File No. 246-470 for 2000 Notice of Intent filing for 2001 addition) Also
proposed is the relocation of the existing walkway and new stairway and landing_
wpaformi.doo Page 2 of 4
011 Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands Northampton
WPA Form 1- Request for Determination of Applicability City%Town
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
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.)
wpaformt Aoc Page 3 of 4
L "IMP" Massachusetts Department of •r Protection
Bureau of Resource Protection - Wetlands Northampton_
•F. y. Request for of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
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:
193 Locust Street Associates LLP (Northampton Area Pedia4rics cJo Kime�
Name
193 Locust Street
Mailing Address
Northampton
City/Town
MA 01060
State Zip Code
Signatures:
I also understand that notification of this Request will be placed in a local newspaper at my expense
in accorc�ae wi h ection 10.05(3)(b)(1) of the Wetlands Protection Act regulations.
Sign ure of Ap lica t Date
r
Signature of Representative (if any) D e
wraformi.tloc Page 4 of 4
NORTHAMPTON AREA PEDIATRICS LLP 2799
193 LOCUST ST.
NORTHAMPTON, MA 01060 )),�
DATE'
PAY
TO THEs ORDER OF '� 4knqpsI 1're, 60-zo t lei 7% i 00
DOLLARS - 8`
s FLORENCE SAVINGS BANK
85 MAIN STREET: FLORENCE. MA 01062
FOR V
B■00 2799n■ is 21 la 7 i6$8i: i 25 '109 28 LB'
NORTHAMPTON AREA PEDIATRICS LLP 2798
193 LOCUST ST.
NORTHAMPTON, MA 01000..
DATE �l/ o e3-7168/2118
PAY �O
TO THE
ORDER OF 1
Ps' c
i ve DOLLARS
LSO. FLORENCE SACKINGS BANK \
85 MAIN STREET, FLORENCE. MA01062
I
FOR ;4
11000279871■ 1:2LL87L6881: I 25 10928 u' '
wmmmasm=
Tndnv's Date: 11/16/2010
Owner
Applicant
193 Locust Street Associates, LLP (Northampton
Northampton Area Pediatrics c/o Kim Hayes
Area Pediatrics c/o Kim Hayes)
193 Locust Street
193 Locust Street
Northampton, Massachusetts 01060
Northampton, Massachusetts 01060
413-584-8708
khayes@napeds.com
Citv of Northampton de artment: No
Work Location Information
How many lots involved in the project: 1
Map / Block Lots of all lots in project: 23b-011-001
Deed Book of all lots in project: 4889-335
Project work address: 193 Locust Street
City / State / Zip: Northampton 01060
Zoning District: SI
Application for following Permit Types
[❑ Planning Bd. Special Permit w/ Site Plan
Planning Bd. Special Permit w/
MAJOR Site Plan NO Special Permit
Planning Bd. Major Site Plan Approval (No
Special Permit), including 40R projects
Subdivision Preliminary
o Subdivision Definitive with no Preliminary
Approved
® Zoning Board Special Permit
® Appeal of Building Commissioner -Zoning
Variance
Ei Historic District (Elm St) Determination of
Appropriateness
Wetlands Notice of Intent IF state wetlands
Wetlands Request for Determination OR
® Resource Delineation
® Wetlands Certificate of Compliance
request
Planning Bd. Special Permit w/ Site Plan for flag
lots
Planning Bd. Site Plan (NO Special Permit)
❑ Approval Not Required Plans
Subdivision Definitive with Preliminary Approved
Subdivision Definitive Amendment
E] Zoning Board Finding
Comprehensive Permit (40B)
Demolition (Demolition
Delav)
Central Business Architecture
Wetlands Notice of Intent IF ONLY local
® wetlands
❑ Wetlands Amendment or
extension
210 Main St., Rm. 11, City Hall, Northampton, MA 01060
(413)587-1262
Fee Information
Wetlands Request for Determination OR Resource Delineation $125
(WPA form 1 or 4a) - $125
Total Fee Amount: $125.00
Existing Use
The existing site contains pediatric and dental offices.
Planned Use
The proposed work involves the construction of a 218 square foot office addition for Northampton Area
Pediatrics. The proposed single story addition will be located on the north side of the existing 2001
building addition. (See DEP File No. 246-470 for 2000 Notice of Intent filing for 2001 addition) Also
proposed is the relocation of the existing walkway and new stairway and landing.
Detailed Project Information
Wetlands Description: no waiver
Files Uploaded:
Supporting Information: NORTHAMPTON AREA PEDIATRICS RDA DOCUMENTS.tif
Plan Sheets: NORTHAMPTON AREA PEDIATRICS RDA PLANS.tif
Wetlands Information: NORTHAMPTON AREA PEDIATRICS RDA FORM.tif
By typing my name in the signature box, I certify that all the information above is accurate to the best of my
knowledge, I am the property owner or have permission from the property owner to apply for this permit. I also
grant permission to the City of Northampton to inspect the proposed work
Signature: Mark P. Reed Date Signed: 11{16/2010
210 Main St., Rm. 11, City Hall, Northampton, MA 01060
(413)587-1262
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HERITAGE SURVEYS, INCL
Professional Surveyors and Engineers
241 College Hwy & Clark St„ P O Box 1
Southampton, Massachusetts 01073-0001
Bruce A. Coombs, President
Professional Surveyor, MA, CT & VT
E-mail: brute@heritagesurveys.com
Telephone (413) 527-3600
Facsimile (413) 527-8280
Website: heritagesurveys.com
Yr1PROJECT nOCUM ENTS13960 Mon Pediatric0960 SITE PICTURES.doe
The picture was taken
looking northerly
towards 2001 building
addition corner. This
is the proposed
location of the new
office addition.
The picture was taken
looking northerly
westerly towards 2001
building addition coiner.
This is the proposed
location of the new
office addition. The
door location will
remain and new stairs
and landing are
proposed.
Y:APROJECT DOCUMENTS\3960 Mon Pediatric,0960 SITE PICTURES.doc
The picture was taken looking
northerly easterly towards the
existing basin, showing the
end of the 2001 addition and
the end of the existing office
building.
The picture was taken looking
northerly easterly towards the
existing basin, showing the end
of the existing office building.
The planting area to the left of
the car is up gradient of the
basin and proposed building site
location. Silt fence is proposed
to be placed from the planting
area along the edge of pavement
and along the southerly side of
the basin to the building corner.
The picture was taken looking
northerly easterly towards the
existing basin, showing the rip -
rap area in the basin, the roof
drain pipe, the outlet control
structure and the rip -rap Swale.
The new office addition shall
have the )roof drain connect into
the existing pipe draining to the
basin.
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NOTES
7.) FOR REFERENCE TO ENCLOSED PERIMETER, SEE BOOK 4889,
PAGES 335 & 339.
2.) UNDERGROUND UTILITY LOCATIONS SHOWN HEREON ARE BASED UPON
SURFACE FEATURES AS LOCATED BY SURVEY AND AVAILABLE RECORD
DATA, AND ARE APPROXIMATE. ACTUAL LOCATIONS SHOULD BE VERIFIED
WITH THE APPROPRIATE UTILITY COMPANY AND/OR MUNICIPAL DEPARTMENT
PRIOR TO FINAL DESIGN AND/OR CONSTRUCTION.
3.) EXISTING ROOF DRAINS SHOWN ARE APPROXIMATE. NEW ROOF DRAINS
SHALL BE CONNECTED TO EXISTING ROOF DRAINAGE PIPE THAT FLOWS
TO THE EXISTING BASIN.
4.) WETLAND LOCATION SHOWN ON THIS PLAN ARE BASED ON THE 2000 NOTICE OF
INTENT FILING FOR THE 2001 BUILDING ADDITION, DEP FILE NO. 246-470.
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PLAN V/El'/
PLACEMENT & CONSTRUCTION OF A
SYNTHETIC FILTER BARRIER
SITE PLAN FOR NEW BUILDING ADDITION AND INTERIOR RENOVATIONS
NORTHAMPTON AREA PEDIATRICS
NORTHAMPTON, MASSACHUSETTS
PREPARED FOR
NORTHAMPTON AREA PEDIATRICS, LLP
193 LOCUST STREET
NORTHAMPTON, MASSACHUSETTS DATE: NOVEMBER 16, 2010
I_Ri IP. G, i.. ..aJ R V L ' 5 , INT
REGISTERED PROFESSIONAL LAND SURVEYORS
COLLEGE HIGHWAY & CLARK STREET
POST OFFICE BOX 1
SOUTHAMPTON, MASSACHUSETTS
(413) 527-3600
1
P"
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i
1 100' cpprox.
1 from wettond
1
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10/26/2010 -- Scab 1 :,360
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GENERAL NOTES
193 LOCUST STREET
NORTHAMPTON. MA.
01060
413 384-8700
RENOVATIONS &
ADDITION
Scale P a 30'-0"
Pro} Ho. 0911 PBA
DW: 10/20/2010
nraea aT: M.O.U.
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1 ---
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!>E>�i3lISZf�1
GENERAL NOTES
193 LOCUST STREET
NORTHAMPTON. MA.
01060
413 384-8700
RENOVATIONS &
ADDITION
Scale P a 30'-0"
Pro} Ho. 0911 PBA
DW: 10/20/2010
nraea aT: M.O.U.
3REET OF
ADDITION & INTERIOR
�1 RENOVATIONS
I
10/68/2010 — Scale 1 96
MARK O.
OE>LOTTE
AIRC1FIIET ECT
70 ELM STREET
HATFIELD, MA.
0103@
413 247 9624
GENERAL NOTES
Northampton Area
Pediatrics
193 LOCUST STREET
NORTHAMPTON, MA.
01060
413 384-8700
RENOVATIONS &
ADDITION preliminary
Seale 1/8' = l'-0'
er.l. Ne. 0911 PED
wu: 10/812010
M.O.G.
�TIC ,2
SHEET OF
NEW OFFICE
ADDITION
T_9"
❑❑ ❑❑ ❑o ❑❑ ❑❑ M11❑ ❑❑ ❑
I'll -
ELEVATION WEST
� NEW OFFICE ADDITION
VP_0.. 16,_$,.
i
ELEVATION EAST
2 1�a-_ 1,_0..
❑❑ 00
NEW OFFICE ADDITION
23'-3"
❑❑ 10. �� 3 T-0ELEVATION NORTH10
1008/2010 .- Scale 1 : 96
MARK 0.
GELOTTIE
A] CHETIECT
70 ELN[ STREET
111ATF➢ELD. MA.
01035
413 247 9624
Northampton Area
Pediatrics
193 LOCUST STREET
NORTHAMPTON, MA.
01060
413 584.8700
RENOVATIONS &
ADDITION preliminary
Scale 1/8' . 1'-0'
Ero} Ho. 0911 PED
O.ra: 10/8/2010
mo. ef: M.O.O.
NMI
SHEET OF
HERITA6E, SURVEYS, INC.
Professional Surveyors and Engineers
241 College Hwy & Clark St, P O Box I
Southampton, Massachusetts 01073-0001
Bruce A. Coombs, President Telephone (413) 527-3600
Professional Surveyor, MA, CT & VT Facsimile (413) 527-8280
E-mail: brace@heritagesurveys.com Website: heritagesurveys.com
November 16, 2010
Northampton Conservation Commission
City of Northampton
City Hall - 210 Main Street
Northampton MA 01060
RE: Request for Determination of Applicability
Northampton Area Pediatrics
193 Locust Street, Northampton, MA
Northampton Assessor's Map 23B Parcel 011
HSI Job #3960-101026
Dear Commission Members:
Please find enclosed nine (9) copies of a Request for Determination of Applicability (WPA Form 1)
as per the Massachusetts Wetlands Protection Act, G. L. c. 131 s40 and the Northampton Wetland
Ordinance, relative to the proposed 218 square foot office addition for Northampton Area Pediatrics.
The Request for Determination of Applicability package also includes the following items:
1. Nine (9) prints of plan entitled, "Site Plan for New Building Addition and Interior Renovations,
Prepared for Northampton Area Pediatrics, LLP, dated November 16, 2010.
2. Nine (9) prints of 11" x 17" plans prepared by Mark O Gelotte Architect, SK 1, dated October 20,
2010, SK 2 & SK 3, dated October 8, 2010.
3. Nine (9) copies of Maps (Orthophoto, Orthophoto with NHESP overlay, Orthophoto with DEP
Wetland overlay and Topographical).
4. Nine (9) copies site pictures with description, dated November 10, 2010.
5. A check in the amount of $125.00, addressed to the City of Northampton & copy of check.
6. A check in the amount of $45.00, addressed to the Daily Hampshire Gazette & copy of check.
We would appreciate your directing any correspondence regarding the above referenced filing to
Northampton Area Pediatrics, c/o Kim Hayes, 193 Locust Street, Northampton, MA 01060 (413) 584-
8708, with copies of the same to Heritage Surveys, Inc.
Sincerely,
CC: DEP Western Regional Office
Northampton Area Pediatrics
HERITAEiE SURVEYS, INC..,
Professional Surveyors and Engineers
241 College Hwy & Clark St, P O Box I
Southampton, Massachusetts 01073-0001
Bruce A. Coombs, President
Professional Surveyor, MA, CT & VT
E-mail: brute@heritagesurveys.com
November 16, 2010
DEP Western Regional Office
State House West, 4th Floor
436 Dwight Street
Springfield, MA 01103
RE: Request for Determination of Applicability
Northampton Area Pediatrics
193 Locust Street, Northampton, MA
Northampton Assessor's Map 23B Parcel 011
HSI Job #3960-101026
Dear Sir/ Madam:
Telephone (413) 527-3600
Facsimile (413) 527-8280
Website: heritagesurveys.com
Please find enclosed one (1) copy of a Request for Determination of Applicability (WPA Form 1) as
per the Massachusetts Wetlands Protection Act, G. L. c. 131 s40 and the Northampton Wetland Ordinance,
relative to the proposed 218 square foot office addition and 120 square foot interior renovation.
The Request for Determination of Applicability package also includes the following items:
1. One (1) print of plan entitled, "Site Plan for New Building Addition and Interior Renovations,
Prepared for Northampton Area Pediatrics, LLP, dated November 16, 2010,
2. One (1) print of 11" x 17" plans prepared by Mark O Gelotte Architect, SK 1, dated October 20,
2010, SK 2 & SK 3, dated October 8, 2010.
3. One (1) copy of Maps (Orthophoto, Orthophoto with NHESP overlay, Orthophoto with DEP
Wetland overlay and Topographical).
4. One (1) copy of Site Pictures with description, dated November 10, 2010.
5. A copy of a check in the amount of $125.00, addressed to the City of Northampton.
6. A copy of a check in the amount of $45.00, addressed to the Daily Hampshire Gazette.
We would appreciate your directing any correspondence regarding the above referenced filing to
Northampton Area Pediatrics, c/o Kim Hayes, 193 Locust Street, Northampton, MA 01060 (413) 584-
8708, with copies of the same to Heritage Surveys, Inc.
Sincerely,
Mark P. Reed
CC: Northampton Conservation Commission
Northampton Area Pediatrics
Sarah LaValley
From: Sarah LaValley
Sent: Wednesday, December 01, 2010 1:53 PM
To: 'khayes@napeds.com'; 'mark@heritagesurveys.com'
Subject: Request for Determination, Northampton Area Pediatrics
Mark and Kim -
The Conservation Commission. Upon an initial review of the materials submitted, I noticed that a Certificate of Compliance was has
not been requested or issued for DEP File 246-41o, which expired in 2003. As you know, Certificates of Compliance are required under
the Wetlands Protection Act, and a request was specifically called out in condition 11.
Additionally, Chapter 331-8 of the Northampton Wetlands Ordinance notes that "The Commission shall have the right to refuse to
issue a permit if a previous permit on the same property or on contiguous properties under the same or affiliated ownership has not
been complied with or has not received a certificate of compliance."
A certificate of compliance must be issued before the Request for Determination can be considered by the Commission, and a request
should be filed as soon as possible.
Thanks very much -
Sarah L LaValley
Conservation, Preservation and Land Use Planner
City of Northampton
Office of Planning and Development
210 Main Street, Room 11
Northampton MA, 01060
Ph: 413.587.1263