23B-011 PermitApplication_193 Locust Street Associates, LLP (Northampton Area Pediatrics c_o Kim Hayes)Permit Application
Todav'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
City of Northampton department: 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
❑ Subdivision Definitive with no Preliminary
Approved
❑ Zoning Board Special Permit
❑ Appeal of Building Commissioner -Zoning
❑ Variance
❑ 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
reauest
❑ 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
❑ 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
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
NORTHAMPTON AREA PEDIATRICS LLP 2799
193 LOCUST ST.
NORTHAMPTON, MA 01060 )),�
DATE'
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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.
rosr Jar ro Nrer �[ >J srn<+rX ro
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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"
i
i
1 100' cpprox.
1 from wettond
1
EXISTING PEDIATRIC
OFFICES—
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i
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1
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from wellsld
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EDGE � GRAVEi. GRNEYIAY
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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
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DW: 10/20/2010
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GENERAL NOTES
193 LOCUST STREET
NORTHAMPTON. MA.
01060
413 384-8700
RENOVATIONS &
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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.
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NEW OFFICE
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ELEVATION WEST
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❑❑ 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
® 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