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64-533 - 4 NURSE WAY - CONSERVATION COMMISSION � N��s�- wad �� , S 33 IIII + SE7070 1e6962) Btch:310659 Southern Essex District Registry 10103/20f3 01:63 PM COMPL Pa: 1/3 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP File Number:- WPA Form 8B — Certificate of Compliance 64-533 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP A. Project Information Important: When filling out 1. This Certificate of Compliance is issued to: forms on the computer,use Salem Homebuilders LLC only the tab key Name to move your 100 Cabot Street cursor-do not use the return Mailing Address key. Beverly MA 01915 Citylrown State Zip Code tl 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: Kenneth G. Steadman �^ Name 9/17/2012 64-533 Dated DEP File Number 3. The project site is located at: 5 Nurse Way(fka 4 Nurse Way, lot 233) Salem Street Address Cityrrown 9 331 Assessors Map/Plat Number ParcellLot Number the final Order of Condition was recorded at the Registry of Deeds for: Kenneth G. Steadman Property Owner(if different) South Essex County Book Page 80815 (Doc. #536276) Certificate 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: 7/6/2013 Date "afrmfloAoc•rev.12n D9 WPA Form BB,Cenincafe of Compliance•Page f of 3 �C✓h 1 � Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP File Number. WPA Form 8B — Certificate of Compliance 1 64-533 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP B. Certification Check all that apply: Complete Certification: It is hereby certified that the work regulated by the above-referenced Order of Conditions has been satisfactorily completed. ❑ Partial Certification: It is hereby certified that only the following portions of work regulated by the above-referenced Order of Conditions have been satisfactorily completed. The project areas or work subject to this partial certification that have been completed and are released from this Order are: ❑ Invalid Order of Conditions: It is hereby certified that the work regulated by the above-referenced Order of Conditions never commenced. The Order of Conditions has lapsed and is therefore no longer valid. No future work subject to regulation under the Wetlands Protection Act may commence without filing a new Notice of Intent and receiving a new Order of Conditions. ❑ Ongoing Conditions: The following conditions of the Order shall continue: (Include any conditions contained in the Final Order, such as maintenance or monitoring, that should continue for a longer period). Condition Numbers: C. Authorization Issued by: Salem 3 Conservation Commission Dog of Iss nce This Certificate must be signed by a majority of the Conservation Commission and a copy sent to the applicant and appropriate DEP Regional Office(See htti)7//www-mass.gov/dep/abouttregion/findvour.htm). ig hires: vryeGmaD tloo•rev.12f13r99 WPA Form Be,Conifrale of Compliance•Page 2 013 i Document: 547070 COMM ESSEX SOUTHERN DISTRICT REGISTRY OF OEEDS RECEIVED FOR REGISTRATION On: 10/3/2013 t1:53 FM Noted on Cert: 36852 BOOK.: 502 CITY OF SALEM � CONSERVATION COMMISSION July 15, 201 Salem Homebuilders LLC Attn: Jeff Holloran 100 Cabot Street Beverly, MA 01915 Witch Hill Subdivision Certificates of Compliance: #64-528 (lot 231), 3 Good Circle; #64-529 (lot 232), 1 Good Circle; #64-530 (lot 230), 5 Good Circle; #64-533 (lot 233), 5 Nurse Way; #64-535 (lot 234), 3 Nurse Way; #64-536 (lot 215), 2 Nurse Way Dear Mr. Holloran: Please find the enclosed certificates of compliance for the above-referenced projects. These certificates must be recorded at the South Essex County Registry of Deeds, 45 Congress Street (Shetland Park) #4100 in Salem. Please fill out and return the Recording . Information on page 3 of the certificates, which will indicate to the Salem Conservation Commission that the documents have been recorded. If you have any further questions please feel free to contact me at 978-619-5685. Sincerely, Tom Devine Conservation Agent/Staff Planner Enclosures CC: Kenneth Steadman DEP Northeast Regional Office i - Ma ssachusetts ssachusetts Department p ent of Environmental Protection Bureau of Resource Protection -c P Wetlands DEP File Number. WPA Form 813 - Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 sa-528 Provided by DEP A. Project Information Important: When - When tilling out 1. This Certificate of Compliance is issued to: forms on the computer,use Salem Homebuilders LLC only the tab key Name to move your cursor-do not - 100 Cabot Street use the return Mailing Address key. Beverly MA 01915 Cfry/Town State Zip Code n° 2. This Certificate of Compliance is issued for work regulated by a final Order.of Conditions issued to: Kenneth G. Steadman 9/17/2012 64-528 _ Dated DEP File Number 3. The project site is located at: 3 Good Circle(fka 3 Good Circle lot 231) Salem Street Address Citylrown 9 333 Assessors Map/Plat Number ParceULot Number the final Order of Condition was recorded at the Registry of Deeds for: Kenneth G. Steadman Property Owner(if different) South Essex County Book - Page - - 80815 (Doc. #536271) Certificate 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: 7/8/2013 . Date wPafrM8b.dw,rev.12@3/O9 WPA Form ae,Cen,ficale of Compliance•Page i of 3 _ Massachusetts Department of Environmental Protection Bureau of Resource Protection Wetlands . ,�\. _ DEP File Number; WPA Form 8B — Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. c: 131, §40 64-528 Provided by DEP B. Certification Check all that apply: Complete Certification: It is hereby certified that the work regulated by the above-referenced Order of Conditions has been satisfactorily completed: ❑ Partial Certification: It is hereby certified that only the following portions of work regulated by the above-referenced Order of Conditions have been satisfactorily completed:The project areas or work subject to this partial certification that have been completed and are released from this Order are: ❑ Invalid Order of Conditions: It is hereby certified that the work regulated by the above-referenced Order of Conditions never commenced:The Order of Conditions has lapsed and is therefore no longer valid.No future work subject to regulation under the Wetlands Protection Act may commence without filing a new Notice of Intent and receiving a new Order of Conditions. ❑ Ongoing Conditions:The following conditions of the Order shall continue: (Include any conditions contained in the Final Order,such as maintenance or monitoring, that should continue for a longer period). Condition Numbers: C. Authorization Issued by: Salem �� Conservation Commission D e of Issriance This Certificate must be signed by a majority of the Conservation Commission and a copy sent to the applicant and appropriate DEP Regional Office(See httpY/www mass oov/deo/about/reaion/findvour htm). ig Lures: \ wpafrm8b,dm,rev.1@ 2WOg W PA Form ea,Cenifiwte of Compliant¢,page 2 W 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP Fie Number. WPA Form 8B - Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 Provide _ . Provided by DEP D. Recording Confirmation The applicant is responsible for ensuring that this Certificate of Compliance is recorded in the Registry of Deeds or the Land Court for the district in which the land Is located: Detach on dotted line and submit to the Conservation Commission: - - - - -- ---- Salem Conservation Commission - Please be advised that the Certificate of Compliance for the project at: Project Location DEP File Number Has been recorded at the Registry of Deeds of: County for: _ Property Owner and has been noted in the chain of title of the affected property on: Date Book Page If recorded land, the instrument number which identifies this transaction is: If registered land, the document number which identifies this transaction is: Document Number Signature of Applicant wpafrmeb.tloC-rev.12)23M WPA Farm 88,Certificate of Compliance•Page 3 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number WPA Form 8B — Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 sa-52s 7 Provided by DEP A. Project Information Important: . When filling out 1 This Certificate of Compliance is issued to: fors on the - - computer,use Salem Homebuilders LLC only the tab key. . - Name to move your 100 Cabot Street cursor-do not use the return Mailing Atldress- - key. Beverly MA 01915 CIry?own - State Zip Code VQ 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: Kenneth G. Steadman rmm Name 9/17/2012 64-529 Dated - DEP File Number - 3. The project site is located at: 1 Good Circle(fka 2 Good Circle lot 232) Salem Street Address - City/town 9 332 Assessors Map/Plat Number PameVLot Number the final Order of Condition was recorded at the Registry of Deeds for: Kenneth G. Steadman Property Owner(if different) - South Essex County Book Page 80815(Doc. #536272) Certificate - 4. A site inspection was made in the presence of the applicant,or the applicant's agent, on: 7/8/2013 Date wpabm8b.doc•rev.122109 WPAForm 88,CBOiflctfe of Compliance•Page I of 3 i Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B - Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 sa-s2s Provided by DEP B. Certification Check all that apply: Complete Certification: It is hereby certified that the work regulated by the above-referenced Order of Conditions has been satisfactorily completed. ❑ Partial Certification: It is hereby certified that only the following portions of work regulated by the above-referenced Order of Conditions have been satisfactorily completed.The project areas or work subject to this partial certification that have been completed and are released from this Order are: ❑ Invalid Order of Conditions: It is hereby certified that the work regulated by the above-referenced Order of Conditions never commenced. The Order of Conditions has lapsed and is therefore no longer valid. No future work subject to regulation under the Wetlands Protection Act may commence without filing anew Notice of Intent and receiving a new Order of Conditions. ❑ Ongoing Conditions:The following conditions of the Order shall continue:. (Include any conditions contained in the Final Order, such as maintenance or monitoring, that should continue for a longer period). Condition Numbers: C. Authorization Issued by: Salem Conservation Commission DaJd of lsspgnce s This Certificate must be signed by a majority of the Conservation Commission and copy sent to the applicant and appropriate DEP Regional Office($ee http://www.mass.qoK/dep/about/region/findyour.htm). Sig ttires: 'a w a1rm8 U b tloc•rev.t2R3N9 V WPA Form 88,Cenifirate of C,,p1,rr a•Page 2 or 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form — o m 8B Certificate rtf trot r e of Compliance phance Mass achusetts 64-529 Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP D. Recording Confirmation The applicant is responsible for ensuring that this Certificate of Compliance is recorded in the Registry of Deeds or the Land Court for the district in which the land is located. Detach on dotted line and submit to the Conservation Commission. To: - - - -- - - - - ------------------------------------ Salem Conservation Commission Please be advised that the Certificate of Compliance for the project at: Project Location DEP File Number Has been recorded at the Registry of Deeds of: County for. Property Owner and has been noted in the chain of title of the affected property on: . Date Book Page If recorded land,the instrument number which identifies this transaction is: If registered land, the document number which identifies this transaction is: .Document Number - Signature of Applicant a,pafrraftd ;•rev.12123M - WPA form 88.Certificate at Caapliance•page 3 a13 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number. WPA Form 8B — Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 sa-53o Provided by DEP A. Project Information Important: When filling out 1. This Certificate of Compliance is issued to: forms on the computer,use Salem Homebuilders LLC only the tab key Name to move your cursor-do not 100 Cabot Street use the return Mailing Address key. Beverly . MA 01915 C1ty/rown State Zip Code r° 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: Kenneth G. Steadman Name 9/17/2012 64-530 Dated DEP File Number 3. The project site is located at: 5 Good Circle(fka 1 Good Cirlce lot 230) Salem Street Address. City/Town 9 334 Assessors Map/Plat Number Parcel/Lot Number the final Order of Condition was recorded at the Registry of Deeds for: Kenneth G. Steadman Property Owner(if different) South Essex County Book page 80815(Doc. #536273) Certificate 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: 7/8/2013 Date wpalrm8b.dm•rev.1223M WPA Form 8e.Ceadi.te W Compliance•Page i of Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP File Number: 0 WPA Form 8B - Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 645$Id _ � . Provided by DEP , B. Certification Check all that apply: a'Complete Certification: It is hereby certified that the work regulated by the above-referenced Order of Conditions has been satisfactorily completed. ❑ Partial Certification: It is hereby certified that only the following portions of work regulated by the above-referenced Order of Conditions have been satisfactorily completed.The project areas or work subject to this partial certification that have been completed and are released from this Order are: ❑ Invalid Order of Conditions:It is hereby certified that the work regulated by the above-referenced Order of Conditions never commenced.The Order of Conditions has lapsed and is therefore no longer valid.No future work subject to regulation under g the Wetlands Prot ection Ac t may commence without filing a ne w Notice o/ Intent and re ceiving a new w Order of Conditions. ❑ Ongoing Conditions:The following conditions of the Order shall continue: (Include any conditions contained in the Final Order, such as maintenance or monitoring, that should continue for a longer period). Condition Numbers: C. Authorization Issued by: Salem . 7 3 Conservation Commission a of Iss ce This Certificate must be signed by a majority of the Conservation Commission and a copy sent to the applicant and appropriate DEP Regional Office (See http://www mass oov/dep/abouttregion/findvour htm), Signatures: 'wPatrmBb.dac•rev.Iti2&O9 WPAFOmIOB,Cervar teot CC010ance•Page 2 of 3 - Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA WPA Form 8B — Certificate of Compliance 64-530 Massachusetts Wetlands Protection Act M.G.L. a. 131, §40 Provided byDEP D. Recording Confirmation The applicant is responsible for ensuring that this Certificate of Compliance is recorded in the Registry of Deeds or the Land Court for the district in which the land is located. Detach on dotted line and submit to the Conservation Commission, To: --- ---------- ---- - --- - - ---- ---- - ------------------------ Salem Conservation Commission- Please be advised that the Certificate of Compliance for the project at: Project Location DEP File Number Has been recorded at the Registry of Deeds of: County for: - Property Owner - and has been noted in the chain of title of the affected property on: Date Book Page If recorded land, the instrument number which identifies this transaction is: If registered land, the document number which identifies this transaction is: Document Number Signature of Applicant wpafnoBD,tlac•rev.f 212NO9 WPA Fom 8e,Certificate of Compliance•Page 3 of 3 Massachusetts Department of Environmental Protection �I IBureau of Resource Protection -Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 64-533 Provided by DEP A. Project Information Important:. . When filling out 1. This Certificate of Compliance is issued to: forms on the computer, use Salem Homebuilders LLC - only the tab key Name -- — --- -----.---_--..—._ ..----_.-.. to move your 100 Cabot Street cursor-do not use the return Mailing Address - ------ key. _Beverly MA_ 01915 Cityrrown State _... Zip Code n0 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: Kenneth G. Steadman Name -.:_—......—_._.__ 9/17/2012, 64-533 Dated _-___.__— —_—. OEP File Number . - 3. The project site is located at: 5 Nurse Way(fka 4 Nurse Way lot 233? . _ Salem — -- —--Street Address City/r ....._—.. _..... ..-...__ own 9 331 Assessors Ma !Plat Number --_-- - ----- P Parcel/L Number the final Order of Condition was recorded at the Registry of Deeds for: Kenneth G. Steadman Property Owner(d ditferenq South Essex 80815 (Doc Book Page. #536276�_...:. . _. ...._ _...-- Certificate --:.r_..._.. 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: 7/8/2013 ' Date _......:.. . .......... wpafrmBb.wc•r. 122399 WPA Form BB.-Cend,otl nl Compiance•Pagal a3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 64-533 Provided by DEP B. Certification Check all that apply: Complete Certification: It is hereby certified that the work regulated by the above-referenced Order of Conditions has been satisfactorily completed. ❑ Partial Certification: It is hereby certified that only the following portions of work regulated by the above-referenced Order of Conditions have been satisfactorily completed.The project areas or work subject to this partial certification that have been completed and are released from this Order are: ❑ Invalid Order of Conditions: It is hereby certified that the work regulated by the above-referenced Order of Conditions never commenced. The Order of Conditions has lapsed and is therefore no longer valid. No future work subject to regulation under the Wetlands Protection Act may commence without filing a new Notice of Intent and receiving a new Order of Conditions. ❑ Ongoing Conditions: The following conditions of the Order shall continue: (Include any conditions contained in the Final Order, such as maintenance or monitoring, that should continue for a longer period). Condition Numbers: C. Authorization Issued by: Salem 1 Conservation Commission D of Iss nce This Certificate must be signed by a majority of the Conservation Commission and a copy sent to the applicant and appropriate DEP Regional Office (See http//www mass gov/deo/abouUregion/findyour htm). ig res: !/ vvrafrmeb doc•rev 12123 WPA Fo"88.Canrfi ate of COMPhance•Page 2 of 3 Massachusetts Department of Environmental Protection IL-11 - Bureau of Resource Protection- Wetlands DEP File Number.rt tWPA Form 8B — Ce ifi ance pcate of Com liMassachusetts Wetlands Protection Act M.G.G 64-533 c: 131, 40 Prowd.. � etl by DEP D. Recording Co nfirmation onfir on The applicant is responsible for ensuring that this Certificate of Compliance is recorded in the Registry of Deeds or the Land Court for the district in which the land is located. Detach on dotted line and submit to the Conservation Commission. To:- - - -- ---- - — - ---- -- - ------ - - — -- - --- Salem .Conservation Commission ' ----.-- -- Please be advised that the Certificate of Compliance for the project at — Project Location .. .:....... ..... DEP File Number Has been recorded at the Registry of Deeds of: for: -- — _ — Property Owner and has been noted in the chain of title of the affected property on: Book If recorded land, the instrument number which identifies this transaction is: If registered land, the document number which identifies this transaction is -.:.._. _. . Document Numbe. .r-. signature of Applicant wpaomab eoc•rev.1212=9. vvPA r—89,ren ficafe M compoance•Pago 3 of 3 l Massachusetts Department of Environmental Protection - Bureau of Resource Protection - Wetlands - DEP File Number: WPA Form 8B — Certificate of Compliance 64 535 Massachusetts Wetlands Protection Act M.G.L. c. 131 §40 Provided by DEP A. Project Information Important: When filling out �1. This Certificate of Compliance is issued to: forms on the - computer,use Salem Homebuilders LLC ----- -- — — —.... --only the tab key Name --- to move your 100 Cabot Street cursor-do not use the return Mailing Address key. Beverly MA 01915 City/rown State TO Code - e 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued Kenneth G. Steadman my -- — — --- --- -------- -- Name ..._..._...._ 9/17/2012 _------ 64-535 Dated DEP File Number 3. The project site is located at: 3 Nurse WWI_(fka 2 Nurse Way, lot 234)__ Salem Street Address -- —.—.._ ._..... City/Town 9 330 Assessors Map/Plat Number Parcel/Lot Number the final Order of Condition was recorded at the Registry of Deeds for. Kenneth G. Steadman Property owner(if different) South Essex __... . County - Book Page 80815 (Doc_#536278) __ Certificate _ .._......_.-- ---- - -.....--- 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: 7/8/2013 Date__ - _._._...... .........._ ....__...... wpehm8b doc•rev 12a3KN WPA Form BB..2pnifi=e of compliance•Page i of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection- Wetlands DEP File Number WPA Form 8B - Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 6a-535 J Provided by DEP B. Certification - Check all that apply: complete Certification: It is hereby certified that the work regulated by the above-referenced Order of Conditions has been satisfactorily completed. ❑ Partial Certification: It is hereby certified that only the following portions of work regulated by the above-referenced Order of Conditions have been satisfactorily completed.The project areas or work subject to this partial certification that have been completed and are released from this Order are: ❑' Invalid Order of Conditions: It is hereby certified that the work regulated by the above-referenced Order of Conditions never commenced. The Order of Conditions has lapsed and is therefore no longer valid. No future work subject to regulation under the Wetlands Protection Act may commence without filing a new Notice of Intent and receiving a new Order of Conditions. ❑ Ongoing Conditions: The following conditions of the Order shall continue: (Include any conditions contained in the Final Order, such as maintenance or monitoring, that should continue for a longer period).` Condition Numbers: C. Authorization Issued by: Salem f _... --...,_.. _ ..__.. _ Conservation Commission "-"'""- ..... e of�s� pce� This Certificate must be signed by a majority of the Conservation Commission and a copy sent to the applicant and appropriate DEP Regional Office(See http://www.mass.gov/dep/about/region/findyour.htm). ) ig tures wpefrmeb.tloc•rav 1223I09 - WPA Form tle,CetlRlrale of Compliance•Page 2 of Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEa Foe Number } WPA Form 86 - Certificate of Compliance Massachusetts Wetlands 40 tld Protection Act M.G.L. c. 131, s4-a3s r � Provided by DEP - D. Recording Confirmation The applicant is responsible for ensuring that this Certificate of Compliance is recorded in the Registry of Deeds or the Land Court for the district in which the land is located. Detach on dotted line and submit to the Conservation Commission. To: - - - - -- - ---- ---- ------- - - salem_ Conservation Commission Please be advised that the Certificate of Compliance for the project at: -—---- -- -...— -- — -- - —---- -----Pro'ect Location - `-- - - - 1 DEP File Number Has been recorded at the Registry of Deeds of: County. _,...... ..... for: ----- Property Owner.. - -- and has been noted in the chain of title of the affected property on: - ...._ ._...__.. _...- ._. . ..-._.__ ...._._---...._ .__......._ ....._.... ...._. - -... Date Book Pag e If recorded land, the instrument number which identifies this transaction is: If registered land, the document number which identifies this transaction is: um Document Number _...._ ..... ... . ......_. ._ .:.__ _. ._ Signat ure of Applic. .ant .... ... .. .._...._ . _„ ._ ... .. wPfrmBb dm•rev.12/23109 - wPA Form 83.Cedlficale of Compliance Page 3 W 3 17 Massachusetts Department of Environmental Protection Bureau of Resource Protection Wetlands DEP File Number.' WPA Form 8B — Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 6a-536 _ � Provided by DEP A. Project Information Important:When fining out 1. This Certificate of Compliance is issued to: forms on the computer,use Salem Homebuilders LLC only the tab key Name - --'---- -------to move your 100 Cabot Street _ cursor-do not Malin -- use the return g Address ---- ------"' key. Beverly MA 01915 City/Town . —_ State Zip Code 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: Kenneth G. Steadman 9/17/2012_ — - - - - — . 64-5 36 Dated —E_PFle Number . 3. The project site is located at 2_NJose Way(fka 1 Nurse Waylot 215)_ Salem Street Address —_ —...._—.--... City/Town ...._... ..:.,. 14 324 - ---—-- -- — ----... Assessors Ma /Plat Number � —e—�---- - ---'`--- ------ P ParcellLot Number - - the final Order of Condition was recorded at the Registry of Deeds for. Kenneth G. Steadman Property Owner(if dAferent). --.- .......„. .„. South Essex County -Boo -....._. ,...,-.:. ,-.,... Book Page 80815(Doc. #536279L — Certificate __ 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: 7/8/2013 - Date ...._.:.. _._...:-_ .. ......__:_ wpafrmeb Coc-rev 12123M9 - - WPA Form 8e.Cetlmrata of Canp1mnta•Page I of 3 Massachusetts Department of Environmental Protection Bureau of Resource� Protection -Wetlands` _ DEP File Number WPA Form 8B — Certificate of Compliance sa e3s Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP" B. Certification Check all that apply: Complete Certification: It is hereby certified that the work regulated by the above-referenced Order of Conditions has been satisfactorily completed, ❑ Partial Certification: It is hereby certified that only the following portions of work regulated by the above-referenced Order of Conditions have been satisfactorily completed.The project areas or work subject to this partial certification that have been completed and are released from this Order are: ❑ Invalid Order of Conditions: It is hereby certified that the work regulated by the above-referenced Order of Conditions never commenced. The Order of Conditions has lapsed and is therefore no longer valid- No future work subject to regulation under the Wetlands Protection Act may commence without filing a new Notice of Intent and receiving a new Order of Conditions. ❑ Ongoing Conditions: The following conditions of the Order shall continue: (Include any conditions contained in the Final Order, such as maintenance or monitoring, that should continue for a longer period). Condition Numbers: C. Authorization Issued by: Salem Conservation Commission L�me of isSVnoe This Certificate must be signed by a majority of the Conservation Commission and a copy sent to the applicant and appropriate DEP Regional Office(See hftp//www mass-gov/dep/abouttregion/findyour htm). Sign ores: 1 1 Pafrmft d.-rov 12123f09 1 - NPA Form 8a,Curfiffeate of Compliance•Page 2 of 3 Massachusetts Department of Environmental Protection -- Bureau of Resource Protection - Wetlands DEP File Number WPA Form 8B - Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 sa-536 - � Provided by DEP D. Recording Confirmation The applicant is responsible for ensuring that this Certificate of Compliance is recorded in the Registry of Deeds or the Land Court for the district in which the land is located. Detach on dotted line and submit to the Conservation Commission. - - — --- -------- Salem Conservation Commission ------ Please be advised that the Certificate of Compliance for the project at: Project Location _.._...__.._:_.. DEP File Number: Has been recorded at the Registry of Deeds of: for: -- --- --- Property Owner and has been noted in the chain of title of the affected property on: --Book--,Date - .---.....-page- If ... . Book recorded land, the instrument number which identifies this transaction is: If registered land, the document number which identifies this transaction is: _._ Document Number ....._. - Signature of Applicant w-frmft dm-rev 121223�09 - MA Porm ao.Cenificale of Compliance•Page 3 of 3 N4rvq Attachment to Order of Conditions # 64-533 Page I of 5 SALEM CONSERVATION COMMISSION DEP FILE #64-533 4 Nurse Way City of Salem, Massachusetts ADDITIONAL FINDINGS Based on the Estimated Habitats of Rare Wildlife and Certified Vernal Pools Map (October 1, 2008) from Natural Heritage & Endangered Species Program (NHESP) of the Massachusetts Division of Fisheries and Wildlife, it has been determined that this project does not occur near any habitat of state-listed rare wildlife species nor contains any vernal pools. This Order is issued under the Massachusetts Wetlands Protection Act,M.G.L. Chapter 131, Section 40 and the City of Salem Wetlands Protection and Conservation Ordinance,Salem Code Chapter 50. This order permits the construction of a single-family house and appurtenances per Notice of Intent submitted June 20, 2012. SPECIAL CONDITIONS I. This Order of Conditions must be recorded in its entirety (including all 5 pages of Special Conditions) at the Essex County Registry of Deeds or the Land Court for the district in which the land is located, after the expiration of the 10-day appeal period and within 30 days of the issuance. A copy of the recording information must be submitted to the Salem Conservation Commission before any work approved in this Order commences. 2. Approval of this application does not constitute compliance with any law or regulation other than M.G.L Chapter 131, Section 40, Wetlands Regulations 310 CMR 10.00 and the City of Salem Wetlands Protection and Conservation Ordinance, Salem Code Chapter 50. 3. All work shall be performed in accordance with this Order of Conditions and approved site plan(s). No alteration of wetland resource areas or associated buffer zones, other than that approved in this Order, shall occur on this property without prior approval from the Commission. 4. Prior to any work commencing on site, a DEP Sign showing DEP File#64-533 must be installed at the entrance to the site and seen from the public P way, but not laced on a living tree. 5. No work approved in this Order may commence until the ten(10)business day appeal period bllsi pled from the date of the issuance of this Order. 6. With respect to this Order, the Commission designates the Conservation Agent as its agent with powers to act on its behalf in administering and enforcing this Order. 7. The Commission or its Agent, officers,or employees shall have the right to enter and inspect the property at any time for compliance with the conditions of this Order, the Wetlands Protection Act MGL Chapter 131, Section 40, the Wetlands Regulations 310 CMR 10.00, and shall have the right to require any data or documentation that it deems necessary for that evaluation. t Attachment to Order of Conditions # 64-533 s jr ll°` Page 2 of 5 8. The term "Applicant"as used in this Order of Conditions shall refer to the owner,any successor in interest or successor in control of the property referenced in the Notice of intent, supporting documents and this Order of Conditions. The Commission shall be notified in writing within 30 days of all transfers of title of any portion of the property that takes place prior to issuance of the Certificate of Compliance. 9. It is the responsibility of the applicant to procure all other applicable federal, state and local permits and approvals associated with this project. These permits may include but are not necessarily limited to the following: (1) Section 404 of the Federal Water Pollution Control Act(P.L. 92-500, 86 stat. 816), U.S. Army Corps of Engineers. (2) Water Quality Certification in accordance with the Federal Water Pollution Control under authority of sec. 27(5) of Chapter 21 of the Massachusetts General Laws as codified in 314 CMR 9.00. (3) Sewer Extension Permit from the DEP Division of Water Pollution Control under G. L. Ch. 21 A ss7 and 314 CMR 7.00. Any Board of Health permit for septic system design for any portion of the septic system within 100 feet of wetlands shall be submitted to the Commission prior to construction initiation. (4) Design Requirements for Construction in Floodplains under the State Building Code(780 CMR 744.). 10. If there are conflicting conditions within this Order, the stricter condition(s)shall rule. 11. All work shall be performed so as to ensure that there will be no sedimentation into wetlands and surface waters during construction or after completion of the project. 12. The Commission or its Agent shall have the discretion to modify the erosion/siltation control methods and boundary during construction if necessary. 13. The Commission reserves the right to impose additional conditions on portions of this project or this site to mitigate any actual or potential impacts resulting from the work herein permitted. 14, The work shall conform to the following attached plans and special conditions: Final Approved Plans Site Development Permit Plan Located in Salem, Mass. (Title) 9/7/2012 (Dated) Clayton Morin (Signed and Stamped by) City of Salem Conservation Commission (On file with) 15. Any proposed changes in the approved plan(s) or any deviation in construction from the approved plan(s) shall require the applicant to file a Notice of Project Change with the Commission. The Notice shall be accompanied by a written inquiry prior to their implementation in the field, as to whether the change(s) is substantial enough to require filing a new Notice of Intent or a request to correct or amend M.0 r Attachment to Order of Conditions # 64-533 ea; <F Page 3 of 5 this Order of Conditions. A copy of such request shall at the same time be sent to the Department of Environmental Protection. 16. In conjunction with the sale of this property or any portion thereof before a Certificate of Compliance has been issued, the applicant or current landowner shall submit to the Commission a statement signed by the buyer that he/she is aware of an outstanding Order of Conditions on the property and has received a copy of the Order of Conditions. PRIOR TO CONSTRUCTION 17. Prior to the commencement of any activity on this site other than activities listed above,there must be a Pre-Construction Meeting on site between the project supervisor, the contractor responsible for the work, and the Conservation Agent and/or a member of the Conservation Commission to ensure that the requirements of the Order of Conditions are understood. The staked erosion control line shall be adjusted, if necessary, during the pre-construction meeting. Please contact the Conservation Agent at (978)619-5685 at least forty-eight(48) hours prior to construction to arrange for the Pre- Construction Meeting. 18. Prior to the pre-construction meeting and commencement of any activity on this site,sedimentation and erosion control barriers shall be installed as shown on the approval plan(s)and detail drawings. The Commission and/or its Agent shall inspect and approve such installation at the pre-construction meeting. 19. No clearing of vegetation, including trees,or disturbance of soil shall occur prior to the pre-construction meeting. Minimal disturbance of shrubs and herbaceous plants shall be allowed prior to the pre- construction meeting if absolutely necessary in order to place erosion control stakes where required. 20. There shalt be sufficient erosion controls stored under cover on the site to be used for emergency erosion control purposes. EROSION CONTROL 21. Appropriate erosion control devices shall be in place prior to the beginning of any phase of construction, and shall be maintained during construction in any wetland resource area and/or buffer zones. The erosion control measures shown on the approval plan(s)and provisions in the Order will be the minimum standards for this project; the Commission or its Agent may require additional measures. 22. All debris, fill and excavated material shall be stockpiled a location far enough away from the wetland resource areas to prevent sediment from entering wetland resource areas. 23. Erosion and sedimentation control devices shall be inspected after each storm event and repaired or replaced as necessary. Any accumulated silt adjacent to the barriers shall be removed. 24. The area of construction shall remain in a stable condition at the close of each construction day. 25. Any de-watering of trenches or other excavation required during construction shall be conducted so as to prevent siltation of wetland resource areas. All discharge from de-watering activities shall be filtered through hay bale sediment traps, silt filter bags or other means approved by the Commission or its Administrator. Ash-z`r_ Attachment to Order of Conditions # 64-533 Page 4 of 5 26. Within thirty (30)days of completion of construction on any given portion of the project, all disturbed areas in the completed portion of the site shall be permanently stabilized with rapidly growing vegetative cover, using sufficient top soil to assure long-term stabilization of disturbed areas. 27. If soils are to be disturbed for longer than two(2) months, a temporary cover of rye or other grass should be established to prevent erosion and sedimentation. If the season is not appropriate for plant growth,exposed surface shall be stabilized by other appropriate erosion control measures, firmly anchored, to prevent soils from being washed by rain or Flooding. DURING CONSTRUCTION 28. A copy of this Order of Conditions and the plants)approved in this Order shall be available on site at all times when work is in progress. 29. No alteration or activity shall occur beyond the limit of work as defined by the siltation barriers shown on the approved plan(s). 30. All waste products,grubbed stumps,slash;construction materials,etc.shall be deposited at least 100 feet from wetland resource areas and 200 feet from river. 31. Cement trucks shall not be washed out in any wetland resource or buffer zone area,nor into any drainage system. Any deposit of cement or concrete products into a buffer zone or wetland resource area shall be immediately removed. 32. All exposed sub-soils shall be covered by a minimum of three(3) inches of quality screened loam topsoil prior to seeding and final stabilization. 33. Immediately following drainage structure installation all inlets shall be protected by silt fence, haybale barriers and/or silt bags to filter silt from stormwater before it enters the drainage system. 34. There shall be no pumping of water from wetland resource areas. 35. All equipment shall be inspected regularly for leaks. Any leaking hydraulic lines,cylinders or any other components shall be fixed immediately. Y 36. During construction, all drainage structures shall be inspected regularly and cleaned as necessary. 37. The applicant is herby notified that failure to comply with all requirements herein may result in the issuance of enforcement actions by the Conservation Commission including, but not limited to,civil administrative penalties under M.G.L Chapter 21 A, section 16. AFTER CONSTRUCTION 38. Upon completion of construction and final soil stabilization, the applicant shall submit the following to the Conservation Commission to request a Certificate of Compliance (COC): (1) A Completed Request for a Certificate of Compliance form (WPA Form 8A or other form if required by the Conservation Commission at the time of request). (2) A letter from a Registered Professional Engineer certifying compliance of the property with this Order of Conditions. (3) An "As-Built" plan signed and stamped by a Registered Professional Engineer or Land Surveyor showing post-construction conditions within all areas under thejurisdiction of the Massachusetts Wetlands Protection Act. This plan shall include at a minimum: `. Attachment to Order of Conditions # 64-533 t Page 5 of 5 (a) All wetland resource area boundaries with associated buffer zones and regulatory setback areas taken from the plants)approved in this Order of Conditions; (b) Locations and elevations of all stormwater management conveyances, structures and best management designs, including foundation drains,constructed under this Order within any wetland resource area or buffer zone; (c) Distances from any structures constructed under this Order to wetland resource areas- "structures" include,but are not limited to,all buildings, septic system components, wells, utility lines, fences,retaining walls,and roads/driveways; (d) A line delineating the limit of work-"work" includes any filling,excavating and/or disturbance of soils or vegetation approved under this Order; 39. When issued, the Certificate of Compliance must be recorded at the Southern Essex County Registry of Deeds and a copy of the recording submitted to the Salem Conservation Commission. 40. If the completed work differs from that in the original plans and conditions, the report must specify how the work differs; at which time the applicant shall first request a modification to the Order. Only upon review and approval by the Commission, may the applicant request in writing a Certificate of Compliance as described above. 41. Erosion control devices shall remain in place and properly functioning until all exposed soils have been stabilized with final vegetative cover and the Conservation Commission and/or its Agent has authorized their removal. ADDITIONAL CONDITIONS 42. Prior to construction, a plantings plan developed by a wetlands scientist must be submitted to the conservation commission for review and approval. Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-533 WPA Form 5 - Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem City/Town A. General Information Please note: Salem this form has 1. From: been modified Conservation Commission with added 2. This issuance is for space to a.®Order of Conditions b.❑ Amended Order of Conditions accommodate (check one): the Registry of Deeds 3. To: Applicant: Requirements Kenneth G. Steadman Important: a. First Name b. Last Name When filling out forms c.Organization on the 67 Village Street computer, use only the d.Mailing Address tab key to Marblehead MA 01945 move our e.City/Town I.State cursory do g.Zip Code not use the 4. Property Owner(if different from applicant): return key. rQ a. First Name D. Last Name c.Organization reran . d. Mailing Address e.City/Town f.State g.Zip Code 5. Project Location: 4 Nurse Way Salem a. Street Address b.City/Town 9 233 c.Assessors Map/Plat Number d. Parcel/Lot Number Latitude and Longitude, if known: 42d30m35s 70d55mO9s d.Latitude e. Longitude wpaform5 doc• rev.05/19/2010 Page 1 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-533 WPA Form 5 — Order of Conditions MassDEPFile# \ Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem City/Town A. General Information (cont.) s. Property recorded at the Registry of Deeds for(attach additional information if more than one parcel): Southern Essex 80814& 80815 a.County b.Certificate Number(if registered land) c. Book d.Page 7. Dates: 6/20/2012 9/13/2012 9/17/2012 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): Site Development Permit Plan Located in Salem Mass a. Plan Title Eastern Land Survey Associates Clayton A. Morin b. Prepared By c.Signed and Stamped by 9/7/2012 1 '=20' d.Final Revision Date e.Scale I.Additional Plan or Document Title g.Date 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(the Act). Check all that apply: a. ® Public Water Supply b. ❑ Land Containing Shellfish c' ® Prevention of Pollution d. ® Private Water Supply e. ® Fisheries t. ® 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: a. ® 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. wpaform5.doc• rev.05/19/2010 Page 2 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-533 WPA Form 5 - Order of Conditions MassDEP-File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem City/town B. Findings (cont.) Denied because: b. ❑ 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 the interests of the Act, 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. c. ❑ 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). 3. ® Buffer Zone Impacts: Shortest distance between limit of project to' +/- disturbance and the wetland resource area specified in 310 CMR 10.02(1)(a) a.linear feet Inland Resource Area Impacts: Check all that apply below. (For Approvals Only) Resource Area Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 4. ❑ Bank a. linear feet b.linear feet c. linear feet d. linear feet a. ❑ Bordering Vegetated Wetland a.square feet b.square feet c.square feet d,square feet s. ❑ Land Under Waterbodies and a.square feet b.square feet c.square feet d.square feet Waterways e.c/y dredged f.c/y dredged 7. El Bordering Land Subject to Flooding a.square feet b.square feet c.square feet d.square feet Cubic Feet Flood Storage e.cubic feet f,cubic feet g.cubic feet h.cubic feet e. ❑ Isolated Land Subject to Flooding a.square feet b.square feet Cubic Feet Flood Storage c.cubic feet d.cubic feet e.cubic feet f.cubic feet s. ❑ Riverfront Area fermi<„ roef b. total sq.feet Sq It within 100 it �.o foot Sq ft between 100- d.square feet „o roof f.square feet 200 It �.o foot h.square feet roor j,square feet wpafurm5.dec•rev.05/192010 Page 3 01 12 I{I 1 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-533 WPA Form 5 — Order of Conditions MassDEP FileN Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction k Salem B. Findings (cont.) City/Town Coastal Resource Area Impacts: Check all that apply below. (For Approvals Only) Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 10. El Designated Port Areas Indicate size under Land Under the Ocean, below it. ❑ Land Under the Ocean a.square feet b.square feet c,r dredged d.c/y dredged 12. ❑ Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes below 13. ❑ Coastal Beaches cu yd cu yd a.square feet b.square feet c.nourishment d.nourishment 14. ❑ Coastal Dunes cu yd cu yd a.square feet b.square feet c.nourishment d.nourishment 15. ❑ Coastal Banks a. linearfeet b.linearfeet 16. ❑ Rocky Intertidal Shores a.square feet b.square feet 17. ❑ Salt Marshes a.square feet b.square feet c.square feet d.square feet ts: ❑ Land Under Salt Ponds a.square feet b.square feet c.ay dredged d,c/y dredged 1s. El Land Containing Shellfish a.square feet b.square feet c.square feet d.square feet 20. ❑ Fish Runs Indicate size under Coastal Banks, Inland Bank, Land Under the Ocean, and/or inland Land Under Waterbodies and Waterways, above a.c/y dredged b.c/y dredged 21. ❑ Land Subject to Coastal Storm a.square feet b.square feet Flowage wpalorm5.doc, rev.05192o10 Page 4 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-533 WPA Form 5 - Order of Conditions MassDEPFile# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem City/Town B. Findings (cont.) '#22.If the project is for 22. ❑ Restoration/Enhancement*: the purpose of restoring or a.square feet of BVW enhancing a b.square feet of salt marsh wetland resource area 23• ❑ Stream Crossing(s): in addition to the square footage that a. number of new stream crossings b.number of replacement stream crossings has been entered in C. General Conditions Under Massachusetts Wetlands Protection Act Section B.5.c (BV or B.1 cl(salt The following conditions are only applicable to Approved projects. please enter, 1. Failure to comply with all conditions stated herein, and with all related statutes and other the additional regulatory measures, shall be deemed cause to revoke or modify this Order. amount here. 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. If this Order constitutes an Amended Order of Conditions, this Amended Order of Conditions does not extend the issuance date of the original Final Order of Conditions and the Order will expire on 9/17/2012 unless extended in writing by the Department. 7. 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. 8. 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. wpaform5.doc• rev.M19/2010 Page 5 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-533 WPA Form 5 - Order of Conditions MasSDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem City/Town C. General Conditions Under Massachusetts Wetlands Protection Act (cont.) 9. 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 the 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. 10. 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, "MassDEP"j "File Number 64-533 11 11. 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 MassDEP. 12. Upon completion of the work described herein, the applicant shall submit a Request for Certificate of Compliance(WPA Form 8A)to the Conservation Commission. 13. The work shall conform to the plans and special conditions referenced in this order. 14. Any change to the plans identified in Condition #13 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. 15. 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. 16. 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. 17. 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. wpaform5.doc• rev.05/19/2010 Page 6 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-533 WPA Form 5 — Order of Conditions MassDEPFIIe# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 aDEPTransaction# Salem City/Town C. General Conditions Under Massachusetts Wetlands Protection Act (cont.) 18. 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. NOTICE OF STORMWATER CONTROL AND MAINTENANCE REQUIREMENTS 19. The work associated with this Order(the "Project') is t1I❑ Is not(2)Z subject to the Massachusetts Stormwater Standards. If the work is subject to the Stormwater Standards, then the project is subject to the following conditions: a) All work, including site preparation, land disturbance, construction and redevelopment, shall be implemented in accordance with the construction period pollution prevention and erosion and sedimentation control plan and, if applicable, the Stormwater Pollution Prevention Plan required by the National Pollution Discharge Elimination System Construction General Permit as required by Stormwater Condition 8. Construction period erosion, sedimentation and pollution control measures and best management practices (BMPs) shall remain in place until the site is fully stabilized. b) No stormwater runoff may be discharged to the post-construction stormwater BMPs unless and until a Registered Professional Engineer provides a Certification that: i. all construction period BMPs have been removed or will be removed by a date certain specified in the Certification. For any construction period BMPs intended to be converted to post construction operation for stormwater attenuation, recharge, and/or treatment, the conversion is allowed by the MassDEP Stormwater Handbook BMP specifications and that the BMP has been properly cleaned or prepared for post construction operation, including removal of all construction period sediment trapped in inlet and outlet control structures; ii. as-built final construction BMP plans are included, signed and stamped by a Registered Professional Engineer, certifying the site is fully stabilized; iii. any illicit discharges to the stormwater management system have been removed, as per the requirements of Stormwater Standard 10; iv. all post-construction stormwater BMPs are installed in accordance with the plans (including all planting plans) approved by the issuing authority, and have been inspected to ensure that they are not damaged and that they are in proper working condition; v. any vegetation associated with post-construction BMPs is suitably established to withstand erosion. wpaform5.doc• rev.O5192010 Page 7 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-533 WPA Form 5 - Order of Conditions MassDEPFIIe# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction k Salem City/Town C. General Conditions Under Massachusetts Wetlands Protection Act (cont.) c) The landowner is responsible for BMP maintenance until the issuing authority is notified that another party has legally assumed responsibility for BMP maintenance. Prior to requesting a Certificate of Compliance, or Partial Certificate of Compliance, the responsible party(defined in General Condition 18(e)) shall execute and submit to the issuing authority an Operation and Maintenance Compliance Statement("O&M Statement) for the Stormwater BMPs identifying the party responsible for implementing the stormwater BMP Operation and Maintenance Plan ("O&M Plan") and certifying the following: i.) the O&M Plan is complete and will be implemented upon receipt of the Certificate of Compliance, and ii.)the future responsible parties shall be notified in writing of their ongoing legal responsibility to operate and maintain the stormwater management BMPs and implement the Stormwater Pollution Prevention Plan. d) Post-construction Pollution prevention and source control shall be implemented in accordance with the long-term pollution prevention plan section of the approved Stormwater Report and, if applicable, the Stormwater Pollution Prevention Plan required by the National Pollution Discharge Elimination System Multi-Sector General Permit. e) Unless and until another party accepts responsibility, the landowner, or owner of any drainage easement, assumes responsibility for maintaining each BMP. To overcome this presumption, the landowner of the property must submit to the issuing authority a legally binding agreement of record, acceptable to the issuing authority, evidencing that another entity has accepted responsibility for maintaining the BMP, and that the proposed responsible party shall be treated as a permittee for purposes of implementing the requirements of Conditions 18(f) through 18(k)with respect to that BMP. Any failure of the proposed responsible party to implement the requirements of Conditions 18(f) through 18(k)with respect to that BMP shall be a violation of the Order of Conditions or Certificate of Compliance. In the case of stormwater BMPs that are serving more than one lot, the legally binding agreement shall also identify the lots that will be serviced by the stormwater BMPs. A plan and easement deed that grants the responsible party access to perform the required operation and maintenance must be submitted along with the legally binding agreement. f) The responsible party shall operate and maintain all stormwater BMPs in accordance with the design plans, the 0&M Plan, and the requirements of the Massachusetts - Stormwater Handbook. wpaform5Aoc• rev.05/192010 Page B of 12 I Massachusetts Department of Environmental Protection Provided by MassDEP: �^ Bureau of Resource Protection - Wetlands 64-533 \A\ WPA Form 5 - Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem City/Town C. General Conditions Under Massachusetts Wetlands Protection Act (cont.) g) The responsible party shall: 1. Maintain an operation and maintenance log for the last three (3)consecutive calendar years of inspections, repairs, maintenance and/or replacement of the stormwater management system or any part thereof, and disposal (for disposal the log shall indicate the type of material and the disposal location); 2. Make the maintenance log available to MassDEP and the Conservation Commission ("Commission") upon request; and 3. Allow members and agents of the MassDEP and the Commission to enter and inspect the site to evaluate and ensure that the responsible party is in compliance with the requirements for each BMP established in the O&M Plan approved by the issuing authority. h) All sediment or other contaminants removed from stormwater BMPs shall be disposed of in accordance with all applicable federal, state, and local laws and regulations. i) Illicit discharges to the stormwater management system as defined in 310 CMR 10.04 are prohibited. j) The stormwater management system approved in the Order of Conditions shall not be changed without the prior written approval of the issuing authority. k) Areas designated as qualifying pervious areas for the purpose of the Low Impact Site Design Credit(as defined in the MassDEP Stormwater Handbook, Volume 3, Chapter 1, Low Impact Development Site Design Credits) shall not be altered without the prior written approval of the issuing authority. 1) Access for maintenance, repair, and/or replacement of BMPs shall not be withheld. Any fencing constructed around stormwater BMPs shall include access gates and shall be at least six inches above grade to allow for wildlife passage. Special Conditions (if you need more space for additional conditions, please attach a text document): wpaform5Aac• rev.05/19/2010 Page 9 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-533 \�\ WPA Form 5 - Order of Conditions MassDEP Fil ## Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem City/Town D. Findings Under Municipal Wetlands Bylaw or Ordinance 1. Is a municipal wetlands bylaw or ordinance applicable? ® Yes ❑ No 2. The Salem hereby finds (check one that applies): Conservation Commission a. ❑that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw, specifically: 1. Municipal Ordinance or Bylaw 2. 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. b. ® that the following additional conditions ar e e necessary to comply with a municipal ordinance or bylaw: Wetlands Protection and'Conservation c.50 1. Municipal ordinance or Bylaw 2.Citation 3. 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. The special conditions relating to municipal ordinance or bylaw are as follows (if you need more space for additional conditions, attach a text document): Attached special conditions are issued under the Wetlands Protection Act and are sufficient for compliance with the local ordinance (c 50) wpafurm5.doc• rev.05 1912010 Page 10 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 6 ti-S 33 t r WPA Form 5 — Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Trans—action# city/Town E. Signatures Important: This Order is valid for three years, unless otherwise specified as a special 9�(When filling out condition pursuant to General Conditions#4, from the date of issuance. 1.Date ofissu7_a— nce forms on the computer,use Please indicate the number of members who will sign this form. only the tab key This Order must be signed by a majority of the Conservation Commission. 2. Numb r of Signers to move your cursor-do not The Order must be mailed by certified mail (return receipt request d) or ha d e Ivered to use the return the applicant. A c t be mailed, hand delivered or filed'ele ronicall th same key. time with the propriate assDEP Regional Office. / r ❑ by hand delivery on by certified mail, return receipt requested, on 9— Date Date (-7 F. Appeals 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 MassDEP 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 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. Any appellants seeking to appeal the Department's Superseding Order associated with this appeal will be required to demonstrate prior participation in the review of this project. Previous participation in the permit proceeding means the submission of written information to the Conservation Commission prior to the close of the public hearing, requesting a Superseding Order, or providing written information to the Department prior to issuance of a Superseding Order. 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. •xpa5sigs.dac- rev.022512010 Page/Lot I(� i Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-533 WPA Form 5 — Order of Conditions MasSDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem G. Recording Information Citylrown Prior to commencement of work, 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 this page shall be submitted to the Conservation Commission listed below. 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 MassDEP File Number Has been recorded at the Registry of Deeds of: County Book Page for: 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.0 511 912 01 0 Page 12 of 12 C�. Attachment to Order of Conditions # 64-532 s Page I of 5 SALEM CONSERVATION COMMISSION DEP FILE #64-532 5 Nurse Way City of Salem, Massachusetts ADDITIONAL FINDINGS Based on the Estimated Habitats of Rare Wildlife and Certified Vernal Pools Map(October 1, 2008) from Natural Heritage & Endangered Species Program (NHESP) of the Massachusetts Division of Fisheries and Wildlife, it has been determined that this project does not occur near any habitat of state-listed rare wildlife species nor contains any vernal pools. This Order is issued under the Massachusetts Wetlands Protection Act,M.G.L. Chapter 131, Section 40 and the City of Salem Wetlands Protection and Conservation Ordinance,Salem Code Chapter 50. This order permits the construction of a single-family house and appurtenances per Notice of Intent submitted June 20, 2012. SPECIAL CONDITIONS 1. This Order of Conditions must be recorded in its entirety (including all 5 pages of Special Conditions) at the Essex County Registry of Deeds or the Land Court for the district in which the land is located, after the expiration of the 10-day appeal period and within 30 days of the issuance. A copy of the recording information must be submitted to the Salem Conservation Commission before any work approved in this Order commences. 2. Approval of this application does not constitute compliance with any law or regulation other than M.G.L Chapter 131, Section 40, Wetlands Regulations 310 CMR 10.00 and the City of Salem Wetlands Protection and Conservation Ordinance, Salem Code Chapter 50. 3. All work shall be performed in accordance with this Order of Conditions and approved site plan(s). No alteration of wetland resource areas or associated buffer zones, other than that approved in this Order, shall occur on this property without prior approval from the Commission. 4. Prior to any work commencing on site, a DEP Sign showing DEP File#64.532 must be installed at the entrance to the site and seen from the public way, but not placed on a living tree. 5. No work approved in this Order may commence until the ten(10) business day appeal period has lapsed from the date of the issuance of this Order. 6. With respect to this Order, the Commission designates the Conservation Agent as its agent with powers to act on its behalf in administering and enforcing this Order. 7. The Commission or its Agent,officers,or employees shall have the right to enter and inspect the property at any time for compliance with the conditions of this Order, the Wetlands Protection Act MGL Chapter 131, Section 40, the Wetlands Regulations 310 CMR 10.00, and shall have the right to require any data or documentation that it deems necessary for that evaluation. Attachment to Order of Conditions # 64-532 „ Page 2 of 5 8. The term "Applicant" as used in this Order of Conditions shall refer to the owner,any successor in interest or successor in control of the property referenced in the Notice of intent, supporting documents and this Order of Conditions. The Commission shall be notified in writing within 30 days of all transfers of title of any portion of the property that takes place prior to issuance of the Certificate of Compliance. 9. It is the responsibility of the applicant to procure all other applicable federal, state and local permits and approvals associated with this project. These permits may include but are not necessarily limited to the following: (I) Section 404 of the Federal Water Pollution Control Act(P.L. 92-500, 86 stat. 816), U.S.Army Corps of Engineers. (2) Water Quality Certification in accordance with the Federal Water Pollution Control under authority of sec. 27(5) of Chapter 21 of the Massachusetts General Laws as codified in 314 CMR 9.00. (3) Sewer Extension Permit from the DEP Division of Water Pollution Control under G. L. Ch. 21 A ss7 and 314 CMR 7.00. Any Board of Health permit for septic system design for any portion of the septic system within 100 feet of wetlands shall be submitted to the Commission prior to construction initiation. (4) Design Requirements for Construction in Floodplains under the State Building Code (780 CMR 744.). 10. If there are conflicting conditions within this Order, the stricter condition(s) shall rule. 11. All work shall be performed so as to ensure that there will be no sedimentation into wetlands and surface waters during construction or after completion of the project. 12. The Commission or its Agent shall have the discretion to modify the erosion/siltation control methods and boundary during construction if necessary. 13. The Commission reserves the right to impose additional conditions on portions of this project or this site to mitigate any actual or potential impacts resulting from the work herein permitted. 14. The work shall conform to the following attached plans and special conditions: Final Approved Plans Site Development Permit Plan Located in Salem, Mass. (Title) 9/7/2012 (Dated) Clayton Morin (Signed and Stamped by) City of Salem Conservation Commission (On file with) 15. Any proposed changes in the approved plan(s)or any deviation in construction from the approved plan(s) shall require the applicant to file a Notice of Project Charge with the Commission. The Notice shall be accompanied by a written inquiry prior to their implementation in the field, as to whether the change(s) is substantial enough to require filing a new Notice of Intent or a request to correct or amend 1 p..pne.. S 4 A Attachment to Order of Conditions # 64-532 Page 3 of S this Order of Conditions. A copy of such request shall at the same time be sent to the Department of Environmental Protection. 16. In conjunction with the sale of this property or any portion thereof before a Certificate of Compliance has been issued,the applicant or current landowner shall submit to the Commission a statement signed by the buyer that he/she is aware of an outstanding Order of Conditions on the property and has received a copy of the Order of Conditions. PRIOR TO CONSTRUCTION 17. Prior to the commencement of any activity on this site other than activities listed above, there must be a Pre-Construction Meeting on site between the project supervisor, the contractor responsible for the work, and the Conservation Agent and/or a member of the Conservation Commission to ensure that the requirements of the Order of Conditions are understood. The staked erosion control line shall be adjusted, if necessary, during the pre-construction meeting. Please contact the Conservation Agent at (978)619-5685 at least forty-eight (48) hours prior to construction to arrange for the Pre- Construction Meeting. 18. Prior to the pre-construction meeting and commencement of any activity on this site,sedimentation and erosion control barriers shall be installed as shown on the approval plan(s)and detail drawings. The Commission and/or its Agent shall inspect and approve such installation at the pre-construction meeting. 19: No clearing of vegetation, including trees,or disturbance of soil shall occur prior to the pre-construction meeting. Minimal disturbance of shrubs and herbaceous plants shall be allowed prior to the pre- construction meeting if absolutely necessary in order to place erosion control stakes where required. 20. There shall be sufficient erosion controls stored under cover on the site to be used for emergency erosion control purposes. EROSION CONTROL 21. Appropriate erosion control devices shall be in place prior to the beginning of any phase of construction, and shall be maintained during construction in any wetland resource area and/or buffer zones. The erosion control measures shown on the approval plan(s)and provisions in the Order will be the minimum standards for this project; the Commission or its Agent may require additional measures. 22. All debris, fill and excavated material shall be stockpiled a location far enough away from the wetland resource areas to prevent sediment from entering wetland resource areas. 23. Erosion and sedimentation control devices shall be inspected after each storm event and repaired or replaced as necessary. Any accumulated silt adjacent to the barriers shall be removed. 24. The area of construction shall remain in a stable condition at the close of each construction day. 25. Any de-watering of trenches or other excavation required during construction shall be conducted so as to prevent siltation of wetland resource areas. All discharge from de-watering activities shall be filtered through hay bale sediment traps, silt filter bags or other means approved by the Commission or its Administrator. Attachment to Order of Conditions # 64-532 %a ?8` Page 4 of 5 26. Within thirty (30) days of completion of construction on any given portion of the project, all disturbed areas in the completed portion of the site shall be permanently stabilized with rapidly growing vegetative cover, using sufficient top soil to assure long-term stabilization of disturbed areas. 27. If soils are to be disturbed for longer than two (2) months, a temporary cover of rye or other grass Should be established to prevent erosion and sedimentation. If the season is not appropriate for plant growth, exposed surface shall be stabilized by other appropriate erosion control measures,firmly anchored, to prevent soils from being washed by rain or Flooding. DURING CONSTRUCTION 28. A copy of this Order of Conditions and the plan(s)approved in this Order shall be available on site at all times when work is in progress. 29. No alteration or activity shall occur beyond the limit of work as defined by the siltation barriers shown on the approved plan(s). 30. All waste products,grubbed stumps, slash;construction materials,etc.shall be deposited at least 100 feet from wetland resource areas and 200 feet from river. 31. Cement trucks shall not be washed out in any wetland resource or buffer zone area, nor into any drainage system. Any deposit of cement or concrete products into a buffer zone or wetland resource area shall be immediately removed. 32. All exposed sub-soils shall be covered by a minimum of three(3)inches of quality screened loam topsoil prior to seeding and final stabilization. 33. Immediately following drainage stricture installation all inlets shall be protected by silt fence, haybale barriers and/or silt bags to filter silt from stormwater before it enters the drainage system. 34. There shall be no pumping of water from wetland resource areas. 35. All equipment shall be inspected regularly for leaks. Any leaking hydraulic lines,cylinders or any other components shall be fixed immediately. 36. During construction,all drainage structures shall be inspected regularly and cleaned as necessary. 37. The applicant is herby notified that failure to comply with all requirements herein may result in the issuance of enforcement actions by the Conservation Commission including, but not limited to,civil administrative penalties under M.G.L Chapter 21 A, section 16. AFTER CONSTRUCTION 38. Upon completion of construction and final soil stabilization, the applicant shall submit the following to the Conservation Commission to request a Certificate of Compliance (COC): (1) A Completed Request for a Certificate of Compliance form (WPA Form 8A or other form if required by the Conservation Commission at the time of request). (2) A letter from a Registered Professional Engineer certifying compliance of the property with this Order of Conditions. (3) An "As-Built" plan signed and stamped by a Registered Professional Engineer or Land Surveyor showing post-construction conditions within all areas under the jurisdiction of the Massachusetts Wetlands Protection Act. This plan shall include at a minimum: i Attachment to Order of Conditions # 64-532 � �F.. Page 5 of 5 (a) All wetland resource area boundaries with associated buffer zones and regulatory areas taken from the plan(s)approved in this Order of Conditions; g rY setback (b) Locations and elevations of all stormwater management conveyances,structures and best management designs, including foundation drains,constricted under this Order within any wetland resource area or buffer zone; (c) Distances from any strictures constricted under this Order to wetland resource areas- "structures"include, but are not limited to, all buildings, septic system components, wells, utility lines, fences,retaining walls,and roads/driveways; (d) A line delineating the limit of work-"work"includes any filling,excavating and/or disturbance of soils or vegetation approved under this Order; 39. When issued, the Certificate of Compliance must be recorded at the Southern Essex County Registry of Deeds and a copy of the recording submitted to the Salem Conservation Commission. 40. If the completed work differs from that in the original plans and conditions, the report must specify how the work differs; at which time the applicant shall first request a modification to the Order. Only upon review and approval by the Commission, may the applicant request in writing a Certificate of Compliance as described above. 41. Erosion control devices shall remain in place and properly functioning until all exposed soils have been stabilized with final vegetative cover and the Conservation Commission and/or its Agent has authorized their removal. ADDITIONAL CONDITIONS 42. Prior to construction, a plantings plan developed by a wetlands scientist must be submitted to the conservation commission for review and approval. Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-532 WPA Form 5 - Order of Conditions MassDEPFile# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem A. General Information City/Town Please note: Salem this form has 1. From: been modified Conservation Commission with added 2. This issuance is for space to accommodate (check one): a. ®Order of Conditions b.ElAmended Order of Conditions the Registry of Deeds 3. To: Applicant: Requirements Kenneth G. Steadman Important: a. First Name b. Last Name When filling out forms C.Organization on the computer, 67 Village Street use only the d Mailing Address tab key to Marblehead move your MA 01945 e.City/town f.State cursor-do g.Zip Code not use the 4, Property Owner(if different from applicant): return key. r� a. First Name b. Last Name c.Organization rerun d. Mailing Address e. Citylrown f. State g.Zip Code 5. Project Location: 5 Nurse Way Salem a. Street Address b.Citylrown 9 217 c. Assessors-map/plat Number d. Parcel/Lot Number Latitude and Longitude, if known: 42d30m35s 70d55mO9s d, Latitude e. Longitude wpaform5.tloc• rev.o5/19/2oio - Page 1 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-532 WPA Form 5 - Order of Conditions MasSDEPFIIe# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction k Salem A. General information (cont.) City/Town 6. Property recorded at the Registry of Deeds for(attach additional information if more than one parcel): Southern Essex 80814&80815 a.County b.Certificate Number(if registered land) c.Book d. Page 7. Dates: 6/20/2012 9/13/2012 9/17/2012 a. Date Notice of Intent Filed b.Date Public Hearing Closed c.Data of Issuance 8. Final Approved Plans and Other Documents (attach additional plan or document references as needed): Site Development Permit Plan Located in Salem Mass a Plan Title Eastern Land Survey Associates Clayton A. Morin b. Prepared-By c.Signed and Stamped by 9/7/2012 1"=20' d. Final Revision Date e.Scale f.Additional Plan or Document Title g. Date 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(the 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: a. ® 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. wpaform5.tlac• rev.o5/1g12olo Page 2 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-532 WPA Form 5 - Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem City/Town B. Findings (cont.) Denied because: b. ❑ 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 the interests of the Act, 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. c. ❑ 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). 3. ® Buffer Zone Impacts: Shortest distance between limit of project 10' +/- disturbance and the wetland resource area specified in 310 CMR 10.02(1)(a) a.linear feet Inland Resource Area Impacts: Check all that apply below. (For Approvals Only) Resource Area Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 4. ❑ Bank a. linear feet b. linear feet c, linear feet d. linear feet s. El Bordering Vegetated Wetland a.square feet b.square feet c.square feet d.square feet s. ❑ Land Under Waterbodies and a.square feet b.square feet c,square feet d.square feet Waterways e.c/y dredged f o/y dredged 7. El Bordering Land Subject to Flooding a.square feet b.square feet c.square feet d.square feet Cubic Feet Flood Storage e.cubic feet f.cubic feet g.cubic feet h.cubic feet 9. ❑ Isolated Land Subject to Flooding a.square feet b.square feet Cubic Feet Flood Storage c.cubic feet d.cubic feet e.cubic feet f.cubic feet 9. ❑ Riverfront Area , t.,f ion roof b.total sq,feet Sq it within 100 ft feoe d.square feet o o fun. f, square feet Sq ft between 100• 200 It foor h,square feet , feof I.square feet wpaform&doc• rev.0 5/1 912 01 0 Page 3 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-532 \�\ WPA Form 5 - Order of Conditions MdssDEP File k Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction k Salem B. Findings (cont.) City/Town Coastal Resource Area Impacts: Check all that apply below. (For Approvals Only) Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 10. [I Designated Port Areas Indicate size under Land Under the Ocean, below 11. ❑ Land Under the Ocean a.square feet b.square feet c.c/y dredged d.c/y dredged 12. ❑ Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes below 13. ❑ Coastal Beaches cu yd cu yd a.square feet b.square feet c.nourishment d.nourishment 14. ❑ Coastal Dunes cu yd cu yd a.square feet b.square feet c.nourishment d.nourishment 15. ❑ Coastal Banks a. linear feet b.linear feet 15. ❑ Rocky Intertidal Shores a.square feet b.square feet 17. ❑ Salt Marshes ts. Land Under Salt a.square feet b.square feet c.square feet d.square feet ❑ Ponds a.square feet b.square feet c.c/y dredged d.c/y dredged ts. El Land Containing Shellfish a.square feet b.square feet c.square feet d.square feet 20. ❑ Fish Runs Indicate size under Coastal Banks, Inland Bank, Land Under the Ocean, and/or inland Land Under Waterbodies and Waterways, above a.c/y dredged b.c/y dredged 21. ❑ Land Subject to Coastal Storm a.square feet b.square feet Flowage 1palarm5.tloc• rev.05JM2010 Page 4 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-532 WPA Form 5 - Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction if Salem B. Findings (cont.) City/Town #22.If the project is for 22. ❑ Restoration/Enhancement the purpose of restoring or enhancing a a.square feet of BVW b.square feet of salt marsh wetland resource area 23. ❑ Stream Crossing(s): in addition to the square footage that a.number of new stream crossings b. number of replacement stream crossings has been entered in C. General Conditions Under Massachusetts Wetlands Protection Act Section B.5.c B.1Tc)(Salt The following conditions are only applicable to Approved projects. pease r Marsh) above, 1. Failure to comply with all conditions stated herein, and with all related statutes and other the additional regulatory measures, shall be deemed cause to revoke or modify this Order. amount here. 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. If this Order constitutes an Amended Order of Conditions, this Amended Order of Conditions does not extend the issuance date of the original Final Order of Conditions and the Order will expire on 9/17/2012 unless extended in writing by the Department. 7. 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. 8. 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. wpaform5 doc• rev.05/19/2010 Page 5 of 12 Li Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-532 WPA Form 5 - Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem CityTown C. General Conditions Under Massachusetts Wetlands Protection Act (cont.) 9. 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 the 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. 10. 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, "MassDEP"] "File Number 64-532 11 11. 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 MassDEP. 12. Upon completion of the work described herein, the applicant shall submit a Request for Certificate of Compliance(WPA Form 8A)to the Conservation Commission. 13. The work shall conform to the plans and special conditions referenced in this order. 14. Any change to the plans identified in Condition #13 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. 15. 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. 16. 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. 17. 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. wpaforra5.doc• rev.o6 i wo1 o Page 6 of 12 Massachusetts Department of Environmental Protection Provided by MassOEP: Bureau of Resource Protection - Wetlands 64-532 WPA Form 5 - Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem City/Town C. General Conditions Under Massachusetts Wetlands Protection Act (cont.) 18. 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. NOTICE OF STORMWATER CONTROL AND MAINTENANCE REQUIREMENTS 19. The work associated with this Order(the"Project") is itl ❑ is not(2)® subject to the Massachusetts Stormwater Standards. If the work is subject to the Stormwater Standards,then the project is subject to the following conditions: a) All work, including site preparation, land disturbance, construction and redevelopment, shall be implemented in accordance with the construction period pollution prevention and erosion and sedimentation control plan and, if applicable, the Stormwater Pollution Prevention Plan required by the National Pollution Discharge Elimination System Construction General Permit as required by Stormwater Condition 8. Construction period erosion, sedimentation and pollution control measures and best management practices (BMPs) shall remain in place until the site is fully stabilized. b) No stormwater runoff may be discharged to the post-construction stormwater BMPs unless and until a Registered Professional Engineer provides a Certification that: i. all construction period BMPs have been removed or will be removed by a date certain specified in the Certification. For any construction period BMPs intended to be converted to post construction operation for stormwater attenuation, recharge, and/or treatment, the conversion is allowed by the MassDEP Stormwater Handbook BMP specifications and that the BMP has been properly cleaned or prepared for post construction operation, including removal of all construction period sediment trapped in inlet and outlet control structures; ii. as-built final construction BMP plans are included, signed and stamped by a Registered Professional Engineer, certifying the site is fully stabilized; ifi. any illicit discharges to the stormwater management system have been removed, as per the requirements of Stormwater Standard 10; iv. all post-construction stormwater BMPs are installed in accordance with the plans (including all planting plans) approved by the issuing authority, and have been inspected to ensure that they are not damaged and that they y are in proper working condition; v. any vegetation associated with post-construction BMPs is suitably established to withstand erosion. wpa10ra15.doc• rea 05/1W2010 Page)of 12 1 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-532 El WPA Form 5 - Order of Conditions MassDEPFile# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem City/Town C. General Conditions Under Massachusetts Wetlands Protection Act (cont.) c) The landowner is responsible for BMP maintenance until the issuing authority is notified that another party has legally assumed responsibility for BMP maintenance. Prior to requesting a Certificate of Compliance, or Partial Certificate of Compliance, the responsible party(defined in General Condition 18(e)) shall execute and submit to the issuing authority an Operation and Maintenance Compliance Statement("O&M Statement) for the Stormwater BMPs identifying the party responsible for implementing the stormwater BMP Operation and Maintenance Plan ("O&M Plan") and certifying the following: i.) the O&M Plan is complete and will be implemented upon receipt of the Certificate of Compliance, and ii.)the future responsible parties shall be notified in writing of their ongoing legal responsibility to operate and maintain the stormwater management BMPs and implement the Stormwater Pollution Prevention Plan. d) Post-construction pollution prevention and source control shall be implemented in accordance with the long-term pollution prevention plan section of the approved Stormwater Report and, if applicable, the Stormwater Pollution Prevention Plan required by the National Pollution Discharge Elimination System Multi-Sector General Permit. e) Unless and until another party accepts responsibility, the landowner, or owner of any drainage easement, assumes responsibility for maintaining each BMP. To overcome this presumption, the landowner of the property must submit to the issuing authority a legally binding agreement of record, acceptable to the issuing authority, evidencing that another entity has accepted responsibility for maintaining the BMP, and that the proposed responsible party shall be treated as a permittee for purposes of implementing the requirements of Conditions 18(f) through 18(k)with respect to that BMP. Any failure of the proposed responsible party to implement the requirements of Conditions 18(f) through 18(k)with respect to that BMP shall be a violation of the Order of Conditions or Certificate of Compliance. In the case of stormwater BMPs that are serving more than one lot, the legally binding agreement shall also identify the lots that will be serviced by the stormwater BMPs. A plan and easement deed that grants the responsible party access to perform the required operation and maintenance must be submitted along with the legally binding agreement. f) The responsible party shall operate and maintain all stormwater BMPs in accordance with the design plans, the O&M Plan, and the requirements of the Massachusetts Stormwater Handbook. wpaform5.doc• rev.05/19/2010 Page 8 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-532 \h\ WPA Form 5 - Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem City/Town C. General Conditions Under Massachusetts Wetlands Protection Act (cont.) g) The responsible party shall: 1. Maintain an operation and maintenance log for the last three(3) consecutive calendar years of inspections, repairs, maintenance and/or replacement of the stormwater management system or any part thereof, and disposal (for disposal the log shall indicate the type of material and the disposal location); 2. Make the maintenance log available to MassDEP and the Conservation Commission ("Commission") upon request; and 3. Allow members and agents of the MassDEP and the Commission to enter and inspect the site to evaluate and ensure that the responsible party is in compliance with the requirements for each BMP established in the O&M Plan approved by the issuing authority. h) All sediment or other contaminants removed from stormwater BMPs shall be disposed of in accordance with all applicable federal, state, and local laws and regulations. i) Illicit discharges to the stormwater management system as defined in 310 CMR 10.04 are prohibited. j) The stormwater management system approved in the Order of Conditions shall not be changed without the prior written approval of the issuing authority. k) Areas designated as qualifying pervious areas for the purpose of the Low Impact Site Design Credit(as defined in the MassDEP Stormwater Handbook, Volume 3, Chapter 1, Low Impact Development Site Design Credits) shall not be altered without the prior written approval of the issuing authority. 1) Access for maintenance, repair, and/or replacement of BMPs shall not be withheld. Any fencing constructed around stormwater BMPs shall include access gates and shall be at least six inches above grade to allow for wildlife passage. Special Conditions (if you need more space for additional conditions, please attach a text document): wpaform5.doc• rev.05/192010 Page 9 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-532 WPA Form 5 - Order of Conditions MassDEPFile# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction Salem Cityfrown D. Findings Under Municipal Wetlands Bylaw or Ordinance 1. Is a municipal wetlands bylaw or ordinance applicable? ® Yes ❑ No 2. The Salem hereby finds (check one that applies): Conservation Commission a. ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw, specifically: 1. Municipal Ordinance or Bylaw 2.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. b. ® that the following additional conditions are necessary to comply with a municipal ordinance or bylaw: Wetlands Protection and Conservation c.50 1.Municipal Ordinance or Bylaw 2.Citation 3. 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. The special conditions relating to municipal ordinance or bylaw are as follows (if you need more space for additional conditions, attach a text document): Attached special conditions are issued under the Wetlands Protection Act and are sufficient for compliance with the local ordinance (c.50) wpaforra5.doc• rev.0s192010 Page 10 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 6`t� S3'� WPA Form 5 — Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEPII Transaction# S41LW City/Town E. Signatures Important: This Order is valid for three years, unless otherwise specified as a special When filling out condition pursuant to General Conditions#4, from the date of issuance. 1.Date of issuance forms on the computer,use Please indicate the number of members who will sign this form. only the tab key This Order must be signed by a majority of the Conservation Comm n. 2.Nu ber of Signers to move your cursor-do not The Order must be mailed by certified mail (return receipt r ques ed) or h�nd delivered to use the return the applicant. A cop must be mailed, hand delivered or f ele tronically,at the s e key' time with the opria MassDEP Regional Office. n rd S tur Na C ❑ by hand delivery on by certified mail, return receipt requested,on Date Date F. Appeals 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 MassDEP 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 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. Any appellants seeking to appeal the Department's Superseding Order associated with this appeal will be required to demonstrate prior participation in the review of this project. Previous participation in the permit proceeding means the submission of written information to the Conservation Commission prior to the close of the public hearing, requesting a Superseding Order, or providing written information to the Department prior to issuance of a Superseding Order. 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. wpa5sigs.doc• rev.02 M010 Pago tL of 10�, Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 64-532 WPA Form 5 - Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem City/Town G. Recording Information Prior to commencement of work, 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 this page shall be submitted to the Conservation Commission listed below. 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 MassDEP File Number Has been recorded at the Registry of Deeds of: County Book Page for: 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.05119I2010 Page 12 of 12 Massachusetts Department of Environmental Protection , Provided by MassDEP: Bureau of Resource Protection - Wetlands MassDEP File Number WPA Form 3 — Notice of Intent Document Transaction Number Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem City/Town Important:When filling out A. General Information forms on the computer,use 1. Project Location (Note: electronic filers will click on button to locate project site): only the tab key to move your 4 Nurse Way Salem 01970 cursor-do not a.Street Address b.City/Town c.Zip Code use the return key. Latitude and Longitude: 42-30-35 70-55-09 d.Latitude e.Longltude Map 9 Part Parcel 30 Lot 233 f.Assessors Map/Plat Number g.Parcel/Lot Number 2. Applicant: Kenneth G. Steadman a.First Name b.Last Name Note: Before c.Organization completing this 67 Village Street form consult your local d.Street Address Conservation Marblehead MA 01945 Commission a.City/Town I.State g.Zip Code regarding any 781-631-3751 municipal bylaw or ordinance. h.Phone Number L Fax Number j.Email Address 3. Property owner(required if different from applicant): ❑ Check if more than one owner Same a.First Name b.Last Name c.Organization d.Street Address e.City/Town I.State g.Zip Code h.Phone Number I. Fax Number j.Email address 4. Representative (if any): Attorney George W. Atkins III a.First Name b.Last Name Ronan, Segal & Harrington c.Company 59 Federal Street d.Street Address Salem MA 01970 e.City/Town I.State g.Zip Code 978-744-0350 h.Phone Number 1.Fax Number j.Email address 5. Total WPA Fee Paid(from N01 Wetland Fee Transmittal Form): 500.00 237.50 262.50 a.Total Fee Paid b.State Fee Paid c.City/Town Fee Paid wpaform3.doc•rev. 11/16/09 Page 1 of 8 Massachusetts Department of Environmental Protection Pr9vided;byMassDEP: 'BAu/reaau/�ofResourcegProtection - Wetlands MassDEP File Number YY - PA Form J orm — Notice of Intent .DocumentTransact_IonNumbeY Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem City/Town A. General Information (continued) 6. General Project Description: Construction of single family dwelling, driveway, utilities, grading and landscaping 7a. Project Type Checklist: 1. Z Single Family Home 2. ❑ Residential Subdivision 3. ❑ Limited Project Driveway Crossing 4. ❑ Commercial/Industrial 5. ❑ Dock/Pier 6. ❑ Utilities 7. ❑ Coastal Engineering Structure 8. ❑ Agriculture (e.g., cranberries, forestry) 9. ❑ Transportation 10. ❑ Other 7b. Is any portion of the proposed activity eligible to be treated as a limited project subject to 310 CMR 10.24 (coastal)or 310 CMR 10.53 (inland)? 1. ❑ Yes Z No If yes, describe which limited project applies to this project: 2.Limited Project 8. Property recorded at the Registry of Deeds for: Essex South 80814 & 80815 a.County b.Certificate#(if registered land) c.Book d.Page Number B. Buffer Zone & Resource Area Impacts (temporary & permanent) 1. Z Buffer Zone Only—Check if the project is located only in the Buffer Zone of a Bordering Vegetated Wetland, Inland Bank, or Coastal Resource Area. 2. ❑ Inland Resource Areas(see 310 CMR 10.54-10.58; if not applicable, go to Section B.3, Coastal 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. For all projects affecting other Resource Area Size of Proposed Alteration Proposed Replacement(if any) Resource Areas, please attach a narrative a. El Bank 1.linear feet 2.linear feet explaining how b. ❑ Bordering Vegetated the resource area was Wetland 1.square feet 2.square feet delineated. c.❑ Land Under 1.square feet 2.square feet Waterbodies and Waterways 3.cubic yards dredged wpaform3.doc•rev. 11/16/09 Page 2 of 8 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands MaasDEP File Number WPA Form 3 — Notice of intent Document Tran saction Number: Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem C ty/rown B. Buffer Zone & Resource Area Impacts (temporary & permanent) (cont'd) Resource Area Size of Proposed Alteration Proposed Replacement(if any) d. ❑ Bordering Land Subject to Flooding 1.square feet 2.square feet 3.cubic feet of flood storage lost 4,cubic feet replaced e. ❑ Isolated Land Subject to Flooding 1.square feet 2.cubic feet of flood storage lost 3.cubic feet 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 1 00 R and 200 ft. 5. Has an alternatives analysis been done and is it attached to this NOI? ❑ Yes❑ No 6.Was the lot where the activity is proposed created prior to August 1, 1996? ❑ Yes❑ No 3. ❑ Coastal Resource Areas: (See 310 CMR 10.25-10.35) 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 Resource Area Size of Proposed Alteration Proposed Replacement (if any) document transaction number a. ElDesignated Port Areas Indicate size under Land Under the Ocean, below (provided on your receipt b. ❑ Land Under the Ocean 1.square feet page)with all supplementary information you 2.cubic yards dredged submit to the Department. c. ❑ Barrier Beach Indicate size under Coastal Beaches and/or Coastal Dunes below d. ❑ Coastal Beaches 1.square feet 2.cubic yards beach nourishment e. ❑ Coastal Dunes 1.square feet 2.cubic yards dune nourishment wpaform3.doc•rev.11/16/09 Page 3 of 8 r Massachusetts Department of Environmental Protection Provided by MassDEP;. Bureau of Resource Protection - Wetlands MassDEP File Number WPA Form 3 — Notice of Intent Document Transaction,Number Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Sale m m Cityrrown B. Buffer Zone & Resource Area Impacts (temporary & permanent) (cont'd) Size of Proposed Alteration Proposed Replacement(if any) f. ❑ Coastal Banks 1.linear feet g. ❑ Rocky Intertidal Shores 1,square feet h.❑ Salt Marshes 1,square feet 2.sq it restoration,rehab.,creation I. ❑ Land Under Salt Ponds 1.square feet 2.cubic yards dredged i. ❑ Land Containing Shellfish 1.square feet t. ❑ 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. ❑ Land Subject to Coastal Storm Flowage 1.square feet 4. ❑ Restoration/Enhancement If the project is for the purpose of restoring or enhancing a wetland resource area in addition to the square footage that has been entered in Section B.2.b or B.3.h above, please enter the additional amount here. a.square feet of BVW b.square feet of Salt Marsh 5. ❑ Project Involves Stream Crossings a.number of new stream crossings b.number of replacement stream crossings C. Other Applicable Standards and Requirements Streamlined Massachusetts Endangered Species Act/Wetlands Protection Act Review 1. Is any portion of the proposed project located in Estimated Habitat of Rare Wildlife as indicated on the most recent Estimated Habitat Map of State-Listed Rare Wetland Wildlife published by the Natural Heritage and Endangered Species Program (NHESP)?To view habitat maps, see the Massachusetts Natural Heritage Atlas or go to http://www.mass.gov/dfwele/dfw/nhesp/regulatory review/priority habitatlonline viewer htm. a. ❑ Yes ® No If yes, include proof of mailing or hand delivery of NO[to: Natural Heritage and Endangered Species Program Division of Fisheries and Wildlife 2006 Route 135, North Drive b.Date of map Westborough, MA 01581 wpaform3.doc•rev.11116/09 Page 4 of 8 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands MaaaDEP File Number WPA Form 3 — Notice of Intent D umentTransaction. I - I I Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Soc alem CWTown C. Other Applicable Standards and Requirements (cont'd) If yes, the project is also subject to Massachusetts Endangered Species Act(MESA) review(321 CMR 10.18). To qualify for a streamlined, 30-lay, MESA/Wetlands Protection Act review, please complete Section CAL, and include requested materials with this Notice of Intent (N01); OR complete Section C.1.d, if applicable. If MESA supplemental information is not included with the N01, by completing Section 1 of this form, the NHESP will require a separate MESA filing which may take up to 90 days to review(unless noted exceptions in Section 2 apply, see below). 1. c. Submit Supplemental Information for Endangered Species Review' 1. ❑ Percentage/acreage of property to be altered: (a)within wetland Resource Area percentage/acreage (b)outside Resource Area percentage/acreage 2. ❑ Assessor's Map or right-of-way plan of site 3. ❑ Project plans for entire project site, including wetland resource areas and areas outside of wetlands jurisdiction, showing existing and proposed conditions, existing and proposed tree/vegetation clearing line, and clearly demarcated limits of work""' (a)❑ Project description (including description of impacts outside of wetland resource area& buffer zone) (b) ❑ Photographs representative of the site (c)❑ MESA filing fee (fee information available at: http://www.mass.gov/dfwele/dfvv/nhesp-/regulatory review/mesa/mesa fee schedule htm). Make check payable to"Commonwealth of Massachusetts- NHESP" and mail to NHESP at above address Projects altering 10 or more acres of land, also submit: (d)❑ Vegetation cover type map of site (a)❑ Project plans showing Priority& Estimated Habitat boundaries d. OR Check One of the Following 1.❑ Project is exempt from MESA review. Attach applicant letter indicating which MESA exemption applies. (See 321 CMR 10.14, http://www,mass.gov/dfwele/dfw/nhesp/regulatory review/mesa/mesa exemptions htm; the N01 must still be sent to NHESP if the project is within estimated habitat pursuant to 310 CMR 10.37 and 10.59.) 2.❑ Separate MESA review ongoing. a.NHESP Tracking# b.Date submitted to NHESP Some projects not in Estimated Habitat may be located in Priority Habitat,and require NHESP review(see http://www.mass.gov/dfwele/dfw/nheso/nhesp,htm, regulatory review tab). Priority Habitat includes habitat for state-listed plants and strictly upland species not protected by the Wetlands Protection Act. MESA projects may not be segmented (321 CMR 10.16).The applicant must disclose full development plans even if such plans are not required as part of the Notice of Intent process. wpaform3.doc•rev. 11/16/09 Page 5 of 8 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands MissQI P File Number WPA Form 3 — Notice of Intent TocumeMassachusetts Wetlands Protection Act M.G.L. c. 131, §40 SalemntTraneaotionNumber Salem City/Town C. Other Applicable Standards and Requirements (cont'd) 3.❑ Separate MESA review completed. Include copy of NHESP"no Take" determination or valid Conservation&Management Permit with approved Ian. PP P 2. For coastal projects only, is any portion of the proposed project located below the mean high water line or in a fish run? a. ❑ Not applicable—project is in inland resource area only b.❑ Yes ❑ No If yes, include proof of mailing or hand delivery of NOI to either: South Shore-Cohasset to Rhode North Shore-Hull to New Hampshire: Island, and the Cape&Islands: Division of Marine Fisheries- Division of Marine Fisheries- Southeast Marine Fisheries Station North Shore Office Attn: Environmental Reviewer Attn: Environmental Reviewer 1213 Purchase Street—3rd Floor 30 Emerson Avenue New Bedford, MA 02740-6694 Gloucester, MA 01930 Also if yes, the project may require a Chapter 91 license. For coastal towns in the Northeast Region, please contact MassDEP's Boston Office. For coastal towns in the Southeast Region, please contact MassDEP's Southeast Regional Office. 3. Is any portion of the proposed project within an Area of Critical Environmental Concern (ACEC)? Online users: a. [I Yes ® No If yes, provide name of ACEC (see instructions to WPA Form 3 or MassDEP Include your Website for ACEC locations). Note: electronic filers click on Website. document transaction b.ACEC number (provided on 4. Is any portion of the proposed project within an area designated as an Outstanding Resource Water your receipt (ORW) as designated in the Massachusetts Surface Water Quality Standards, 314 CMR 4.00? page)with all supplementary a. ❑ Yes ® No Information you submit to the 5. Is any portion of the site subject to a Wetlands Restriction Order under the Inland Wetlands Department. Restriction Act(M.G.L. c. 131, §40A) or the Coastal Wetlands Restriction Act(M.G.L. c. 130, § 105)? a. ❑ Yes ® No 6. Is this project subject to provisions of the MassDEP Stormwater Management Standards? a.® Yes. Attach a copy of the Stormwater Report as required by the Stormwater Management Standards per 310 CMR 10.05(6)(k)-(q) and check if: 1.❑ Applying for Low Impact Development(LID) site design credits(as described in Stormwater Management Handbook Vol. 2, Chapter 3) 2.❑ A portion of the site constitutes redevelopment 3.❑ Proprietary BMPs are included in the Stormwater Management System. b.❑ No. Check why the project is exempt: project Stormwater Management was 1.El Single-family house addressed under DEP File No. 64-391 wpaform3.doc•rev.11116/09 Page 6 of 8 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands MaaaDEP File Number WPA Form 3 — Notice of Intent ' pocum;fit Transaction Number Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem c ty/Town C. Other Applicable Standards and Requirements (cont'd) 2.❑ Emergency road repair 3.❑ Small Residential Subdivision(less than or equal to 4 single-family houses or less than or equal to 4 units in multi-family housing project)with no discharge to Critical Areas D. 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. ® 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. 0 Plans identifying the location of proposed activities (including activities proposed to serve as a Bordering Vegetated Wetland [BVWI replication area or other mitigating measure)relative to the boundaries of each affected resource area. 3. ❑ Identify the method for BVW and other resource area boundary delineations(MassDEP BVW Field Data Form(s), Determination of Applicability, Order of Resource Area Delineation, etc.), and attach documentation of the methodology. 4. ® List the titles and dates for all plans and other materials submitted with this NOI. Site Development Permit Plan a.Plan Title Eastern Land Survey Associates Inc. Christopher R. Mello PLS b.Prepared By c.Signed and Stamped by May 15 2012 1" = 20' d.Final Revision Date e.Scale f.Additional Plan,or Document Title g.Date 6. ❑ If there is more than one property owner, please attach a list of these property owners not listed on this form. 6.❑ Attach proof of mailing for Natural Heritage and Endangered Species Program, if needed. 7. ❑ Attach proof of mailing for Massachusetts Division of Marine Fisheries, if needed. 6. ® Attach NOI Wetland Fee Transmittal Form 9. ❑ Attach Stormwater Report, if needed. wpaform3.doc•rev.11/16/09 Page 7 of 8 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection -Wetlands MassDEP,File Number WPAI L Form 3 - Notice of Intent 7 . ,Ddcument Transaction.Number Massachusetts Wetlands Protection Act M.G.L. c. 131 40 Salem City/Town E. Fees 1. ❑ Fee Exempt: No filing fee shall be assessed for projects of any city, town, county, or district of the Commonwealth, federally recognized Indian tribe housing authority, municipal housing authority, or the Massachusetts Bay Transportation Authority. Applicants must submit the following information (in addition to pages 1 and 2 of the NO[Wetland Fee Transmittal Form)to confirm fee payment: //(o F 4 /i Ph X- 2.Municipal Check Number 3,Check date y'?/ & //or// a_ 4.State Che k Number Meee"-)V7-e �—N 577;:,ee!22" 6.Payor name on check:First Name 7.Payor name on check:Last Name F. Signatures and Submittal Requirements I hereby certify under the penalties of perjury that the foregoing Notice of Intent and accompanying plans, documents, and supporting data are true and complete to the best of my knowledge. I understand that the Conservation Commission will place notification of this Notice in a local newspaper at the expense of the applicant in accordance with the wetlands regulations, 310 CMR 10.05(5)(a). I further certify under penalties of perjury that all abutters were notified of this application, pursuant to the requirements of M.G.L. c. 131, §40. Notice must be made by Certificate of Mailing or in writing by hand delivery or certified mail (return receipt requested)to all abutters within 100 feet of the property line of the project to atiWApplical 1. atur2.Date 3.Signature of Property Owner(if different) 4.Date 5.Signature of Representative(if any) 6.Date For Conservation Commission: Two copies of the completed Notice of Intent(Form 3), including supporting plans and documents, two copies of the NOI Wetland Fee Transmittal Form, and the city/town fee payment, to the Conservation Commission by certified mail or hand delivery. For MassDEP: One copy of the completed Notice of Intent(Form 3), including supporting plans and documents, one copy of the NOI Wetland Fee Transmittal Form, and a copy of the state fee payment to the MassDEP Regional Office(see Instructions) by certified mail or hand delivery. Other: If the applicant has checked the"yes" box in any part of Section C, Item 3, above, refer to that section and the Instructions for additional submittal requirements. The original and copies must be sent simultaneously. 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