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27 PIERCE RD - BUILDING INSPECTION t 13 - 1 t-r CV) N C b The Commonwealth of Massachusetts I'a Board of Building Regulations and Standards CEf Y OF \� ! Massachusetts State Building Code, 780 CMR IagPEC � NAL OhC�$ Revised Mar Z 7 Building Permit Application To Construct, Repair, Renovate Or Demflli,S,h�UN 20 A I) 3 One-or Two-Family Dwelling t91V This Section For Official Use Only Building Permit Number: Date P p�plied: 1 Building Official(Print Name) Signature VDate SECTION l: SITE INFORMATION 1.1 Property Address: n 1.2 Assessors Map& Parcel Numbers I.I a Is this an accepted street?yes--pC no Map Number Parcel Number . e.° 7os,in E; 2nform:!ti<>u: --- 1:t i'eopt:rty t➢inx•nsions Zoning District Proposed Use Lot Area(sq fQ Frontage(R) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided R,qttired Provided 1.6 Water Supply:(M.G.1,a 40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public Private❑ Zone: _ Outside Flood Zone'? MunicipalAK On site disposal system Cl if yes❑ SECTION 2: PROPERTY OWNERSHIP' 22 wnej of Record:C/o, X, ^� �/ 1W . , J ft )� City,State.ZIIP(' No.and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORK'(check all that apply) New Construction ❑ Existing Buildingjlt Owner-Occupied:9 1 Repairs(s) ❑ 1 Alteration(s) W Addition M Demolition ❑ Accessory Bldg.❑ Number ofUnits_L I Other ❑ Specify: Brief Description of Prop sed Work-: SECTION 4: ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only Labor and Materials 1. Building $ p8' — 1. Building Permit Fee: $ _Indicate how fee is determined: ❑Standard City/Town Application Fee 2. Electrical $ /a. 1co- 0 Total Project Cos[ (Item 6)x multiplier x 3. Plumbing $ 174 6 00 — 2. Other Fees: $ 4. Mechanical (HVAC) $ U — List: 5. Mechanical (Fire $ - Su tression�_ Total All Fees: $ .11 Check No. Check Amount Cash Amount: G. Total Project Cost: $ _ ❑paid in Full ❑Outstanding Balance Due: Q6 0,00 I y SECTION 5: CONSTRUCTION SERVICES 5.1 Construction gupervisor License(CSL) 10171 License Number Expiration Date Name of CSL Holder List CSL Type(see below) No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) R Restricted 1&2 Family Dwelling CityTown,Stafe,ZIP M Mason ry RoofingCovering OC,ra4gA/Gl WS Window and Sid in SF Solid Fuel Burning Appliances r� I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(1IIC) IVY J y I �"'d'� `i6'"'� LLC _ HIC Registration Number Expiration Date HIC Company N ame or HIC Registrant Nano / .2 /J/e.r, �j.�cu.G�Joir.✓iie tuni�/�w ��. r, No.�nd Street // A,^ Email address Cit /Tow ,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152. § 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes .......... ❑ No...........A SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property, hereby authorize /.�/'�CL Zr /GiaoF/�t to act on my behalf,in all matters relat�authorized by this building permit application. 7 ' T-/L Print Owners ame(Electronic Signature) Date SECTION 7b: OWNEW OR AUTHORIZED AGENT DECLARATION By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding.n Print Owner's or Authorized Agents Name(Electronic Signature) Data NOTES: I. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC) Program), will not have access to the arbitration program or guaranty fund under M.G.L.a I42A.Other important information on the HIC Program can be found at www.mass. ov/oca Information on the Construction Supervisor License can be found at www.mass.eov/dps 2. When substantial work is planned,provide the information below: Total Floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area.(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" i CITY OF'S:ULEM, ANSSACHUSETTS S BUILDING DEPARTMEINT tt??PP i � YI'6 7 5r 120 WASHLNGTON STREET, 3w FLOOR aY TEL (978) 745-9595 F.kx(978) 740-9846 KI\IBERLEY DRISCOLL LiYOR THmus ST.PIERRH DIRECTOR OF PUBLIC PROPERTY/BI:ILDMG CO\L\IISSIONER Workers' Compensation Insurance Affidavit: Dnild.Crs/Contractors/Electricians/Plum6ero, Applicant Information Please l PrriC.� innt'1 l egihiy Name (Ilusinass.Organiralion,'Individual): - / ��Or//e, .r ZG Address: � �/n /� fl— City/State/Zip: srww.+r�io �l /r/`IM0.7Phone #: 74/— IW IWO Are you an employer?Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with 4. 6.1 am a general contractor and 1 6. ❑New constriction employees(full and/or part-time).• have hired the sub-contractors 2.❑ lama sole proprietor or partner- listed on the attached sheet.' 7. ®'Remodeling ship and have no employees These sub-contractors have 0. ❑ Demolition working for me in any capacity. workers'comp. insurance, y. Building addition [,No workers' comp. insurance 5. El We are a corporation mid its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I! CI Plumbing repairs or additions myself. (No workers'comp.. C. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. (No workers' 13,(� Other comp.insurance required.] •Any applicant tlur dncka box tt moat also rill out the section below thawing their workers'eumpemadun pulicy inllnmatiun. '1lumeawners ahu suhmit this amdnvih indicating they ore doing all work and then hire uWfide conitactan most.nihmit a new afr dzvit indicating such $'namewn Ihut shack this bux most anaehev!an additiuwl ahevl showing the name of hhe sub<amneors and their worken'camp.pulley information. I ant can employer that is providing workers'compensaton insurance for my employees. Below Is the policy and job site - iuforrnation. In.aur:mce Company Name: i" f 7— Policy 4 or Sclf-iim Lie. �fl: �/���� �/O�oL�_ Expiration Date: 0.2.. IIJ-1.'y�/f / lob Site Address: /� /leACe— // City/State/Zip:,..Js�n �/�• Attach a Copy of the workers'compensation policy deciaratlan page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A ot'NIGL c. 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and aline of up to$230.00 a day against the violator. lie advised that a copy of this statement may be furwardcd to the Office of Investigations ofthe DIA for insurance coverage verification. /do/rereby certify wider dos/pains auud ppenalties of perjury that the information provided above is true and correct. sI,Fmlu e' /—l7w.ry� 1-2 Phone 1 �/!� 7--��(, (5 Ojjiciul use Will. Do not write in this area, to be completed by city or town njjiviul City ar'I'mvn: __ I'ermitl.lcensc R Issuing Authority(circle one): -- _— _--- -- l. Board of Ilealth 2. Building Beparlotent 11.Cityfrimn Clerk 4. Electrieal IWspector 5. Plumbing luspector 6. Other Phone ti: PATR°NTEN TRANSMITTAL LAND DEVELOPMENT ENGINEERING 14 BROWN STREET DATE JOB NO. 3_ / SALEM, MA 01970 TEL. (978)836-6400 FAX(978)745-4110 PROJECT NAME E-mail: scott.patrowicz@verizon.net ToC� .. ........_ __.... . .. __S�l�t �•aP`�s.._f--- �r ram .14 _.......... S '_ ,. 1_-N-2 ± .........---..... ..........owg_o0._.... ._. TRANSMITTING: -Attached Ategular Mail ❑Overnight Express ❑ Hand Delivered ❑ Picked Up jt,Plans/Prints ❑Original Mylar ❑Computer Disk ❑ Specifications ❑Calculations ❑ Letter ❑Report CeD C. COPIES DATE / DESCRIPTION _._._.._._......... _-------- _ _�------'-�-�-.3i-�!-�'- -0� of ���i'lon1�-- �c,/�;`c�i"► i THESE ARE TRANSMITTED as checked below: ❑ For Approval For Your Use JAAs Requested ❑ For Review And Comment ❑ ❑ For Bids Due: ❑ Please call me to discuss. ❑ REMARKS --- -- - �_ .. __. -.. . - COPY TOc�k~ COPY TO3. 3%4 - -- — COPYTO_O .�1t'' SIGNED Scott Patrowicz, P.E. I/enclosures are not as noted, kindly notify us at once. IIEO RFPOM:B WMNESS FONMSLO\ -W-180b93MR t Massachusetts -Department of Public Safety Board of Building Regulations and Standards _.Construction Super isor License: CS-040208 ' BRUCE E PARAD)SE 21 ELM PLACE ; SWAMPSCOTT MA 01907 - I ; Expiration Commissioner 10/31/2014 ��O�PiM/E9i000I60G'CGIt�O�C✓t'�!lJJC/[J!(6JCQ� r Office of Consumer Affairs&Business Regulation I &JOME IMPROVEMENT CONTRACTOR .t egistration 103634 Type: Expiration 7/9/2014 . Individual BRUCE E.PARADISE Bruce Paradise _ 21 ELM PL. Swampscott, MA 01907 Undersecreta— ry I }. CITY OF SAL.EM, A-1S&kCRUSETTS 8l:[LI]LNc; DEPARTMENT 120 WASHLNGTON S-mUT 1'O FLOOR TaL (979) 745-9595 KIMOERLEY DRISCOLL FAA(973) 74MS45 NLAYoa 1 i-+osct3 Sr.Pt`�tg DIRECTOR OF PLOLIC PROPERTY/aMOLNG CONLNUSSIONER Construction Debris Disposal Aftldavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 730 C"JR section l l Debris, cuid die provisions of tMOL e 40, S 54; 1.5 Building Permit /# is issued with the condition that the debris resulting from this work shall be disposed of in a properly licensed waste disposal facility as dafiacd by ,1(CL c I If, S I50A. The debris will be transported by: y (name ut hauler) ZZ, The debris will bc.disposed ot.in _At�/I f� (nano of facility) �-- (aJJtess of tauluy) 9 siynaturr ufpa'rnit applicant J.ur -- V i 1 5 t' tl� y } { r Essex Southern District i Registry of Deeds 45 Congress Street I Suite 4100 li Salem, MA 01970 04/16/2014 11:03 AM Station: ESSX-REC10 Time:11:03 Type: CONDN Loc: SALEM Inst 197 BK 33221-167 FEE 55.00 _ ` ENV FEE 20.00 i Check 8931 PATROWICZ 75.00 ��n � III IIIII III IIIII�I� IIIIIIII I I IIIIII 2014041600197 H:33221 Pg:167 04116/2014 11:03 CONDN Pe 1116 I Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection -Wetlands 64-563 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: Conservation Commission been modlfied with added 2.This issuance is for apace to a.®Order of Conditions b.❑Amended Order of Conditions accommodate (check one): the Registry of Deeds 3. To: Applicant: Requirements Charles A. Smith a.First Name b.Last Name Important: - - When filling out fortes on c.Organization the 4 Gal loupes Point Road computer, d.Mailing Address use only the tab key to Swampscott MA 01907 move your e.City/rown I.State g.Zip Code cursor-do not use the 4. Property Owner(if different from applicant): return key. Clayton W. and Jean L. Smith 1�1 a.First Name b.Last Name c.Organization 27 PierceeRoad d.Mailing Address Salem MA 01970 e.City/Tovm f.State g.Zip Code s. Project Location: 27 Pierce Road Salem a.Street Address b.City/Town 31 319 c.Assessors Map/Plat Number d.Parcemot Number Latitude and Longitude, if known: d m s it m s d.Latitude e.Longitude wpaforms,doc- W.05na2010 Pape 1 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection -Wetlands 64-563 WPA Form 5 — Order of Conditions MassDEP File ft Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem Cityrrown A. General Information (cont.) . 6. Property recorded at the Registry of Deeds for(attach additional information if more than one parcel): South Essex a.County b.Certificate Number(if registered land) 6803 527 c.Book d.Page 2/27/2014 3/27/2014 3/31/2014 7. Dates: a.Date Notice of Intent Filed b.Date Public Hearing Closed c.Date of Issuance 8. Final Approved Plans and Other Documents(attach additional plan or document references as needed): See attached a.Plan Title b.Prepared By c.Signed and Stamped by d.Final Revision Date e.Scale I.Additional Plan or Document Tale g.Date B. Findings i. 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. Z Land Containing Shellfish c. ® Prevention of Pollution d. ® Private Water Supply e. ® Fisheries I. Wi 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. wparwrasow• Psg112cf I2 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection -Wetlands 64-563 WPA Form 5 — Order of Conditions MmDEP Fit-# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem cityrrown 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 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.linearfeet b.linear-feet c.linear-feet d.linear feet s. ❑ Bordering a. Vegetated Wetland square feet b.-square feet c.square feet d.square feet 6. ❑ Land Under Waterbodies and a.square feet b.square feet c.square feet d.square feet Waterways a.c/y dredged f.dy dredged 7. ❑ Bordering Land Subject to Flooding a.square feet b.square feet c.square feet d.square feel Cubic Feet Flood Storage e.cubic feet T.cubic feet 9.cubic feet h.cubic feet a., ❑ Isolated Land Subject to Flooding a.square feet b.square feet Cubic Feet Flood Storage c.cubic feel d.cubic feet e.cubic feet f,cubic feel 3130+/- 3130+/- e. ® Riverfront Area a.total sq.feet b,total sq.feet Sq ft within 100 it 310+/- 310+/- c.square feel d.square feet e.square feet f.square feet Sq ft between 100- 2820+/- 2320+/- 200 ft g.square feet h.square feet I.square feet I.square feet aparorms.doc• row.051IM010 Page 3of 1.2 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection Wetlands 64-563 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.) Coastal Resource Area Impacts:Check all that apply below. (For Approvals Only) Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement to. ❑ Designated Port Indicate size under Land Under the Ocean, below Areas it. ❑ Land Under the Ocean. a.square feet b.square feet c.dy dredged d.cry dredged 1z. ❑ Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes below yd 13. El Coastal Beaches a.square feet b.square feel c.nourishment d,nourishment nt cued cu yd 14. ElCoastal Dunes a.square feel_ b.square feet e.nourishment d.nourishment 15. ❑ Coastal Banks a.linear-feet b.linear feet 16. ❑ Rocky Intertidal - Shores a.square feet b.square feet n. ❑ Salt Marshes a.square feet b.square feet c.square feet d.square feet ie. ❑ Land Under Salt Ponds a.square feet b.square feet c.c-dredged d.cry dredged ig. ❑ 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.vy dredged b.cty dredged 21. ❑ Land Subject to I • Coastal Storm a.square feet b.square feet ' Flowage nyMerms,1"- lee e5faQef a Page 4 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection -Wetlands 64-663 WPA .Form 5 - Order of Conditions MassDEP File If Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem Cityrrown B. Findings (cont.) p# . Itthect ist 22• ❑ Restoration/Enhancement': the purpose of square or restoring a. uare feet of BVW b. enhancing ng a q square feet of sett 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 C. General Conditions Under Massachusetts Wetlands Protection Act entered in Section B.5.c (Bvw) 6.17.c(Salt The following conditions are only applicable to Approved projects. Marsh)above, 1 Failure to comply with all conditions stated herein, and with all related statutes and other please enter regulatory the additional r ulato 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 3/31/2017 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. wMafwm5.d=• ror.e5na2010 Page 5 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP; \ Bureau of Resource Protection -Wetlands 64-563 WPA Form 5 — Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem Cityrrown 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. % 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 64-563 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 worts, 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. wpafarm6Aa•rev.OWIM2010 Page 6 or 12 Massachusetts Department of Environmental Protection Prodded by MassDEP: Bureau of Resource Protection -Wetlands 64-563 WPA Form 5 — Order of Conditions MassDEP File# 1 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem Cityrrown 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.Al 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(1)❑ 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 maybe discharged to the post-construction stormwater.BMPs unless and until a Registered Professional Engineer provides a Certification that: L 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. wpefa S.dw- rer.0&1=010 Page 7 d 12 Massachusetts Department of Environmental Protection Provided by MassDEP: \ Bureau of Resource Protection -Wetlands 64-563 WPA Form 5 — Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem Cily/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 0&M Plan is complete and will be implemented upon receipt of the Certificate of Compliance, and fi.)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. wpatann54oc• rev.051912010 Page Sol 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection -Wetlands 64-563 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.) 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): wy2}mm4.d=- w.0190 0 Pape 9d 12 Massachusetts Department of Environmental Protection Provided by MassDEP Bureau of Resource Protection -Wetlands 64-563 MassDE WPA Form 5 - Order of Conditions MasaDEP File# 1 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction 0 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 are necessary to comply with a municipal ordinance or bylaw: Wetlands Protection and Conservation Ordinance c. 50 1.Municipal Ordinance or Bylaw 2.Citation a. 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): The attached special conditions are issued under the Wetlands Protection Act and are sufficient for compliance with the local ordinance wpalwm5.tloc• rer.OSr1920t0 Page 10 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: ^ Bureau of Resource Protection -Wetlands 64-5 DE WPA Form 5 — Order of Conditions MassP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# Salem CityrTown E. Signatures Important:when This Order is valid for three years,unless otherwise specified as a special filling out forms condition pursuant to General Conditions#4,from the date of issuance. t. ate oil Issuance on the computer, use only the tab Please indicate the number of members who will sign this form. S key to move your This Orderesignajority of the Conservation Commission. 2.Number of Signers cursor-do not use the return The Ordey rtified mail (return receipt r qt este r and elivered to key. the applice ailed, hand delivered or filed elec oni Ily he same time with the aRegional Office. Signature FA 2K by hand delivery on ❑ by certified mail,return receipt 14 P / �Ot`� 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. 1 wpa5slgsAm- rev,=25f20te Pepe II r -tQ- Attachment to Order of Conditions#64-563 Page 1 of 5 SALEM CONSERVATION COMMISSION DEP FILE #64-563 27 Pierce Road City of Salem, Massachusetts ADDITIONAL FINDINGS Based on the Estimated Habitats of Rare Wildlife and Certified Vernal Pools Map(3/6/2014, online)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 permits the construction of a house addition and appurtenances at 27 Pierce Road. GENERAL 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 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#64-563 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. 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 Attachment to Order of Conditions#64-563 ip Page 2of 5 Z. 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 scat. 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 PLAN TO ACCOMPANY A NOTICE OF INTENT APPLICATION (Title) 3/18/2014 (Dared) Scott Patrowicz (Signed and Stamped by) City of Salem Conservation Commission (on file will)) 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 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 P'✓L� Attachment to Order of Conditions#64-563 Page 3of 5 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. 17. [Reserved) PRIOR TO CONSTRUCTION 18. 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. 19. 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. 20. 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. 21. There shall be adequate additional erosion control devices stored under cover on the site to be used for emergency erosion control purposes. EROSION CONTROL 22. 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. 23. 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. 24. 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. 25. The area of construction shall remain in a stable condition at the close of each construction day. 26. 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. 27. 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. ��. Attachment to Order of Conditions # 64-563 Page 4of 5 28. 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 29. 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. 30. No alteration or activity shall occur beyond the limit of work as defined by the siltation barriers shown on the approved plan(s). 31. 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. 32. 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. 33. 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. 34. 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. 35. There shall be no pumping of water from wetland resource areas. 36. All equipment shall be inspected regularly for leaks. Any leaking hydraulic lines,cylinders or any other components shall be fixed immediately. 37. During construction,all drainage structures shall be inspected regularly and cleaned as necessary. 38. 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 21A,section 16. AFTER CONSTRUCTION 39. 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: (a) All wetland resource area boundaries with associated buffer zones and regulatory setback areas taken from the plan(s)approved in this Order of Conditions; Attachment to Order of Conditions#64-563 t Page 5of 5 (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; 40. When issued,the Certificate of Compliance must be recorded at the Essex County Registry of Deeds and a copy of the recording submitted to the Salem Conservation Commission. 41. 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. 42. 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 43. Applicant shall monitor disturbed areas for invasive species until planted vegetation is fully established. 44. In order to reduce the spread of invasive species,only weed-free certified erosion controls shall be utilized.