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22 SUNSET RD - BUILDING INSPECTION �a s +L� aE wlrwNu w�ovao aY ZiiE soyfj B PIER TO A'.VMW OM GRAWkD. CITY OF SALEM ore rwrd 210"o, TAWatlOO ft MMmb OYblal'1� Ya No X sw of Y PApwM Loowd In b Oollawwaon Awat . Yav No BULDNO PEIMEI•APPLMTM P01% Partnk t0: (Chb whWWW apply) Roof. PAN IMW 81!1 Wdd, Pool, RNpow%ploa. Other. PLEASE PLL ONT L9=LY A OOYPLETELY TO AV=OSUYS N PROOfkf1IIII1110 TO THE INSPECTOR OF BUILDINGS ' Ths w aiprnd hwft appUn for a pannk to bulid aomditto ft.fokowiiq OwwsName B o r ba,rc, -I�myy\,hG Addraaa a Phan (.,Qo� 60r)5l Pok Mhkaat'a Nrna I .R. M66(md c G('D , n Addmu a Phone ( ff� UJG YM wj(l J`'t s4m MW*ni= NanN J.Pl(UYICA { 1 HC�, CQu • Ad*m a Phom 11W rrcev ScvQ. (2811 S93 -_i 3Jc( MIIW N b pupaM al biidrg4 �51,��Y.0 Ica��a �ti�iid IM< 1( mium al INdlalg9 Lj6aol N a dIN.for how mWW ImMu4 °� MINI al"owdoas to►wa hJ f) y Eau"cod M.07 d o iD CRY ums 000 (>uGor ftb uowrr r mows Improvement Lis. i of Applf fff1O INiONI r P&NALTY' OP P�iNIRY DESCI im TO w HONE I i eedL d er (m (9 MAIL PERMITTOL Cal/ �t o� /11-c cr'eq J � � v Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. General Information Important: When filling out From: forms on the SALEM computer, use Conservation Commission only the,-tab key to move To: Applicant Property Owner(if different from applicant): your cursor- do not use the Dr. Barbara Poremba return key. Name Name 22 Sunset Road m Mailing Address Mailing Address Salem MA 01970 Citylrown State Zip Code City/rown State Zip Code 1. Title and Date (or Revised Date if applicable)of Final Plans and Other Documents: Proposed Residential Addition April 2004 Title Date Title Date ix Tide Date 2. Date Request Filed: June 24, 2004 B. Determination Pursuant to the authority of M.G.L. c. 131, §40, the Conservation Commission considered your Request for Determination of Applicability, with its supporting documentation, and made the following Determination. Project Description (if applicable): The construction of a two story addition and a first floor exterior deck to an existing single family residendial structure. Project Location: 22 Sunset Road Salem Street Address City/Town Map 31 Lot 0251 Assessors Map/Plat Number Parcel/Lot Number wpaforrn2.dw•rev.12/15/00 Page 1 of 5 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Determination (cont.) The following Determination(s)is/are applicable to the proposed site and/or project relative to the Wetlands Protection Act and regulations: Positive Determination Note: No work within the jurisdiction of the Wetlands Protection Act may proceed until a final Order of Conditions (issued following submittal of a Notice of Intent or Abbreviated Notice of Intent)has been received from the issuing authority(i.e., Conservation Commission or the Department of Environmental Protection). ❑ 1. The area described on the referenced plan(s)is an area subject to protection under the Act. Removing,filling,dredging,or altering of the area requires the filing of a Notice of Intent. ❑ 2a.The boundary delineations of the following resource areas described on the referenced plan(s)are confirmed as accurate. Therefore, the resource area boundaries confirmed in this Determination are binding as to all decisions rendered pursuant to the Wetlands Protection Act and its regulations regarding such boundaries for as long as this Determination is valid. ❑ 2b. The boundaries of resource areas listed below are not confirmed by this Determination, regardless of whether such boundaries are contained on the plans attached to this Determination or to the Request for Determination. ❑ 3.The work described on referenced plan(s)and document(s) is within an area subject to protection under the Act and will remove,fill, dredge, or alter that area. Therefore, said work requires the filing of a Notice of Intent. ❑ 4.The work described on referenced plan(s)and document(s) is within the Buffer Zone and will alter an Area subject to protection under the Act. Therefore, said work requires the filing of a Notice of Intent. ❑ 5.The area and/or work described on referenced plan(s) and document(s)is subject to review and approval by: Name of Municipality Pursuant to the following municipal wetland ordinance or bylaw: Name Ordinance or Bylaw Citation wp form2.dw•rev.12115MO Page 2 of 5 i 7LMassachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Determination (cont.) ❑ 6.The following area and/or work, if any, is subject to a municipal ordinance or bylaw but not subject to the Massachusetts Wetlands Protection Act: ❑ 7. If a Notice of Intent is filed for the work in the Riverfront Area described on referenced plan(s) and document(s),which includes all or part of the work described in the Request, the applicant must consider the following alternatives. (Refer to the wetland regulations at 10.58(4)c.for more information about the scope of alternatives requirements): ❑ Alternatives limited to the lot on which the project is located. ❑ Alternatives limited to the lot on which the project is located, the subdivided lots, and any adjacent lots formerly or presently owned by the same owner.' ❑ Alternatives limited to the original parcel on which the project is located,the subdivided parcels, any adjacent parcels, and any other land which can reasonably be obtained within the municipality. ❑ Alternatives extend to any sites which can reasonably be obtained withirf the appropriate region of the state. Negative Determination Note: No further action under the Wetlands Protection Act is required by the applicant. However, if the Department is requested to issue a Superseding Determination of Applicability,work may not proceed on this project unless the Department fails to act on such request within 35 days of the date the request is post-marked for certified mail or hand delivered to the Department.Work may then proceed at the owner's risk only upon notice to the Department and to the Conservation Commission. Requirements for requests for Superseding Determinations are listed at the end of this document. ❑ 1.The area described in the Request is not an area subject to protection under the Act or the Buffer Zone. ❑ 2.The work described in the Request is within an area subject to protection under the Act, but will not remove,fill, dredge, or alter that area.Therefore, said work does not require the filing of a Notice of Intent. ® 3. The work described in the Request is within the Buffer Zone, as defined in the regulations, but will not alter an Area subject to protection under the Act. Therefore, said work does not require the filing of a Notice of Intent, sub'ecj t to the following conditioner any). 1. Silt fencing and haybales will be install prior to construction. 2. NO building material or excavated material shall be stockpiled within the buffer zone to the resource area. 3 NO construction machinery will be left on site at the end of each work day. ❑ 4. The work described in the Request is not within an Area subject to protection under the Act (including the Buffer Zone).Therefore, said work does not require the filing of a Notice of Intent, unless and until said work alters an Area subject to protection under the Act. Page 3 al gafort 2.doc•rev.12JI5100 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Determination (cont.) ❑ 5.The area described in the Request is subject to protection under the Act. Since the work described therein meets the requirements for the following exemption, as specified in the Act and the regulations, no Notice of Intent is required: Exam t Activity(stte applicable statuatory/reguWtory provisions) ❑ 6.The area and/or work described in the Request is not subject to review and approval by: Name of Municipality Pursuant to a municipal wetlands ordinance or bylaw. Name Ordinance or Bylaw Citation C. Authorization This Determination is issued to the applicant and delivered as follows: ❑ by hand delivery on by certified mail, return receipt requested on Date Date This Determination is valid for three years from the date of issuance (except Determinations for Vegetation Management Plans which are valid for the duration of the Plan).This Determination does not relieve the applicant from complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. This Determination must be signed by a majority of the Conservation Commission. A copy must be sent to the appro ri nal Office (see Appendix A)an the roperty owner(if different from the applican . • net s: /�/oy Dates Page 4 of wpafm 2.dac•rev.121151W Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 D. Appeals The applicant, owner, any person aggrieved by this Determination, any owner of land abutting the land upon which the proposed work is to be done, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate Department of Environmental Protection Regional Office(see Appendix A)to issue a Superseding Determination of Applicability.The request must be made by certified mail or hand delivery to the Department,with the appropriate filing fee and Fee Transmittal Form (see Appendix E: Request for Departmental Action Fee Transmittal Form)as provided in 310 CMR 10.03(7)within ten business days from the date of issuance of this Determination. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant if he/she is not the appellant.The request shall state clearly and concisely the objections to the Determination which is being appealed. To the extent that the Determination is based on a municipal ordinance or bylaw and not on the Massachusetts Wetlands Protection Act or regulations, the Department of Environmental Protection has no appellate jurisdiction. Page 5 of 5 wpafor .doc•rev.12115MO , CITY OF SALEM IRON ROD SET - IRON ROD 70,00' SET Y! 0.4 .CONCRETE SLAB D�• MAP 31 LOT 251 MAP 31 P„ MAP 31 AREA — 7,337t S.F. $ LOT 252 LOT 250 IRON ROD gg 5.0 S ET P DECK IRON ROD > Q SET 7 g• 'i 1-1/2 STORY 9 DWELLING IRON ROD 7.8 k 22 s I SET 8 ` v 0 o IRON ROO 65.00, SEr IRON L RODS SET EDGE OF PAVEMENT SUNSET ROAD 2 t*01i Of 44,re H ca PLOT PLAN OF LAND I CERTIFY THAT THE BUILDINGS No 36043 22 SUNSET ROAD HEREON ARE LOCATED ON 4fCI SALEM. MA THE GROUND AS SHOWN. fs' Y OF Ios°" BARBARPROPERT A. POREMBA _ C pC 5C� 0 SCALE 1" - 20' JUNE 8, 2004 A REG. PROF. LAND SURVEYOR NORTH SHORE SURVEY CORPORATION L 47 LINDEN ST., SALEM, MA -...,. I-Tjgn,,I 35S Ga:8ZP99Ls Ee:eT reazicriSo CITY OF SALEM IRON ROD SET - IRON ROD 70,00' SET 0.4' CONCRETE SLAB 0 �• i� MAP 31 LOT 251 MAP 31 MAP 31LOT 252 LOT 250 AREA - 7,337t S,F. $ IRON ROD Q 5.0 f T P DECK IRON ROD D SET 7.5' j $ 1-1/2 STORY 5 DWELLING IRON 7.6 ROD 22 I a I SET $ o < ct IRON ROD a5.00' AVSET IRON I _ RODS �. �. _J L_ — SET EDGE OF PAVEMENT SUNSET ROAD �tp`tH O f'A,3J'�C 2 tiL cN PLOT PLAN OF LAND I CERTIFY THAT THE BUILDINGS No. o<3 22 SUNSET ROAD HEREON ARE LOCATED ON $ SALEM, MA °F 9fG,S E0.tG p� PROPERT THE GROUND AS SHOWN. Y OF �r'OMe,., uo so BARBART A. POREMBA � / a�s�r 1� SCALE 1" - 20' JUNE B, 2004 DATE REG. PROF. LAND SURVEYOR NORTH SHORE SURVEY CORPORATION 47 LINDEN ST., SALEM, MA • �78 -- ^„An,� oss 9aZ8ZV98LG ee:Ei ooaueTieo Ltty uj outern, :wassacnusetts ' ,dire Department \ Mn� 48 Lafayette Street 29 Fort Avi Robert W turner Satem,Massachusetts.Q1970-3695 Cf 4e(978-744-1235 Tre Prevention of 978.744-6990 FaX 978-745-4646 'Bureau 978-745-7777 FIRE DEPARTMENT CERTIFICATE OF APPROVAL. FOR A BUILDING PERMIT` IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND THE SALEM FIRE CODE, APPLICATION IS HEREBY MADE FOR IRE APPROVAL OF PLANS ° AND THE ISSUANCE OF A CERTIFICATE OF APPROVAL FOR A BUILDINGPERMIT BY THE SALEH FIRE DEPARTMENT, ( Ref. Section LIM of the Mass.�Bldg. Code)", JOB LOCATION: OWNER/OCCUPANT: C � O V ri ? ,# ELECTRICAL CONTRACTOR:'° 0 FIRE SUPPRESSION CONTRACTOR: SIGNATURE OF APPLICANT; PHONE 0: ADDRESS OF APPLICANT: ] J J+ ✓�( j� 'CITY OT x TOWN: � APPROVAL DATE: Jo -'J �LuO� g Certificate,of approval is hereby granted. on approvad ,plans`or'submittal of 4 x project details, by the SALEM FIRE DEPARTMENT. All plaas`ara approved'solely for identification of'type and location;of fire protection devices and equipment w " All plans are subject to approval of any other. authority having jurisdiction,. ` Upon completion,' the applicant or installer(s) shall, request an inspection and/or test of the fire protection devices and equipment. (ADDITTIONAL REQUIREMENTS, SEE REVERSE SIDE, e*e) ` �J - . NEW CONSTRUCTION. . PROPERTY LOCATION HAS NO COMPLIANCE WITH THE PROVISIONS OF {" CHAPTER 148, SECTION 26 C/E, M.G.L: , RELATIVE TO THE INSTALA- TION OF APPROVED FIRE ALa9M DEVICES. S THE OWNER PRO- PERTY T1ti PR S ' PERTY IS REQUIRED TO OBTAIN COMPLIANCE AS A CONDITION OF OBTAINING A BUILDING PERMIT. I—D PRO^:,RTY LOCATION IS I Ci1FiPLIACNF, S4I'111 171r PROVISION OF CHAPTEP 143, SECTION ZG . 00 $5 1.00 - CHF.CF_;1 (V compliance with the: prevision of Section 112, 5 of rr3 :�".a. ....::1:',)?F'.Lt Scale Oi £ r We, and under guidelines . lVor, ry ia'la 7r"� 3 1 dg. WsPect3r and the Salem Fire Chief, Lhe appl }y ,.n Co.- a building i_aYth shall obtain Lha Certificate,.kite of npprg al f Q' evr)r e a4idej id k' .s.p"`d av plan appral m the Sallof4!. Fi''� Said application and approval W regWred before a building permV may W issued. The Massachusetts State Building Code requires eamplinuce WWII Of the Salem Fire Department, with r'eferflAce to. Provia''ialns of Articleg 4 and 12 of the Building Code, the Fire I,-ode, � s,,G}2uset.tfa e ' General Last, and 527 Code of wassachu_etts ileglalstionso The applicant shall submit this application with three (3) sets Cat plansp drnvn in sufficient clarity, to obtain st&wpe?s approval of the Salem 57.r+' Department. Thiz ayglies for all newconstructaoan, siah`ntantEci alterations, chOng€° Of '.age land/Or Occupancy, and amr other approvals required by the Massachusetts General Laws, W the Salem Fire Code. Kcaption: Plans will not be required for Structural work when the 4 proposed work to be performed larunez the building permit Hal t . aOt, in the opinion of the Buildlnsg Inspector, r*quiire a plan to show the nature ,:Hard character of the work to be performed. Notice., Plans are normally required for fire suppression systems, # < fire alarm cyst 1s, tank instaliatiorna9 and Fire Cone requirements. a Under the Provisions of Article 22 of the Massachusetts State Building Code, certain proposed projects may not require submission of plans or complete compilance with new construction requirements. In theme cases, provisions of article 22, Appendix Tp and Tables applicable '• shall apply. This section shrill not, however, saapersede the 9 Provisions outlined in the aalecs Eire Prevention Regulations, Chapter XGL, or 527 Code of :Massachusetts Regulations. All pacmits for fire code use and/ter occupancy shall apply for than entire structure; fire alarms and/or smoke detector incatallation shall apple to the entire structure based upon current requirements As per Laws and/or . - Crudes, but the existing str'uctf➢le way c4+. }l.y with r6ejulation app, -able for existing stvuctures. No t: is e: Sub-contractors may Wo be ;b( t.i:";E to file u_a k' i ati ns foe .a Fire Department t ertific. e e.lt ippruv al :Irv_ tivi aL.gq, of their work .,., . Sub-contractors. shall F . . _ an :li;pl.ication co Enstall with We !sire ur9verntion Buren ; prior to 4Amen . any wo-_k tci^ those AR'en5 ru�uc rNvrprrll DirARTMtNT 120 vAUSHIM ON WMENr 3RD FLOOR srALSN.w�►of Aso TRL.(978)745-MM RtT.iab FAX Wf)7404MI" STAIel.tr�JJ..rtNOy1CZ. JA. __---.-_ - _ --- DISPOSAL OF DEN AFFIDAVIT 12 so urft ee with the provisions ofMM a 4%SA I aclmowledte dW r a condition of Bmmg Permit/ .an debris rankbq am the omwoc"scow pninM by this BWftPermit"be dispaed otin&pop*&m "sol WOW disposal A'We m defined by UM c in SISQ& The debris w M be ftmW of it Locm"ofFa ft tine of Pesmit ARIi Dow FMY MUUM� aR iofomion:l elcwjd . 1 : N olsi2 rTime ofPesmie AppBoW lm?huoo inns Addntsrs sty t sterns The above statute iegnira that debris from the demohdM nmWW016 rA*or odes shmadw 8 of defined byeing be disposed in a p mpaly_licsosed solid-w t mgxw ( 50&and the bW t pa»rid or Ne mses ate to indicate the locsdon of the balky. . � �ffasmontuuaQli of�Ja�,K�►w.ttd � � •�.P.ai...d.�.�afirYrid�esTf..b• boo w..[I.�r.Sw • as 1 ca.Is 86fw M .dri 021 If Workers' Compensadn lummum AffMirivig LJ OA* I� M. r 0sxl,� . . who" pritdpsl place of bodaso so t do hereby-CF* Under SIR paint awd peniMn of pol.wo dm O 1 am an employer providing workers' eompemstkw covep/e for NW eir0a)0 wetkie an Inswaaase Congaq► Faft Number 1 an:sole propriaoi and have ee own we king fear me in mW opedry. 1 awl a so'k ara proprfeaor, general eowtraoor or hommowner (ch-1 am) and hove bored the s cetetoa lined bebelowwho•hsys the feNorriwg worker ' caimpeRS8410111 pollIdw fJ Im�,d Gg4 kcal 14c, 03 a i O CEO Insurance Co /P Nuwier PCi Yz17 c it ew,�l A^IV� 9yi Q29/17�yob Co snot Insurance ConsPOSIFIFefty NuMbW Conersaer Intwance Company/Follia Nunlies () 1 am a homeowner performing all the work mysaM. •I a.aan""a.a a an al OiY naaeaaw.e N IWWWS" ■ iq Oliva A MroftMw d Oct M 10 ea.wae ..mate.SW M MM O NO" tawpp a rwaaa~fRi 21A of WA 15 1 ea.kag r ao wMeaiea tf ebuwe.a.ae cuuabq d a ear of a ni I JC0Oi aa.Iea am real'iaa+eaw"M Al qa a el.t..d in ow Iam of a STOP WORK ORDER aas a 6a of r ICOAO. ON atiw MIL signed this . dv' of — :icersetiFermittee BUalding Gepartn.ent Jtensing fioalC Selefsmew Office =ealth Gepat-.mer: - - _-.ccCC Ye : _ 90A epc spe 77!