18 CLARK AVENUE - BUILDING JACKET Cit "of Salem ward
4t1�r
APPLICATION
FOR
PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION
IMPORTANT-Applicant to complete all items in sections:1, It, /it, IV, and IX-
1. AT(LOCATION( 19 C t a r K n U P n u e. ZONINDISTRIG
LOCATION iN0'1 S1"EE
OF BETWEEN AND
BUILDING CnOSSSTREPTI yAf7 yb/ lCR)SS SMEETI
SUBDIVISION LOT(' BLOCK DO S �E 0 oZ 3
II. TYPE AND COST OF BUILDING -All applicants complete Parts A -D
A. TYPE OF IMPROVEMENT D. PROPOSED USE•FOR"DEMOLITION'USE MOST RECENT USE
1 d New building Residential Nbnreatdenhal
2 Q Addition tit resdenhal.enter number or new 12 9One handy 18 Q Anusentem.recma,"
housing units added.It anv in part D. 13) 19 E] Chnrch.other relgous
t 3 Q Tvq or mqe famlry•Enter number
3 ❑ Attention(See 2 above) at untie_..._._� __.__._ 20 ❑ lwustriel
4 ❑ Rehr replacement 14 ❑ Transient how.motel,or dormitory• 21 ❑ Parked gage
Enter number of un45 .__...__..._._�_ 22 Q Service station,repairgarap -
5 Q Whacking la mulfdamey resdarrae(enter number
23 E] NosPltal,insirlulerel
W unns m budding in Part D. 13) 15 ❑ Garage 24 ❑ palace.bark protmonel
6 Q Moving Irelocatdnl 76 ❑ Carton 25 ❑ Pudic utility
7 ❑ Foundation only t7 ❑ Other-Spaces 26 Q School.library,other educational
27 Stores.norrancle
B.OWN�RSHIP 28 Q Tanks,towers
8 Privatefmdbdual.corporaborl,nonprofit
irutriution.etc.) 29 Q Other-Speco
9 Q Public(Federal.State,or local govemrrbrn
C.COST (Omit Cams) ldoraesrperttW-Describe in debut proposed use of buildirgs,e.g..loco procesaag plant
machine anon.laundry budding at hospnal.elementary school.secondary school.code".
1 O. Cost Of improvement ...__......_ _______ S O 00 Mooned school.Parking gage for denanment Store,rentalg office building.of budding
at industrial darn It use of existing budding is being charged,enter proposed owe,
To be installed but rot included
in am above post
a Electrical
b. Plumbing
c. a Mob ,air caWiboning..
d. Oder(elevator.etch
11. TOTAL COST OF IMPROVEMENT S S e 29
IIL SELECTED CHARACTERISTICS OF BUILDING -For new buildings and additions,complete Parts E-L:demolition,
complete only Parts J&M,all others skip to IV
E. PRINCIPAL TYPE OF FRAME F. PRINCIPAL TYPE OF HEATING FUEL G. TYPE F SEWAGE DISPOSAL I. TYPE OF MECHANICAL
30 Q Masonry IwaB beeri g) 35 d Gas 40 1Public or private oom=W will Mere be cerm air
31 l�Wood frame 36 ❑ Oil 41 ❑ Private ISepne tank ele.l card es
32 ❑ Structural steal 37 Q Electrody a4 Yea 45 Q No
33 I] Rerre rced b0(KlBe 38 ❑ Coal H. TYPE QF WATER SUPPLY WA there by es elslew
34 Q Oder-Saecwr 39 Q Oder-Specify 42 Public or private company 46 0 Yes 47 dNo
43 ❑ Piivatalwaitciaeml
F
i
7
J.48 N.,,fo ,o o M. DEMOLITION OF STRUCTURES: i
.t8 Numper 0f sl0nea ...............os.....ya?s.._.............__ _
49. Twal square feet of floor area. Has Approval from Historical Commission been received
3::b00rs Da M exrerar
ar1r 00n5 ............. ...b...P'z.-..._..._.. for any structure over fifty(50)years? Yes_ No_
1
5o. Total wnu area.so.I......!. Dig Safe Number 3
I
K.NUMBER OF OFF-STREET PARKING SPACES
�7 Pest Control:
51. Enclosea ...._..............._aa.._._.._..._._._..._...__....._..
HAVE THE FOLLOWING UTILITIES BEEN DISCONNECTED?
ez. outdoors........._........__..__.._........._.__.._....-- Yes No
L RESIDENTIAL BUILDINGS ONLY Water:
53. Erclosca............ Electric.
Full___.__�._ .Sewer. f
54. Number of
oamroams -- - DOCUMENTATION FOR THE ABOVE MUST BE ATTACHED I
— BEFORE A PERMIT CAN BE ISSUED. j
_ I
IV. COMPLETE THE FOLLOWING: i
Historic District? Yes_ No✓ (if yes,please enclose documentation from Hist Com.)
i
Conservation Area? Yes✓ No_ (If yes, please enclose Order of Conditions)
Has Fire Prevention approved and stamped plans or applications? Yes_ No_ !�
Is property located in the S.R.A. district? Yes_ No
Comply with Zoning? Yes No_ (If no,enclose Board of Appeal decision)
Is lot grandfathered? Yes_ No—L (If yes,submit documentationlf no,submit Board of Appeal decision)
If new construction, has the proper Routing Slip been enclosed? Yes_ No_
i
Is Architectural Access Board approval required? Yes_ No (If yes,submit documentation)
i
Massachusetts State Contractor License# Salem License# j
,
Home Improvement Contractor# Homeowners Exempt form(if applicable) Yes_ No_
CONSTRUCTION TO BE COMMENCED WITHIN SIX(6)MONTHS OF ISSUANCE OF BUILDING PERMIT
9 an extension is necessary,please submit
CONSTRUCTION IS TO BE COMPLETED BY: in writing to the Inspector of Buildings.
V. IDENTIFICATION - To be completed by all applicants
Nacre Mad"aooress-Number.Street cM,and abte LP code Te,No.
oKYwf or
e.Ll, Ss JT<. ea60Q If o(q6 i) �1�8-ssz
E. j
Contractor BuddWs
LCIOVIII N1 {
3.
Architect or
�urfeee
3
1 herebycertify that the proposed work is authorized by the owner of record and that I have been authorized b the owner to make this fY Y application
as his authorzea aa_ent ana we ao_ree to conform to all applicable laws of this iunsdiction.
Signature pplicent Address Applica0on date '
I
i
f I,
t
F
DO NOT WRITE BELOW THIS LINE
VI. VALIDATION
Building FOR DEPARTMENT USE ONLY
Permit number
Building use Group
Permit issued 19_
Fire Gracing
Building '^
Permit Fee $ /V Live Loading
Certificate of Occupancy $ Approved occupancy Load
by �
Drain Tile $
Plan Review Fee $
TITLE
NOTES AND Data• (For department use)
fe
PERMIT TO BE MAILED TO:
i
DATE MAILED:
Construction to be started by. Completed by.
i
i
VI ZONING PLAN EXAMINERS NOTES
DISTRICT �-
USE
1
FRONT YARD
SIDE YARD SIDE YARD
REAR YARD
i
NOTES
i
SITE OR PLOT PLAN •For Applicant Use
d a# aeLed Qlcxs, .
i
/ O N
i
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r.
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands 64-352
WPA Form 5 - Order of Conditions Povided by DEP
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. General Information
Important:
When filling From:
out forms on Salem
the computer, Conservation Commission
use only the
tab key to This issuance if for (check one):
move your
cursor-do ® Order of Conditions
not use the
return key. ❑ Amended Order of Conditions
To: Applicant: Property Owner(if dent from applicant):
Paula Buresh Same P9
Name Name `
58 Franklin Street
Mailing Address Mailing Address
Peabody MA 01960
City/Town State Zip Code CitytTown State Zio Code
1. Project Location:
18 Clark Ave. Salem
Street Address city/Town
Map 02 Lot 0008
Assessors Map/Plat Number - Parcel/Lot Number
2. Property recorded at the Registry of Deeds for:
Essex 287
61844
County Book
Page
Certificate(if registered land)
3. Dates:
August 25 2003 October 23, 2003 October 23, 2003
Date Notice of Intent Filed Dale Public Hearing Closed Date of Issuance
4. Final Approved Plans and Other Documents (attach additional plan references as needed):
Propose Site Plan for Conservation Commission Filing Salem Mass Rev. 10/22/03
Tille
Date
5. Final Plans and Documents Signed and Stamped by:
H. L. Millard and Evan A- Wilmarth
Name
6. Total Fee:
$500-00
(from Appendix B:Wetland Fee Transmittal Form)
y
Massachusetts Department of Environmental Protection DEP File Number:
� - P
Bureau of Resource Protection - Wetlands 64-352
WPA Form 5 - Order of Conditions Provided by DEP
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Findings
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. Check all that apply:
❑ Public Water Supply ❑ Land Containing Shellfish ❑ Prevention of Pollution
❑ Private Water Supply ❑ Fisheries
® Protection of Wildlife Habitat
® Groundwater Supply ❑ Storm Damage Prevention ❑ Flood Control
Furthermore, this Commission hereby finds the project,as proposed, is: (check one of the following boxes)
Approved subject to:
® the following conditions which are necessary, in accordance with the performance standards set forth
in the wetlands regulations, to protect those interests checked above. 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 Ord
er. 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.
Denied because:
❑ the proposed work cannot be conditioned to meet the performance standards set forth in the wetland
regulations to protect those interests checked above. 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 these interests, and a final Order of Conditions is issued.
❑ 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).
General Conditions (only applicable to approved projects)
1. Failure to comply with all conditions stated herein, and with all,related statutes and other regulatory
measures, shall be deemed cause to revoke or modify this Order.
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.
WPA Farm 5
Rev.MOO Page 2 at 7
Massachusetts Department of Environmental Protection DEP File Number.
�x Bureau of Resource Protection - Wetlands 64-352
WPA Form 5 - Order of Conditions Provided by DEP
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Findings (cont.)
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. 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.
7. 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.
8. 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 this 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.
9. 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, "MA DEP'J
"File Number 64-352 "
10. 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 DEP.
11. Upon completion of the work described herein, the applicant shall submit a Request for Certificate of
Compliance (WPA Form 8A) to the Conservation Commission.
12. The work shall conform to the plans and special conditions referenced in this order.
13. Any change to the plans identified in Condition #12 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.
14. 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.
WPA Farm 5
Rev.02/00 Page 3&7
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands 64-352
WPA Form 5 - Order of Conditions Provided byDEP
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Findings (cont.)
15. 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.
16. 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.
17. 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.
Special Conditions (use additional paper, if necessary):
See Attched.
Findings as to municipal bylaw or ordinance
Furthermore, the Salem hereby finds (check one that applies):
Conservation Commission
❑ that the proposed work,cannot be conditioned to meet the standards set forth in a municipal
ordinance or bylaw specifically:
Name Municipal Ordinance or Bylaw
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.
❑ that the following additional conditions are necessary to comply with a municipal ordinance or bylaw,
specifically:
Name Municipal Ordinance or Bylaw
The Commission orders that all work shall be performed in accordance with the said additional
conditions and with t'.s Notice of Intent referenced above. To the extent that the following conditions
modify or differ from the Mans, specifications, or other proposals submitted with the Notice of Intent,
the conditions shall control.
WPA Forth 5
Rev.02I00 Page 4 of 7
., :,. Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands �y_3sZ
r WPA Form 5 - Order of Conditions Provided byDEP
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
t
B. Findings (cont.)
Additional conditions relating to municipal ordinance or bylaw:
This Order is valid for three years, unless otherwise specified as a special condition pursuant to General
Conditions #4, from the date of issuance.
Date
This Order must be signed by a majority of the Conservation Commission. The Order must be mailed by
certified'mail (return receipt requested) or hand delivered to the applicant. A copy also must be mailed or
hand delivered at the ame time to the appropriate Department of Environmental Protection Regional
Office (see A ndi A) he operty owner (i different from applicant).
Signatures: ..
On �t 12r�•> T� it \ Of 0 `foe 2
Day _ Month and Year t ..
before me personally appeared
to me known to be the person described in and who executed the foregoing instrument and
acknowledged that he/she xecuted the same his/her free act and deed.
Notary Public My Comfnission Expires
This Order is issued to the applicant as follows:
❑ by hand delivery on Xby certified mail, return receipt requested, on
Date Date ate loL
WPA Farm 5
Rev.02/00 Page 5 of
Salem Conservation Commission
SPECIAL CONDITIONS—DEP FILE # 64-352
18 Clark Ave. , Salem, MA
I. The Conservation Agent will be notified 48 hours prior to commencement of construction activities(978-745-
9595 ext 311). Members and agents of the Salem Conservation Commission(Commission)shall have the right
to enter and inspect the premises to evaluate and ensure compliance with the conditions and performance
standards stated in this Order,the Notice of Intent,the referenced plans,the Act, and 310 CMR 10.00,and may
require any information,measurements,photographs,observation and/or materials or may require the submittal
of any data or information deemed necessary by the Commission, agent, or DEP determines that any of the
work is not in compliance with this Order of Conditions. Work shall not resume until the Commission is
satisfied that the work will comply,and has so notified the applicant in writing.
2. Approval of this application does not constitute compliance with any law or regulation other than MGL Chapter
131, Section 40, and Wetlands Regulations 310 CMR 10.00.
3. This Order shall apply to any successor in control or successor in interest of the property described in the Notice
of Intent and accompanying plans. These obligations shall be expressed in covenants in all deeds to succeeding
owners or portions of the property.
4. The form provided at the end of tbis'Order shall be completed and stamped at the Registry of Deeds after the
expiration of the 10-day appeal period and within 30 days of the issuance if no request for appeal has been filed
with the Department of,Environmental Protection. This form shall be returned to the Commission within 21
days of recording accordance and prior to commencement of any activities subject to the Order of Conditions.
5. Prior to any work commencing, a sign shall be displayed showing DEP file"64-352, and not placed on a living
tree.
6. 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.
7. 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 Corp of
Engineers.
(2) Water Quality Certification in accordance with the Federal Water Pollution Control under authority of scc.
27 (5) of Chapter 21 of the Massachusetts General Laws as codified
(3) Flood PIain
(4) Grading Ordinance
8. 1`there are conflicting conditions within this Order,the stricter condition(s)shall rule.
9. 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.
10. The Comirussion and its Administrator shall have the discretion to modify the erosion/siltation control methods
and boundary during construction if necessary.
11. All work shall be performed in accordance with this Order of Conditions and approved site plans(s). No
alteration of wetland resource areas or associated buffer zone, other than that approved in this Order,shall occur
on this property without prior approval from the Commission.
12. If any changes are made in the above-described plan(s)which may or will alter an area subject to protection
under the Wetlands Protection Act, or any changes in activity subject to regulations under G.L. Ch. 131,Section
40, the applicant shall inquire from this Commission in writing,prior to their implementation in the field,
whether the change(s)is significant enough to require the filing of a new Notice of Intent. Any error in the
plans or information submitted by the applicant shall be considered changes and the above procedures shall be
followed. A copy of such request shall at the same time be sent to the Department of Environmental Protection.
13. 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 signed statement 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.
14. Conditions number 45 as indicated shall continue in force beyond the Certificate of Compliance,in perpetuity,
and shall be referred to in all future deeds to this property.
PRIOR TO CONSTRUCTION
15. Prior to commencement of any activZry on this site,there shall be a PRECONSTRUCTION MEETING
between the project supervision; the contractor responsible for the work or its administrator to and phone
numbers of all responsible parties shall be registered with the Commission at the pre-construction meeting.
16. 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 Commssion and/or
its Administrator shall inspect and approve such installation at the pre-construction meeting.
17. Prior to the commencement of any activity on this site,the applicant or current landowner shall submit to the
Commission in writing a construction schedule/sequence of work to complete this project.
18. Prior to any work on site,the proposed limits of work shall be clearly marked with stakes or flags and shall be
confirmed by the Commission or its Administrator. Such markers shall be checked and replaced as necessary
and shall be maintained until all construction is complete. Workers shall be informed that no use of machinery,
storage of machinery or materials, stockpiling of soil or construction activity is to occur beyond this line at
anytime.
19. Prior to commencement of construction on site,the limits of wetland resource areas closest to construction
activity shall be flagged with surveyor's tape and shall remain in place during construction. The limits of areas
to be impacted and the limits of work in the replication area(a)shall be clearly flagged.
20. There shall be 25 hav bales and wooden staked stored under cover on the site to be used only for emergency
erosion control.
EROSION CONTROL
21. Appropriate erosion control devices shall be in place prior to the beginning of any phases of construction, and
shall be maintained during construction in the wetland areas and buffet zones. The erosion control specification
provided in the Notice of Intent and the erosion control provision in the Order will be the minimum standards
for this project; additional measures may be required by the Commission.
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 areas of construction shall nmz_ in a stable condition at the close of each construction day.
25. Any de-watering of trenches or other excavations required during construction shall be conducted so as to
prevent siltation of wetland resource areas. All discharges from de-watering activities shall be filtered through
haybale sediment traps, silt filter bags or other means approved by the Commission or its Administrator.
26. Within thirty 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 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
surfaces shall be stabilized by other appropriate erosion control measures,frmily anchored,to prevent soils
from being washed by rain or flooding.
DURING CONSTRUCTION
28. A copy of the Order of Conditions, construction plans, and copies of the documents and reports cited in
Condition m 11, shall be on the site upon commencement and during any site work for contractors to view and
adhere to.
29. 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.
30. Only clean fill, free of masonry, stumps, asphalt, and any other kind of waste material shall be used on the site.
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 rivers.
32. All filling or removal of waste material from the site shall be done in accordance with the regulations of the
City of Salem Health Department.
33. Cement trucks shall not be washed out in any wetland resource or buffer zone area. Any deposit of cement or
concrete products into a buffer zone or wetland resource area shall be removed by hand.
34. No fuel, oil, or other pollutants shall be stored in any resource area or the buffer zone thereto,unless specified
in this Order of Conditions.
35. There shall be no pumping of water from wetland resource areas.
36. During construction, all drainage structures shall be inspected regularly and cleaned as necessary.
37. The project shall not cause an increase in run-off onto adjacent properties,either during construction or when
completed. - -
38. The applicant is hereby 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.
POST CONSTRUCTION
39. All disturbed areas, slopes and proposed landscape areas shall be loamed and seeded or stabilized through the
use of erosion control blankets or other approved means. All disturbed areas will be graded, loamed, and
seeded prior to November I of each year, if possible. No disturbed areas or stockpiled material will be left
unprotected or without erosion controls during the winter.
40. Upon completion of construction, the applicant or current landowner shall submit the following to the
Commission to request a Certificate of Compliance:
(1) A letter requesting a Certificate including the following information:
a. Name and address of current landowner;
b. Name and address of the individual/trust or other entity to whom the Certificate is to be issued:
c. Street address and lot number for the project;and
d. DEP file number
(2) A letter from a Registered Professional Engineering or Land Surveyor certifying compliance of the
property with this Order of Conditions
(3) An"As-Built"plan signed and stamped by a Registered Professional Engineer showing post-construction
conditions and:
a. As-built elevations of all drainage ways constructed within 100 feet of any wetland resource area;
b. As-built elevations and grades of all filled or altered wetland resource areas,buffer zones and
replicated areas; and
c. Distances to all structures within 100 feet of any wetland resource area.
4 L When issued, the Certificate of Compliance must be recorded at the Essex County Registry of Deeds.
42. 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.
43. Erosion control devices shall remain in place and properly functioning until all exposed soils have been
stabilized with final vegetative cover and the Commission and/or its Administrator has authorized their
removal.
ADDITIONAL CONDITIONS
44. Grass sod shall be planted along the base of the retaining wall in order to stabilize the expose soil. Once the sod
has been established,this area shall be left to grow freely and not be cut in order to promote further vegetation
growth.
45. Upon completion of the proposed project,the area beyond the outward limits (west,northwest&southwest) of
the retaining wall shall be designated as a "No Cut/No Disturbance Zone"area.
Massachusetts Department of Environmental Protection DEP File Number:
k Bureau of Resource Protection - Wetlands 64-352
WPA Form 5 - Order of Conditions Provided by DEP
/ Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. 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 DEP 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 Appendix E: 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.
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.
D. Recording Information
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 Page 7 of Form 5 shall be submitted to the Conservation Commission listed below.
Salem
conservation Commission
a
WPA Form 5 Rev.02/00 page fi of 7
Uci v� JUCetn, AWSSaCIIUSMS
Fire Deparbmnt
48 Lafaye tte Street 29 Fort Av
Rg6ert IV Turner Salem, 'Massachusetts o1970.3695
Chef Tet 978-744-1235 91-re Prevention
i 97*744•69910 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 THE`APPROVAL OF PLANS ;`' '' t
r AND THE ISSUANCE OF A CERTIFICATE OF APPROVAL FOR A BUILDING PERMIT BY THE
t SALEM FIRB DEPARTMENT.' ( Ref. Section 113:3 of the'Hass. Bldg. Code). a.*
[. JOB LOCATION: : �C o
OWNER/OCCUPANT: ( ct v!.r 8
y .
ELECTRICAL CONTRACTOR:
,i FIRE 'SUPPRESSION CONTRACTOR: > f Y w
SIGNATURE OF � /� � � '
APPLICANT:. ,1/� (/ c cL. PH0,1*R E_ b'
n� 77,
• ` /
" ADDRESS OF
APPLICANT: Lc O ��� U CZTY OTTJ
#
6 ` APPROVAL ,
DATE -�a a.CIL3 . ^,s .� �.'' y, • -�s�� _ :-
w :': wH sd'i �' -•_ .c: •'.. 70,
x 4 4w.
i Certificate of•approval is hereby granted, on approved picas or aubmitEalFof
project details, by the SALEM FIRE DEPARTMENT;:" All plans are=approvedsolely` ► +F
for identification of type location-of fire � 3 a
s , t ' YP pzotection` devices and n ui meat a
All place are subject to approval,of any'other authority having jurisdiction `` ;l 4 } �.
Upon.completion, the applicant ror installer(s),; shall 'r'equest 'awin'apeetion and/or
teat of+ehe ,fira protection devices-and equipment (ADDITTIONAL: REQVIREMENTS, 153
SEE REVERSE SIDE ,►*e). - a` .€ r_:
,� °, c ._ - �: 'v„ — �. - P t.°`fit' A'�r. "� . �.• w�}� �{p as;'
® NEW CONSTRUCTION: q s:
PROPERTY LOCATION HAS NO COMPLIANCE. WITB;THE PROVISIONS OF
CHAPTER 148`, SECTION'.26 C/E, M.G.L. , RELATIVE TO,THE INSTALA-
? TION 'OF APPROVED FIRE.AUURM DEVICE.S.ALTHE°OWNER 0" THIS 'PRO'- "^
PERTY;IS-REQUIRED TO,OBTAIN COMPLIANCE AS A CONDITION OF r t•
_OBTAINING A BUILDING;PERHIT: ? • '`
T OPF DRRY .LOCATION IS 1N' CQpiPLIACNF, !
. C7 ... _ . JI1'H TftE PROVISIONF'0 c4.\PTFN " 3
148, ohCTIQN 21
t
1.iUi111 ?v fJ',:T 7,
6 � c10U�= lr✓ d� `_
$30. 0
$50.00
CHECR:i'
i
In compliance with the provision of Section 113. 5 of the Massachusetts
State Building Code, and under guidelines agreed upon by the Salem Bldg.
Inspector and the Salem Fire Chief, the applicant for a building permit
shall obtain the Certificate-.of Approval (see reverse side) and stamped
plan approval from the Salem Fire Prevention Bureau.
Said application and approval is required before a building permit may be
issued. The Massachusetts State Building Code requires compliance
approval, of. the Salem Fire Department, with. reference to provisions of
Articles d and 12 of the ,Building Code, the Salem Fire Code, Massachusetts
General Lawa,' and 527 Code of Massachusetts Regulations..
The applicant° shall submit this application,'with three (3) sets of plans, .
drawn In sufficient clarity, to obtain stamped approval of the Salem, Fire
Department. This applies:for all new 'conatruction, substantial:
alterit-ions, change of. use ,and/or occupancy, and any other approvals
required ':by the Massachusetts GeneraliLawsp•and the Salem 41re Code.
g Exception: ; Plans-will not be required for structural- work when the
proposed work .to be performed under the building permit will
not,, in the opinion of ,the 'Building Inspector, require a
plan to show the natureaand character of . the work to be
performed.
'otice: Plans are normally _required for fire suppression systems,
f fire alarm systems, tank installations;-and FireCode a
requirements. ,, _ g ,:�b .
r Cnder the provisions of �Article`22 of the Massachusetts State=HuiIding'
' Code, certain°proposed;projects may notirequire subvisalon•of plans or
complete compliance with new construction requrreseki'.'' in these
t, cases, provisions of,,Article, 22,' Appendix T, an_d 'Tables applicable'
shall apply. This section.shall'notj,however, '.supersede the t" :;•
provisions outlined in the Salem Fire PreventioniRegulations., Chapters
118, MGL, `'or 527,Code.of Massachusetts Regulations. r All.,permits for
-$ 'fire code use'and/or occupancyshall apply-Yor `the'entire ,structure;
fire alarm and/or asoke 'detector installation 'shall apply to the
entire structure based upon current tequirements as .per Lars ,and/or 4
'Codes,; but the, existing-,structure may - ul complyly with reggulations , $
applicable _for `existingsstructures.. -
3
Notice: Sub-contractors may also be required to file ind-iiidual
f applications for a Fire:Department Certificate of ,.lpprocal
4' for the area' of' their-' ork.. Such sub-contractors shall fila"
an :application to install with the Fire prevent ion ;Bureau 4
prior to commencing,, any work ,for those areas applicable.,
re is y ,
i f
a
CITY OF SALEM mar zo
ROUTING SLIP
CHECKED DEPARTMENTS REQUIRE SIGNATURES BEFORE BUILDING PERMIT WILL BE ISSUED.
LOCATION: l (J �j K t� / \V DATE: y
APPLICANT: a v �Gc /Jv/" 'r Sal
ASSESSORS OFFICE ® ///J n /
@ 93 FRANK
KULTON ST� // f �'^L _ ` /�� I
FRANK KULIK /sL/6 S /",, ("L , DATE: 1/ d
0 CITY CLERK(if involving a new street)
Ou93 WASHINGTON ST.
DEBBIE BURKINSHAW DATE:
PUBLIC SERVICES(Engine ' g Dept.)
rQ 120 WASHINGTON ST,4TH FL.
BRUCE THIBODEAU f DATE:
WATER DEPT.
Q 120 WASHINGTON ST,4TH FL.
i3F1X&ALAADQ9Z DATE: a
d CROSS CONNECT SUP'R
BOB DESCHENE
Cu 120 WASHINGTON ST,30.0 FL. DATE:
L] PLANNING
@120 WASHINGTON ST.,30.D FL.. U
990SEM, DATE:
vl{'I.�Q.1(c�t�I tolUGtk
CONSERVATION COMINUSSION Dept.)
Q120 WASHINGTON ST.,3-FL.
�p ' DATE: O
�eanK Taoavnma
ELECTRICAL
rci 48 LAFAYETTE STREET, ND FL. EAR
JOHN GIARDI DATE: 4
FIRE PREVENT N /
@29 FORT AVE(WILLOWS AREA) DATE: V /CAPT.HUDSON �� 2 ` y{a« �Ckl
HEALTH
@120 WASHINGTON ST.,4TH FL.
JOANNE SCOTT DATE: 8 3 D
❑ BUILDING DEPT J/�9 /, ,1
C 120 WASHINGTON ST.,J"D FL. /� '`f f ' 9 `/ V L.
TOM ST. PIERRE G�7u>> DATE:
***SUBMIT WITH PERMIT APPLICATION' WHEN COMPLETED***
18 CLARK AVENUE I
14 ovao)UPC 10 3L330 '
_U 1'5' 1q o�
HASTINGS. UN
r
Monday, February 21, 2005 8:10 AM Evan A.Wilmarth SCE-478-%90 p.02
I certify the foundation As—Built and shown hereon
conforms with the current Zoning Bylaws of the City
of Salem, Mass, I further certify the foundation
does not lie within a Federal Designated Flood Zone
as depicted on FEMA Community Panel
No. 25010200056.
118.62'
100.00'
Lot 357
L.C .C . 7159W oFoundation
42, 023 S. F. 6 certified
2/17/05
Concrete Retaining Wall
IF —V2.7ft
Q 44.0 N 20.0'
6 TOC-139.7 0
64.0' 12.7ft
186.74' 15'9 164
CLARK AVENUE
AS—BUILT PLAN
OF FOUNDATION
SALEM, MASS.
SCALE: 1 In.=40 Ft. Dover Land Surveying, Inc. t
Feb. 17, 2005 NOFN eId, Mass. 1
fe° EVAN /
d A
WILMAM
NO.45M
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LOCUS MRI'
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4
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SCAUE: : 1 1N = 20 r--r. SURVE.YI G CG.
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