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` .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 Richard & Diane Pabich Same
return key. Name Name
35 Winter Island Road
red Mailing Address Mailing Address
Salem MA 01970
City/Town Slate Zip Code Citylrown State Zip Code
inn 1. Title and Date of Final Plans and Other Documents:
Details I & II included in RDA filing 7/16/03
Title Final Date(or Revised Date if applicable)
2. Date Request Filed:
August 11, 2003
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):
Construction of new concrete stair to an existing wall along a coastal bank at 35 Winter Island Road
Project Location:
35 Winter Island Road Salem
Street Address City/Town
Map 44 Lot 28
Assessors Map/Plat Number Parcel/Lot Number
WPA Form 2 Page 1 of 5
Rev.02/00
.Massachusetts Department of Environmental Protection
" w 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
WPA Form 2 Page 2 of 5
Rev.02/00
-Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
w, WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
a ,
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 within 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, subject to the following conditions (if any).
"The stairs are to be constructed long the side and anchored to the existing seawall above the
mean high water mark, on top of an existing large rock outcrop. The Commission determined that
there would be no impact to any resource area (rocky intertidal shore and beach).
❑ 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.
WPA Form 2 Page 3 of 5
Rev.02100
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 2 — Determination of Applicability
R 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:
Exempt Activity(site applicable statuatory/regulatory 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
SCt��car��.er �Si 7uo�
Date Date j-
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 appropriate DEP Regional Office (see Appendix A)and the property owner (if different from the
applicant). Signatures:
I
Date
WPA Form 2
Rev.02100 Page 4 of 5
L
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.
WPA Forth 2 Page 5 of 5
Rev.02/00
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands diyr-w:m
WPA Form 1 - Request for Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A.. General information
Important:
When filling out 1• Applicant:
forms on the Richard&.Diane Pabici. d abich. bellatlantic.net
computer. use —----..—_..--..—... — — —�.— .. — — --- —E-Mail Address
—
only the tab key
Name
to move your 35 Winter.Island_Pd.
_.—._ _—.—.—_---.-- .—.—..---------
cursor-do not Mailing Address
use the ratum Salem MA 01970
State __..._—..._ zip Code
----...—..
key, Ci y rows
978
745-7274
+tl . Phone Number Fax Number(if appNcable)
2. Representative (if any): -^- ------ _ —
Ffirn
--- --- ---._..— -- .....--- --- -- --.
Contact Name: E-MaO.Address
Mailing Address -�
.—....- --....----- '---- - ...—.. - ---'—
Cdy/Town state
Zip Code
phone Number Fax Number(if applicable)
B. Determinations
1. I request the Salem. — make the following determination(s)-Check any that.apply:
Conservation Commission
❑ a.whether the area depicted on pliiln(s) and/or map(s) referenced below is an area subject to
z jurisdiction of the Wetlands Protection Act.
®
W o "� ❑ b:whether the boundaries of resource area(s)depicted on plan(s) and/or map(s)referenced
N Z�
:> below are accurately delineated.
.- -MW ate.
c,whether the work depicted on plan(s)referenced below is subject to the Wetlands Protection Act.
W c� z
Q ❑ d. whether the area and/or work depicted on plan(s) referenced below is subject to the jurisdiction `
of any municipal wetlands.ordina nce.or.bylaw of:
Name of Mun,dpail
❑. e. whether the following scope of alternatives is adequate for work 1n the Riverfront Area as
depicted on refers need plan(s).
Massachusetts Department.of Environmental Protection
Bureau of Resource Protection -Wetlands ctyRown
l WPA Form 1 - Request for Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. Project Description
1. a. Project Location (use maps and plans.to identify the location of.the area subject to.this request):
35 Winter Island Road Salem
Street Address. . . Gity[Town
44 28
Assessors Map/Plat Number Parcel/Lot Number
b. Area Description (use additional paper, if necessary):
North side of parcel, abutting resource.area.
c. Plan and/or Map.Reference(s):
�cxys r-1A-P
Tide Dorte
Pi-ak PL&IJ a' /4 l03
Title D e
Nt_rort�' r �qlt� � I6�U3
Tide-.. —Date
-
2. a. Work Description (use additional paper and/or provide plan(s) of work, if necessary):
LAIMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands Gry Town
WPA Form 1 - Request for Determination of Applicability
', Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. Project Description (cunt.)
b. Identify provisions of the Wetlands Protection.Act or regulations which may exempt the applicant
from having to file a Notice of Intent for all or part of the described work(use additional paper, if
necessary).
Project limited in scope no adverse impact to resource area.
3. a. If this application is a Request for Determination of Scope of Alternatives for work in the
Riverfront Area,:indicate the one classification below that best describes the project.
® Single family house on a lot recorded on or before 811/96
El-Single.famlly.house on a lot recorded after8/1/96
❑ Expansion of an existing structure on a lot recorded after 8/1196 .
❑. ,Project, other than a single family house or public project, where the applicant owned the lot
before 8/7/96
❑..New.agriculture or aquaculture project
❑ Public project where funds were appropriated prior to 817/96
El Project on.a.lot shown on an approved;definitive subdivision plan where there is a recorded deed
restriction limiting total alteration of the Riverfront Area for the entire subdivision
❑. Residential..subdivision,,institutional,industrial;or commercial project
❑ Municipal project
El-District, county, state, or federal government project
❑ Project required to evaluate off-site alternatives in more than one municipality in an .
Environmental Impact.Reporl under MEPA or in an alternatives analysis pursuant to an
application for a 404 permit from the U.S. Army Corps of Engineers or 401 Water Quality ,
Certification from the Department of Environmental Protection.
b. Provide evidence (e.g., record of date subdivision lot was recorded) supporting the classification
above (use.additionai paper and/or attach appropriate documents, if necessary.)
Dunn g M l
Massachusetts.Department.of Environmental_Protection
Bureau of Resource Protection - Wetlands cry Town
WPA Form 1 - Request for Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131; §40
D.Signatures and Submittal Requirements
I hereby certify under-the penalties.of perjury that.the foregoing Request for Determination.of.Applicability
and accompanying plans, documents, and supporting data are true and complete to the best of my
knowledge.
1 further certify.that the property owner, if different from the applicant,:and the appropriate DEP Regional
Office (see Appendix A)were sent a complete copy of this Request (including all appropriate
documentation)simultaneously with the submittal of this Request to the Conservation Commission.
Failure by the applicant to send copies in a timely manner may result in dismissal of the Request for `
Determination,of Applicability.
Name and address of the property owner: ,
�7 t
Name
S SJ Z/)J Yi f r r JA:1u 40,
Mailing Address
CityrTawn..
State Zip Code
Signatures: lv •, � -.0
I also understand that notification.of this Request.will.be placed.in a local newspaper at my.expense
in accordance with Section 10.05(3)(b)(1) of the Wetlands Protection Act regulations.
Signatureof Applicant Date
Signature of Representative(if any) Date
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Commonlua:tL� 0� r t l0�nchula�
�atnes l CamooN &J,e, ///..a.elaataelh 02111
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Workers' Compensation Insurance Ada*
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. . with.a principal place of business at:
itJgt,.n.q+p
do hereby'certify under she pairs and penalties of perjury. thus:
() 1 am an employer providing worker' compensation coverage for my cinployees working on
this job.
Insurance Compimy Policy Number
i am a sole proprietor and have no one working fdr me in any capaeiq.
O 1 am a sole proprietor, general conmcwr or homeowner (circle one) and have hired the
contractors listed below who-have the following workers' com
rs pertsatlon policies:
Contractor insuranie Comparry/Policy Number
Contractor Insurance Company/Polity Number
Contractor Incur race Company/Policy Number
O I am a homeowner performing all the work myself.
I unowwne mat a tear d this wo meet wi be ion.aroee to &* orree ei invotitaupm of the DIA la eoversre vvirVic•d•n aft ahaa labour 1e ate.re
corerart as tto vto.new Section 2SA of HGL 15 2 can kad to ow:taoetnion of cnnnat oetanon conatstins of a hm of W M-61-500A0 sewer one
ream' iaxttotenmt at%o at eivi eenvisio in the lortn of a STOP WORK ORDER ano a fort of S 100.00 s .rl aµiat ttae.
Sirned this day of
ccnscci'Fcrmittct cuilcing Departr. ent
uctnsing Ecare
Seiectmens Office
one r.05, epe, 77t