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FORM A CITY CLEitM. SALFM, MASjS
APPLICATION FOR ENDORSEMENT
OF PLAN BELIEVED NOT TO REQUIRE APPROVAL
In accordance with provisions of Section II-B of the Salem Subdivision Regulations, the applicant must
file, by delivery or registered mail, a notice with the City Clerk stating the date of submission for such
determination. The notice shall be attached to this application form. Seven (7) hard copies of the notice
and application shall be brought by the applicant to the City Clerk to be "date stamped". The City Clerk
will retain the original; the remaining six (6) hard copies of the notice and application, as well as six (6)
hard copies of the Plan, and one (1) electronic copy of the notice, application, and plan, shall be filed in
.pdf format with the Planning Board by the applicant. All hard-copy notices and applications shall be
typewritten or neatly printed in ink.
To the Planning Board:
The undersigned,believing that the accompanying plan of his property in the City of Salem does not
constitute a subdivision within the meaning of the Subdivision Control Law because(state specific
reasons):
The plan depicts two non–buildable lots, .Parcel A and Parcel B. Once
conveyed, those lots _willeach- form one contiguous lot with the
abutting lots. The conveyances will change the size and shape of the
lots without decreasing the amount of frontage.
and herewith submits said plan for a determination and endorsement that Planning Board approval under
the Subdivision Control Law is not required.
I. Name ofOwner Salem Hospital and the City of Salem
81 ig an venue, 'Salem, Phone
Address .81
WashingtonStreet, Salem,!ATO
2. Name ofAp Iicant/Contact(ifdifferentthanowner) c/o Joseph C. Correnti, Esq.
S erafini, Darling & Correnti,—LLF—
Address Aj Fo l.r.l street RRI om MA ' 01970 Phone (978) 744-0212
3. Name of Engineer or Surveyor .North Shore Survey Corporation
Address 14 Brown Street, Salem, MA 01970 Phone (978) 744-4800
4.Deed of property records in Essex South District Registry
Book 2272 Page 526 and Book 1850, Page 447
5.Location and Description of Property:
55 Highland Avenue and 1 Powder House Lane, Salem, MA
6. All streets and abutting lot lines shall be shown_on the Plan together with the names of the Owners of
f/ butt' lots. dic 1 nter, Inc.
a o
By: S' na r p can[ Signature of Owner(attached consent letter is also acceptable)
sepPlr orrentY, Esq.
December 13, 2016
Date Dale
9LI;o��
FEE PAID: $75.00
By:
Date: December 13, 2016
NOTICE TO BE A`P`I'ACIMII TfT ----- ----
FORM"A"APPLICATIONS
See Form"A"applications for
Complete instructions for filing.
All insertions shall be typewritten
Or printed neatly in ink.
Date: December 13, 2016
City Clerk
Salem,Massachusetts 01970
Dear Sir/Madam:
I hand you herewith a Form A application submitted by me this day to the Planning
Board of the City of Salem requesting a determination and an endorsement on a plan filed with
said application that Planning Board approval under the Subdivision Control Rules and
Regulations is not required.
The land shown on the accompanying plan is located at 55 Highland Avenue and 1 Powder House Lane
(Insert street name and number(s)here)
Map 24, Lot 0220 & Map 24, Lot 219 in Ward 3
(Insert map and lot number(s)here)
Nort Shore edical Center, Inc.
f/k/ Sa]!e> I t
Signature of Owner Ey: d
s p C. C rrenti, Esquire
Street Address C-ti, LLP
City/Town& State 6 Federal Street, Salam, MA 01970
Telephone Number (978) 744-0212
'ty of em .
Bye
L
93 Washington Street
Salem, MA 01970
SERAFINI, DARLING & CORRENTI, LLP
ATTORNEYS AT LAW
63 FEDERAL STREET
SALEM, MASSACHUSETTS 01970
JOHN R. SERAFINI, SR. TELEPHONE
JOHN E. DARLING 976-744-0212
JOSEPH C. CORRENTI FACSIMILE
KRISTIN E. KOLICK 976-741-4683
December 13, 2016
VIA HAND DELIVERY
Amanda Chiancola, Staff Planner ��/ ��
City of Salem
Department of Planning and Community Development SEC 13 2016
120 Washington Street cc�"MUNpro ANNI , &
Salem, Massachusetts 01970
SENT
Re: North Shore Medical Center, Inc., et al
Applications for Site Plan Review
Dear Ms. Chiancola:
Enclosed for filing with the Planning Board please find the following:
1. One (1) full-size set of revised landscape plans (Sheets L.1.1 — L.1.5)
prepared by VHB dated December 7, 2016;
2. Nine (9) 11"x17" sets of revised plans dated December 7, 2016.
An electronic set of the materials listed above have been sent to you
previously under separate cover.
Very truly yours, '
?JoephC. o�renti
Enclosures
cc: client
MAP 25 LOT 659
CITY OF SALEM
MIDDLE SCHOOL WEST
29 HIGHLAND AVE.
CITY OF SALEM �`�7, w
POWDER HOUSE LANE -o°F s�o
PO WDER HOUSE L A N E " o
S 54.06 46 E ��\ MAP 24 LOT 219 yo �
S 54'06'46" E CITY OF SALEM G MAP 24 LOT 288
136.55 IRON 52'39 PARCEL A � BERTRAM FIELD `s'c� �O
ROD MAP 24 LOT O 1 POWDER HOUSE LN. !y Z
sET o PARCEL A SALEM HOSPITAL
I.s HIGHLAND HALL L�
AREA = 6298 f S.F. OFFICE CONDOMINIUM Z
she IRON 55 HIGHLAND AVE. GF
ROD MAP 24 LOT 87
SET
ai PARCEL B MAP 24 LOT 218
f NORTH SHORE MEDICAL
CENTER, INC.
13.92'
N 02.09'05" W y A� MAH CORP.
MAP 24 LOT 2 MAP 24 LOT 216
NORTH SHORE MEDICAL CENTER, INC.
O 2 1 DOVE AVE.
S� A D
Z
F sp
v
p � CONCRETE BLOC D
\;S,Op BUILDING Z
\ode C SALEM HOSPITAL
°� m MAP 24 LOT 221
07 �
> MAP 14 LOT 129�f MASALEM4 HOSPILOTTAL O .
cs�
pace_
afl.0=
.y •may .,
\0�� S 50"11'34' E
21.38
F
i
CITY OF SALEM
Z� BERTRAM FIELD
REEN
SALEM HOSPITAL �p`�� WA
D.
PLANNING BOARD APPROVAL UNDER
DEED REFERENCE - REC. BK. 2272 PG. 526
THE SUBDIVISION CONTROL LAW NOT REQUIRED t�
PLAN REFERENCES - REC. BK. 2272 PG. 600 \
PLAN BOOK 189 PLAN 74 - LOT 1 y
SALEM PLANNING BOARD AREA f A gg,,05 f S.F. Os�s�� .
LOCUS MAP
6. ? tES (EXISTING) �.� , SCALE 1 - 200'+
AREA = 261 759 f S.F. s f
6.47 f ACRS (REMAINING) <11
i
�s
s o�
f
O
c!�
\
THE ABOVE ENDORSEMENT IS NOT A DETERMINATION G NOTES:
OF CONFORMANCE WITH ZONING REGULATIONS 1. PARCEL A IS CURRENTLY OWNED BY SALEM HOSPITAL. SALEM
O�
HOSPITAL HIGHLAND HALL OFFICE CONDOMINIUM IS THE LESSEE
UNDER GROUND LEASE RECORDED IN RECORD BOOK 7491 PAGE 185.
PARCEL A IS TO BE CONVEYED TO THE CITY OF SALEM
AND INCORPORATED INTO THE LOT OF BERTRAM FIELD TO FORM ONE
3 CONTIGUOUS LOT. PARCEL A IS NOT A BUILDABLE LOT.
O 2. PARCEL B IS CURRENTLY OWNED BY THE CITY OF SALEM.
IT IS TO BE CONVEYED TO NORTH SHORE MEDICAL CENTER, INC.
AND INCORPORATED INTO THEIR LAND TO FORM ONE CONTIGUOUS LOT.
PARCEL B IS NOT A BUILDABLE LOT.
s
s /5
s /�\. S 09'23'S'�1" W
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ONS�Rv �� F , 12.09'
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Fqs �2ti PLAN OF LAND I VE
SALEM `77'
e..'.m.J 1 �..•i�
DEPT. OF PLANNING &
FOR REGISTRY USE ONLY o O�0% 39 F X216 55 HIGHLAND AVENUE COMMUNITY DEVELOPMENT
A'�a IRON PROPERTY OF
Xo ��%' ROD SALEM HOSPITAL HIGHLAND HALL OFFICE CONDOMINIUM
� 1
SET
0.k 18. NORTH SHORE 1 DOVE AVENUE
S $ MEDICAL CENTER, INC. PROPERTY OF
4 � UG
AREA = 399,371 t S.F. NORTH SHORE MEDICAL CENTER
9.17 � ACRES (EXISTING 1 POWDER HOUSE LANE
q Y, )
PARCEL 6 HOF
�+ = REC. BK. 34428 PG. 229 PROPERTY OF
o AREA 1219 f S.F. 0 9y
GAIL L. m
CITY OF SALEM
A�, PLAN BOOK 312 PLAN 98 � N
SMITH
4L PARCELS A, B, C, & 2 AND LOT 2 � 2016
+ INCLUDING: LCC#1563 E PARCEL 2 NO.35M co SCALE 1 = 30 APRIL 28,
i CERTIFY THAT THIS PLAN CONFORMS TO THE $ 9 NORTH SHORE SURVEY CORPORATION
LCC 1563 F PARCEL 3 �s �G�STER�� 14 BROWN STREET - SALEM, MA
RULES AND REGULATIONS OF THE REGISTERS OF DEEDS. LCC#1563 G LOT 10 s'`�wc wao
• ,,,, 978-744-4800
I
�{ Ile- I� � AREA = 400,590 f S.F. —
9.20 ACRES (INCLUDING PARCEL B) GAIL L SMITH, PLS
DATE PROFESSIONAL LAND SURVEYOR 0 30 60 90 #1647