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AMANDA WAY - CONSERVATION COMMISSION RDA JLot-39 Amanda Way UNITED STATES POSTAL SERVICE ... r . Ilk w99 ESStaes�aidEH7�5 i :1�� .L -L. • Sender: Please print your name, address, andTffl =ifl this box II I I I I Salem Conservation Commission 120 Washington Street,3rd FI Salem,MA 01970 I to 9 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse X 0 Addressee so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery 0-Attach this card to..the back of the mailplece, or on the front if space permits. D. Is delivery address different from item 1? 0 Yes 1. Article Addressed to: If YES,enter delivery address below: 0 No The Commonwealth of Massachusetts Department of Environmental Protection Northeast Regional Office 3. Service Type 205B Lowell Street 0 Certified Mail 0 Express Mail Wilmington,MA 01887 0 Registered 0 Retum Receipt for Merchandise O Insured Mall 0 C.O.D. 4. Restricted Delivery?fED&a Fee) 13 Yee 2. Article Number 70051 3110;;00007176' 7',64`3 (fiansfer irrom service label) Ili PS Form 3811,February 2004 Domestic Return Receipt 102595 2-M-IW' -UNIT POSTALERVIC?. '7Y 1p MA 018 Sender: Please print your name, address, and ZI4 in th (�, z Y..61'� � p � � zo Salem Conservation Commission > z 120 Washington Street,3rd R w °Q w I` Salem,MA 01970 o a { ULD C) = � W = I a oC) rr C-3 C) I I p s a3 Ill�nn�l�lilnln��l�um�ln l�lml�ln ll�li�ulilui�l�ll SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Sign ure item 4 if Restricted Delivery is desired. X Ln/1 s gent ■ Print your name and address on the reverse K- Addressee so that we can return the card to you. g R d by Pdnted Name j C. Date of Delivery ■ Attach this card to the back of the mailplece, or on the front if space permits. - --c) C 1. Article Addressed to: D. Is delivery address different from Item 11 ❑Yes If YES,enter delivery address below: 0 No Mr. Paul DiBiase Osborne Hills Realty Trust PO BOX 780 1 3. Service Type 13 Certified [3 etu Ript Mall Receipt for Merchandise Lymtfield Ma 01940 111 - -'..- — - ❑Insured Mail 0 C.O.D. 4. Restricted Delivery!(Extra Fee) ❑Yes I2. Article Number3110 `0000 71767'650 1 (transfer from service taboo J PS Form 3811,February 20D4 Domestic Return Receipt 102595.02-M-1540 COMM- CITY OF SALEM CONSERVATION COMMISSION August 6, 2007 Mr. Paul DiBiase Osborne Hills Realty Trust PO Box 780 Lynnfield,Massachusetts 01940 Re: Determination of Applicability Lot 39 Amanda Way, Salem, Massachusetts Dear Mr. DiBiase: Enclosed, please find the Determination of Applicability for the above referenced project. Following the 10-day appeal period (as of August 15, 2007), you may proceed with your project. Please note that the Commission has issued a Negative 3 Determination stating that the work described is located with the Buffer Zone, as defined in the regulations, but will not alter an Area subject to protection under the Act. The Commission is not requiring that you file a Notice of Intent, however the Commission requests that you include information outlined in the attached additional conditions, relating to information to be included on the property deed for Lot 19, information included in the association documents, saving a tree located approx. 40 feet from the southwest corner of the proposed house, and the installation of orange construction fence around the base of the tree to help protect the tree from damage during the construction of the proposed house and associated activities. This Determination is good for three years from the date of issuance, August 6, 2007, except in Areas Subject Protection as stated in the Wetlands Protection Act under MGL c. 131, Section 40. If you have any further questions, please feel free to contact me 978-619-5685. Sincerely, Carey Duq es Conservation Agent/Staff Planner Enclosures CC: DEP Northeast Regional Office 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 Osborne Hills Realty Trust. return key. Name Name PO Box 780 m Mailing Address Mailing Address 40 Lity/Ton MA 0p Cod Lynnown State Zip Code City/Town State Zip Code a�a 1. Title and Date (or Revised Date if applicable) of Final Plans and Other Documents: Site Development Permit Plan Lots 16-19 & 37-39 May 3, 2007 Title Date Title Date Title Date 2. Date Request Filed: May 31 2007 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 proposed project includes the grading and landscaping within the buffer zone of BVW on Lot 39 on Amanda Way. Project Location: Lot 39 Amanda Way Salem Street Address City/Town Map 9 Parcel 1 (portion) Assessors Map/Plat Number Parcel/Lot Number wpaform2.dm•rev.3/1/05 Page 1 of 6 LlMassachusetts 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) or Order of Resource Area Delineation (issued following submittal of Simplified Review ANRAD) 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 or ANRAD Simplified Review (if work is limited to the Buffer Zone). ❑ 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 wpaform2Am•rev.&1/05 Page 2 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.) ❑ 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). See attached sheet. ❑ 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. wpaform2.dm•rev.3/1/05 Page 3 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.) ❑ 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 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 appropriate DEP Regional Office (see Attachment) and the property owner (if different from the applicant). Signatur I/ July 26 2007 Date wpaiorr .doc•rev.311105 Page 4 o15 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 Attachment) 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 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. "pecan .dw•rev.3/1/05 Page 5 of 5 �CONWP / CITY OF SALEM CONSERVATION COMMISSION Determination of Applicability Special Conditions Osborne Hills SubDivision Lot 39 on Amanda Way, Salem, MA The Salem Conservation Commission finds this Request for a Determination of Applicability negative so long as,the following Special Conditions are met: 1. The applicant shall include the following information in the association documents for Lot 39 located on Amada Way. 2. The applicant shall include the following language in the deed for Lot 39 located on Amada Way: "the owner(s)of Lot 39,pursuant to said Order of Conditions and the Massachusetts Wetlands Protection Act,are prohibited from certain activities. Certain prohibited activities shall remain in affect notwithstanding the issuance of a Certificate of Compliance relating to the Order of Conditions. These prohibited activities include: installation of a swimming pool,re-grading or filling of the lot, adding additional impervious material such as bituminous concrete or regular concrete or any other activity that would be regulated by the Massachusetts Wetlands Protection Act. The activities that are prohibited,however,may occur upon appropriate approvals obtained from the Salem Conservation Commission or the Massachusetts Department of Environmental Protection or any successor entity." A copy of the deed shall be submitted to the Conservation Agent to be included in the project file. 3. The applicant shall include language in the association documents stating"The subdivision is developed within and around Wetland areas that are subject to the jurisdiction of the Salem Conservation Commission. The dumping of leaves,yard waste,debris or any other material into any Wetland area or into the Open Space or Common Parcels is prohibited. The Owners of any Lot responsible for violating this prohibition shall be responsible fmancially and criminally for any violation of this prohibition,including all costs(including court costs and attorney fees)associated with the restoration of the disturbed area" A copy of the association documents shall be submitted to the Conservation Agent to be included in the project file. 4. Applicant shall install orange construction fence around the base of the large caliper tree, located approximately 40 feet from the southwest corner of the house,to protect the tree from damage during construction. 5. If the applicant does not comply with these Special Conditions the applicant shall file a Notice of Intent. r w CITY OF SALEM CONSERVATION COMMISSION PROJECT LOCATION: DATE OF SITE VISIT U PROJECT PROPONENT: 11AI o ZLqJ DEP FILE NUMBER:__ PROPOSED WORK: VaSt1y`s r Commission Members/Agent: � Abutters: r Applicant/Property Owner/Representative: SITE ViSIIS PURPgSE ' []Request for Determination O Abbreviated Notice of Resource Area Delineation (Notice of Intent ❑Certificate of Compliance ❑Enforcement/Violation Emergencyf` � Informal AREAS OF]URISDICTION.a c -? INLAND RESOURCE AREAS COASTAL RESOURCE AREAS ❑Bank Land Subject to Coastal O Land Under the Ocean ElBordering Vegetated Wetland Storm Flowage ❑Land Subject to Flooding O Designated Port Area OCoastal Beach OLand Under Water Bodies or Waterway ❑Coastal Dune O Barrier Beach Name: O Coastal Bank .. ii.. —ORiverfront Area O Salt Marsh 0Rocky IntertidalShore- 11Land Under Salt Pond ❑Vernal Pools OLand Containing OAnadromous/Cata- Shellfish dromous Fish Run OBordering Vegetated Wetland in Coastal Area 120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 w TEL: 978'.745 9595 FAx: 978.740.0404 • WWW.SALEM.COM ❑Water Body Bordering Vegetated Wetland ❑ Bank ❑ Coastal Beach ❑Coastal Dune Protection of Water Supply Protection of Groundwater Supply Flood Control jStorm Damage Prevention prevention of Pollution ❑Protection of Fisheries otection of Wildlife Habitat ❑ Protection of Land Containing Shellfish Is this an exempt project: If so,why? Are resource area boundaries delineated correctly? If not,explain. .?t":��i'sTrau;.r.�;b�.n:°.^.�=r�3',� F:..�, . _ �,", ' '�a �Yl'. '••+a-..»r;:vx,: SiCE•VISrG=DOCUMEI4T/bTIO `� `•� �� �. '. ❑Photos ❑ Site Map ❑Other: %F�3149��'fi*,�,?.i� "F5 - x � w m,-g�z'x,.,u,. ,.�. � n^us- • m ,���. .-�r :':+ Take into account relevant aspects or features such as: natural or piped drainage or obvious pollution; topography; existing vegetation; possible alternative sites; signs of wildlife, possible vernal pools, rare species habitat; landmarks; recent or historical disturbances; proximity to other water bodies or drainage areas; adjacent land uses. & 59 mL fr� q13(6- lG fQarve HiQ rttrn P� i 7 Lo 0 - a 4a Ivi t - o, 1 ` I �b9 7 I l� .�,,. �,�,. -� k1.8 : -, htiw � of Cot l4 RECOMMENDATIONSi a Y 5 s �s*' % z f rA 21 U t i OSBORNE HILLS LOTS 16-19 & 37-39 Lot Filing Type Maximum Distance Distance Roof Impervious Impervious Comments Wall Height Work to Dwelling to Recharge Coverage as Coverage as Resource Resource Shown on Proposed Area Area Definitive May 2007 Plan (SF) (SF) 16 NOI 8 FT. 48 FT. 93 FT. Yes (2) 1,925 2,400 Increase 475 SF. Added Roof Rech. 17 NOI 10 FT. 49 FT. 95 FT. Yes (2) 2,060 2,400 Increase 475 SF. Added Roof Rech. 18 NOI 10 FT. 41 FT. 80 FT. Yes (2) 2,060 2,400 Increase 475 SF. Added Roof Rech. 19 RDA 8.5 FT. 78 FT. 104 FT. Yes (2) 2,600 3,100 Increase 500 SF. Added Roof Rech. 37 NOI 4.5 FT. 7 FT. 42 FT. No 1,925 1,925 ----- 38 NOI 4.5 FT. 73 FT. 125 FT. Yes 1,920 2,160 Increase 240 SF 39 RDA ----- —7-8 —FT--U-7 FT. Yes 1,920 2,400 Increase 240 SF Increased Size of Roof Rech. CONDITION NO. The deed for lot 13 shall contain the following restrictive language: Lot 13 is subject to an Order of Conditions issued by the Salem Conservation Commission (DEP File# ), recorded at Essex South Registry of Deeds at Book , Page . The owners of Lot , pursuant to said Order of Conditions and the Massachusetts Wetlands Protection Act, are prohibited from certain activities. Certain prohibited activities shall remain in affect notwithstanding the issuance of a Certificate of Compliance relating to the Order of Conditions. These prohibited activities include: installation of a swimming pool, re-grading or filling of the lot, adding additional impervious material such as bituminous concrete or regular concrete or any other activity that would be regulated by the Massachusetts Wetlands Protection Act. The activities that are prohibited, however, may occur upon appropriate approvals obtained from the Salem Conservation Commission or the Massachusetts Department of Environmental Protection or any successor entity. J ARTICLE XII CONSERVATION COMMISSION The subdivision is developed within and around Wetland areas that are subject to the jurisdiction of the Salem Conservation Commission. The dumping of leaves, yard waste, debris or any other material into any Wetland area or into the Open Space or Common Parcels is prohibited. The Owners of any Lot responsible for violating this prohibition shall be responsible financially and criminally for any violation of this prohibition, including all costs (including court costs and attorney fees) associated with the restoration of the disturbed area. 5= � CITY OF SALEM �s CONSERVATION COMMISSION AhClglN6 City of Salem mmi Conservation Commission Will hold a public hearing for a Request for Determination of Applicability under the Wetlands Protection Act, Massachusetts General Laws, Chapter 131, Section 40 and Salem's Ordinance Pertaining to General Wetlands at the request of the Osborne Hills Realty Trust, P.O Box 780, Lynnfield, MA 01940. The purpose of the hearing is to discuss the proposed grading and landscaping of in the buffer zone of BVW on Lot 39 on Amanda Way off of Marlborough Road. This hearing will be held on Thursday,June 14, 2007 at 6:00 pm in Room 313, City Hall Annex, 120 Washington Street. Kevin P. Cornacchio Chairman Please print legal advertisement on: June 7, 2007 Please send bill to: Attorney John Keilty 40 Lowell Street Peabody, MA 01960 978-531-7900 I City of Salem [Department of Planning & Community Development Check/Cash Receipt and Tracking Form Please complete form and make two copes, Date Received S D Amount Received g . 0 0 Form of Payment Check Cash CHECK PAYMENTS: write check number / 9 9 CASH PAYMENTS: write dient Initials r❑-1�nSiDn %nrdt Application Fee LJ wvatlon Commission Fee Payment received for what Service? ❑ P1111n"1111V Nwd Fee 0 Old Town Hae Rental Fee 0 Other Name Of staff person receiving payment Additional Notes I, =1i, t DATE! = INVOICE' , AMOUNT f1i 53-179ll r, EI !• ItJOHNR KEILTY,ESQUIRE �1 na II jj� ,I II! wenfs TrustA'ccn-?it Eti � 1f� 11 �� ! k ii 40 LOWELL S•PR�T 1�1 I �I1 I li' E, I 1 ' Itl ll�:'-1 ! i' 7i� !�' � �17 �i+�. i�! it ' PEABODYt MASSACHUSETTS 01960 I �` - !" ' ' it It It '– AYI�I It I�f= 3 ^— _ T _. TO THE OF' I {{ —GROSS AMI? t! ! OESCNPLON i ` " NET AMO !� 0 ilt , ,t, � t4 s � -, � kt! 1 ` .; ��� t ' ii � t -� rl •: 11 ��' ® m ti ii t �II E` ,— I!! _ I _1� �1 – i❑ j. ' n Bank, rlo ' 1 _=i u•OOi909u• � OL1�3OL798.�: 140 1324 L311• I II - II --'lt u � , !It Ilt - Original Check and Fonm DPCD Flnanca Cour 1: Client Copy 2:APPlIcatlon File Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands Salem �\ WPA Form 1- Request for Determination of Applicability City/Town Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. General hiformation y\. Important: When filling out 1. Applicant: forms on the Osborne Hills Realty Trust computer, use Name E-Mail Address only the tab key to move your P. O. Box 780 cursor-do not Mailing Address use the return Lynnfield MA 01940 key. City/Town State Zip Code 781-844-7026 rd Phone Number Fax Number(if applicable) 2. Representative (if any): Firm Attorney John Keilty Contact Name E-Mail Address 40 Lowell Street Mailing Address Peabody MA 01960 City/Town State Zip Code 978-531-7900 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 plan(s) and/or map(s) referenced below is an area subject to jurisdiction of the Wetlands Protection Act. ❑ b. whether the boundaries of resource area(s) depicted on plan(s) and/or map(s) referenced below are accurately delineated. ® c. whether the work depicted on plan(s) referenced below is subject to the Wetlands Protection Act. ❑ d. whether the area and/or work depicted on plan(s) referenced below is subject to the jurisdiction of any municipal wetlands ordinance or bylaw of: Name of Municipality ❑ e. whether the following scope of alternatives is adequate for work in the Riverfront Area as depicted on referenced plan(s). wpaf.,l.d.c Page 1 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands Salem WPA FOrm 1 - Request for Determination of Applicability City/Town 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): Lot 39 Amanda Way Salem Street Address City/Town 9 (portion) Assessors Map/Plat Number Parcel/Lot Number b. Area Description (use additional paper, if necessary): Approximately 450 SF of land in the southeast portion of Lot 39 Amanda Way. c. Plan and/or Map Reference(s): Site Development Permit Plan May 3, 2007 Title Date Title Date Title Date 2. a. Work Description (use additional paper and/or provide plan(s) of work, if necessary): Grading and landscaping. I wpaforml.doc Page 2 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands Salem WPA Form 1- Request for Determination of Applicability Cityffown Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 C. Project Description (cont.) b. Identify provisions of the Wetlands Protection Actor 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). 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 8/1/96 ❑ Single family house on a lot recorded after 8/1/96 ❑ Expansion of an existing structure on a lot recorded after 8/1/96 ❑ 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 8/7/96 ❑ 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 ❑ District, county, state, or federal government project ❑ Project required to evaluate off-site alternatives in more than one municipality in an Environmental Impact Report 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 additional paper and/or attach appropriate documents, if necessary.) wpaforml.d= Page 3 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands Salem 1 WPA Form 1 - Request for Determination of Applicability CitylTown 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. I further certify that the property owner, if different from the applicant, and the appropriate DEP Regional Office 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: Osborne Hills Realty Trust Name P. O. Box 780 Mailing Address Lynnfield Cityfrown MA 01940 State Zip Code Signatures: I also understand that notification of this Request will be placed in a local newspaper at my expense in accordance with Sec ' 10.0 (3) b)(1) of the Wetlands Protection Act regulations. JT�7 07 Signature of App cant 4 Date Signature ep to iv d ny) Date w aforml.doc Page 4 of 4 sr M MA Ow IQLNN�l W MO gw 'All. Nix, a.0.itr .,4 WA xv, D2 Um V�l b""14!�-`,Zll�&W, All ,t o_q 3 W111 ld!n vL w,0371 ra s ;Met f, WOO I.M 4k, �'Pm U®ri-� lf�I�10.- 1 of I k am'. 51 --Q `-4­­'�,"T.,- ­'I ,I�Vmol%mmd Me! r W 1 101;22 '15orm 0 A R -WP Am 11 1 MP IT CID, F glp�sgj jy I .............. 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