4 BLANEY STREET - CONSERVATION COMMISSION RP4- y Brie y Sfrr
. n
Massachusetts Department of Environmental Protection
ILIBureau 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 Gary Palardy
return key. Name Name
er Mailing
Hull Street
Address Mailing Address
+' Beverly MA 01915
® City/Town State Zip Code Cily/rown State Zip Code
na 1. Title and Date(or Revised Date if applicable)of Final Plans and Other Documents:
Plan of land in Salem, Me
Title Date
Title Date
Title Date
2. Date Request Filed:
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):
Addition to multi-family dwelling at 4 Blaney Street
Project Location:
4 Blaney Street Salem
Street Address Cityrrown
Map 41 Lot 278
Assessors Map/Plat Number Parcel/Lot Number
wpafwrnZ x•w.12/15,00 Pepe 7 0!s
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
WPA Form 2 — Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Determination (cont.)
The following Determination(s) is/are applicable to the proposed site and/or project relative to the
Wetlands Protection Act and regulations:
Positive Determination
Note: No work within the jurisdiction of the Wetlands Protection Act may proceed until a final Order of
Conditions(issued following submittal of a Notice of Intent or Abbreviated Notice of Intent)has been
received from the issuing authority(i.e., Conservation Commission or the Department of
Environmental Protection).
❑ 1. The area described on the referenced plan(s)is an area subject to protection under the Act.
Removing,filling,dredging, or aftering 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 no 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
wpd rm2. o •m.1205M Page 2 d5
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 no
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.
❑ Altematives 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).
❑ 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.
wpefam2.d=•rev.11HSW Pape 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 0 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).
Signatures• C
i
Al
�i✓ary 9, 2006
Date
wpaform2.dm•rev.3/1/05 Page 4 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
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 tan 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 Appendb(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.
wpmam2Aee• 12/15= Pepe 5 a 5
ILIMassachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
WPA Appendix A — DEP Regional Addresses
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Mail transmittal forms and DEP payments,payable to:
Commonwealth of Massachusetts
Department of Environmental Protection
Box 4062
Boston,MA 02211
DEP Western Region Adeno coffin Hanpdan Monroe Pittsfield TynnW-
436 Dwight Street � H M Hancock Montwxx It
chinond were,
Suite 402 Amhewl Damn Hawley MMVM—Y Rowe Warwick
Springfield,MA 01103 Ashfield oswrrem Heath Monson Ru$WP wad-ow
Phone:413.784-1100 Rocket Eawnima°n lamdale Momq Washw4tan Sw diwsm Wardwell
Befderimae Ee&Lapnea4w Holland New Ashford Savoy weadlem
Fax 413.7841149 Beraddon Eyenaa Hayeke Now Marlborough St~ Weeaanpmn
Blamrad Ening Hudkglan New Baler, Shelburne West Spr"agnw
sretlem Florida Laneaeaaugh Nerd,Adarre Snuleaosy Went Stockbridge
Buddend
an Lee Nmmalp0en SouNarpm who"
Chademom Goehan Lerox Northfield Soudl Hedley vWsrehern
Chashire Grapy Levered OragB Sa Werk watarnsMeg
Chaeta Granville Leyden Ode SRVgfiem Wlaarutalw
Chasherlreld Great Bardnston Lagmeadaw PeCner stod c De Wnmao
Chicopee Grome m Wtltow Panum Sumonlem wadiagton
clebawg Hadley Middleaem Pen, Tolled,
DEP Central Region Aden Charlton, HoPkirdm Mek,wy RWlrm Wmrkile
627 Main Street As bnman clinical Hubbadsho, Mamie money waren
Webster
Worcester,MA 01608 AimDudley Holliston Naaraa
augh sme
mDudleyo gh wesmmmm
Phone:508.792-7650 Aubilrn Wad" Lanadw Nwhr+roe SmAlftdpe West Boylston
Fax:508-792-7621 Ayer East Brookfield Leicester Nam Brookfield Spencer Wer Brookfield
Bene Fldidwg Leamnsler OaMhen Swag Westford
TDD:508-767-2766 Baughan Gardner utaemn Octad Stow Wewnirutur
Berlin Grafton L--"" Paxton SoaaidSe Wirlo a don
Bledutare Grew Madbaagh Pepperell Sudan Wmwsta
Balm Harvard Mainland peteehan Templeton
Bmbaor,yn Hardwick Medway Phill'prm Townsend
Boylston Holder, Mended P1 xxIkX Tyrgebo`oLQh
Bre� Hopedale Milled RoyeMm Upton
DEP Southeast Region Abington ortnpum Freetown Mwapoiw Prowmahow, Tsory
20 Riverside Drive ACUSNW oasis Gey Heed Miadkbaagln ReyMem Truro
Lakeville,MA 02347 Abner Dw Newaearaa RRodvaa weitneet
Phone:508.946-2700 BarWeMe Feetham Hanover North ABiebam,ph Roddene Weal Bridgewater
Far.50&947-6557 BaurBe" Easton Norwell scikuda west TubLoy
TDD:50&946-2795 Brewer Edgertown wrgsmn Oak Skala Seekonk Whban
woomabr Fabtaven Letuville, orm" Shan V*Wom
Brockton Fell River Manhaki Penbroke sorreraet Yannorah
clever Feklnum Marion Pkknille Slo,*aon
chamem Faxbor-0 Mrshrukl Pvmuth Swruee
chinned, Franklin Mekpq Ptynptm Taunton
DEP Northeast Region ArrNw,y clpmvetord Hapten Merbmuc Quit" Wakarem
205 Lowell Street Andover Chelsea Holbrook Merin RWXb" welpde
Arlington Cd�
Hm Roxanne
Wilmington,MA 01887 Ashland co l� Mitre Watertown
Phone:978861-7600 Bedford Dowers Lawlerre Midan Rodpmt waylaid
Fax: 978-661-7615 Bein1pre Dedham Lexington Nahra Rowley Wei""
TDD:978-661-7679 sale", wenharn
Beverly
DrLowell eem rSalida" West Newey
Saxton Ease, Lynn Newbery sag- Weston
Bomad Everett Lrvftm NwAuyyat Sharban Westwood
Braintree Franirgtan Malden Newton set ite Weymoum
Broomire Geogelown Mlewremnay-Th See Norfolk Star~ Wilmhgton
Batagtm Gkarester Marblehead Nam Armover Sum,ry Wwcha
Carbidge Grweland Merbm Nam Reeling swarpeoad WM"V
caam Hendon MBMond Norwood Tewkedwy Wbbmn
cadieb Havedel Melrose Peabody Topsfum
Wpatomadoe•Appendix A•rev.11Q2W Page is 1
A
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: From:
When filling out
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 Gary Palardy
return key. Name Name
Hull Street
Ma
� Mailing Address Mailing Address
Beverly MA 01915
City/room State Tap Code Cily/rown State Zip Code
1. rifle and Date(or Revised Date if applicable)of Final Plans and Other Documents:
Plan of Land in Salem, Ma
rifle Date
rale Date
Title Date
2. Date Request Filed:
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):
Addition to multi-family dwelling at 4 Blaney Street
Project Location:
4 Blaney Street Salem
Street Address Citylrown
Map 41 Lot 278
Assessors Map/Plat Number Parce"Number
wpafmm2.doo•rev.ivtsm Paw r or 5
' Massachusetts Department of Environmental Protection
Bureau of Resource
Protection -Wetlands
WPA Form — Determinat on of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Determination (cont.)
The following Determination(s) istare 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 no 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
wpnlwmYAW•rev.12H510p Pope 2 of 6
Massachusetts Department of Environmental Protection
tection - Wetlands
Ll oWPAFResource — 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 no
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 a@ematives. (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).
❑ 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
wpafam2.d=•rev.12fISM Pape 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
❑ q 1
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 X 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).
Signatures, - cl
��✓a.y
17-
9, .2006
Date
w aforrrldx•rev.11/05 Page 4 of 5
:t
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 Appends 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.
wpmamz.dcc•m.12n5im papa s d s
L11Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Appendix A — DEP Regional Addresses
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Mail transmittal forms and DEP payments,payable to:
Commonwealth of Massachusetts
Department of Environmental Protection
Box 4062
Boston, MA 02211
DEP Wester Region Aosta Cotrm Hempen ranee pleaded Tymothem
436 Dwight Street � oler GaHancock Moroevue P49toM woke
$aIle 402 Mosel Darton Heated Moreover Richmond were
Hawley Monganay Rowe Warawk
Spring6ekf,MA 01103 Ashfield Demad Heath Martean Russell Wastlirgbk
Phone:413.7641100 eedwt Eadm Vice Heatless Mood warogmn samtefield Wanted
Belchertoan Eft Lapnaedow Holland New Ashford Sewy Waemed
Fax 413-7841149 Been Eprensd Holyoke New Manemouo, shied Wemnangm
Blardbd Erving HwftVtm New Salton Shalbne watsiannoed
Bdmftekd Flo ids Lar aborouph North Mann Slwrtea ay West Skddlydpe
Bmiderd Gin Lee Northampton Souwmaryb, Wtralaly
charismata Go~ Lean Northfield sneak Hedley, mbnthton
Craig" Gravy Levered orange Soldwrick wrmbnebrp
Cheeler Grenville Leydon One Sp vgmw Wdhwrdt wt
Cheuanud Greet Barmgton Lanmeemow Palmer skddeidpe Wmaar
Chicopee C#eennald Ludlow Panum Sunderland Worthington
Ckanabrp Hedley Motioned Pau Tolland
DEP Central Region ASA ch Hopkthdn Mido" Rutland thdafdpa
627 Main Street Aa lOurnh." Clinton Hwmdsmn MilNdk
Shirleyshirky Waren
Worcester,MA 01608 A hof om�ky Hdlg Nuffborogh wweabwapt
Phone:508-792-7650 Awn Dung" teneekr Northbridge wet Boyh on
Far.508.792-7621 Ayer Eau Broolfied Leiceekr Norm Brookfield Spenser wet Broddield
TDD:506-767-2788 BFitmWB Leaninua Oddh Stalinn Westford
nglsn Gardner LAUb oxford stow Waanlutx
Ballo Grafton LueMva Paden Serbndpe Wn,d,erdor,
Bleckat" Croeon Maborwgh Peppe en Sutton Wacater
Bolen Harvard Maynard Petoalm Templeton
Bo>maogh Htodwdrk Medway Pallpstm Twvuww
BgkEon Holden Manby Pntcolor Tytganotouph
Brookfield Hopedale MiBad Royelskn Upton
DEP Southeast Region AbinW- Darrow, Freetown Melupoum Prowlaeerow, Teluy
20 Riverside Dare AWUYIet Dennis Gay,Head HeMlddkDaoph Reynnan Toro
Wareharn
Lakeville,MA 02347 Avon,eboro oru�mronry Newaedfod RRoc ester wekmed
Phone:506.9462700 Btorretable East an Hanover Nod,Mmara,vn Rodderd West emoliev aar
Fax 508-947-6557 Bmday Eau Bridgewater Hanson Nona, Sandwich Westport
TDD:5069462795
Searle
err Edaamm aniekr,Easton Harwich Helms sedw
INdvewma Faehaven Lslur'nk Od to Sham vwmrdem
Brocidon Fal Rha Mansfieldpontroka Soared ymnwum
Cents F= Maim pkdmille Stoughton
Chatham Fosbarough Marshfield! Plynculn Swansea
Cnlrark FrwWm Madpw pNnvw Teuton
DEP Northeast Region Amosbuy Chanuord Nekglean Mmirac Glancy waermw
205 Lowell Street ArKlOW Chelsea Hobroolr Mama"
Roofing Wapde
ewwo Waterton
Wilmington,MA 01887 Ashland concord kpewim Md Revere Watertown
Phone:978661-7600 Boosted Davars Lawrance Mikan Rodpat Wayland
Fax: 978861-7615 Bel""dDedham Ladrgkn Nahan Rowley Wellesley
Beverly Dave Lincoln Natick Salem woman
TDD:978{61-7679 Bnbim Drama Lowell Needham salietway Wed Nmb y
Boum Eaton Lynn Newb-y Saupu Waum
Boxford Ever LyrMad Nwturypat Shaean Weamood
Brakaee Fttodndem Marlon Heston Somerville Weymouth
Brookline Georvelow, Mersteaew-sy-Twsse Norfolk sdroh m wianuptam
&Awgbn Gloucester Marblehead Nam Andover S,mdhuy Wffm* r
Cambridge Grovebd Medfield Nath Remkp Swtonpswe Winthrop
Cana HanlEm Medford Norwood Twksbuy \Nobm
CmkN Haemin Mdse Peabody Topdww
Wpefam2doc•Appendix A-mv.I lra W Pape tom l
l
«. CITY OF SALEM
CONSERVATION COMMISSION
City of Salem
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 Gary Palardy, 85 Hull Street,Beverly,MA 01915. The purpose
of this hearing is for a determination of whether a proposed addition to a multi-family dwelling at 4
Blaney Street is within an area subject to jurisdiction of the Wetlands Protection Act. This hearing will
be held on Thursday, February 9,2006 at 6:00 p.m.in City Hall Annex,Room 313, 120 Washington
Street.
Kevin R Cornacchio �J
Conservation Commission Chairman
Please print legal ad on:
February 2, 2006
Please send bill to:
Gary Palardy & Daniel Spencer
85 Hull Street
Beverly, MA 01915
978-376-2555
120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 .TEL: 978.745.9595 FAx: 978.740.0404 . WWW.SALEM.COM
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Creation Date:Nov 23,2003 11:27
Modification Date:Dec 15,2003 10:32 Average Scale: 1 inch=59.9 feet Distance between tick marks: 56.45 feet
City of Salem Department of Planning & Community Development
Check/Cash Receipt and Tracking Form
Please complete form and make two copies.
Date Received
Amount Received
Form of Payment Check Cash
CHECK PAYMENTS:
write check number Z
CASH PAYMENTS:
write client initials
Q Sign Permit Appikatim Fee
Conservation Commission Fee
Payment received for panning Board Fee
what service?
Q Old Town Hall Rental Fee
Q Other
Name staff person Fax r 0 f".a
i
receiving payment
Additional Notes Re� _
•
y r JI
GARY•H. PALAROY ' t'83 OW2113
DANIEL' SPENCER"SPENCER y ,> "+ �n OWi89188 A mss`' 2;5„ z
85 HULL ST At-
BEVERLY MA 019151'445 Z' �4 G /
Y 7lilw CO�Sevaa��
Co
SaletniP n:
4y 4
210 E;—S-m Salem,MA 01970
41: 2-1 & 3405581: 0960i89i8i3u' 01'25
Original Check and Form: DPM Flnance
Copy 1: Client
Copy 2: Application File
Massachusetts Department of Environmental Protection
Sale y .
Bureau of Resource Protection -Wetlands c�n-own
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 G aY 'v�Zv 77 _yl(E Y S `aC S�teZT� ® �o�vk� ce4r
computer,use Name E-Mail Address
only the tab key
to move your q 1� V C,�t
cursor-do not Mailing Add
use the return g�PCU Cly
key. City/rows stateZip e
On%- `37v- 97$ - 9a_),-aoo5
m Phone Number Fax Number(H applicable)
2. Representative(if any):
/VIA
Firm
Contact Name E-Mail Address
Mailing Address
Cityrrown State Zip Code
Phone Number Fax Number(if applicable)
B. Determinations
1. I request the ('"o-S.1 o A m CUrftuus� N make the following determination(s). Check any that apply:
Conservation Commission
da.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 pian(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).
wparormtdoc•m.07114104. Page 1 oro
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 1- Request for Determination of Applicability cdy/rom
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):
q CA - S aAew�-
street Address Q CRy/r""
Hl .L� kt - 033y + a 'zg
Assessors Map/Plat Number Parce"Number
b. Area Description (use additional paper, if necessary):
C Soya
c. Plan and/or Map Reference(s):
�f " �/arj fie - B.kIH�41 P, S9 �1�7/9rr
TitleP Date
c`rt-�� d/ ! — � /-�iSeSsdo• s Nyz ,f'- ��� G17�/o:G 33N �
Title Date
Title Date
Z a. Work Description
nn11(u11slI a additional paper and/or provide plan(s)of work, if necessary):
N 't, 15
wpalam7Aoc•rev.07H4I04. Pape 2 014
Massachusetts Department of Environmental Protection S a cw„
Bureau of Resource Protection - Wetlands
WPA Form 1- Request for Determination of Applicability crtrRom
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. Project Description (cont.)
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).
3. a. If this application is a Request for Determination pp eq nation 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 817/96
❑ 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.)
wparoimt Goo•m.m114ffik
aaae s a a
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 1- Request for Determination of Applicability C4/1'own
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(see Attachment)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.
C�zr p / pz,, spe�c�r
Name
Mailing Address
gzscrl� µPQ . olgl�
Citylrown
Ra. (9c41i
State zip Code
Signatures:
I also understand that notification of this Request will be placed in a local newspaper at my expense
mr lit on 10 05(3, )(b)(1)of the Wetlands Protection Act regulations.
lLc` x/10/0 6
g�reol`Applicant " Date
Signature of Rdoresentative(H any) Date
wpafm I.doe•rev.0711409. Page40f4
SENDER: 1 1N COMPLETE THIS SECTMNON DELIVERY
■ Complete Items 1,2,and 3.Also complete A. Signatufe
Item 4 if Restricted Delivery Is desired. ❑Agent
X
■ Print your name and address on the reverse M;fAdressee
so that we can return the card to you. e. ceiv b (PH Name) 'C. Date Delivery
■ Attach this card to the back of the mailpiece,
or on the front If space permits. L AR L6
1. Article Addressed to: D. Is delivery aficress different Am em 1? UYSS
If YES,enter delivery address below: ❑No
3. Service Type
K Certified Mail ❑Express Mail
❑Registered ❑Return Recelpt for Merchandise
❑Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑yes
2. Article Nurt r i i j — - . !t
(narrsfer� iI 1. �0o'S��La:2ol 879511292 I
PS Forth 3811,February 2004 Domestic Return Recelpt 1025955-02-M-1540
UNITED STATES 'W jy�qR 'X-r,'..`a� ,osta9 e R
'USP
• Sender: Please print your name, address, and ZIP+4 in this box
Salem Conservation Commission
120 Washington Street,3rd FI
Salem,MA 01970
SENDER: DELIVERY
■ Complete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. ❑Agent
X
■ Print your name and address on the reverse v Q/YLQ/Y�' ❑Addressee
so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
D. Is delivery address different from Item 17 ❑Yes
1. Article Addressed to: If YES,enter delivery address below: ❑ No
The Commonwealth of MassachtM tsett �-
Department of Environmental Protection
Northeast Regional Office 3. Service Type
205B Lowell Street I tK
r Cerbfied Mail 13 Express Mail
Wilmington,M 01887 ❑Registered ❑Return Receipt for Merchandise
- x - ❑ Insured Mail ❑C.O.D.
4. Restricted Delivery?(E#m Fee) ❑Yes
2. Article Numbs- 1i[Lfi 7005 '1820 0�001t6.795112-85, 1
(Transfer fro tr
PS Form 3811,February 2004 Domestic Return Receipt 702595-02-M-7540
UNITED STATES POSTAL SERVICE tt i
ge
USPS
• Sender: Please print your name, address, and ZIP+4 in this box
I
Salem Conservation Commission
120 Washington Street,3rd FI
Salem,MA 01970
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wood deck s
existing stair new bay windows e
to grade -
(reconstructed)
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existing wood frame structure
(new structure
shaded)
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open porch E deck
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parking or 8 cars
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Site Flan
Scale: 1/6"
Note
Data obtained from "Plan of Land In Salem, MA.
Goldeneye corp. Salem Assessors Map Reference: Map 41 Lot 2-18
Locus Title Reference: Book 14192 Page 59
September 29, 1998" by county Land Surveyors, Inc.
Professional Land Surveyore P.O. Sox 543 Gloucester, MA 01931
(9'18)-282-0443