MARLBOROUGH ROAD - CONSERVATION COMMISSION Rik cx�� X115Ib � d
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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION .
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• Sender: Please print your name, address, and ZIP+4 in this box
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Salem Conservation Commission
120 Washington Street,3rd H
Salem,MA 01970
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CITY OF SALEM
CONSERVATION COMMISSION
January 17, 2007
Mr. Paul DiBiase
Osborne Hills Realty Trust
PO Box 780
Lynnfield, Massachusetts 01940
Re: Determination of Applicability
Lot 6 Osborne Hills Drive, 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 January 31, 2007), you may proceed with your
project. This Determination is good for three years from the date of issuance, January 17,
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,
W, �)Zwza--'
Carey Duques
Conservation Agent/Staff Planner
CC: Attorney John Keilty
DEP Northeast Regional Office
Enclosures
120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 . TEL: 978.745.9595 FAx: 978.740.0404 0 WWW.SALEM.COM
A
V
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 Osbome Hills Realty Trust
return key. Name Name
PO Box 760
w Mailing Address Mailing Address
Lynnfiled Mat 01940
CilyfTownyliown state zip code Citylrown state zip code
M. 1. Title and Date(or Revised Date if applicable)of Final Plans and Other Documents:
Site Development Permit Plan November 6 2006
Title Date
Title Date
Title Date
2. Date Request Filed:
November 3 2006
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 construction of a boulder wall, grading of a driveway, and
landscaping within the buffer zone of Bordering Vegetated Wetlands
Project Location:
Lot 6 Osborne Hill Drive Salem
Street Address Cityfrown
Map 9 Parcel 1 (portion)
Assessors Map/Plat Number Parcel/Lot Number
wpe(0rm7.dW•rev.311105 Pepe 1 N 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.)
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)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 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 Mt 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
wpafonnldw•rev.311105 Pepe 2 d 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 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.
❑ 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 owners 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 atter 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.
i
wpehrm2.dx•rev.3I1M Pepe 3 o15
l
0
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
Soon q 1*1 alb-'
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 Commissi . A copy must be sent
to the appropriate DEP Regional Office (see Attachment) and the pro erty own r(if different from the
applicant).
Signatur
O
14
Jif►tunru t(, aog
Date
w alo,m .doc•rev.3/1/05 Page 4 o15
LIMassachusetts 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 Detennination. 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.
vgslam2.dw•rev.301105 Page 5 of 5
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
DEP Regional Addresses
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Mall transmittal fortes and DEP payments,payable to:
Commonwealth of Massachusetts
Department of Environmental Protection
Box 4062
Boston, MA 02211
DEP Western Region Adona Cottee, Hanpden Mo"'°° Pitlalidtl Trno-
436 Dwight Street wm� uWr
Afford H qad Were
Suite 402 AnMerd Damn Hawley Madpmnay Rowe Wordk
Springfield,MA 01103 Ashfield Denfield Hearn Mmuon Russell Washington
Phone:4137841100 as" Ene."prm HimdeW Ma,aween`Igton samleneM Wendell
Belt3mnovn East Lorpnewdow Holland Now Ashford Savoy Wes"Ield
Fax 413.7841149 aemermmn Egtemad Holyoke New Marlborough Sheffield WeetmmnPton
Blandford Hunfingtori New Below, Shsauma wad sprVoleot
Bnrefib
eld F�fdu La ugh Plaint,Athena StateeWy Wed Slodatidpe
Br+ddmd Gill Lea Nadamlar soulnanplM vwa*
CtaNnare Godwn Lerhmt NordfAld Sash Hartley vvmxuhan
ClesLera Granby Leveret Draw saanidt Williemsoag
Cheater Grenville Leydal ode SprbV old Waiaremwh
Chesterfield Grad Barrington Lwpneadow Pana ShOdidwWge Windsor
Chicopee Greeastd LWIw pemmn Sunderland Walhiroon
Clenebng Hadley MddhReld Pere Tolland
DEP Central Region Aacn Cfa1m^ Hopkinton "I" Rutland U,brdga
627 Main Sheet Ashburnharn gtlf°011Hmaerdston MIMIS Shirley Warren Hudson NOW Braintree, Shn-Obly
ebster
Worcester,MA 01608 AAM Ashby D Eley Holl'alerh Northborough Soudiltorough Westborough
Phone:508-792-7650 Auburn Dndaae Lanmeda NONNIN a Southt]ridpe Wed Buyaon
Fax:508.792-7621 Ayer East Brodaldd Leicester Nat'9'edmea spencer wed BrooMiew
Barre Fithoag Leominster Demon Ster@q washed
TDD:508-767-2788 Bentrlghmn Gama Liadon oxford Stow wasdnetder
Berlin Grenan Lhnenmag Paxton Sturbridge W"I nendon
Blackstone Gros, Marlborough Pepperell Suton Watmter
Dorm Harvard Maynard Pdadan Tenpletm
Boamo g h Hardwick MerNey, Phillipson Townsend
Boylston Holden Marlon prattex n Tyrgsbaaugh
Brobldield Hopedale Word Royeldon Upton
DEP Southeast Region Aangmn
Dmmnah Freeman risbury
20 Riverside Drimre Acushi led Dermis Gey Hem Middleborough Rayn an Truro
ACleboo DWdon Goaold Nantucket Rehoboth Warrenton
Lakeville,MA 02347 Awn Mobley Hdlra. New Bedford Roresster welded
Phone:508.946.2700 Barnstable Eeat an Harm Ham Atieborough Rod ad wed&agwarer
Fax 508-947.6557 Bourne, asOort
E ern East H NorwellSaWe� West ry
TDD:506.946-2795 Brewster Edgartvevh IDnpston oak Bhdrs Seekonk Vftm
Bripewaw Faineven Lakerille Orleans Sharon wraaan
Broddm Fell Rivet Maafled Pembroke scenarist varmurh
cava Fabnoth Mann PlaMille swughmn
Chilean Faborough MmeMheld Plymouth Swa sea
Chimak F.."h Mae" Plynplon Talton
DEP Northeast Region An�v Chebratord Hingham,C Holbrook Madmen R&rdaph Walpole
1 Winter Wakefield
Street AdWOM Colhmeet wet Will ] Reearq Welton
Boston,MA 02108 Ashland concord paws h Mira Revere waterfowl
Phone:617-6546500 Bedford Danvers Lawranm Millon Rodport Waylad
Fax: 617-556-1049 anent warn La""g1on Nie Rey wdbday
Bunny Dover Lnmin Natick Satan Watrem
TDD:617-574-6868 all Dracut Lowell Naed am Sauhury Wed Newbury
Bodin Esse" Lyon NewWy sata s Weston
Boxford Ewret Lrm,lad Newdaypon Sherbom Westwood
Btarntree Frendryimn Maden Newlin Sonavilb Weynoth
&oddine Geogelwn MmnJeAa'8y-Thw$we Nook Smndan wni khglm
Burtlrypon Glouceda Marblehead Nook Andover Sudbury Winrreatm
Canlbndge Gmwlarhtl Meafom North Reading saatpamt Winthrop
canter] Hamilton Medford Norwood Tewkeday Woburn
Cedide Haverhill Metwe Peabody Topdad
Wpolo nZolo:•DEP Adaeveee-rev.IONW04 Page 1df 1
SENDER: COMPLETE-THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3.Also complete A Signal re
item 4 if Restricted Delivery is desired. 0 Agent
■ Print your name and address on the reverse X 0 Addressee
so that we can return the card to you. B. Re iv by(Printed Name) -. Date of Delivery
■ Attach this card to the back of the mailpiece, ' ./
or on the front if space permits.
D. delivery address different from ttem 77 O Y
1. Article Addressed to: f rES,enter delivery address below: 0 No
0k9(P 3. Service Type
XCertified Mail 0 Express Mail
{ 0 Registered 0 Return Recelpt for Merchandise
0 Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number
(nansferfromservlcelaw �(-�� 117005 311010000 `717616080
PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1500
UNITED STATES POSTAL SERVICE First-Class Mail
Postage&Fees Paid I
USPS
Permit No.G-10 I
• Sender: Please print your name, address, and ZIP+4 in this box
'I
Salem Conservation Commission
120 Washington Street,3rd FI
Salem,MA 01970
(o 056k (t
III,,,,,,iIIA i,,,ill,,,,,11„1,i,,1111HI,6i„I,L,,,,i,11
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands Salem
(; WPA Form 1 - Request for Determination of Applicability Citylrown
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. General Information
Important:
When filling out 1. Applicant:
forms on the Osborne Hills Realty Trust
computer, use Name
only the tab key E-Mail Address
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
"d 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
Cityrrown 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).
wpaforml.doc
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 6 Osborne Hill Drive Salem
Street Address City/Town
9 1 (portion)
Assessors Map/Plat Number Parcel/Lot Number
b. Area Description (use additional paper, if necessary):
Approximately 225 sf shown as the northeast corner of Lot 6 on the accompanying plan
c. Plan and/or Map Reference(s):
Site Development Permit Plan November 9, 2006
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 and approximately 25 sf of driveway.
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 City/Town
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 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.tloc
Page 3 of 4
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands Salem
WPA Form 1 - Request for Determination of Applicability City(rown
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
City/Town
MA 01940
State Zip Code
Signatures:
I also understand that notificationI Request will be placed in a local newspaper at my expense
in accordanc with ction )(b t Wetlan Pro ection Act regulations.
Si nat nt Date
I&I &� l/-o�-0
gn re of esentati any) Date
wpaforml.tloc
Page 4 of 4
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_ °`�
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands Salem
City/Town
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 Osborne Hills Realty Trust
computer, use
only the tab key Name E-Mail Address
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
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
Cityfrown - 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).
wpaforml,doc Page 1 of
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 6 Osborne Hill Drive Salem
Street Address City/Town
9 1 (portion)
Assessors Map/Plat Number Parcel/Lot Number
b. Area Description (use additional paper, if necessary):
Approximately 225 sf shown as the northeast corner of Lot 6 on the accompanying plan.
c. Plan and/or Map Reference(s):
Site Development Permit Plan November 9, 2006
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 and approximately 25 sf of driveway.
wpaforml.doc Page 2 of 4
s i
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands Salem
City/Town
WPA Form 1 - Request for Determination of Applicability
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 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.c Page 3&4
LIMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands Salem
WPA Form 1 - Request for Determination of Applicability Citylrown
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
City/Town
MA 01940
State - Zip Code
Signatures:
I also understand that notificationi Request will be placed in a local newspaper at my expense
in accordanc with ction )(b Wetlan Pro ection Act regulations.
Mitfi /l 09 6�
Si net nt Date
d
gn re of esentati any) Date
wpaforml.tloc Page 4 of 4
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I,3
I Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands Salem
WPA Form 1 - Request for Determination of Applicability City/rown
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. General Information
Important:
When filling out 1. Applicant:
forms on the Osborne Hills Realty Trust
computer, use Name
only the tab key E-Mail Address
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
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
Cityrrown 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.,ml.dac
Page 1 of 4
L
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands Salem
city/Town
WPA Form 1- Request for Determination of Applicability
Al� 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 6 Osborne Hill Drive Salem
Street Address CityrFown
9 1 (portion)
Assessors Map/Plat Number Parcel/Lot Number
b. Area Description (use additional paper, if necessary):
Approximately 225 sf shown as the northeast corner of Lot 6 on the accompanying plan
c. Plan and/or Map Reference(s):
Site Development Permit Plan November 9, 2006
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 and approximately 25 sf of driveway.
wpa(orml doc
Page 2 of 4
,a
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands Salem
\�
WPA Form 1 - Request for Determination of Applicability dtty/Town
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 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.
L 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.)
wpaformi.tloc
Page 3 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
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
Cdyrrown
MA 01940
State Zip Code
Signatures:
I also understand that notification i Request will be placed in a local newspaper at my expense
in accordant with ction )(b t Wetlan Pro ection Act regulations.
Si net nt Date
gn re of esentatir fany) Date
wpafarml.doc
Page 4 of 4
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3v 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 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 approximately 25 sf of driveway in the buffer zone of BVW on Lot 6 off of
Marlborough Road. This hearing will be held on Thursday, at 6:00 pm in
Room 313, City Hall Annex, 120 Washington Street. Son. ll ,1007-
& P (;"io
Kevin P. Comacchio
Chairman
Please print legal advertisement on:
November 22, 2006
Please send bill to:
Attorney John Keilty
40 Lowell Street
Peabody, MA 01960
978-531-7900
120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 TEL: 978.745.9595 FAx: 978.740.0404 WWW.SALEM.COM
JOHN R. KEILTY, COUNSELOR AT LAW TELEPHONE (978) 531-7900
40 LOWELL STREET FACSIMILE (978) 531-2479
PEABODY, MA 01960 E-MAIL: KEILTYLAW@AOL.COM
November 27, 2006 RECEIVED
NOV 2 9 2006
Conservation CommissionEPT. PLANNING&
COCOMMUNITT Y DEVELOPMENT
City of Salem
120 Washington Street
Salem, MA 01970
Attn: Carey Duques, Agent
Re: Request for Determination of Applicability
Lots 6 and 31, Osborne Hill Drive, Salem,Massachusetts
�O
� ri -{
Please find enclosed two (2) checks in the amounts of$25.00 each which
represent the Local By-Law fee pertaining to the Osborne Hill Realty Trust's Request for
Determination of Applicabilites which I filed previously.
Kindly return the two (2) checks in the amount of$80.00 each which I had
erroneously filed.
Very truly yours,
ahn*R.Ity, E ire
JRK/emb
Enclosures
I
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 4e�5- 00
Form of Payment 21Check Cash
CHECK PAYMENTS:
write chedc number 33�
CASH PAYMENTS:
write client initials
Q Sign Permit Application Fee
Conservation Commission Fee PDA
Payment received for 0 Planning Board Fee
what service?
0 Old Town Hail Rental Fee
0 Other
Name of staff person
receiving payment uey
Additional Notes
DATE INVOICE AMOUNT i.
JOHNR. KEILTY, ESQUIRE ,'39
. Counselor at hffW
40 LONVELL STREET.
PEAEOUx MASSACHUSE- 'S 01960 - N2 1'3 33 1
PAY
AMOUNT DOLLARS
TT � I, ATE A 7TW ORD DESCRIPTION:. x NET AMOUNT
to '" �� .�.� ..€ /� .:..r z.' I'✓Nr^<< _ r'.., c ,�, _
'011
:
I
Eastern Bank-Lynn, MA H P 051 NPE'...
V0,h3.311111 1:01130179aE:. 60.F0045 n'
Original Check and Form: DPCD Finance
Copy 1: Client
Copy 2:Application File
JOHN R. KEILTY, COUNSELOR AT LAW TELEPHONE (978) 531-7900
40 LOWELL STREET FACSIMILE (978) 531-2479
PEABODY, MA 01960 E-MAIL: KEILTYLAW@AOL.COM
November 18, 2004
Conservation Commissiona h
City of Salem I L—
ED
120WashingtonStreet NOV J 7 2006
Salem, MA 01960
Attn: Carey Duques DEPT. OF PLANNING&
COMMUNITY DEVELOPMENT
RE: REOUEST FOR DETERMINATION OF APPLICABILITY
OSBORNE HILL DRIVE,SALEM,MA
Dear Ms. Duques:
Please be advised that I represent Paul DiBiase Trustee of Osborne Hills Realty Trust,
relative to the filling of a Determination of Applicability as it applies to the property for Lot 6, 31,
Osborne Hill Drive, Salem Massachusetts.
Submitted herewith are the following instruments:
1. Checks in the amount of$80.00 for each one of the lots:
Lot 6, 31 as application fee;
2. 8 copies of the Determination of Applicability;
3. Certified list of abutter,and notification to abutters will be provided
by Carey Duques of the Salem Planning Department;
Kindly schedule this matter for hearing at your earliest convenience.
Thank you for your anticipated cooperation.
Very truly yours,
Johnit
JRK/smw
Enclosures