64-101 - 40 MARLBOROUGH ROAD - CONSERVATION COMMISSION i
,J
r ---
• . �
� ��f� cls �.. f.� f� ��- � .
(/^ forma DEOE Fide No. 64-101
(To be provided by DEO.E)
r
lug . City/rown Salem -
Commonwealth
of Massachusetts Applicant Donald Masella !1
Certificate of Compliance
If
Massachusetts Wetlands.Protection Act, G.L.c. 131, §40,
From Salem congervat 'nn C•n m' JssuingAuthorily
ii. To Mr. Donald Masella 36 Marlborough Road
F (Name) (Address)-
October 24, 1985 •
Date of Issuance
This Certificate is issued for work regulated by an Order of Conditions issued to the above-named
dated 4-12-84 endissuedbythe Salem Concervatinn Cnmm
1. 6c7c --It is hereby certified that the work regulated by the above-referenced Order of Conditions has
Cbeen satisfactorily completed.
2. ❑ It is hereby certified that only the following portions of the work regulated by the above-refer-
enced Order of Conditions have been satisfactorily completed:(If the Certificate of Compliance
does not include the entire project,specify what portions are included.)
3. 0 It is hereby certified that the work regulated by the above-referenced Order of Conditions was
never commenced.The Order of Conditions has lapsed and is therefore no longer valid.No future .
work subject to regulation under the Act may be commenced without filing a new,Notice of In
and receiving a new Order of Conditions.
......................................................................................................................_._._-.._..........._.._.__v.....�_........
(Leave Space Blank) _
8-1
4. ❑ This certificate shall be recorded in the Registry of Deeds or the Land Court for the district in
Which the land is located.The Order was originally recorded on (date)
at the Registry of Book , Page
5. ❑ The following conditions of the Order shall continue:(Set forth any conditions contained in the
Final Order,such as maintenance or monitoring,which are to continue for a longer period.)
Issued by Salem vaticn Commission
Signatures)
f i r
Ho )�o 2 M )�-J
When issued by the Conservation Commision this Certificate must be signed by a majority of is members.
On this 24 day of October 19 85 before me
personally appeared rhe av nv named to me known to be the
person described in and who executed the foregoing instrument and acknowledged that he/she executed
the same a is/her free act and dee
l 9-9-88;
Notary Public My commission expires
Detach on dotted line and submitto the
TO .Issuing Authority .
Please be advised that the Certificate of Compliance for the project at
Fite Number !has been recorded at the Registry of
and has been noted in the chain of title of the affected property on ,is-
11
g11 recorded land,the instrument number which identifies this transaction is
If registered land,the document number which identifies this transaction is
Signature - Applicant
8-2
W- Ilav4
� - _
il_ - � - -- - -- -.. _. - _ .__ _. _. -- - - -- -- - -- - -_ _. _ __ _ . __ - -- _
92
Form 4 - DEaE Fb No.
. ;oma - (To G oiovMW OY DEDE)
Commonwealth OW rown
of Massachusetts APPUMK
• 1
Abbreviated.Notice.of Intent
Massachusetts Wetlands,Protection Act,.G.L c.131, §40
To be used only for projects of minimum impact,as described In the General Instructions for Completing the
Notice of Intent
1.Location:Street dre F Lot Number
2.Project TypeP C! / J 2/l!i✓f Description L,RFtcQ Zv
3.Registry:County —Current Boo Sit, b Page aQ
Certificate(If Registered Land)
4. ApPlicant /ie/vsr//a T6J Tel
Address: 5/6-2 — - 4-
5.
5. Property Owner / x=, c-�k Tel.
Address- -36- Yn�r (�or� f < �,kc
8. Representative*
Tel
Addr
7. Have the Conservation Commission and DEOE Regional Office each been sent,by certified mail or
hand delivery, 2 copies of completed Notice of Intent,with supporting plans and documents?
Yes M. No ❑
8. Have all obtainable permits,variances and approvals required by local by-law been obtained or applied
for?Yes ❑ No ❑
Obtained: . Applied For. s Not A�piled For.
paHr�
9. Is any portion of the site subject to a Wetlands Restriction Order pursuant to G.L c. 131, §40A or G.L
c. 130,-6105? Yes ❑ No Z
10.List all plans and supporting documents submitted with this Notice of Intent.
Identifying
Number/Letter Title/Date.
/i /W/?- 11A
4-1
93
11. For work proposed within the Buffer Zone(as defined in Part I,Sections 10.02(2)and 10.04 of the reg-
ulations)describe,with reference to supporting plans and calculations where necessary:
(a) The size,shape,type and location of the proposed work.
(b) Mitigating measures and designs to Insure that the proposed work will not alter the resource area
which said Buff ar Zone borders;or If It will alter said resource area,the mitigating measures and
designs proposed to meet the performance standard established for that resource area In Part II
or Part III of these regulations
/v6 Fi // a R Pc G6 iti B<yo�, t % G
s�aP� itr�X i
7� w
12.For work proposed within Land Subject to Flooding(as defined in Part III,Section 10.57(2)of the reg-
ulations)describe,with reference to supporting plans and calculations where necessary:
(a) The size,shape,type and location of the proposed work.
(b) Mitigating measures and designs proposed to meet the performance standard9 set forth in Part 111,
Section 10.57(4)of the regulations.
I hereby certify under the pains and penalties of perjury that the foregoing Notice of Intent and accompanying
ans documents and supporting t e true and complete,to the best of my knowledge.
(! aaL2,Z2 - -
Signature of Appli Date
Signature of Applicant's Representative Date
4.2