64-481 - 24 OLD ROAD - CONSERVATION COMMISSION / ��P � �4 -481 zy ��� �.�.
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Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 - Order of Conditions 64-481
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
A. General Information 009061200161 Bk;202 Pg,212
Important: Salem
06/12/2009 11:31 CONDN P9 1116
_
When filling 1. From: Conservation Commission
out forms on
the computer, 2. This issuance is for(check one): a. ® Order of Conditions b. ❑ Amended Order of Conditions
use only the
tab key to 3. To: Applicant:
move your
cursor-do not Shelly Bisegna
use the return a. First Name b. Last Name
key. North Shore Medical Center
c.Organization
81 Highland Avenue _
d.Mailing Address
Salem MA 01970
e.Cityrrown f.State g.Zip Code
4. Property Owner(if different from applicant):
a. First Name b.Last Name
City of Salem
c.Organization
_93 Washington Street _
d.Mailing Address
Salem MA 01970
e.City/Town I.State g.Zip Code
5. Project Location:
24 Old Road Salem
a.Street Address b.Cityrrown
24 216, 218, 221
c.Assessors Map/Plat Number d.Parcel/Lot Number
Latitude and Longitude, if known: e. Latitude f. Longitude
6. Property recorded at the Registry of Deeds for(attach additional information if more than one parcel):
Essex
Ia.County b.Certificate Number(if registered land)
14401 (Parcel 216) 47 (Parcel 216)
c.Book d. Page
7. Dates: September 11 2008 April 23, 2009 May 11, 2009
a.Date Notice of Intent Filed b.Date Public Hearing Closed c.Date of Issuance
8. Final Approved Plans and Other Documents (attach additional plan or document references as
needed):
Site Plan for the Proposed Expansion of the Heliport Landing Pad at the North Shore Medical Center
#81 Highland Avenue
Scott Patrowicz Scott Patrowicz
b.Prepared By c.Signed and Stamped by
January 8, 2009 1"=20'
d. Final Revision Date - e.Scale
I.Additional Plan or Document Title g.Date
wpaf..5.dw• rev.5/88 Page 1 of 11
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Essex Southern District
Registry of Deeds
45 Congress Street
Suite 4100
Salem, MA 01970
06/12/2009 11:31 AM
Station: ESSx-REC04
Operator: akotz
Time:11:31 Type: CONON Loc: SALEM
Inst 167 SK 28682-212
FEE 55.00
ENV FEE 20.00
Check 7605 PATROWICZ 75.00
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�� CITY OF SALEM
CONSERVATION COMMISSION
SITE VISIT FORM
PROJECT LOCATION: 24 Old Road, Salem Hospital Heliport DATE OF SITE VISIT: 2/7/09
PROJECT PROPONENT: Salem Hospital and the City of Salem DEP FILE NUMBER: 64-481
PROPOSED WORK: Expansion of an existing helicopter pad located within the 100 foot buffer
zone to a bordering vegetated wetland.
Commiss Members/A ent: Abutters:
d
V Yl G
Applicant/Property Owner/Representative: S�.�f ) 1" �r"r/�'r'l l C t
0 Request for Determination ❑ Abbreviated Notice of Resource Area Delineation X Notice of Intent
ElCertificate of Compliance ❑Enforcement/Violation ❑Emergency ❑ Informal
INLAND RESOURCE AREAS COASTAL RESOURCE AREAS
Bank ❑ Land Subject to Coastal F]Land Under the Ocean
Storm Flowage
X Bordering Vegetated Wetland
Designated Port Area 0 Coastal Beach
Land Subject to Flooding
Coastal Dune ❑Barrier Beach
0 Land Under Water Bodies or Waterway s
Name: ❑ Coastal Bank ❑Rocky Intertidal Shore
Riverfront Area ❑ Salt Marsh ❑ Land Under Salt Pond
Vernal Pools ❑ Land Containing ❑Anadromous/Cata-
Shellfish dromous Fish Run
ElBordering Vegetated Wetland in Coastal Area
t
❑yvy�Wrya�t`er Bod}y�yy�y �XB�o�rrdering Vegetated Wetland ❑ Bank ❑ Coastal Beach ❑Coastal Dune
X Protection of Water Supply X Protection of Groundwater Supply X Flood Control
X Storm Damage Prevention X Prevention of Pollution X Protection of Fisheries
X Protection 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.
Photos ❑ Site Map ❑Other:
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.
LICENSE AGREEMENT
WHEREAS, the=CI-TY OF SALEM bby=vote=o€the=City Counci-1,
4rdated-December-6-1994�authorized=the�May_or to.executea:License,
cAgreement tolpermit,the use�of-City=owned property as=per_theplan
entitled,-"Sit"ePlan=Helipad-Layout-L-(Salem Hospital-Parking.Lot-10).
balam7M"zi7"-=dated=March=2-4 1993;.- ttached,-hi reto..aslExhibit_A;-:�
4kas_a_Hel-ipad, and
WHEREAS, -T-H-E=NORTH-SHORE-MEDI-CA"L-CENTER=;ZINC...has.agreed,
,to-constr-uct�and=operate=and=maintain=said=Helipad; and
WHEREAS, it is in the public interest to have a facility
close to The Borth Shore Medical Center for the transportation of
acutely ill patients as may be required by City or State officials
or by the Hospital;
NOW, THEREFORE, in consideration of the mutual benefits,
the parties hereto agree as follows:
1. THE NORTH SHORE MEDICAL CENTER, INC. is authorized to
construct, operate and maintain the Helipad for the landing
and takeoff of helicopters as may be required from time to
time to transport acutely ill patients to The North Shore
Medical Center and from The North Shore Medical Center.
2 . Construction and maintenance shall be in accordance with the
requirements of the Building Code of the City of Salem.
3 . The North Shore Medical Center agrees to indemnify and hold
harmless the City of Salem, its officials, agents, and
employees from any and all claims for damages arising out of
the operation and maintenance of said Helipad.
4 . The City of Salem agrees to assist The North Shore Medical
Center, as may be required, in obtaining all necessary permits
for construction and maintenance.
5. Both parties agree to cooperate with each other, and in the
event said Helipad is not longer needed, this License
Agreement will terminate without any further responsibility
to either party.
6. Either party may on one hundred twenty (120) days' notice to
the other terminate this Agreement.
1
Executed as an instrument under seal this day of
1995.
THE NORTH SHORE MEDICAL CENTER, INC.
by
Michael J. Geaney, Jr.
President
CITY OF SALEM /
by ?/Z"o
NEIL J1 HA RING N, MAYOR
hereunto duly authorized
See copy of City Council Vote,
attached hereto
2
s CITY OF SALEM
r_
In Ciiy Council,
November 21, 1994
Ordered:
That the Mayor be authorized to enter into a license agreement
with North Shore Medical Center for the construction and
maintenance of a helipad on the parcel as delineated on the
attached site plan.
In City Council November 21, 1994
Referred to the Committee on Government Services
In City Council December 1, 1994
Adopted
Approved by the Mayor on December 6, 1994
ATTEST: DEBORAH E. BURKINSHAW
CITY CLERK
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CITY OF SALEM
All
CONSERVATION COMMISSION
SITE VISIT FARM
-,24
PROJECT LOCATION: ` ka LA, DATE OF SITE VISIT
PROJECT PROPONENT: IICJ DEP FILE NUMBER:
PROPOSED WORK:
IN ATT DANCE:
Commission b rs/Agent:CUej Abutters:
�� L
t
ApplicantJ /Property Owner/Representative: `�` �'J`l u-tY
SITE VISIT PURPOSE:
❑Request for Determination ❑Abbreviated Notice of Resource Area DelineationNotice of Intent
❑Certificate of Compliance ❑Enforcement/Violation ❑Emergency Informal
AREAS OF JURISDICTION:
INLAND RESOURCE AREAS COASTAL RESOURCE AREAS
❑Bank ❑ Land Subject to Coastal ❑Land Under the Ocean
E:1 Bordering Vegetated Wetland Storm Flowage
El Land Subject to Flooding ElDesignated Port Area ElCoastal Beach
❑Land Under Water Bodies or Waterway El Coastal Dune El Barrier Beach
Name: ❑ Coastal Bank
❑Rocky Intertidal Shore
❑Riverfront Area ❑ Salt Marsh ❑ Land Under Salt Pond
❑Vernal PoolsLand Containing ❑Anudromous/Cata-
Shellfish dromous Fish Run
❑ Bordering Vegetated Wetland in Coastal Area
120 W.asnIN(,r(;,v Snera;'r. Sai.EM, NIAS�ACII01970 • Tr-r: 978.7-45-')595 F;vx: 979,7-10.040} 1 www.sAIL co\I
BUFFER ZONE (within 100-feet)
❑Water Body Bordering Vegetated Wetland ❑ Bank ❑ Coastal Beach ❑Coastal Dune
INTERESTS PROTECTED:
SStorm
rotection of Water Supply Protection of Groundwater Supply ❑Flood Control
Damage Prevention Prevention of Pollution ❑Protection of Fisheries
` ❑J Protection of Wildlife Habitat F-1 Protection of Land Containing Shellfish
Is this an exempt project: If so,why?
Are resource area boundaries delineated correctly? If not,explain.
SITE VISIT DOCUMENTATION:
❑Photos ❑ Site Map ❑Other: A
OBSERVATIONS: m ..,,.
t..
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.
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RECOMMENDATIONS:
• ce,�'.ltiUlf�q
CITY OF SALEM
` ^r CONSERVATION COMMISSION
May 11, 2009
Scott Patrowicz
Patrowicz Land Development
14 Brown Street
Salem, MA 01970
Re: Order of Conditions—DEP#64-481
24 Old Road, North Shore Medical Center Salem Hospital, Salem Massachusetts
Dear Mr. Patrowicz:
Enclosed, please find the Order of Conditions for the above referenced project.
Following the 10-day appeal period (as of May 21, 2009), this document and the attached
Special Conditions must be recorded at the Essex County Registry of Deeds (Shetland
Park 45 Congress Street, Suite 4100 Salem, Massachusetts). Once recorded, please
return a copy of Page 9 of the Order, which will indicate to the Commission that the
document has been recorded.
As indicated in the Order, prior to any work commencing:
1. this Order must be recorded,
2. a sign shall be displayed showing DEP File# 64-481 within public view, and
3. contact me at least 48 hours prior to any activity to schedule a pre-construction
meeting to review the Order with your hired contractor.
If you have any further questions, please feel free to contact me 978-619-5685.
Sincerely,
�I
Carey �r
JDques
Conserv tion Agent/ Staff Planner
Enclosures
CC: DEP Northeast Regional Office
Shelly Bisegna, North Shore Medical Center
Beth Rennard, City Solicitor City of Salem
Massachusetts Department of Environmental Protection
MassDEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 5 — Order of Conditions 64-481
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. General Information
Important: Salem
When filling t. From: Conservation Commission
out forms on
the computer, 2. This issuance is for(check one): a. ® Order of Conditions b. ❑ Amended Order of Conditions
use only the
tab key to 3. To: Applicant:
move your
cursor-do not Shelly Bisegna
use the return a.First Name b. Last Name
key. North Shore Medical Center
c.Organization
81 Highland Avenue
d.Mailing Address
Salem MA 01970
e.City/Tom f.State g.Zip Code
4. Property Owner(if different from applicant):
a. First Name b.Last Name
City of Salem
c.Organization
93 Washington Street
d. Mailing Address
Salem MA 01970
e.City/Town f.Stale g.Zip Code
5. Project Location:
24 Old Road Salem
a.Street Address b.City/Tom
24 216, 218, 221
c.Assessors Map/Plat Number d. Parcel/Lot Number
Latitude and Longitude, if known: e.Latitude f. Longitude
6. Property recorded at the Registry of Deeds for(attach additional information if more than one parcel):
Essex
a.County b.Certificate Number(if registered land)
14401 (Parcel 216) 47 (Parcel 216)
c. Book d. Page
�. Dates: September 11, 2008 April 23, 2009 May 11, 2009
a.Date Notice of Intent Filed b. Dale Public Hearing Closed c.Date of Issuance
a. Final Approved Plans and Other Documents (attach additional plan or document references as
needed):
Site Plan for the Proposed Expansion of the Heliport Landing Pad at the North Shore Medical Center
#81 Highland Avenue
Scott Patrowicz Scott Patrowicz _
b. Prepared By c.Signed and Stamped by
January 8, 2009 1"=20'
d. Final Revision Date e. Scale
I.Additional Plan or Document Title g. Date
wpalorm5.doo• rev.5100 Page 1 of 11
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 - Order of Conditions 64-481
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Findings
f. Findings pursuant to the Massachusetts Wetlands Protection Act:
Following the review of the above-referenced Notice of Intent and based on the information provided
in this application and presented at the public hearing, this Commission finds that the areas in which
work is proposed is significant to the following interests of the Wetlands Protection Act. Check all that
apply:
a. ® Public Water Supply b. ❑ Land Containing Shellfish c. ® Prevention of Pollution
d. ® Private Water Supply e. ® Fisheries f. ® Protection of Wildlife
Habitat
g. ® Groundwater Supply h. ® Storm Damage Prevention i. ® Flood Control
2. This Commission hereby finds the project, as proposed, is: (check one of the following boxes)
Approved subject to:
a. ® the following conditions which are necessary in accordance with the performance standards set
forth in the wetlands regulations. This Commission orders that all work shall be performed in
accordance with the Notice of Intent referenced above, the following General Conditions, and any
other special conditions attached to this Order. To the extent that the following conditions modify or
differ from the plans, specifications, or other proposals submitted with the Notice of Intent, these
conditions shall control.
Denied because:
b. ❑ the proposed work cannot be conditioned to meet the performance standards set forth in the
wetland regulations. Therefore, work on this project may not go forward unless and until a new Notice
of Intent is submitted which provides measures which are adequate to protect these interests, and a
final Order of Conditions is issued. A description of the performance standards which the
proposed work cannot meet is attached to this Order.
c. ❑ the information submitted by the applicant is not sufficient to describe the site, the work, or the
effect of the work on the interests identified in the Wetlands Protection Act. Therefore, work on this
project may not go forward unless and until a revised Notice of Intent is submitted which provides
sufficient information and includes measures which are adequate to protect the Act's interests, and a
final Order of Conditions is issued. A description of the specific information which is lacking and
why it is necessary is attached to this Order as per 310 CMR 10.05(6)(c).
Inland Resource Area Impacts: Check all that apply below. (For Approvals Only)
3. ® Buffer Zone Impacts: Shortest distance between limit of project disturbance and 55 _
wetland boundary (if available) a.linear feet
Resource Area Proposed Permitted Proposed Permitted
Alteration Alteration Replacement Replacement
4. ❑ Bank a. linearfeet b.linearfeet c.-linear feet d. linearfeet
5. ❑ Bordering Vegetated
Wetland a.square feet b.square feet c.square feet d.square feet
6. ❑ Land Under Waterbodies a.square feet b.square feet c.square feet d.square feet
and Waterways
e.Gy dredged f.cty dredged
wpalorm5.doc- rev.5109 Page 2 of I I
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
i .
WPA Form 5 — Order of Conditions 64-481
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Findings (cont.)
Resource Area Proposed Permitted Proposed Permitted
Alteration Alteration Replacement Replacement
7. ❑ Bordering Land
. b.square feel
Subject to Flooding asquare feet c.square feet d.square feet
Cubic Feet Flood Storage e.cubic feet f.cubic feet g.cubic feet In.cubic feet
8. ❑ Isolated Land Subject
to Flooding a.square feet b.square feet
Cubic Feet Flood Storage c.cubic feet d.cubic feel e.cubic feet f.cubic feet
9. ❑ Riverfront area a.total sq.feet b.total sq.feet
Sq It within 100 ft c.square feet i-square feet e.square feet f.square feet
Sq ft between 100-200 ft g,square feet h.square feet i.square feet j.square feet
Coastal Resource Area Impacts: Check all that apply below. (For Approvals Only)
10. ❑ Designated Port Areas Indicate size under Land Under the Ocean, below
11. ❑ Land Under the Ocean a.square feet b.square feet
c.Gy dredged d.cly dredged
12. ❑ Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes below
13. ❑ Coastal Beaches asquare feet b.square feet c.cty nourishmt. J.c/y nourishmt.
14. ❑ Coastal Dunes a.square feet square feet c.Uy nourishmt. d.Gy nourishmt.
b.
15. ❑ Coastal Banks a.linear feet b.linear.feet
16. ❑ Rocky Intertidal Shores a.square feet b.square feet
17. ❑ Salt Marshes a.square feet bsquare feet c.square feet d.square feet
18. ❑ Land Under Salt Ponds a.square feet b.square feet
c.ay dredged d.cly dredged
19. ❑ Land Containing
Shellfish a.square feet b.square feet c.square feet d.square feet
20. ❑ Fish Runs Indicate size under Coastal Banks, inland Bank, Land Under the
Ocean, and/or inland Land Under Waterbodies and Waterways,
above
a.Gy dredged b.Gy dredged
21. ❑ Land Subject to Coastal
Storm Flowage a.square feet b.square feet
wpaforrr5.doc• rev.5/08 Page 3 of 11
Massachusetts Department of Environmental Protection
MassDEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 5 — Order of Conditions 64-481
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. General Conditions Under Massachusetts Wetlands Protection Act
(only applicable to approved projects)
1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory
measures, shall be deemed cause to revoke or modify this Order.
2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any
injury to private property or invasion of private rights.
3. This Order does not relieve the permittee or any other person of the necessity of complying with all
other applicable federal, state, or local statutes, ordinances, bylaws, or regulations.
4. The work authorized hereunder shall be completed within three years from the date of this Order
unless either of the following apply:
a. the work is a maintenance dredging project as provided for in the Act; or
b. the time for completion has been extended to a specified date more than three years, but less
than five years, from the date of issuance. If this Order is intended to be valid for more than three
years, the extension date and the special circumstances warranting the extended time period are
set forth as a special condition in this Order.
5. This Order may be extended by the issuing authority for one or more periods of up to three years each
upon application to the issuing authority at least 30 days prior to the expiration date of the Order.
6. Any fill used in connection with this project shall be clean fill. Any fill shall contain no trash, refuse,
rubbish, or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard,
pipe, tires, ashes, refrigerators, motor vehicles, or parts of any of the foregoing.
7. This Order is not final until all administrative appeal periods from this Order have elapsed, or if such
an appeal has been taken, until all proceedings before the Department have been completed.
8. No work shall be undertaken until the Order has become final and then has been recorded in the
Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title
of the affected property. In the case of recorded land, the Final Order shall also be noted in the
Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to
be done. In the case of the registered land, the Final Order shall also be noted on the Land Court
Certificate of Title of the owner of the land upon which the proposed work is done. The recording
information shall be submitted to this Conservation Commission on the form at the end of this Order,
which form must be stamped by the Registry of Deeds, prior to the commencement of work.
9. A sign shall be displayed at the site not less then two square feet or more than three square feet in
size bearing the words,
"Massachusetts Department of Environmental Protection" (or, "MassDEP")
"File Number 64-481 "
wpafory doc• rev.5108 Page 4 of 11
Massachusetts Department of Environmental Protection
- Bureau of Resource Protection - Wetlands MassDEP File Number:
\� WPA Form 5 — Order of Conditions 64-481
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. General Conditions Under Massachusetts Wetlands Protection Act
10. Where the Department of Environmental Protection is requested to issue a Superseding Order, the
Conservation Commission shall be a party to all agency proceedings and hearings before MassDEP.
11. Upon completion of the work described herein, the applicant shall submit a Request for Certificate of
Compliance(WPA Form 8A)to the Conservation Commission.
12. The work shall conform to the plans and special conditions referenced in this order.
13. Any change to the plans identified in Condition #12 above shall require the applicant to inquire of the
Conservation Commission in writing whether the change is significant enough to require the filing of a
new Notice of Intent.
14. The Agent or members of the Conservation Commission and the Department of Environmental
Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours
to evaluate compliance with the conditions stated in this Order, and may require the submittal of any
data deemed necessary by the Conservation Commission or Department for that evaluation.
15. This Order of Conditions shall apply to any successor in interest or successor in control of the property
subject to this Order and to any contractor or other person performing work conditioned by this Order.
16. Prior to the start of work, and if the project involves work adjacent to a Bordering Vegetated Wetland,
the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden
stakes or flagging. Once in place, the wetland boundary markers shall be maintained until a Certificate
of Compliance has been issued by the Conservation Commission.
17. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully
stabilized with vegetation or other means.At no time shall sediments be deposited in a wetland or
water body. During construction, the applicant or his/her designee shall inspect the erosion controls
on a daily basis and shall remove accumulated sediments as needed. The applicant shall immediately
control any erosion problems that occur at the site and shall also immediately notify the Conservation
Commission, which reserves the right to require additional erosion and/or damage prevention controls
it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of
work line has been approved by this Order.
NOTICE OF STORMWATER CONTROL AND MAINTENANCE REQUIREMENTS
18. The work associated with this Order(the"Project") is(t)❑ is not(2)® subject to the
Massachusetts Stormwater Standards. If the work is subject to the Stormwater Standards,
then the project is subject to the following conditions:
a) All work, including site preparation, land disturbance, construction and redevelopment, shall be
implemented in accordance with the construction period pollution prevention and erosion and
sedimentation control plan and, if applicable, the Stormwater Pollution Prevention Plan required by the
National Pollution Discharge Elimination System Construction General Permit as required by
Stormwater Condition 8. Construction period erosion, sedimentation and pollution control measures
and best management practices (BMPs)shall remain in place until the site is fully stabilized.
wpaform5.doc• rev.5108 Page 5 of 11
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 — Order of Conditions 64-481
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. General Conditions Under Massachusetts Wetlands Protection Act (cont.)
b) No stormwater runoff may be discharged to the post-construction stormwater BMPs unless and
until a Registered Professional Engineer provides a Certification that:
i. all construction period BMPs have been removed or will be removed by a date certain specified in
the Certification. For any construction period BMPs intended to be converted to post construction
operation for stormwater attenuation, recharge, and/or treatment, the conversion is allowed by the
MassDEP Stormwater Handbook BMP specifications and that the BMP has been properly cleaned or
prepared for post construction operation, including removal of all construction period sediment trapped
in inlet and outlet control structures;
ii. as-built final construction BMP plans are included, signed and stamped by a Registered
Professional Engineer, certifying the site is fully stabilized;
iii. any illicit discharges to the stormwater management system have been removed, as per the
requirements of Stormwater Standard 10;
iv. all post-construction stormwater BMPs are installed in accordance with the plans (including all
planting plans)approved by the issuing authority, and have been inspected to ensure that they are not
damaged and that they are in proper working condition;
v. any vegetation associated with post-construction BMPs is suitably established to withstand erosion.
c) The landowner is responsible for BMP maintenance until the issuing authority is notified that
another party has legally assumed responsibility for BMP maintenance. Prior to requesting a
Certificate of Compliance, or Partial Certificate of Compliance, the responsible party(defined in
General Condition 18(e))shall execute and submit to the issuing authority an Operation and
Maintenance Compliance Statement ("O&M Statement)for the Stormwater BMPs identifying the party
responsible for implementing the stormwater BMPsOperation and Maintenance Plan ("O&M Plan")
and certifying the following: i.)the O&M Plan is complete and will be implemented upon receipt of the
Certificate of Compliance, and ii.)the future responsible parties shall be notified in writing of their
ongoing legal responsibility to operate and maintain the stormwater management BMPs and
implement the Stormwater Pollution Prevention Plan.
d) Post-construction pollution prevention and source control shall be implemented in accordance
with the long-term pollution prevention plan section of the approved Stormwater Report and, if
applicable, the Stormwater Pollution Prevention Plan required by the National Pollution Discharge
Elimination System Multi-Sector General Permit.
e) Unless and until another party accepts responsibility, the landowner, or owner of any drainage
easement, assumes responsibility for maintaining each BMP. To overcome this presumption, the
landowner of the property must submit to the issuing authority a legally binding agreement of record,
and acceptable to the issuing authority, evidencing that another entity has accepted responsibility for
maintaining the BMP, and that the proposed responsible party shall be treated as a permittee for
purposes of implementing the requirements of Conditions 18(f)through 18(k)with respect to that
BMP. Any failure of the proposed responsible party to implement the requirements of Conditions 18(f)
through 18(k)with respect to that BMP shall be a violation of the Order of Conditions or Certificate of
Compliance. In the case of stormwater BMPs that are serving more than one lot, the legally binding
agreement shall also identify the lots that will be serviced by the stormwater BMPs. A plan and
easement deed that grants the responsible party access to perform the required operation and
maintenance must be submitted along with the legally binding agreement.
f) The responsible party shall operate and maintain all stormwater BMPs in accordance with the
design plans, the O&M Plan, and the requirements of the Massachusetts Stormwater Handbook.
wpaform5.doc- rev.5108 Page 6 of 11
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 — Order of Conditions 64-481
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. General Conditions Under Massachusetts Wetlands Protection Act (cont.)
g) The responsible party shall:
1. Maintain an operation and maintenance log for the last three (3)consecutive calendar years
of inspections, repairs, maintenance and/or replacement of the stormwater management
system or any part thereof, and disposal (for disposal the log shall indicate the type of material
and the disposal location);
2. Make the maintenance log available to MassDEP and the Conservation Commission
("Commission")upon request; and
3. Allow members and agents of the MassDEP and the Commission to enter and inspect the site
to evaluate and ensure that the responsible party is in compliance with the requirements for
each BMP established in the O&M Plan approved by the issuing authority.
h) All sediment or other contaminants removed from stormwater BMPs shall be disposed of in
accordance with all applicable federal, state, and local laws and regulations.
i) Illicit discharges to the stormwater management system as defined in 310 CMR 10.04 are
prohibited.
j) The stormwater management system approved in the Order of Conditions shall not be changed
without the prior written approval of the issuing authority.
k) Areas designated as qualifying pervious areas for the purpose of the Low Impact Site Design
Credit(as defined in the MassDEP Stormwater Handbook, Volume 3, Chapter 1, Low Impact
Development Site Design Credits)shall not be altered without the prior written approval of the issuing
authority.
1) Access for maintenance, repair, and/or replacement of BMPs shall not be withheld. Any fencing
constructed around stormwater BMPs shall include access gates and shall be at least six inches
above grade to allow for wildlife passage.
Special Conditions (if you need more space for additional conditions, please attach a text document):
see attached
D. Findings Under Municipal Wetlands Bylaw or Ordinance
1. Is a municipal wetlands bylaw or ordinance applicable? ® Yes ❑ No
2. The hereby finds (check one that applies):
Conservation Commission
a. ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal
ordinance or bylaw specifically:
1. Municipal Ordinance or Bylaw 2.Citation
Therefore, work on this project may not go forward unless and until a revised Notice of Intent is
submitted which provides measures which are adequate to meet these standards, and a final
Order of Conditions is issued.
wpaformitlac• rev.5108 Page 7 of 11
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 - Order of Conditions 64-481
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
D. Findings Under Municipal Wetlands Bylaw or Ordinance (cont.)
b. ❑ that the following additional conditions are necessary to comply with a municipal ordinance or
bylaw:
1. Municipal Ordinance or Bylaw 2.Citation
3. The Commission orders that all work shall be performed in accordance with the following conditions
and with the Notice of Intent referenced above. To the extent that the following conditions modify or
differ from the plans, specifications, or other proposals submitted with the Notice of Intent, the
conditions shall control.
The special conditions relating to municipal ordinance or bylaw are as follows (if you need more space
for additional conditions, attach a text document):
w,afo,m5.dac• rev.5108 Page 8 of 11
Massachusetts Department of Environmental Protection
MassDEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 5 — Order of Conditions 64-481
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
E. Issuance
This Order is valid for three years, unless otherwise specified as a special H&L4I t Zoog
condition pursuant to General Conditions#4, from the date of issuance. t.Date Iss nce
Please indicate the number of members who will sign this form: 3 v '
This Order must be signed by a majority of the Conservation Commission. 2. Number of sig ers
The Order be ma ed by certified mail (return receipt requested) or hand delivered to the applicant. A
copy also ust be mail dor hand delivered at the same time to the appropriate Department of
Env
ironm tal Protec on Regional Office, if not filing electronically, and the property owner, if different
from applic t.
Signatures:
CL
i
Notary Acknowledgement
Commonwealth of Massachusetts County of Essex
23 April 2009
On this Day ofApril
Year
Before me, the undersigned Notary Public, D. Pabich, K. Glidden, A. Hamilton, C.
personally appeared McCauley, K. Cornacchio
proved to me through satisfactory evidence of identification, which was/were
personally known
Description of evidence of identification
to be the person whose name is signed on the preceding or attached document, and acknowledged to
me that he/she signed it voluntarily for its stated purpose.
As member of Salem Conservation Commission
City/Town
CAREY R.DUGUEB
NauryPtele
%)MM
wwr�M lo rMY c4"Wrilomn w
11~ Signature of otary Public
Carey R. u ues
Printed Name of Notary Public
Place notary seal and/or any stamp above August 16, 2013
My Commission Expires(Date)
This Order is issued to the applicant as follows:
❑ by hand delivery on by certified mail, return receipt requested, on
---
Date Date
wpf0rm5.d0c• rev.5108 Page 9 of 11
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
?; WPA Form 5 — Order of Conditions 64-481
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
F. Appeals
The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject
to this Order, 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 MassDEP Regional Office to issue a Superseding Order of
Conditions. The request must be made by certified mail or hand delivery to the Department, with the
appropriate filing fee and a completed Request of Departmental Action Fee Transmittal Form, as provided
in 310 CMR 10.03(7)within ten business days from the date of issuance of this Order. 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. Any appellants seeking to appeal the Department's
Superseding Order associated with this appeal will be required to demonstrate prior participation in the review
of this project. Previous participation in the permit proceeding means the submission of written information
to the Conservation Commission prior to the close of the public hearing, requesting a Superseding Order
or Determination, or providing written information to the Department prior to issuance of a Superseding
Order or Determination.
The request shall state clearly and concisely the objections to the Order which is being appealed and how
the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands
Protection Act(M.G.L. c. 131, §40), and is inconsistent with the wetlands regulations (310 CMR 10.00).
To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts
Wetlands Protection Act or regulations, the Department has no appellate jurisdiction.
Section G, Recording Information is available on the following page.
wpalorm5.doc• rev.5108 Page 10 of 11
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 - Order of Conditions 64-481
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
G. Recording Information
This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in
which the land is located, within the chain of title of the affected property. In the case of recorded land, the
Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land
subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court
Certificate of Title of the owner of the land subject to the Order of Conditions. The recording information on
this page shall be submitted to the Conservation Commission listed below.
Salem
Conservation Commission
Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission.
---------------------------------------------------------------------------------------------------------------------------
To:
Salem
Conservation Commission
Please be advised that the Order of Conditions for the Project at:
24 Old Road, North Shore Medical Center 64-481
Project Location MassDEP File Number
Has been recorded at the Registry of Deeds of:
County Book Page -
for:
Property Owner
and has been noted in the chain of title of the affected property in:
Book Page
In accordance with the Order of Conditions issued on:
Date
If recorded land, the instrument number identifying this transaction is:
Instrument Number
If registered land, the document number identifying this transaction is:
Document Number
Signature of Applicant
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Attachment to Order of Conditions # 64-481
Page lof 5
SALEM CONSERVATION COMMISSION
DEP FILE #64-481
24 Old Road, North Shore Medical Center Heliport Pad
City of Salem,Massachusetts
ADDITIONAL FINDINGS
Based on the Estimated Habitats or Rare Wildlife and Certified Vernal Pools Map (June 1, 2003) from Natural
Heritage & Endangered Species Program (NHESP) of the Massachusetts Division of Fisheries and Wildlife, it has
been determined that this project does not occur near any habitat of state-listed rare wildlife species nor contains any
vernal pools.
This Order is issued under the Massachusetts Wetlands Protection Act, M.G.L. Chapter 131, Section 40 and the City
of Salem Wetlands Protection Ordinance, Salem Code Chapter 34,Section 34-1 —34-13.
This Order permits the expansion of the existing heliport landing pad as shown on the approved plan referenced in
this document. The expansion includes first installing a silt barrier that will serve as a limit of work line. The
existing asphalt will be removed along with organics, loan and any unsuitable material. Re-grading will occur
within the limit of work area, followed by the installation of sub-base course (two 6-inch compacted lifts of road
gravel), 6-inch thick crushed stone and 44' diameter 6-inch thick(minimum thickness)reinforced concrete landing
pad per FAA specifications. Also approved is the pruning of adjacent vegetation (72 foot radius clearing area
measured from the center of the landing pad) to a height of 2-feet (measured from the existing ground plain).
Planting of a low maintenance grass such as No Mow was agreed upon by the applicant and the Conservation
Commission Continual to ensure that the areas remain vegetated while providing habitat. Herbicides and pesticide
shall not be used on the vegetation adjacent to the wetlands. The applicant is also required to properly manage the
snow on the heliport by not plowing snow into the wetlands.
GENERAL CONDITIONS
1. This Order of Conditions must be recorded in its entirety(all 5 pages)at the Essex County Registry of
Deeds or the Land Court for the district in which the land is located, after the expiration of the 10-day
appeal period and within 30 days of the issuance. A copy of the recording information must be
submitted to the Salem Conservation Commission before any work approved in this Order
commences.
2. Approval of this application does not constitute compliance with any law or regulation other than
M.G.L Chapter 131, Section 40, Wetlands Regulations 310 CMR 10.00 and the City of Salem Wetlands
Protection Ordinance, Salem Code Chapter 34, Section 34-1 —34-13.
3. All work shall be performed in accordance with this Order of Conditions and approved site plan(s). No
alteration of wetland resource areas or associated buffer zones, other than that approved in this Order,
shall occur on this property without prior approval from the Commission.
4. Prior to any work commencing, a sign shall be displayed showing DEP File #64-481, and not placed on
a living tree.
5. No work approved in this Order may commence until the ten(10)day appeal period has lapsed from the
date of the issuance of this Order.
Attachment to Order of Conditions # 64-481
Page 2of 5
6. With respect to this Order, the Commission designates the Conservation Agent as its agent with powers
to act on its behalf in administering and enforcing this Order.
'7. The Commission or its Agent,officers, or employees shall have the right to enter and inspect the property at
any time for compliance with the conditions of this Order,the Wetlands Protection Act MGL Chapter 131,
Section 40,the Wetlands Regulations 310 CMR 10.00,and shall have the right to require any data or
documentation that it deems necessary for that evaluation.
8. The term"Applicant' as used in this Order of Conditions shall refer to the owner, any successor in
interest or successor in control of the property referenced in the Notice of intent, supporting documents
and this Order of Conditions. The Commission shall be notified in writing within 30 days of all
transfers of title of any portion of the property that takes place prior to issuance of the Certificate of
Compliance.
9. It is the responsibility of the applicant to procure all other applicable federal, state and local permits and
approvals associated with this project. These permits may include but are not necessarily limited to the
following:
(1) Section 404 of the Federal Water Pollution Control Act(P.L. 92-500, 86 stat. 816), U.S. Army
Corps of Engineers.
(2) Water Quality Certification in accordance with the Federal Water Pollution Control under authority
of sec. 27(5)of Chapter 21 of the Massachusetts General Laws as codified in 314 CMR 9.00.
(3) Sewer Extension Permit from the DEP Division of Water Pollution Control under G. L. Ch. 21A ss7
and 314 CMR 7.00. Any Board of Health permit for septic system design for any portion of the
septic system within 100 feet of wetlands shall be submitted to the Commission prior to
construction initiation.
(4) Design Requirements for Construction in Floodplains under the State Building Code (780 CMR
744.).
10. If there are conflicting conditions within this Order, the stricter condition(s) shall rule.
11. All work shall be performed so as to ensure that there will be no sedimentation into wetlands and
surface waters during construction or after completion of the project.
12. The Commission or its Agent shall have the discretion to modify the erosion/siltation control methods
and boundary during construction if necessary.
13. The Commission reserves the right to impose additional conditions on portions of this project or this site
to mitigate any actual or potential impacts resulting from the work herein permitted.
14. The work shall conform to the following attached plans and special conditions:
Final Approved Plans
Site Plan for the Proposed Expansion of the Heliport Landing Pad at the North Shore Medical
Center#81 Highland Avenue Salem, MA
(Title)
January 8, 2009
(Dated)
Scott Ian Patrowicz
Attachment to Order of Conditions k 64-481
Page 3of 5
(Signed and Stamped by)
City of Salem Conservation Commission
(On file with)
15. Any proposed changes in the approved plan(s) or any deviation in construction from the approved
plan(s) shall require the applicant to file a Notice of Project Change with the Commission. The Notice
shall be accompanied by a written inquiry prior to their implementation in the field, as to whether the
change(s) is substantial enough to require filing a new Notice of Intent or a request to correct or amend
this Order of Conditions. A copy of such request shall at the same time be sent to the Department of
Environmental Protection.
16. In conjunction with the sale of this property or any portion thereof before a Certificate of Compliance has
been issued,the applicant or current landowner shall submit to the Commission a statement signed by the
buyer that he/she is aware of an outstanding Order of Conditions on the property and has received a copy of
the Order of Conditions.
17. Condition Number 44 as indicated shall continue in force beyond the Certificate of Compliance, in
perpetuity,and shall be referenced to in all future deeds to this property.
PRIOR TO CONSTRUCTION
18. Prior to the commencement of any activity on this site other than activities listed above, there
shall be a Pre-Construction Meeting between the project supervisor,the contractor responsible for the
work, and a member of the Conservation Commission or its Administrator to ensure that the
requirements of the Order of Conditions are understood. The staked erosion control line shall be
adjusted,if necessary, during the pre-construction meeting. Please contact the Conservation Commission
Agent at(978) 745-9595 ext 311 at least forty-eight(48)hours prior to any activity to arrange for the
pre-construction meeting.
19. Prior to the pre-construction meeting and commencement of any activity on this site, sedimentation and
erosion control barriers shall be installed as shown on the approval plan(s)and detail drawings. The
Commission and/or its Administrator shall inspect and approve such installation at the pre-construction
meeting.
20. No clearing of vegetation, including trees,or disturbance of soil shall occur prior to the pre-construction
meeting. Minimal disturbance of shrubs and herbaceous plants shall be allowed prior to the pre-
construction meeting if absolutely necessary in order to place erosion control stakes where required.
21. There shall be twenty (20)hay bales and wooden stakes under cover on the site to be used only for
emergency erosion control.
EROSION CONTROL
22. Appropriate erosion control devices shall be in place prior to the beginning of any phase of construction,
and shall be maintained during construction in the wetland areas and buffer zones. The erosion control
specifications provided in the Notice of Intent and the erosion control provision in the Order will be the
minimum standards for this project; the Commission may require additional measures.
23. All debris, till and excavated material shall be stockpiled a location far enough away from the wetland
resource areas to prevent sediment from entering wetland resource areas.
Attachment to Order of Conditions # 64-481
Page 4of 5
24. Erosion and sedimentation control devices shall be inspected after each storm event and repaired or
replaced as necessary. Any accumulated silt adjacent to the barriers shall be removed.
25. The area of construction shall remain in a stable condition at the close of each construction day.
26. Any de-watering of trenches or other excavation required during construction shall be conducted so as
to prevent siltation of wetland resource areas. All discharge from de-watering activities shall be filtered
through hay bale sediment traps, silt filter bags or other means approved by the Commission or its
Administrator.
27. Within thirty (30) days of completion of construction on any given portion of the project, all disturbed
areas in the completed portion of the site shall be permanently stabilized with rapidly growing
vegetative cover, using sufficient top soil to assure long-term stabilization of disturbed areas.
28. If soils are to be disturbed for longer that two (2)months, a temporary cover of rye or other grass should
be established to prevent erosion and sedimentation. If the season is not appropriate for plant growth,
exposed surface shall be stabilized by other appropriate erosion control measures, firmly anchored, to
prevent soils from being washed by rain or flooding.
DURING CONSTRUCTION
29. A copy of this Order of Conditions and the plan(s)approved in this Order shall be available on site at all
times when work is in progress.
30. No alteration or activity shall occur beyond the limit of work as defined by the siltation barriers shown on
the approved plan(s).
31. All waste products,grubbed stumps,slash; construction materials,etc. shall be deposited at least 100 feet
from wetland resource areas and 200 feet from river.
32. Cement trucks shall not be washed out in any wetland resource or buffer zone area,nor into any drainage
system. Any deposit of cement or concrete products into a buffer zone or wetland resource area shall be
immediately removed.
33. All exposed sub-soils shall be covered by a minimum of three(3)inches of quality screened loam topsoil
prior to seeding and final stabilization.
34. Immediately following drainage structure installation all inlets shall be protected by silt fence,haybale
barriers and/or silt bags to filter silt from stormwater before it enters the drainage system.
35. There shall be no pumping of water from wetland resource areas.
36. All equipment shall be inspected regularly for leaks. Any leaking hydraulic lines,cylinders or any other
components shall be fixed immediately.
37. During construction,all drainage structures shall be inspected regularly and cleaned as necessary.
38. The applicant is herby notified that failure to comply with all requirements herein may result in the issuance
of enforcement actions by the Conservation Commission including,but not limited to, civil administrative
penalties under M.G.L Chapter 21A, section 16.
AFTER CONSTRUCTION
Attachment to Order of Conditions k 64-481
Page 5of 5
39. Upon completion of construction and final soil stabilization, the applicant shall submit the following to
the Conservation Commission to request a Certificate of Compliance (COC):
(1) A Completed Request for a Certificate of Compliance form(WPA Form 8A or other form if
required by the Conservation Commission at the time of request).
(2) A letter from a Registered Professional Engineer certifying compliance of the property with this
Order of Conditions.
(3) An"As-Built' plan signed and stamped by a Registered Professional Engineer or Land Surveyor
showing post-construction conditions within all areas under the jurisdiction of the Massachusetts
Wetlands Protection Act. This plan shall include at a minimum:
(a) , All wetland resource area boundaries with associated buffer zones and regulatory setback
areas taken from the plan(s)approved in this Order of Conditions;
(b) Locations and elevations of all stormwater management conveyances, structures and best
management designs,including foundation drains,constructed under this Order within any
wetland resource area or buffer zone;
(c) Distances from any structures constructed under this Order to wetland resource areas-
"structures"include,but are not limited to,all buildings, septic system components,wells,
utility lines, fences,retaining walls,and roads/driveways,
(d) A line delineating the limit of work-"work"includes any filling,excavating and/or
disturbance of soils or vegetation approved under this Order;
40. When issued,the Certificate of Compliance must be recorded at the Essex County Registry of Deeds
and a copy of the recording submitted to the Salem Conservation Commission.
41. If the completed work differs from that in the original plans and conditions, the report must specify how
the work differs; at which time the applicant shall first request a modification to the Order. Only upon
review and approval by the Commission, may the applicant request in writing a Certificate of
Compliance as described above.
42. . Erosion control devices shall remain in place and properly functioning until all exposed soils have been
stabilized with final vegetative cover and the Conservation Commission and/or its Administrator has
authorized their removal.
ADDITIONAL CONDITIONS
43. Prior to starting this project, the applicant shall submit a planting plan describing the 7 (seven)trees to
be planted along the top of the embankment abutting the parking lot(see attached photo indicating the
location)to the Conservation Commission or Conservation Agent for approval. If the applicant is
unable to plant the trees at this location, the new location must be approved by the Conservation
Commission prior to the trees being planted.
PERPETUAL CONDITIONS
44. The applicant shall maintain a snow management plan for the heliport landing pad to ensure that snow is
not being plowed into the wetlands.
PATROWICZ
RCCI V
• LAND DEVELOPMENT ENGINEERING SEP 1 j
2008
COMPA I. OFPLANNW6.g
September 5, 2008 BEVELOp4E-11 ;
• City of Salem
Conservation Commission
120 Washington Street-Third Floor
Salem, MA 01970
• RE: Notice of Intent Application
Proposed Expansion of Existing Heliport Landing Pad
#24 Old Road, Salem, MA
Assessor's Map 24, Lot 221
PLDE#08-24
•
Dear Commission Members:
On behalf of the North Shore Medical Center/Salem Hospital (applicant), I respectfully request that
you review the attached Notice of Intent(NOI) application in compliance with the Massachusetts
• Wetlands Protection Act and Salem Wetlands Protection Ordinance.
The applicant is proposing to expand the existing heliport land pad as shown on the attached Site
Plan. The scope of work will include the following:
• (1) Install a silt fence barrier that will serve as a limit of work line.
(2) Remove existing asphalt, organics, loam and any unsuitable material. Re-grade the area.
Install the sub-base course (two 6-inch compacted lifts of road gravel (MHD M1.03.0 type
B). Install 6-inch thick crushed stone (MHD M2.01.4). Install 60-foot diameter 6-inch thick
(minimum thickness) reinforced concrete landing pad per FAA specifications.
(3) Proposed pruning of adjacent vegetation (70-foot radius clearing area measured from the
center of the landing pad) to a height of 2-feet (measured from the existing ground plain).
Continual maintenance is required to keep the existing vegetation low. There shall be no
pesticides or fertilizers applied to this clearing area.
The proposed work is partially within the 100-foot buffer zone. No work is proposed within any
wetland resource area. The limit of work line is approximately 54-feet from the flagged and
• surveyed Bordering Vegetated Wetlands.
I respectfully submit seven (7) copies and one (1) original of the Notice of Intent application to
include the following:
•NOI Application (WPA Form 3),
•
*List of abutters and map (prepared by City of Salem Assessors),
14 Brown Street, Salem, Massachusetts 01970
Cell: 978-836-6400 Fax: 978-745-4110 Email: scott.patrowicz@verizon.net
*Form entitled: Notification to Abutters under Massachusetts Wetlands Protection Act and City
of Salem Wetlands Protection Ordinance,
• •Wetlands Report (prepared by Wetlands and Land Management, Inc) dated 8/15/08,
•USGS Locus Map, Scale=1:25,000 (approximately: 1"2000'),
•Bird's Eye Views of the project site (taken from Windows Live),
•Photographs of the site (taken on 9/5/08) showing areas for the proposed work,
*Plan entitled: "Site Plan" (prepared by Patrowicz Land Development Engineering) dated
9/5/08 showing flagged and surveyed wetland resource area and proposed scope of work,
• Scale: 1"=20',
It is my understanding that I will notify the abutters (from the list of abutters provided to me by your
office from the City Assessors Dept.) via certified mail with the attached form entitled: "Notification
to Abutters". 1 will submit receipts of the certified mailings to the Commission the night of the
public hearing. It is also my understanding that you have submitted the legal advertisement to the
• local newspaper for publication of the hearing date. The applicant will receive the invoice for the
legal advertisement.
One copy of the above NOI application package is being sent via certified mail to DEP-Wetlands,
Northeast Regional Office, 205B Lowell Street, Wilmington, MA 01887.
• In accordance with the BRP WPA Form 3 instruction, no fee shall be assessed to projects of any
city, therefore the NOI Wetland Fee Transmittal Form and fees are not being sent to DEP, P.O.
Box 4062, Boston, MA 02211.
Thank you for taking this matter under consideration. We look forward to the public hearing on
• September 25, 2008. If you have any questions, please do not hesitate to call me.
Sincerely,
PATRO I Z LAND DEVELOPMENT ENGINEERING
s
Scott Patrowicz, P.E.
•
cc. Shelly Bisegna, w/attachments
• cc. DEP-Wetlands, Northeast Regional Office w/attachments
PATROWICZ LAND DEVELOPMENT ENGINEERING
Massachusetts Department of Environmental protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands MassDEP File Number
WPA Form 3 - Notice of Intent
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Document Transaction Number
• Salem
Cityrrown
ImpoWhen filling A. General Information
When filling out
forms on the
computer, key 1. Project Location (Note: electronic filers will click on button to locate project site):
only to move your 24 Old Road Salem 01970
cursor-do not a.Street Address
use the return b.City/Town c.Zip Code
key' Latitude and Longitude:
d.Latitude e.Longitude
°6 24 221
f.Assessors Map/Plat Number g.Parcel/Lot Number
2. Applicant:
Shelly Bisegna
a.First Name b.Last Name
Note: North Shore Medical Center(Salem Hospital)
Before c.Organization
completing this 81 Highland Avenue
form consult
0 your local d.Street Address
Conservation SalemMA 01970
Commission e.City/Town f.State g.Zip Code
regarding any
municipal bylaw 978-354-2598 978-741-4872 sbisegna@partners.org
or ordinance. h. Phone Number i. Fax Number j.Email Address
0 3. Property owner(required if different from applicant): ❑ Check if more than one owner
a.First Name b.Last Name
City of Salem
c.Organization
0 d.Street Address
e.City/iown f.State g.Zip Code
h.Phone Number i.Fax Number j.Email address
. 4. Representative(if any):
Scott Patrowicz, P.E.
a.First Name b.Last Name
Patrowicz Land Development Engineering
c.Company
14 Brown Street
r d.Street Address
Salem MA 01970
e.City/Town f.State g.Zip Code
978-836-6400 978-745-4110 scott.patrowicz@verizon.net
h.Phone Number i.Fax Number j.Email address
0 5. Total WPA Fee Paid (from NOI Wetland Fee Transmittal Form):
Exempt(City/Hospital project) N/A N/A
a.Total Fee Paid b.State Fee Paid c.City/Town Fee Paid
0
wpaformIdoc•rev.02/21/08 Page 1 of 8
• Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands MassDEP File Number
WPA Form 3 - Notice of Intent
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem
• Cityrrown
A. General Information (continued)
6. General Project Description:
Salem Hospital proposes to expand an existing heliport landing pad (which includes pruning
• vegetation within the buffer zone).
7a. Project Type Checklist:
• 1. ❑ Single Family Home 2. ❑ Residential Subdivision
3. ❑ Limited Project Driveway Crossing 4. ❑ Commercial/Industrial
5. ❑ Dock/Pier 6. ❑ Utilities
• 7. ❑ Coastal Engineering Structure 8. ❑ Agriculture(e.g., cranberries, forestry)
9. ❑ Transportation 10. ® Other
7b. Is any portion of the proposed activity eligible to be treated as a limited project subject to 310 CMR
10.24 (coastal) or 310 CMR 10.53 (inland)?
• 1. ❑ Yes ® No If yes, describe which limited project applies to this project:
2.Limited Project
8. Property recorded at the Registry of Deeds for:
Essex
• a.County b.Certificate#(if registered land)
c.Book d. Page Number
B. Buffer Zone & Resource Area Impacts (temporary & permanent)
1. ® Buffer Zone Only—Check if the project is located only in the Buffer Zone of a Bordering
Vegetated Wetland, Inland Bank, or Coastal Resource Area.
2. ❑ Inland Resource Areas(see 310 CMR 10.54-10.58, if not applicable, go to Section B.3,
Coastal Resource Areas).
Check all that apply below. Attach narrative and any supporting documentation describing how the
project will meet all performance standards for each of the resource areas altered, including standards
• requiring consideration of alternative project design or location.
For all projects
affecting other Resource Area Size of Proposed Alteration Proposed Reolacement(if any)
Resource Areas,
please attach a
narrative a. ❑ Bank 1.linear feet 2.linear feet
explaining how
the resource b. ❑ Bordering Vegetated
• area was Wetland 1.square feet 2.square feet
delineated.
c. ❑ Land Under 1.linear feet 2. linear feet
Waterbodies and
Waterways 3.cubic yards dredged
• wpaform3.doc•rev.02/21/08 Page 2 of 8
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands MassDEP File Number
WPA Form 3 - Notice of Intent
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem
• City/Town
B. Buffer Zone & Resource Area Impacts (temporary & permanent) (cont'd)
Resource Area Size of Proposed Alteration Proposed Replacement(if any)
d. ❑ Bordering Land
• Subject to Flooding 1.square feet 2.square feet
3.cubic feet of flood storage lost 4.cubic feet replaced
e. ❑ Isolated Land
Subject to Flooding 1.square feet
• 2.cubic feet of flood storage lost 3.cubic feet replaced
I. ❑ Riverfront Area 1. Name of Waterway(if available)
2. Width of Riverfront Area (check one):
❑ 25 ft. - Designated Densely Developed Areas only
❑ 100 ft. - New agricultural projects only
❑ 200 ft. -All other projects
3.Total area of Riverfront Area on the site of the proposed project: square feet
4. Proposed alteration of the Riverfront Area:
a.total square feet b.square feet within 100 ft. c square feet between 100 ft.and 200 ft.
• 5. Has an alternatives analysis been done and is it attached to this NO[? ❑ Yes❑ No
s. Was the lot where the activity Is proposed created pdor to August 1, 1996?
❑ Yes❑ No
3. ❑ Coastal Resource Areas: (See 310 CMR 10.25-10.35)
Check all that apply below. Attach narrative and supporting documentation describing how the project
will meet all performance standards for each of the resource areas altered, including standards
requiring consideration of alternative project design or location.
Online Users:
Include your Resource Area Size of Proposed Alteration Proposed Replacement(if any)
document
transaction
number a. r_1 Designated Port Areas Indicate size under Land Under the Ocean, below
•
(provided on
your receipt b. ❑ Land Under the Ocean
page)with all 1.square feet
supplementary
information you 2.cubic yards dredged
submit to the
Department. c. ❑ Barrier Beach Indicate size under Coastal Beaches and/or Coastal Dunes below
•
d. ❑ Coastal Beaches 1.square feet 2.cubic yards beach nourishment
e. ❑ Coastal Dunes 1.square feet 2.cubic yards dune nourishment
• wpaform3.doc rev.02/21/08 Page 3 of 8
Massachusetts Department of Environmental ProtectionProvided by M assDEP:
Bureau of Resource Protection - Wetlands MassDEP File Number
WPA Form 3 - Notice of Intent
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem
City/Town
B. Buffer Zone & Resource Area Impacts (temporary sr permanent) (cont'd)
Size of Proposed Alteration Proposed Replacement(if any)
•
f. ElCoastal Banks 1.linear feet
g. ❑ Rocky Intertidal
Shores 1.square feet
h. ❑ Salt Marshes 1.square feet 2.sq it restoration, rehab.,creation
i. ❑ Land Under Salt
• Ponds 1.square feet
2.cubic yards dredged
j. ❑ Land Containing
Shellfish 1.square feet
k. ❑ Fish Runs Indicate size under Coastal Banks, inland Bank, Land Under the
Ocean, and/or inland Land Under Waterbodies and Waterways,
above
1.cubic yards dredged
I. ❑ Land Subject to
Coastal Storm Flowage 1.square feet
4. ❑ Restoration/Enhancement
If the project is for the purpose of restoring or enhancing a wetland resource area in addition to the
square footage that has been entered in Section B.2.b or B.3.h above, please enter the additional
amount here.
a.square feet of BVW b.square feet of Salt Marsh
C. Other Applicable Standards and Requirements
Streamlined Massachusetts Endangered Species Act/Wetlands Protection Act Review
1. Is any portion of the proposed project located in Estimated Habitat of Rare Wildlife as indicated on
• the most recent Estimated Habitat Map of State-Listed Rare Wetland Wildlife published by the Natural
Heritage and Endangered Species Program (NHESP)?To view habitat maps, see the Massachusetts
Natural Heritage Atlas or go to http://www.mass.gov/dfwele/dfvv/nhesp/nhregmar).htm.
a. ❑ Yes ® No If yes, include proof of mailing or hand delivery of NOI to:
Natural Heritage and Endangered Species Program
• Division of Fisheries and Wildlife
10/06 Route 135, North Drive
b. Date of map Westborough,MA 01581
If yes, the project is also subject to Massachusetts Endangered Species Act(MESA) review(321
CMR 10.18). To qualify for a streamlined, 30-day, MESA/Wetlands Protection Act review, please
complete Section CA.C, and include requested materials with this Notice of Intent(NOI); OR
• complete Section C.1.d, if applicable. If MESA supplemental information is not included with the NOI,
by completing Section 1 of this form, the NHESP will require a separate MESA filing which may take
up to 90 days to review(unless noted exceptions in Section 2 apply, see below).
• 7
3.doc•rev.02121/08 Page 4 of 8
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands MassDEP File Number
WPA Form 3 - Notice of Intent
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem
• Cityrrown
C. Other Applicable Standards and Requirements (cont'd)
1. c. Submit Supplemental Information for Endangered Species Review
1. ❑ Percentage/acreage of property to be altered:
(a)within wetland Resource Area
percentage/acreage
(b) outside Resource Area
percentage/acreage
2. ❑ Assessors Map or right-of-way plan of site
3. ❑ Project plans for entire project site, including wetland resource areas and areas outside of
wetlands jurisdiction, showing existing and proposed conditions, existing and proposed
tree/vegetation clearing line, and clearly demarcated limits of work**
(a)❑ Project description (including description of impacts outside of wetland resource area &
• buffer zone)
(b) ❑ Photographs representative of the site
(c)❑ MESA filing fee (fee information available at:
hftp://www.mass.clov/dfwele/dfw/nhesp/nhenvmesa.htm)
Make check payable to"Natural Heritage& Endangered Species Fund" and mail to
NHESP at above address
Projects altering 10 or more acres of land, also submit.
(d)❑ Vegetation cover type map of site
(e)❑ Project plans showing Priority& Estimated Habitat boundaries
d. OR Check One of the Following
1.❑ Project is exempt from MESA review.
Attach applicant letter indicating which MESA exemption applies. (See 321 CMR 10.14,
http://www.mass.gov/dfwele/dfw/nhesp/nhenvexemptions.htm; the NOI must still be sent to
NHESP if the project is within estimated habitat pursuant to 310 CMR 10.37 and 10.59.)
2. ❑ Separate MESA review ongoing.
a. NHESP Tracking Number b. Date submitted to NHESP
3. ❑ Separate MESA review completed.
Include copy of NHESP"no Take"determination or valid Conservation &Management
Permit with approved plan.
* Some projects not in Estimated Habitat may be located in Priority Habitat, and require NHESP
review(see www.nhesp.org regulatory review tab). Priority Habitat includes habitat for state-
listed plants and strictly upland species not protected by the Wetlands Protection Act.
" MESA projects may not be segmented(321 CMR 10.16).The applicant must disclose full development plans
even if such plans are not required as part of the Notice of Intent process.
• wpaforrn3.doc•rev.02/21/08 Page 5 of 8
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands MassDEP File Number
WPA Form 3 - Notice of Intent
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Document Transaction Number
Salem
CityRbwn
C. Other Applicable Standards and Requirements (cont'd)
2. For coastal projects only, is any portion of the proposed project located below the mean high water
line or in a fish run?
a. ® Not applicable—project is in inland resource area only
b. ❑ Yes ❑ No If yes, include proof of mailing or hand delivery of NOI to either:
South Shore-Cohasset to Rhode North Shore-Hull to New Hampshire:
Island, and the Cape& Islands:
Division of Marine Fisheries-
Division of Marine Fisheries- North Shore Office
Southeast Marine Fisheries Station Attn: Environmental Reviewer
Attn: Environmental Reviewer 30 Emerson Avenue
838 South Rodney French Blvd. Gloucester, MA 01930
New Bedford, MA 02744
Also if yes, the project may require a Chapter 91 license. For coastal towns in the Northeast Region,
please contact MassDEP's Boston Office. For coastal towns in the Southeast Region, please contact
MassDEP's Southeast Regional Office.
3. Is any portion of the proposed project within an Area of Critical Environmental Concern (ACEC)?
Online users: a. EJ Yes ® No If yes, provide name of ACEC (see instructions to WPA Form 3 or MassDEP
Include your Website for ACEC locations). Note: electronic filers click on Website.
document
transaction b.ACEC
number
(provided on 4. Is any portion of the proposed project within an area designated as an Outstanding Resource Water
your receipt (ORW)as designated in the Massachusetts Surface Water Quality Standards, 314 CMR 4.00?
page)with all
• supplementary a. ❑ Yes ® No
information you
submit to the 5. Is any portion of the site subject to a Wetlands Restriction Order under the Inland Wetlands
Department. Restriction Act(M.G.L. c. 131, §40A)or the Coastal Wetlands Restriction Act(M.G.L. c. 130, § 105)?
a. ❑ Yes ® No
6. Is this project subject to provisions of the MassDEP Stormwater Management Standards?
a. ❑ Yes. Attach a copy of the Stormwater Report as required by the Stormwater Management
Standards per 310 CMR 10.05(6)(k)-(q) and check if:
1. ❑ Applying for Low Impact Development(LID) site design credits(as described in
Stormwater Management Handbook Vol. 2, Chapter 3)
2.❑ A portion of the site constitutes redevelopment
3. ❑ Proprietary BMPs are included in the Stormwater Management System.
b. ® No. Check why the project is exempt:
1. ❑ Single-family house
2. 0 Emergency road repair
3. ❑ Small Residential Subdivision (less than or equal to 4 single-family houses or less than or
equal to 4 units in multi-family housing project)with no discharge to Critical Areas.
• wpafonn3.doc•rev.02/21/08 Page 6 of 8
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands MassDEP File Number
WPA Form 3 - Notice of Intent
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem
• Cdy/rown
D. Additional Information
Applicants must include the following with this Notice of Intent(NOI). See instructions for details.
Online Users:Attach the document transaction number(provided on your receipt page)for any of the
• following information you submit to the Department.
1. 2 USGS or other map of the area (along with a narrative description, if necessary) containing
sufficient information for the Conservation Commission and the Department to locate the site.
(Electronic filers may omit this item.)
•
2. 0 Plans identifying the location of proposed activities(including activities proposed to serve as a
Bordering Vegetated Wetland [BVW] replication area or other mitigating measure) relative to
the boundaries of each affected resource area.
3. ® Identify the method for BVW and other resource area boundary delineations (MassDEP BVW
Field Data Form(s), Determination of Applicability, Order of Resource Area Delineation, etc.),
• and attach documentation of the methodology.
4. ® List the titles and dates for all plans and other materials submitted with this NOI.
Site Plan
a.Plan Title
Patrowicz Land Development Engineering Scott Patrowicz, P.E.
b. Prepared By c.Signed and Stamped by
9/5/08 V=20'
d.Final Revision Date e.Scale
Wetlands and Land Management, Inc report 8/15/08
f.Additional Plan or Document Title g.Date
5. ❑ If there is more than one property owner, please attach a list of these property owners not
• listed on this form.
6. ❑ Attach proof of mailing for Natural Heritage and Endangered Species Program, if needed.
7. ❑ Attach proof of mailing for Massachusetts Division of Marine Fisheries, if needed.
8. ❑ Attach NOI Wetland Fee Transmittal Form
9. ❑ Attach Stormwater Report, if needed.
E. Fees
1. ® Fee Exempt: No filing fee shall be assessed for projects of any city, town, county, or district of
• the Commonwealth, federally recognized Indian tribe housing authority, municipal housing
authority, or the Massachusetts Bay Transportation Authority.
Applicants must submit the following information (in addition to pages 1 and 2 of the NOI Wetland Fee
Transmittal Form)to confirm fee payment:
N/A N/A
• 2.Municipal Check Number 3.Check date
N/A N/A
4.State Check Number 5.Check date
N/A N/A
6. Payor name on check: First Name 7.Payor name on check: Last Name
• wpaforrn3.doc•rev.02/21/08 Page 7 of 8
• Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands MassDEP File Number
WPA Form 3 - Notice of Intent
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem
• city/rown
F. Signatures and Submittal Requirements
I hereby certify under the penalties of perjury that the foregoing Notice of Intent and accompanying plans,
documents, and supporting data are true and complete to the best of my knowledge. I understand that
the Conservation Commission will place notification of this Notice in a local newspaper at the expense of
• the applicant in accordance with the wetlands regulations, 310 CMR 10.05(5)(a).
I further certify under penalties of perjury that all abutters were notified of this application, pursuant to the
requirements of M.G.L. c. 131, §40. Notice must be made by Certificate of Mailing or in writing by hand
delivery or certified mail (return receipt requested)to all abutters within 100 feet of the property line of the
project location.
:Sin re 2. Dto
32 0
3.Signature of Pro ner(if different) 4.Date
• 5.Signature of Re se ative(if any) >,��;�\,. 6.Date
p SCJT&.AN
PATRGwi CZ T
For Conservation Commission
Two copies of the completed Notice of In t, i supporting plans and documents,
two copies of the NOI Wetland Fee Trans ity/town fee payment, to the
• Conservation Commission by certified mail o ft,
For MassDEP:
One copy of the completed Notice of Intent(Form 3), including supporting plans and documents, one
copy of the NOI Wetland Fee Transmittal Form, and a copy of the state fee payment to the MassDEP
Regional Office(see Instructions) by certified mail or hand delivery.
Other:
• If the applicant has checked the"yes" box in any part of Section C, Item 3, above, refer to that section
and the Instructions for additional submittal requirements.
The original and copies must be sent simultaneously. Failure by the applicant to send copies in a
timely manner may result in dismissal of the Notice of Intent.
•
•
• wpaform3.doc•rev.02/21/08 Page 8 of 8
SCALE 1:25 000
PATROWICZ LAND DEVELOPMENT ENGINEERING I CENTIMETER ON THE MAP REPRESENTS 2W METERS ON THE GROUT
Lend Planning,Civil Engineering,Environmental Permitting CONTOUR INTERVAL 3 METERS
DATE:
SUBJECT Site Locus (U.S.G.S. map) Z SHEET NO.: 1
foA,aPa 91cn trl `2 it-f�r+SI o T•J °n JOB NO.:
N o/Lci 1�.-_.S I+.�__ /—r+ !C�l-ti"
-S Po 3�. I�;PI'Tya.. I S�'l L¢w� Mt* .
..500 0 1000 . I 2ao0 1...7000 40011 METERS
i000 o moo 4000 Will eom loam 12000 FEET
• KILOMETERS 1 .5 0 -- +sp 1 2 7
t --
MILES 1 .5 0
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"� r •�J �`+ ,X11 B i�'"' Co° / O ' Sal m Termin {�
rf 3
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/
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• ` 49
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0 '�V 0 � 0 U2 ° '✓ - 1...
+ i
• �= ._P- ! 1 -F_t�..t ! f
CITY OF SALEM
ASSESSOR'S CERTIFICATION OF ABUTTERS AND
• PROPERTY OWNERS
RECEIVED
BOARD/COMMISSION: Conservation Commission SEP 0 8 2008
• PROJECT SITE: 24 Old Road (24-0221-0) DEPT.OF PLANNfNG&
CONM/ILOTY DEVELOPKW
DESCRIPTION OF REQUIREMENT: All abutters and any property owner
within 100 feet of the property line of the land where the activity is proposed
including if land is separated by a public or private street or a body of water and
0 not unreasonably distant from the project site.
This is to certify that the time of the last assessment for taxation made by the City of
• Salem,the names and addresses of those listed on the attached sheets are"abutters and
property owners" (as defined by Wetlands Protection Act 310 CMR 10.05(4)(a))to the
parcel(s) of land listed above as the project site.
i
• Assessor's Signature: Date: ,
Number of initialed pages attached: _
• Once Certified,Return to:
Carey Duques, Department of Planning and Community Development
•
i • �
•
•
Salem Web GIS -Map Page Page 1 of 1
Welcorne to
the Cin o Salern,Marsachfrseds
Property Viewer
! New Property Search Property Record Card AHELP
Property ID 24_0221_0
509 feet Address 24 OLD ROAD
Owner SALEM CITY OF
41
Property ID 24_0218_0 i
Address DOVEAVENUE
Owner SALEM CITY OF
A
Property ID 240216_0
Address 1 DOVE AVENUE 1
l Owner SHAUGHNESSY-KAPLAN REHAB HOSP E
Property ID 240001202
Address 81 HIGHLAND AVENUE
Owner SALEM HOSPITAL
Property ID 240001201
O
Address 81 HIGHLAND AVENUE
_ Owner SALEM HOSPITAL
0 4 Property ID 2400310
Address 34 HORTON STREET
• p _ Search (��. Use Add I Remove Add Abutter
Distance .100�tt Parcels fool to Remove arcels
p Target Parcels
Mailing Labels Export T
® Q q " e� RFyj � I >' E1 m e �n tP Scale t"= 509 - ft
Salem City Hall 93 Washington Steel,Salem,MA 01970
Phone:918445-9595
!
City Hall Hours of Operation:Monday,Tuesday 8 Wednesday 8AM-4PM Thursday 8AM-7PM Fdday 8AM-12PM
Us deelpned by AppGeo.
!
!
I •
�h4://host.appgeo.com/salemma/Map.aspx 9/5/2008
24_0218_0 24_0221_0
SALEM CITY OF.. - SALEM CITY OF
24_0216_0
SHAUGHNESSY-KAPLAN REHAB HOSP
I DOVE AVENUE
SALEM,MA 01970
24_0001_202
SALEM HOSPITAL
P O BOX 6240
BOSTON,MA 02114
24_0001_201
SALEM HOSPITAL
81 HIGHLAND AVENUE
SALEM,MA 01970
24_0031_0
NEW ENGLAND POWER CO
25 RESEARCH AVENUE
WESTBOROUGH,MA 01581
24_0020_0
CLARK LUCYI
36 HORTON STREET
SALEM,MA 01970
24_0088_0
SALEM HOSPITAL
81 HIGHLAND AVE
SALEM,MA 01970
24_0019 0
SALEM HOSPITAL
P O BOX 6240
BOSTON,MA 02114
• 24_0005_0
BRYCE ELIZABETH E S
17 OLD ROAD
SALEM,MA 01970
• 24_0018_0
LABRECQUE NORMAN
19 OLD ROAD
SALEM,MA 01970
•
NOTIFICATION TO ABUTTERS
• Under the Massachusetts Wetlands Protection Act
& the City of Salem Wetlands Protection Ordinance
• In accordance with the second paragraph of the Massachusetts General Laws Ch 131, §40, you are
hereby notified of the following:
A. The name of the applicant isL- vC}�
14oSPl �'}a
B. The applicant is filing a NC>rl k„S OF. )C4 17CO f application with the Salem
• Conservation Commission seeking permission to
n-�, e:'A... -s Ik%—IPo2.` Pc--r>
such work being near wetlands subject to protection under the Wetlands Protection Act and the
Salem Wetlands Protection Ordinance.
C. The address of the property where the work is being proposed is
V v'1 (a(' 1-1-
D. Copies of the application and plans may be examined at Salem City Hall Annex, 3rd floor, 120
Washington Street between the hours of 8:00am to 4:00pm Monday through Wednesday, 8:00am
to 7:00pm on Thursdays, and 8:00am to 12:00pm (noon) on Fridays.
•
E. Information regarding this matter may be obtained from the Salem Conservation Commission Agent
at (978) 745-9595 ext 311.
• Note: Notice of the public hearing, including its date, time and place, will be published at least a week
prior to the meeting date in The Salem News.
Note: Notice of the public hearing, including its date, time, place, will be posted on the Public
Meetings Bulletin Board in Salem City Hall not less than 48-hours in advance.
• Note: You also may contact the Salem Conservation Commission or the nearest Department of
Environmental Protection Regional Office for more information about this application or the
Wetlands Protection Act.
To contact DEP call:
• Central Region: (508)792-7650 Q Northeast Region: (978) 694-3200
Southeast Region: (508) 946-2714 Western Region: (413) 784-1100
•
•
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•
• r ._ Wetlands &
Land Management, Inc.
August 15,2008
Mr. Scott Patrowicz,P.E.
Patrowicz Land Development Engineering
14 Brown Street
Salem,MA 01970
RE: Wetland Evaluation for the Heliport Expansion,North Shore Medical Center
•
Dear Mr.Patrowicz:
Wetlands&Land Management,Inc. (WLM)has completed our evaluation of wetland resource areas at or
near the proposed heliport expansion at the North Shore Medical Center in Salem,MA. Following is a
summary of jurisdictional wetlands as regulated by the Wetlands Protection Act and other local regulations.
• Wetlands on the site were evaluated using delineation methodology established in the Wetlands Protection
Act and the Department of Environmental Protection"Delineating Bordering Vegetated Wetlands
Handbook"dated 1995,and the US Army Corps of Engineers Manual(1987). These regulations and
methodology incorporate the evaluation of hydric soils,predominance of wetland vegetation and wetland
hydrology to evaluate the upper limit of vegetated wetlands.Virtually the entire site has been affected by
• historical grading and land disturbance for the hospital,parking and roadway construction. The wetland
boundaries generally follow along the edge of old grading or channelized stream areas.
I placed three separate wetland flag series near the existing heliport. All the wetlands are associated with a
small stream/drainage ditch that flows through the property. This stream originates from a large culvert
near the lower parking lot at the cardiac care addition. The stream flows overland between the hospital and
the southerly parking lots and thence through a culvert,under the hospital circulatory roads to a phragmucs
• marsh along Jefferson Avenue.
I placed flags 100 to 111 at the edge of bordering vegetated wetlands northeasterly of the existing heliport.
These wetlands were located at the toe of historic fill of the adjacent parking lot. The flagging followed an
area of overland drainage down slope along the parking lot,and then turned back up slope along the
opposite side of the wetland along the edge of a ridge of upland fill area.
•
A second,larger wetland area is located on the far side of the same ridge of upland fill as the 100 series. I
placed flags 200 to 208 along this boundary. This flagging trends down slope southwesterly to what
appears to be an overgrown causeway or service road. Twin culverts pass water under this causeway area
and I stopped flagging when the flag line curved away from the heliport area
• I picked up the flagging on the opposite side of the filled road. Here I placed flags 300 to 305. Flag 300
begins at the outlet of the previously mentioned culverts,trends along the steep fill slope adjacent to the
stream and ends where the stream enters a very large concrete headwall/culvert at the edge of the
circulatory road to the heliport. The stream flows through this culvert for a significant distance. I did not
•
100 Conifer Hill Drive, #516, Danvers, Massachusetts 01923
Tel 978-777-0004 • Fax 978-539-0005
•
locate the outlet of this pipe on the opposite side of the circulatory road but presumed it flowed towards the
phmgmites marsh along Jefferson Avenue.
• Finally,I rough delineated the upper edge of the phmgmites marsh on the southerly side of the circulatory
road. It was obvious that the wetlands along Jefferson Avenue were well removed from the heliport area,
but I wanted to be able to confirm for the Commission that there was no jurisdiction from this wetland area.
This wetland boundary is again affected by historical grading and land disturbance under the power lines.
The boundary meanders within the power line right of way. Here I placed three widely spaced flags at the
closest"points"or lobes of wetlands to the heliport area I believe these flags are more than 200 feet from
• the existing heliport.
Work in buffer zones to,or in the bordering vegetated wetland falls under Conservation Commission
jurisdiction. Regulations found at 310 CMR 10.55 apply. The City of Salem has a local wetlands by-law
as well.
• NoRiverfrontArea
The stream mentioned in this report is not shown on the USGS map. I used the USGS StreamStat Program
to compute the watershed contributing to the stream on site. The resultant watershed is approximately one-
tenth square mile. Given the contributing watershed is less than one-half square mile,there is a regulatory
presumption that no riverfront area is found on this site.
• The USGS map does indicate a perennial stream paralleling Jefferson Avenue. Pacing in the field,I
estimated that this stream is over 400 feet from the existing heliport pad. The existing heliport is well
outside riverfront area of the river along Jefferson Avenue.
Rare Species and Certified Vernal Pools
• The Natural Heritage Atlas October 2006 indicates there is no estimated habitat of rare wetlands wildlife or
certified veinal pools on or near the subject property.
I trust this information will be useful to you. Be advised,the Conservation Commission is the authority
that will make a final determination of the limits of resource areas.
• Sincerely,
Wetlands&Land Management, Inc.
William J.Manuell
Wetland Scientist
•
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USGS MA StreamStats Page 1 of 1
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Legend
,a
* Point Delineation
Q Watershed Delineation
• Place Nantes
HIGHWAYS
,s
• ROADS
l.acm Ramtx .h � i ., /. ` n. - 3'� 4 �"-• ` r. h
i 1 ,
f/ Towns ; r
N 25K WHO Flowlines ♦_��
Gray 3011A Relief ( "�. .• �.n ♦ ♦ 5 .�li
t
•
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http://streamstats.usgs.gov/mastreamstats/printPage.asp 8/15/2008
•
Streamstats Report Page 1 of 1
•
ail
• Stream low Statistics Report
Date: Fri Aug 15 2008 14:15:25
Site Location: Massachusetts
Drainage Area: 0.12 mit
♦ Latitude(NAD83): 42.5101 (42 30 36)
Longitude(NAD83): -70.9041 (-70 54 14)
Low Flow Basin Characteristics
100%Statewide Low Flow(0.12 m12)
• Parameter Value Min Max
Drainage Area F 0.12
Mean Basin Slope from 250K DEM 1.205
Stratified Drift per Stream Length
• Massachusetts RegionIF oF
Parameter Stratified Drift per Stream Length cou/d not be computed.
•
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http://streamstats.usgs.gov/output/Report4l4671.httn 8/15/2008
LICENSE AGREEMENT
WHEREAS, the CITY OF SALEM, by vote of the City Council
dated December 6, 1994, authorized the Mayor to execute a License
Agreement to permit the use of City owned property as per the plan
entitled, "Site Plan Helipad Layout (Salem Hospital Parking Lot 10)
Salem, Mass. " dated March 24, 1993, attached hereto as Exhibit A,
as a Helipad; and
WHEREAS, THE NORTH SHORE MEDICAL CENTER, INC. has agreed
to construct and operate and maintain said Helipad; and
WHEREAS, it is in the public interest to have a facility
close to The North Shore Medical Center for the transportation of
acutely ill patients as may be required by City or State officials
or by the Hospital;
NOW, THEREFORE, in consideration of the mutual benefits,
the parties hereto agree as follows:
1. THE NORTH SHORE MEDICAL CENTER, INC. is authorized to
construct, operate and maintain the Helipad for the landing
and takeoff of helicopters as may be required from time to
time to transport acutely ill patients to The North Shore
Medical Center and from The North Shore Medical Center.
2. Construction and maintenance shall be in accordance with the
requirements of the Building Code of the City of Salem.
3. The North Shore Medical Center agrees to indemnify and hold
harmless the City of Salem, its officials, agents, and
employees from any and all claims for damages arising out of
the operation and maintenance of said Helipad.
4 . The City of Salem agrees to assist The North Shore Medical
Center, as may be required, in obtaining all necessary permits
for construction and maintenance.
5. Both parties agree to cooperate with each other, and in the
event said Helipad is not longer needed, this License
Agreement will terminate without any further responsibility
to either party.
6. Either party may on one hundred twenty (120) days' notice to
the other terminate this Agreement.
1
,
Executed as an instrument under seal this SA day of
1995.
THE NORTH SHORE MEDICAL CENTER, INC.
by kt;�
Michael J. Geaney, Jr.
President
CITY OF SALEM
by
NEIL J1 HARRING N, MAYOR
hereunto duly authorized
See copy of City Council Vote,
attached hereto
2
CITY OF SALEM
in CiLy Counc,i,
November 21, 1994
Ordered:
That the Mayor be authorized to enter into a license agreement
with North Shore Medical Center for the construction and
maintenance of a helipad on the parcel as delineated on the
attached site plan.
In City Council November 21, 1994
Referred to the Committee on Government Services
7n City Council December 1, 1994
Adopted
Approved by the Mayor on December 6 , 1994
ATTEST: DEBORAH E. BURKINSHAW
CITY CLERK
nia3si �088 _. .� .. • .
s
P. (�
rL GRANT OF USENEHT _
t�
WHEREAS, the City of Salem owns and operates the Shaughnessey
Rehabilitation Hospital in close proximity to Salem Hospital; and
WHEREAS, the two institutions coordinate patient treatment and
other activities on a routine basis; and
WHEREAS, the Salem Hospital needs increased parking facilities
to provide parking for its personnel and patients; and
WHEREAS, Salem Hospital desires to assist in alleviating
traffic conditions on Colby Street and Highland Avenue for the
benefit of the City Of Salem; and o
s 7
WHEREAS, Salem hospital will contribute and be responsible for a' v
maintenance of an emergency gate on Old Road, a way in the City of o �
i�
WHEREAS, the City has a parcel of land suited to improving 115i
7
said parking facilities which the City does not need for other
purposes; ,v
N
NOW, THEREFORE, in consideration of the mutual covenants and
recitals herein, the City of Salem grants to Salem Hospital, a
charitable corporation duly established under the laws of the
0
Commonwealth of Massachusetts and havingo
its usual place of o
business at 81 Highland Avenue, Salem,
Massachusetts, Essex County, m
N
a perpetual right and easement over that portion of
property owned by the City of Salem and as described on a Plan _
entitled "Plan of Land in Salem, Massachusetts prepared for Salem
Hospital, October IS, 1988", T 6 M Engineering Associates, Inc., �'�•
83 Pine Street, Peabody, Massachusetts, Scale 1• - 80', said parcel
being
entitled -Easement Parcel, City of Salem to Salem Hospital, `4
Area a 195,011 +/- S. r - '
/ F. 4.0768 Acres , and being bounded and
z:
described as set forth in Schedule A attached hereto. _
a.
nK010381 089 n{6
t:
Said right and easement shall be �
used for Parking purposes and
Improvements in connection therewith. Grantee Salem hospital has
the right to improve the premises for parking purposes consistent
with the use granted. In consideration of the {�
grant of said i.
easement, Salem Hospital, its successors and assigns, warrant and rr
cavenant as follows: is
i.
{
1• All improvements to the granted.premises will be at
Salem Hospital's expense;
2• Salem Hospital will maintain and keep the granted
Premises in good operating condition at its expense; '
f 3• Salem Hospital will be responsible for maintenance
Of liability insurance in an amount of at least {
$5,000.000.00;
i
' <• Salem hospital will be responsible for the
i
' installation and maintenance of an emergency type
i
gate at the point where its property abuts Old Road,
1 shown on said plan; j
S. Salem Hospital agrees to indemnify and save harmless
the City Salem
from om and against ainst all claims, 'I
costs, charges and liability incurred in or in
connection with the use of said easement.
For title see deed of
recorded in theouth dated of December 5, 1906
ec Page 4he Se also land CourtDistrictCertificate Of Title no. 271,E
eeds in Book
recorded in the Land Court Office of said Registry,
CITY OF SALEM
By:.
• .n Tony V. salvo, Mayor -
'a 1
duly authorized
The commonwealth of Massachusetts
Esse% ss. - �J� 1989
Then personally appeared the above named Anthony V. Salvo and
J
acknowledged the foregoing instrument to b is free act and deed F
before me. k
No ary Publict,` �$
my commission expirels 04 /Z /W.,—
,µ
City
by
c
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t:
4
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9
3
6
9
FF'
SCBBDOLB A
A certain parcel of land shown on a plan entitled "Plan of Land in
Salem, Massachusetts Engineering rAssoe prepared
Salem Hospital, October ls,
'Sale T 6
Inc
83 Pine
Massachusetts, Scale 1" = 80', said pa cel being entitled"Peabody,
Parcel, City of Salem to Salem Hospital, Area 195,011 +asement
4.4768 Acres", and being bounded and described as follows:
/- S.F.
Beginning at appoint Veere the Avenue a marked
haughnessy Parking
Lot" on said len,
premises intersect; thence running ) and the granted
along the arc of a circle curving to the
right, with aradius oed
f two hundred
ninety-nine and 04/100 (299-04)f two phut, ed
said Dove Avenue, by
seven and 06/100 (7.06)
feet; thence running
S 43. 48' 32" E by said Dove Avenue (as extended), thirty-
four and 81/100 (34.81) feet to a point;
± thence turning and running
S 38. 54' 36" W eighty 4 Y six and 25/100 (86.25) feet to a
Point; thence running
i
along the arc of a circle curving to the
right with a radius of one hundred sixty
and 0o/100 (160.00) feet, one hundred
thirtY-four and 69/100 (134.69) feet to
a point; thence turning and running
S 87. 08' 32" W sixty and 00/100 (60.00)
thence Peet to a point
turni ;
ng and running
t S 31' 39' 33" E one hundred siXty-eight and 63/100
(168.63) feet to a point; thence turning
and running
S 54. 43' 04" W by land being shown as Lot B on Land Court
A Plan 15638, two hundred fifty-pour and
1 20/100 (254.20) feet to a stone wall;
thence running
S 55• 08' 32" W by said stone wall, one hundred pony_
three and 59/100 (143.59) feet to a point
on said stone wall; thence running
S 54. 48' 34" W by said stone wall, three hundred six
95/100 (306,95) feet to Old Road, as shand
ove
i N 4• as' 90„ W on said plan; thence turning and running
± by the easterly side line Of said old
r
- , 86111 U38ITWtIe
MM
Road, one hundred five and 69/100 (105.69)
feet to a point; thence turning and
running
N 19' 46' 13" E by the easterly side line of said Old
Road, two hundred seventeen and 10/100 '
(217.10) feet to a point at the end of -
said Old Road; thence turning and running -
R 70' 13' 47" W by the end of said Old Road, fifty and
00/100 (50.00) feet to a stone wall;
thence turning and running
r
R 19. 02' 38" E by said stone wall, one hundred twenty-
five and 00/100 (125.00) feet to a point;
thence turning and running
R 55. 08' 32" E by other land of the City of Salem, one
hundred sixty and 00/100 (160.00) feet to
a point; thence running
by said other land of the City of Salem, -
along the arc of a circle curving to the
right with a radius of three hundred •i€'.
eighty-three and 62/100 (383.62) feet, two
hundred fourteen and 25/100 (214.25) feet
to a point; thence running k •-
N 87' 08' 32" E by said other land of the City of Salem,
one hundred fifty-five and 00/100 (155.00)
feet to a point; thence turning and -
running
by said other land of the City of Salem,
along the arc of a circle curving to the
left with a radius of one hundred and
00/100 (100.00) feet, eighty-four and -
18/100 (84.18) feet to a point; thence
running
s
N 38. 54' 36" E by said other land by the City of Salem, - -
ten and 66/100 (10.66) feet to said land -
marked "Shaughnessy Parking Lot"; thence `
turning and running -
S 65. 18' 50" E by said land marked "Shaughnessy Parking
Lot", nineteen and 04/100 (19.04) feet to
a point; thence turning and running :€E
R 38' 54' 36" E by said land marked "Shaughnessy Parking E.
Lot", seventy-six and 14/100,(76.14) feet,
4
to the point of beginning.
All measurements are according to said plan. rt
F}
E
88010381114093
a
i
IN CITY COUNCIL.
City of Silam, ..November 20 19 89
THE CO4"t .E oN COlCNYITY DEVELOPMENT
to sham wa referred
the matter of the request by Salem Hospital to be granted an easement for parking
ourooses only on Cicv owned land to the rear of Salem Hospital.
has con.idcmd mid master sod vowid recommend: chat the Mavor be authorized to
grant an easement
to Salem Hospital on a certain parcel of land to the rear of Salem Hospital property in
£ as d029ribed on the attachments ereto. And further that Salem i
3 1
i Hospital obtain all the necessarya '
approvals as may be requited by the Conservation I
9 -
f Commission, and consult with the Planning Department prior to the construction of the
parking area.
I
r
In City Council November 20, 1989
Adopted by a roll call vote of 10 yeas, 1 nay, 0 absent
'lotion for immediate reconsideration in the hopes it would not prevail
was denied
Approved-by the Mayor on November 22, 1989
i ATTEST[
S
JOS HINE R. SCO
CITY CLERE
Foa rHe Coasmsrrtt. - .. - .
s
Z