Loading...
OSBORNE HILLS OFF MARLBOROUGH ROAD - CONSERVATION COMMISSION Rb N og Ma.rltourN.- Loi" 3l r Massachusetts Department of Environmental Protection f Bureau of Resource Protection Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. General Information When fI II II II ��I II I I III'IIIII I�I Important:illing out From: 2007050800236 Bk;26818 Pg;216 When forms on theSalem 05/06/2007 11:16:00 OTHER Pg 115 _- - computer, use Conservation Commission only the tab key to move To: Applicant Property Owner (if different from applicant)- your cursor- do pplicant):yourcursor- do not use the Osborne Hills Realty Trust. return key. Name Name PO Box 780 Mailing Address Mailing Address Lynnfiled MA 01940 City/Town State Zip Code City/Town State Zip Code 1. Title and Date (or Revised Date if applicable) of Final Plans and Other Documents: Site Development Permit Plan November 6 2006 Title - Date Title Date Title Date 2. Date Request Filed: November 3 2006 B. Determination Pursuant to the authority of M.G.L. c. 131, §40, the Conservation Commission considered your Request for Determination of Applicability, with its supporting documentation, and made the following Determination. Project Description (if applicable): The proposed project includes the construction of a single family house, associated utilities, driveway, retaining wall, grading, and landscaping. Project Location: Lot 31 Osborne Hill Drive Salem Street Address City/Town Map 9 Parcel 1 (portion) Assessors Map/Plat.Number Parcel/Lot Number - n+ lorm2.dm-rev.311/05 Facci r!5 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box I l I Salem Conservation Commission 120 Washington Street,3rd A I Salem,MA 01970 II I p IN 31 i SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. SI naK Cada n item 4 if Restricted Delivery is desired. I,^InVn(,rµu,--�� 9an t I ■ Print your name and address on the reverse 0 Addressee so that we can return the card to you. B. Received by(Printed Name} C. Date of Delivery ■ Attach this card to the back of the mailpiece, V(J/) or on the front if space permits. d �SG7 1. Article Addressed to: D. Is delivery address different from item 1? 0 Yes If YES,enter delivery address below: 0 No ` ma 'N blZts�- A x 3. Service Type X)ertified Mall 13 Express Mail 1q, A( fn�n1/Rt Off. /7 V 0 Registered 0 Return Receipt for Merchandise 0 Insured Mall 0 C.O.D. 1\ 4. Restricted Delivery?(EMra Fee) 0 Yes z. Article Number I j t 7005 '3110'. - 0000' 7176 `6158 (transfer fromms service label) {. PS Form 3811,February 2004 Domestic Return Recelpt 102595-02-M-1a UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box I Salem Conservation Commission I i 120 Washington Street,3rd FI Salem,MA 01970 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Sig re item 4 if Restricted Delivery is desired. 0 Agent X ■ Print your name and address on the reverse "'�' tom"✓" 1 0 Addressee so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: D. Is delivery address different from Rem 1? 0 Yes If YES,enter delivery address below: 0 No The Commonwealth of Massachusetts Department of Environmental Protection , Northeast Regional Office a 205B Lowell Street 3. Service Type Wilmington,MA 01887 dCertified Mail ❑Express Mail - - 0 Registered 0 Return Receipt for Merchandise 0 Insured Mail 0 C.O.D. 4. Restricted Delivery?(Extra Fee) 0 Yes 2. Article Number _ _ -- (Transfer from service label) 7005 3110 0000 717 6 6165 PS Form 3811,February 2004 Domestic Return,Receipt 102595-02-WI540 I m CITY OF SALEM CONSERVATION COMMISSION February 13, 2007 Mr. Paul DiBiase Osborne Hills Realty Trust PO Box 780 Lynnfield, Massachusetts 01940 Re: Determination of Applicability Lot 31 Osborne Hills Drive, Salem, Massachusetts Dear Mr. DiBiase: Enclosed, please find the Determination of Applicability for the above referenced project. Following the 10-day appeal period (as of February 23, 2007), you may proceed with your project. Please note that the Commission has issued a Negative 3 Determination stating that the work described is located with the Buffer Zone, as defined in the regulations, but will not alter an Area subject to protection under the Act. The Commission is not requiring that you file a Notice of Intent, however the Commission requests that you obtain the necessary building permits for the retaining wall proposed on the property. This Determination is good for three years from the date of issuance, February 13, 2007, except in Areas Subject Protection as stated in the Wetlands Protection Act under MGL c. 131, Section 40. If you have any further questions, please feel free to contact me 978-619-5685. Sincerely, Carey Du ubs q Conservation Agent/ Staff Planner Enclosures 120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 • TEL: 978.745.9595 FAX: 978.740.0404 ♦ WWW.SALEM.COM Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. General Information Important: When filling out From: forms on the Salem computer, use Conservation Commission only the tab key to move To: Applicant Property Owner (if different from applicant): your cursor- do not use the Osborne Hills Realty Trust. return key. Name Name PO Box 780 1d� Mailing Address Mailing Address Lynnfiled MA 01940 citylrown State Zip Code City/Town State Zip Code 1. Title and Date (or Revised Date if applicable) of Final Plans and Other Documents: Site Development Permit Plan November 6 2006 Title Date Title Date Title Date 2. Date Request Filed: November 3 2006 B. Determination Pursuant to the authority of M.G.L. c. 131, § 40, the Conservation Commission considered your Request for Determination of Applicability, with its supporting documentation, and made the following Determination. Project Description (if applicable): The proposed project includes the construction of a single family house, associated utilities, driveway, retaining wall, grading and landscaping. Project Location: Lot 31 Osborne Hill Drive Salem Street Address City/Town Map 9 Parcel 1 (portion) Assessors Map/Plat Number Parcel/Lot Number wpaform doc rev.3/1/05 Page t of Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Determination (cont.) The following Determination(s) is/are applicable to the proposed site and/or project relative to the Wetlands Protection Act and regulations: Positive Determination Note: No work within the jurisdiction of the Wetlands Protection Act may proceed until a final Order of Conditions(issued following submittal of a Notice of Intent or Abbreviated Notice of Intent)or Order of Resource Area Delineation (issued following submittal of Simplified Review ANRAD) has been received from the issuing authority(i.e., Conservation Commission or the Department of Environmental Protection). ❑ 1. The area described on the referenced plan(s) is an area subject to protection under the Act. Removing,filling, dredging, or altering of the area requires the filing of a Notice of Intent. ❑ 2a. The boundary delineations of the following resource areas described on the referenced plan(s) are confirmed as accurate. Therefore, the resource area boundaries confirmed in this Determination are binding as to all decisions rendered pursuant to the Wetlands Protection Act and its regulations regarding such boundaries for as long as this Determination is valid. ❑ 2b. The boundaries of resource areas listed below are not confirmed by this Determination, regardless of whether such boundaries are contained on the plans attached to this Determination or to the Request for Determination. ❑ 3. The work described on referenced plan(s) and document(s) is within an area subject to protection under the Act and will remove, fill, dredge, or alter that area. Therefore, said work requires the filing of a Notice of Intent. ❑ 4. The work described on referenced plan(s) and document(s) is within the Buffer Zone and will alter an Area subject to protection under the Act. Therefore, said work requires the filing of a Notice of Intent or ANRAD Simplified Review (if work is limited to the Buffer Zone). ❑ 5. The area and/or work described on referenced plan(s) and document(s) is subject to review and approval by: Name of Municipality Pursuant to the following municipal wetland ordinance or bylaw: Name Ordinance or Bylaw Citation wpalorm doc•rev.3/1/05 Page 2 o15 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Determination (cont.) ❑ 6. The following area and/or work, if any, is subject to a municipal ordinance or bylaw but not subject to the Massachusetts Wetlands Protection Act: ❑ 7. If a Notice of Intent is filed for the work in the Rivertront Area described on referenced plan(s) and document(s), which includes all or part of the work described in the Request, the applicant must consider the following alternatives. (Refer to the wetland regulations at 10.58(4)c. for more information about the scope of alternatives requirements): ❑ Alternatives limited to the lot on which the project is located. ❑ Alternatives limited to the lot on which the project is located, the subdivided lots, and any adjacent lots formerly or presently owned by the same owner. ❑ Alternatives limited to the original parcel on which the project is located, the subdivided parcels, any adjacent parcels, and any other land which can reasonably be obtained within the municipality. ❑ Alternatives extend to any sites which can reasonably be obtained within the appropriate region of the state. Negative Determination Note: No further action under the Wetlands Protection Act is required by the applicant. However, if the Department is requested to issue a Superseding Determination of Applicability, work may not proceed on this project unless the Department fails to act on such request within 35 days of the date the request is post-marked for certified mail or hand delivered to the Department. Work may then proceed at the owner's risk only upon notice to the Department and to the Conservation Commission. Requirements for requests for Superseding Determinations are listed at the end of this document. ❑ 1.The area described in the Request is not an area subject to protection under the Act or the Buffer Zone. ❑ 2. The work described in the Request is within an area subject to protection under the Act, but will not remove, fill, dredge, or alter that area. Therefore, said work does not require the filing of a Notice of Intent. 3.The work described in the Request is within the Buffer Zone, as defined in the regulations, but will not alter an Area subject to protection under the Act. Therefore, said work does not require the filing of a Notice of Intent, subje to a following c ditions,(if any)I l ilkCe�aa ru Z11rrvi cs� vs �ui�r t M rnsl�c {L� F✓ /�14zrhir ❑ 4. The work described in the Request is not within an Area subject to protection under the Act (including the Buffer Zone). Therefore, said work does not require the filing of a Notice of Intent, unless and until said work alters an Area subject to protection under the Act. wpaforme.doc-rev.3/1105 Page 3 of 5 J Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Determination (cont.) ❑ 5. The area described in the Request is subject to protection under the Act. Since the work described therein meets the requirements for the following exemption, as specified in the Act and the regulations, no Notice of Intent is required: Exempt Activity(site applicable statuatory/regulatory provisions) ❑ 6. The area and/or work described in the Request is not subject to review and approval by: Name of Municipality Pursuant to a municipal wetlands ordinance or bylaw. Name Ordinance or Bylaw Citation C. Authorization This Determination is issued to the applicant and delivered as follows: ❑ by hand delivery on by certified mail, return receipt requested on - 4�26UA( l I ) '2 Date Date This Determination is valid for three years from the date of issuance (except Determinations for Vegetation Management Plans which are valid for the duration of the Plan). This Determination does not relieve the applicant from complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. This Determination must be signed by a majority of the Conservation Commission. A copy must be sent to the appropriate DEP Regional Office (see Attachment) and the property owner(if different from the applicant). Signature/./ February 8, 2007 Date wpaform .doc•rev.3/1105 Page 4 of 5 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 D. Appeals The applicant, owner, any person aggrieved by this Determination, any owner of land abutting the land upon which the proposed work is to be done, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate Department of Environmental Protection Regional Office (see Attachment) to issue a Superseding Determination of Applicability. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and Fee Transmittal Form (see Request for Departmental Action Fee Transmittal Form) as provided in 310 CMR 10.03(7) within ten business days from the date of issuance of this Determination. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant if he/she is not the appellant. The request shall state clearly and concisely the objections to the Determination which is being appealed. To the extent that the Determination is based on a municipal ordinance or bylaw and not on the Massachusetts Wetlands Protection Act or regulations,the Department of Environmental Protection has no appellate jurisdiction. wpalorm2.d.•rev.3/1/05 Page 5 of 5 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands (1 DEP Regional Addresses Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Mail transmittal forms and DEP payments,payable to: Commonwealth of Massachusetts Department of Environmental Protection Box 4062 Boston, MA 02211 DEP Western Region Adams Colrain Hampden Monroe Pittsfield Tynngham 436 Dwight Street Agawam Conway Hancock Montague Plainfield Wales Alford Cummngton Hatfield Monterey Richmond Ware Suite 402 Amherst Dalton Hawley Montgomery Rowe Warwick Springfield,MA 01103 Ashfield Deerfield Heath Monson Russell Washington Phone:413-784-1100 Becket Easthampton Hinsdale Mount Washington Sandisfieltl Wendell Belmrdown East Longmeadow Holland New Ashford Savoy Westham Fax: 413-784-1149 Bemartlston Egramont Holyoke New Marlborough Sheffield Westhampton &andfard Erving Huntington New Salem Shelburne West Springfield Brimfield Florida Lanesborough North Adams Shutesbury West Stockbddge Buckland Gill Lee Northampton Southampton Whately Chaderronl Goshen Lenox NOMfield South Hadley Wilbraham Cheshire Granby Levered Orange Southwick Williansburg Chester Granville Leyden Otis Springfield Williamstown Chestedield Great Barrington Longmeadow Palmer Stockbridge Windsor Chicopee Greenfield Ludlow Pelham Sunderland Worthington Clarksburg Hadley Middlefield Pew Tolland DEP Central Region Acton Chariton Hopkinton Millbury Rutland Uxbridge 627 Main Street Ashbumham Clinton Hubbartlstcn M IMI[. Shiley Warren Ashby Douglas Hudson New Braintree Shrewsbury Webster Worcester, MA 01608 Athol Dudley Holliston Northborough Southborough Westborough Phone:508-792-7650 Auburn Dunstable Lancaster Northbridge Southbridge West Boylston Fax:508-792-7621 Ayer East Brookfield Leicester North Brookfield Spencer West Brookfield Barre Fitchburg Leominster Oakham Sterling Wesdord TDD:508-767-2788 Bellingham Gardner Littleton Oxford Stow Westranster earth Grafton Lunenburg Paxton Sturbridge Winchendon Blackstone Groton Marborough Pepperell Sutton Worcester Balton Harvard Maynard Petersham Templeton Boxborough Hardwick Medway Philllpston Townsend Boylston Holden Mandan Princeton Tyngsborough Brookfield Hopedale Milford! Royalsion Upton DEP Southeast Region Abington Dartmouth Freetown Madapoised Provincetown Tisbury 20 Riverside Drive Acushnet Dennis Gay Head Middleborough Raynham Twrc Aril eboro Dighton Gosnold Nantucket Rehoboth Wareham Lakeville,MA 02347 Avon Duxbury Halifax New Bedford Rochester Wellfleet Phone:506-946-2700 Barnstable Eastham Hanover North Attleborough Rockland West Bridgewater Fax:508-947-6557 Berkley East Bridgewater Hanson Notion Sandwich Westport Bourne Easton Harwich Norwell Scituate West Tisbury TDD:508-946-2795 Brewster Edgarc. Kingston Oak Bluffs Seekonk Whitman Bridgewater Fairhaven Lakeville Orleans Sharon Wrentham Brockton Fall River Mansfield Pembroke Somerset Yarmouth Carver Falmouth Marion Plainville Staughton Chatham Foxborough Manih idd Plymouth Swansea Chilmark Franklin Mashpee Plymptcn Taunton DEP Northeast Region Amesbury Chelnrfom Hingham Merrinac Quincy Wakefield 1 Winter Street Andover Chelsea Holbrook Methuen Randolph Walpole Arington Call Hull Middleton Reading Waltham Boston, MA 02108 Ashland Concord Ipswich Millis Revere Watertown Phone:617-654-6500 Bedford Danvers Lawrence Milton Rockport Wayland Fax: 617-556-1049 Belmont Dedham Lexington Nahant Rowley Wellesley Beverly Dover Lincoln Natick Salem Wenham TDD:617-574-6868 Billerica Dracut Lowell Needham Salisbury West Newbury Boston Essex Lynn Newbury Saugus Weston Boxlord Everett Lynnfield Newbdr port Shari Westwood Braintree Framingham Malden Newton Somerville Weymouth Brookline Georgetown Manchester-By-The-Sea Norfolk Stoneham Wilmington Burlington Gloucester Marblehead North Andover Sudbury Winchester Cambridge Groveland Medfield Nonh Reading Swampscott Winthrop Canton Hamltoa Medford Norwood Tewksbury Woburn Carlisle Haverhill Melrose Peabody Topsfield Wpatorm2.doc•DEP Addresses•rev.10/6/04 Page lof 1 4 CITY OF SALEM CONSERVATION COMMISSION %TTF VTSTT_ ,FnRM 1'lW t b' o o— PROJECT LOCATION: 04ot LAf DATE OF SITE VISIT• PROJECT PROPONENTII: �9ornt �IlUS 1C?GlM --rltS�—DEP F/ILE NUMBER: 96A PEP 6il-9No � 0451 PROPOSED PROPOSED WORK: (-Ix q a$ JiN_ATTENDANCE:Y:, Commission Member /A nt: Abutters: i Applicant/Property Owner/Representative: I NM Ir`(1 Y-]c Q cA/ 1. L E SITE VISIT PPURPOSE t KV 3 N4Ts equest for Determination ❑Abbreviated Notice of Resource Area Delineation XNotice of Intent ❑Certificate of Compliance ❑Enforcement/Violation ❑Emergency ❑ Informal INLAND RESOURCE AREAS �j COASTAL RESOURCE AREAS i ❑Bank ❑ Land Subject to Coastal ❑Land Under the Ocean jj Storm Flowage ❑Bordering Vegetated Wetland 'E ii ❑ Designated Port Area ❑Coastal Beach ❑Land Subject to Flooding ? ❑ Coastal Dune ❑Barrier Beach ❑Land Under Water Bodies or Waterway f' Name: !' ❑ Coastal Bank ❑Rocky Intertidal Shore It ❑Riverfront Area j ❑ Salt Marsh ❑ Land Under Salt Pond ❑Vernal Pools ; ❑ Land Containing ❑Anadromous/Cata- }� Shellfish dromous Fish Run I� El Bordering Vegetated Wetland in Coastal Area ?i 120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 TEL: 978.745.9595 FAx: 978.740.0404 0 WWW.SALEM.COM r: ❑Water Body Bordering Vegetated Wetland ❑ Bank ❑ Coastal Beach ❑Coastal Dune x _ :INERESTS`PRO-T.EC[EDe� � � ,. .. %Protection of Water Supply Protection of Groundwater Supply Flood Control Storm Damage Prevention Prevention of Pollution ❑Protection of Fisheries b,Protection of Wildlife Habitat ��i--❑Protection of Land Containing Shellfish Is this an exempt project:If so,why? Are resource area boundaries delineated correctly? If not,explain. SI'�6•VISITUOCUMEhF�I4lI0 �, y u � _, _ ❑Photos ❑ Site Map ❑Other: OBSERYkTIONS• "" ^'� `� '�" 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. r ` ca Q.rno (3lx ( fup MQ - REGOMMEIVD'AllTIONS_=",' �a�t �,�µ a`"�r5 _ a,.m. .�l!�,�.: �2 '11�2R1� �JS�Q�f Glx. 4 `L- ff,&,v,JU 2.1'Q2 vtru. 0 CITY OF SALEM f CONSERVATION COMMISSION City of Salem Conservation Commission Will hold a public hearing for a Request for Determination of Applicability under the Wetlands Protection Act, Massachusetts General Laws, Chapter 131, Section 40 and Salem's Ordinance Pertaining to General Wetlands at the request of the Osborne Hills Realty Trust, P.O Box 780, Lynnfield, MA 01940. The purpose of the hearing is to discuss the proposed construction of a boulder wall, grading and landscaping in the buffer zone of BVW on Lot 31 off of Marlborough Road. This hearing will be held on Thursday, November 30, 2006 at 6:00 pm in Room 313, City Hall Annex, 120 Washington Street. &t- 0 ;ooQ Kevin P. Comacchio Chairman Please print legal advertisement on: November 22, 2006 Please send bill to: Attorney John Keilty 40 Lowell Street Peabody, MA 01960 978-531-7900 120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 TEL: 978.745.9595 FAx: 978.740.0404 WWW.SALEM.COM Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands Salem X11 WPA Form 1 - Request for Determination of Applicability City/Town Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. General Information Important: !, When filling out 1. Applicant: forms on the Osborne Hills Realty Trust computer, use Name only the tab key E-Mail Address to move your P O. Box 780 cursor-do not Mailing Address use the return Lynnfeld MA 01940 key. CityTrown State Zip Code 781-844-7026 "d Phone Number Fax Number(if applicable) 2. Representative (if any): re+un Firm Attorney John Keilty Contact Name E-Mail Address 40 Lowell Street Mailing Address Peabody MA 01960 CityTrown State Zip Code 978-531-7900 Phone Number Fax Number(if applicable) B. Determinations 1. I request the Salem make the following determination(s). Check any that apply: Conservation Commission ❑ a. whether the area depicted on plan(s) and/or map(s) referenced below is an area subject to jurisdiction of the Wetlands Protection Act. ❑ b. whether the boundaries of resource area(s) depicted on plan(s) and/or map(s) referenced below are accurately delineated. ® c. whether the work depicted on plan(s) referenced below is subject to the Wetlands Protection Act. ❑ d. whether the area and/or work depicted on plan(s) referenced below is subject to the jurisdiction of any municipal wetlands ordinance or bylaw of: Name of Municipality ❑ e. whether the following scope of alternatives is adequate for work in the Riverfront Area as depicted on referenced plan(s). wpaforml.doc Page 1 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands Salem ('1 WPA Form 1- Request for Determination of Applicability Ciy T°wn Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 C. Project Description 1. a. Project Location (use maps and plans to identify the location of the area subject to this request): Lot 31 Osborne Hill Drive Salem Street Address City/Town 9 1 (portion) Assessors Map/Plat Number Parcel/Lot Number b. Area Description (use additional paper, if necessary): Approximately 550 sf of land shown as the northeast corner of Lot 31 Osborne Hill Drive on the accompanying plan. c. Plan and/or Map Reference(s): Site Development Permit Plan November 9, 2006 Title Date Title Date Title Date 2. a. Work Description (use additional paper and/or provide plan(s) of work, if necessary): Construction of boulder wall grading and landscaping. wpaformt.tloc Page 2 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands Salem City/Town WPA Form 1 - Request for Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 C. Project Description (cont.) b. Identify provisions of the Wetlands Protection Act or regulations which may exempt the applicant from having to file a Notice of Intent for all or part of the described work (use additional paper, if necessary). 3. a. If this application is a Request for Determination of Scope of Alternatives for work in the Riverfront Area, indicate the one classification below that best describes the project. ❑ Single family house on a lot recorded on or before 8/1/96 ❑ Single family house on a lot recorded after 8/1/96 ❑ Expansion of an existing structure on a lot recorded after 8/1/96 ❑ Project, other than a single family house or public project, where the applicant owned the lot before 8/7/96 ❑ New agriculture or aquaculture project ❑ Public project where funds were appropriated prior to 8/7/96 ❑ Project on a lot shown on an approved, definitive subdivision plan where there is a recorded deed restriction limiting total alteration of the Riverfront Area for the entire subdivision ❑ Residential subdivision; institutional, industrial, or commercial project ❑ Municipal project ❑ District, county, state, or federal government project ❑ Project required to evaluate off-site alternatives in more than one municipality in an Environmental Impact Report under MEPA or in an alternatives analysis pursuant to an application for a 404 permit from the U.S. Army Corps of Engineers or 401 Water Quality Certification from the Department of Environmental Protection. b. Provide evidence (e.g., record of date subdivision lot was recorded) supporting the classification above (use additional paper and/or attach appropriate documents, if necessary.) wpafarml.tloc Page 3 of 4 Massachusetts Department of Environmental Protection - Bureau of Resource Protection - Wetlands Salem WPA Form 1 - Request for Determination of Applicability City/Town Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 D. Signatures and Submittal Requirements I hereby certify under the penalties of perjury that the foregoing Request for Determination of Applicability and accompanying plans, documents, and supporting data are true and complete to the best of my knowledge. I further certify that the property owner, if different from the applicant, and the appropriate DEP Regional Office were sent a complete copy of this Request(including all appropriate documentation) simultaneously with the submittal of this Request to the Conservation Commission. Failure by the applicant to send copies in a timely manner may result in dismissal of the Request for Determination of Applicability. Name and address of the property owner: Osborne Hills Realty Trust Name P. O. Box 780 Mailing Address Lynnfield City/Town MA 01940 State Zip Code Signatures: I also un that notification of this Request will be placed in a local newspaper at my expense in ac rdance ith ion 10.05(3)(b)(1) of the Wetlands Protection Act regulations. /� -9Y�/ Sig ure pliCATDate S of r entative(i ny Date wpaforml doc Page 4 of 4 MIN IS' E�09 ,55,51 zo nx "4;,pfaL, RM, FEE, NN A V' it. S M, N MEN VNE" Us, ow VIM W, 4�rl -48 z t§ 2Y '- Ri� N ' -t%1/2Ms mg PUMPS,4N- -I'll."I 4 M."'. —Ko KIN MOn't FT, SW 60 RE w 1 A. FRI/ "Wr I-W VA kV' gN L t Ww; ff al ' 0, ROOM m 5� PCOMM N "Q JOHN R. KEILTY, COUNSELOR AT LAW TELEPHONE (978) 531-7900 40 LOWELL STREET FACSIMILE (978) 531-2479 PEABODY, MA 01960 E-MAIL: KEILTYLAW@AOL.COM November 18,2004 Conservation Commission t, a City of Salem 120 Washington Street NOV 1 '7 2006 Salem,MA 01960 DEPT. T PLANNING& Attn: Carey Duques COMMUNITY DEVELOPMENT RE: REQUEST FOR DETERMINATION OF APPLICABILITY OSBORNE HILL DRIVE,SALEM,MA Dear Ms. Duques: Please be advised that I represent Paul DiBiase Trustee of Osborne Hills Realty Trust, relative to the filling of a Determination of Applicability as it applies to the property for Lot 6, 31, Osborne Hill Drive, Salem Massachusetts. Submitted herewith are the following instruments: 1. Checks in the amount of$80.00 for each one of the lots: Lot 6, 31 as application fee; 2. 8 copies of the Determination of Applicability; 3. Certified list of abutter,and notification to abutters will be provided by Carey Duques of the Salem Planning Department; Kindly schedule thismatter for hearing at your earliest convenience. Thank you for your anticipated cooperation. Very truly yours, John M' JRK/smw Enclosures City of Salem Department of Planning & Community Development Check/Cash Receipt and Tracking Form Please complete lbrm and make two copies. Date Received it a9 /0L0 Amount Received 3�25,00 Form of Payment Check Cash CHECK PAYMENTS: 333j} write check number CASH PAYMENTS: write Client initials a Sign Permit Alin atlon Fee PaCornervation Commission Fee Payment received for finning Board Fee what service? Q Old Town Han Rental Fee Q Other Name of staff person receiving payment Additional Notes -DATE - INVOICE AMOUNT JOHN R.KEILTY, ESQUIRE s3 ns 'R Counselar`at/mow , 113 40 LOW ELL STREET i ;•I PEABODY MASSACHUSETTS 10', IY PAMOUNT DOLLARS i ,e» ATEvc,r_ ^vx'rx a�,m.v T0.THE OflD OE zGROSSAMT. en,F. -y-;y.,x�.DESEHIPTION. �„f my naNET AMO . rr ei „��'".x. f � ,�5 is a�_..'4.�-tF l"�sSa ' �x "ems+ �'4��- t •A. l s�'�.� y�:£;.t �i v .'* s ��.G`fC.0 SI �(aEastern&v11C" Linn,'MA ?EDV NE' r 11'011 3330111160'1i30V984,= a 00453 Original Check and Form: DPCD Finance s Copy 1: Client Copy 2:Applicadon File