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BOARD OF ASSESSORS
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93 WASHINGTON STREET, CITY HALL, SALEM, MASSACHUSE3695- 1
a o- (508) 745-9595 Ext. 261
s9 (508) 744-9327 FAX
7y po SALEM
June 21, 2000
Deborah E. Burkinshaw
City Clerk
City Hall
Salem, MA 01970
Dear Ms. Burkinshaw:
Please be advised that the new lots created by the subdivision of a parcel of land
forming a new end to Scenic Way (and formerly on Outlook Avenue) will be
assigned the following street numbers and Map and Lot identifiers: (This notice
supercedes any designations made to this subdivision prior to this notice).
4% .5-Scenic-Way(PlanLot#1_ Map 9-.Lot 2841
cenlc Way Ian Lot#2) Map 9, Lot 285
,9 Scenic Way (Plan Lot #3) Map 9, Lot 286
11 Scenic Way (Plan Lot#4) Map 9, Lot 287
Very truly yours,
Frank Kulik
Director of Assessing
Cc: Postmaster
Chief Robert Turner, Fire Dept.
Brian Thibodeau, Water Dept.
Peter Strout, Building Inspector
Capt. Paul Murphy, Police Dept.
John Giardi
! Massachusetts Department of Environmen Protection -S� rr>
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Bureau of Resource Protection - Wetlands i C�!_ `.jL city/Town
WPA Form 1- Request for Deterpination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c '`131', 940
A. General Information w1
Important:
When filling out 1. Applicant:
forms on they^�
computer, use
only the tab key Name E-Mail Address(if applicable)
to move your �4
cursor-do not Mailing Address
use the return
key. City[Town State Zip Code
97T1- ���8 97A - 7�is— Scc/
fel hone Number ax Number(if applicable)
2. Representative (if any):
Firm
Contact Name E-Mail Address(if applicable)
Mailing Address
Cityfrown State Zip Code
Phone Number Fax Number(if applicable)
B. Determinations
1. I request the make the following determination(s). Check any that apply:
Conservation Commission
L�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.
mac. whether the work depicted on plan(s) referenced below is subject to the Wetlands Protection Act.
g -'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).
WPA F..1 Page 1 of 4
Rev.02100
, o
Massachusetts Department of Environmental Protection
m Bureau of Resource Protection -Wetlands aty/rown
WPA Form 1- Request for Determination of Applicability
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):
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Street Address City(rown
Assessors Map/Plat Number e2 ParceULot Number
b. Area Description (use additional paper, if necessary):
c. Plan and/or Map Reference(s):
Title Date
2. a. Work Description
�(use
additional paper and/or provide
/plan(s f work, if necessary):
b. Identify provisions of the Wetlands Protection Actor 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).
WPA Formt Page 2 of 4
R..02JDD
Massachusetts Department of Environmental Protection
� r
Bureau of Resource Protection - Wetlands citylrown
WPA Form 1 - Request for Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. Project Description (cont.)
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.)
WPA Forml Page 3 of 4
Rev.02/00
Massachusetts Department of Environmental Protection
i p Bureau of Resource Protection - Wetlands Cityrown
WPA Form 1 - Request for Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
D. Signatures and Submittal Requirements
I hereby certify under the penalties of perjury that the foregoing Request for Determination of Applicability
and accompanying plans, documents, and supporting data are true and complete to the best of my
knowledge.
I further certify that the property owner, if different from the applicant, and the appropriate DEP Regional
Office (see Appendix A)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:
Name
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Mailing Address
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Cityrrown
AI,Is,
State Zip Code
Signatures:
I also understand that notification of this Request will be placed in a local newspaper at my expense
in accordance with Section 10.05(3)(b)(1) of the Wetlands Protection Act regulations.
2
Si turd of Applica to
Signature of Representative(if any) Date
WPA Foeai Page 4 of 4
Rev.07100
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SCENIC WAY °A
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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 City of 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 John J. Giardi
return key. Name Name
14 Sable Road West
VQ Mailing Address Mailing Address
Salem MA 01970
Citylrown State Zip Code City/Town State Zip Code
A,n 1. Title and Date of Final Plans and Other Documents:
See attached
Title Final Date(or Revised Date if applicable)
2. Date Request Filed:
June 22, 2000
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):
Proposed grading changes and lawn installation within the buffer zone.
Project Location:
5 Scenic Way Salem
Street Address Citylrown
Map 9 Lot 284
Assessors Map/Plat Number Parcel/Lot Number
WPA Forth 2 Page 1 or 5
Rev.02100
7
t'
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
WPA Form 2 — Determination of Applicability
$W Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Determination (cont.)
The following Determination(s) is/are applicable to the proposed site and/or project relative to the
Wetlands Protection Act and regulations:
Positive Determination
Note: No work within the jurisdiction of the Wetlands Protection Act may proceed until a final Order of
- -- - Conditions (issued following submittal of a Notice of Intent or Abbreviated Notice of Intent) has been
received from the issuing authority (i.e., Conservation Commission or the Department of
Environmental Protection).
❑ 1. The area described on the referenced plan(s) is an area subject to protection under the Act.
Removing, filling, dredging, or 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.
❑ 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
WPA Form 2 Page 2 of 5
Rev.02100
'i
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 Riverfront Area described on referenced plan(s)
and document(s), which includes all or part of the work described in the Request, the applicant
must consider the following alternatives. (Refer to the wetland regulations at 10.58(4)c. for more
information about the scope of alternatives requirements):
❑ Alternatives limited to the lot on which the project is located.
❑ Alternatives limited to the lot on which the project is located, the subdivided lots, and any
adjacent lots formerly or presently owned by the same owner.
❑ Alternatives limited to the original parcel on which the project is located, the subdivided
parcels, any adjacent parcels, and any other land which can reasonably be obtained within
the municipality.
❑ Alternatives extend to any sites which can reasonably be obtained within the appropriate
region of the state.
Negative Determination
Note: No further action under the Wetlands Protection Act is required by the applicant. However, if the
Department is requested to issue a Superseding Determination of Applicability, work may not proceed
on this project unless the Department fails to act on such request within 35 days of the date the
request is post-marked for certified mail or hand delivered to the Department. Work may then proceed
at the owner's risk only upon notice to the Department and to the Conservation Commission.
Requirements for requests for Superseding Determinations are listed at the end of this document.
❑ 1. The area described in the Request is not an area subject to protection under the Act or the
Buffer Zone.
❑ 2. The work described in the Request is within an area subject to protection under the Act, but will
not remove, fill, dredge, or alter that area. Therefore, said work does not require the filing of a
Notice of Intent.
�[ 3. The work described in the Request is within the Buffer Zone, as defined in the regulations, but
will not alter an Area subject to protection under the Act. Therefore, said work does not require
the filing of a Notice of Intent, subject to the following conditions (if any).
see attached
❑ 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.
WPA Form 2 Page 3 of 5
Rev.02100
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
'<x
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
e4
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 Appendix A) and the pr perty owner(if different from the
applicant). , n
Signatu e � [/
�I3�oo
Date �
WPA Forth 2 Page 4 of 5
Rev.02/00
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 Appendix A)to issue a Superseding Determination of
Applicability. The request must be made by certified mail or hand delivery to the Department, with the
-- appropriate filing-fee and Fee Transmittal Form (see Appendix E:Request for Departmental Action
Fee Transmittal Form) as provided in 310 CMR 10.03(7)within ten business days from the date of
issuance of this Determination. A copy of the request shall at the same time be sent by certified mail
or hand delivery to the Conservation Commission and to the applicant if he/she is not the appellant.
The request shall state clearly and concisely the objections to the Determination which is being
appealed. To the extent that the Determination is based on a municipal ordinance or bylaw and not
on the Massachusetts Wetlands Protection Act or regulations, the Department of Environmental
Protection has no appellate jurisdiction.
WPA Form 2 Page 5 of 5
Rev.02100
90
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Salem Conservation Commission
SPECIAL CONDITIONS—Address: 5 Scenic Way
1. The Conservation Agent will be notified 48 hours prior to commencement of construction activities(978-745-
9595 ext. 311). Members and agents of the Salem Conservation Commission(Commission)shall have the right
to enter and inspect the premises to evaluate and ensure compliance with the conditions and performance
standards stated in this Order,the Notice of Intent,the referenced plans,the Act, and 310 CMR 10.00,and may
require any information,measurements,photographs,observation and/or materials or may require the submittal
of any data or information deemed necessary by the Commission,agent,or DEP determines that any of the
work is not in compliance with this Order of Conditions. Work shall not resume until the Commission is
satisfied that the work will comply,and has so notified the applicant in writing.
—
-2. Approval of this application does not constitute compliance with any law or regulation other than MGL Chapter
131, Section 40,and Wetlands Regulations 310 CMR 10.00.
3. This Order shall apply to any successor in control or successor in interest of the property described in the Notice
of Intent and accompanying plans. These obligations shall be expressed in covenants in all deeds to succeeding
owners or portions of the property.
4. The form provided at the end of this Order shall be completed and stamped at the Registry of Deeds after the
expiration of the 10-day appeal period and within 30 days of the issuance if no request for appeal has been filed
with the Department of Environmental Protection. This form shall be returned to the Commission within 21
days of recording accordance and prior to commencement of any activities subject to the Order of Conditions.
5. Prior to any work commencing,a sign shall be displayed showing DEP file#64-306,and not placed on a living
tree.
6. 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.
7. 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 Corp 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
(3) Flood Plain
(4) Grading Ordinance
8. If there are conflicting conditions within this Order,the stricter condition(s)shall rule.
9. 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.
10. The Commission and its Administrator shall have the discretion to modify the erosion/siltation control methods
and boundary during construction if necessary.
11. All work shall be performed in accordance with this Order of Conditions and approved site plans(s). No
alteration of wetland resource areas or associated buffer zone,other than that approved in this Order,shall occur
on this property without prior approval from the Commission.
12. If any changes are made in the above-described plan(s)which may or will alter an area subject to protection
under the Wetlands Protection Act,or any changes in activity subject to regulations under G.L.Ch. 131, Section
40,the applicant shall inquire from this Commission in writing,prior to their implementation in the field,
_ whether the change(s)is significant enough to require the filing of a new Notice of Intent. Any error in the
plans or information submitted by the applicant shall be considered changes and the above procedures shall be
followed. A copy of such request shall at the same time be sent to the Department of Environmental Protection.
13. 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 signed statement 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.
14. Conditions number as indicated shall continue in force beyond the Certificate of Compliance,in perpetuity,and
shall be referred to in all future deeds to this property.
PRIOR TO CONSTRUCTION
15. Prior to commencement of any activity on this site,there shall be a PRECONSTRUCTION MEETING
between the project supervision,the contractor responsible for the work or its administrator to and phone
numbers of all responsible parties shall be registered with the Commission at the pre-construction meeting.
16. 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.
17. Prior to the commencement of any activity on this site,the applicant or current landowner shall submit to the
Commission in writing a construction schedule/sequence of work to complete this project.
18. Prior to any work on site,the proposed limits of work shall be clearly marked with stakes or flags and shall be
confirmed by the Commission or its Administrator. Such markers shall be checked and replaced as necessary
and shall be maintained until all construction is complete. Workers shall be informed that no use of machinery,
storage of machinery or materials,stockpiling of soil or construction activity is to occur beyond this line at
anytime.
19. Prior to commencement of construction on site,the limits of wetland resource areas closest to construction
activity shall be flagged with surveyor's tape and shall remain in place during construction. The limits of areas
to be impacted and the limits of work in the replication area(s)shall be clearly flagged.
20. There shall be hay bales and wooden staked stored under cover on the site to be used only for emergency
erosion control.
EROSION CONTROL
21. Appropriate erosion control devices shall be in place prior to the beginning of any phases of construction, and
shall be maintained during construction in the wetland areas and buffer zones. The erosion control specification
provided in the Notice of Intent and the erosion control provision in the Order will be the minimum standards
for this project;additional measures may be required by the Commission.
22. All debris,fill and excavated material shall be stockpiled a location far enough away from the wetland resource
areas to prevent sediment from entering wetland resource areas.
23. 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.
24. The areas of construction shall remain in a stable condition at the close of each construction day.
25. Any de-watering of trenches or other excavations required during construction shall be conducted so as to
prevent siltation of wetland resource areas. All discharges from de-watering activities shall be filtered through
haybale sediment traps,silt filter bags or other means approved by the Commission or its Administrator.
26. Within thirty 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.
27. If soils are to be disturbed for longer than two 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
surfaces shall be stabilized by other appropriate erosion control measures,firmly anchored,to prevent soils
from being washed by rain or flooding.
DURING CONSTRUCTION
28. A copy of the Order of Conditions, construction plans, and copies of the documents and reports cited in
Condition# 11, shall be on the site upon commencement and during any site work for contractors to view and
adhere to.
29. 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.
30. Only clean fill,free of masonry,stumps,asphalt,and any other kind of waste material shall be used on the site.
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 rivers.
32. All filling or removal of waste material from the site shall be done in accordance with the regulations of the
City of Salem Health Department.
33. Cement trucks shall not be washed out in any wetland resource or buffer zone area. Any deposit of cement or
concrete products into a buffer zone or wetland resource area shall be removed by hand.
34. No fuel,oil,or other pollutants shall be stored in any resource area or the buffer zone thereto,unless specified
in this Order of Conditions.
35. There shall be no pumping of water from wetland resource areas.
36. During construction,all drainage structures shall be inspected regularly and cleaned as necessary.
37. Immediately following drainage structure installation,all inlets shall be protected by silt fence,hayblae barriers
and/or silt bags to filter silt from stormwater before it enters the drainage system.
38. The project shall not cause an increase in run-off onto adjacent properties,either during construction or when
completed.
39. The applicant is hereby 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.
POST CONSTRUCTION
40. All disturbed areas, slopes and proposed landscape areas shall be loamed and seeded or stabilized through the
use of erosion control blankets or other approved means. All disturbed areas will be graded,loamed,and
seeded prior to November 1 of each year,if possible. No disturbed areas or stockpiled material will be left
unprotected or without erosion controls during the winter.
41. Upon completion of construction,the applicant or current landowner shall submit the following to the
Commission to request a Certificate of Compliance:
(1) A letter requesting a Certificate including the following information:
a. Name and address of current landowner;
b. Name and address of the individual/trust or other entity to whom the Certificate is to be issued:
c. Street address and lot number for the project;and
d. DEP file number
(2) A letter from a Registered Professional Engineering or Land Surveyor certifying compliance of the
property with this Order of Conditions
(3) An"As-Built"plan signed and stamped by a Registered Professional Engineer showing post-construction
conditions and:
a. As-built elevations of all drainage ways constructed within 100 feet of any wetland resource area;
b. As-built elevations and grades of all filled or altered wetland resource areas,buffer zones and
replicated areas;and
c. Distances to all structures within 100 feet of any wetland resource area.
42. When issued,the Certificate of Compliance must be recorded at the Essex County Registry of Deeds.
43. 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.
44. Erosion control devices shall remain in place and properly functioning until all exposed soils have been
stabilized with final vegetative cover and the Commission and/or its Administrator has authorized their
removal.
45. The following condition(s)shall extend beyond the Certificate of Compliance, in perpetuity,and shall
be recorded as such on the Certificate of Compliance and in all future deeds to this property:
PERPETUAL CONDITIONS
46. There shall be no dumping of leaves,grass clippings,trash or any kind of refuse in the resource are.
47. Herbicides shall not be applied within 100 feet of the wetland.
48. No sodium-based products shall be used for control of ice or snow within 100 feet or the wetland.
Z 011 915 221
US Postal Service'-
Receipt for Certified Mail
No Insurance Coverage Provided.
Do not use for International Mail See reverse
Sent to
VAC. TJa�'+/+ V�4 �
Street&Number
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Post ice,State,&ZIP Code
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Postage $
Certified Fee
Special Delivery Fee
Restricted Delivery Fee
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whom&Date Delivered
n Realm Receipt Showing to Wham,
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0 TOTAL Postage&Fees $
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0
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to
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Stick postage stamps to article to cover First-Class postage,certified mall fee,and
charges for any selected optional services(See front).
1. If you want this receipt postmarked, stick the gummed stub to the right of the return
address leaving the receipt attached, and present the article at a post office service
window or hand it to your rural center(no extra charge).
2. If you do not want this receipt postmarked,stick the gummed stub to the right of the
return address of the article,date,detach,and retain the receipt,and mail the article.
3. H you want a return receipt,write the certMO
on a return receipt card,Form 3811,and attach it to the front of the article by means of the
gummed ends it space permits. Otherwise,affix to back of adicle. Endorse from of article 1 'a
RETURN RECEIPT REQUESTED adjacent to the number. ¢
4. If you want delivery restricted to the addressee, or to an authorized agent of the
addressee,endorse RESTRICTED DEIUVERV on the front of the article. aD
Pa
5. Enter fees for the services requested in the appropriate spaces on the front of this
receipt. tt return receipt is requested,check the applicable blocks in item 1 of Form 3811. ti
6. Save this receipt and present it if you make an inquiry. 102595-9]-6-0145 a
Z 011 914 831
US Postal Service`
Receipt for Certified Mail
No Insurance Coverage Provided.
Do not use for International Mail See reverse
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Post Olfice,State,&ZIP Code
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Whom&Date Delivered
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0 TOTAL Postage&Fees Is
07 Postmark or Date
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charges for any selected optional services(See front).
1. If you want this receipt postmarked,stick the gummed stub to the right of the return
address leaving the receipt attached, and present the article at a post office service y
window or hand it to your rural carer(no extra charge).
2. If you do not want this receipt postmarked,stick the gummed stub to the right of the R
return address of the article,date,detach,and retain the receipt,and mail the aside.
m
3. If you want a return receipt,write the centied mail number and your name and address -. �
on a return receipt card,Form 3811,and attach rt to the front of the article by means of the,
gummed ends ff space perils. Otherwise,affix to back of aside. Endorse front of article
RETURN RECEIPT REQUESTED adjacent to the number. t G
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4. If you want delivery restricted to the addressee, or to an authorized agent of the C
addressee,endorse RESTRICTED DELIVERY on the front of the article. 00
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5. Enter fees for the services requested in the appropriate spaces on the front of this E
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6. Save this receipt and present it if you make an inquiry. 102595-97-B-0145 a
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ol601
ION C�
Conservation Commission
(� Salem Massachusetts 01970
F S
`yASSAC
City of Salem
Conservation Commission
Will hold a public hearing for a Notice of Intent under the Wetlands Protection Act,
Massachusetts General Laws, Chapter 131, Section 40 and Salem's Ordinance Pertaining to
General Wetlands at the request of John J. Giardi, 14 Sable Road West, Salem, MA. The
purpose of the hearing is to discuss proposed grading changes and lawn installation within the
buffer zone at 5 Scenic Way, Salem, MA. This hearing will be held on Thursday,July 13,2000
at 7:00 p.m. in the second floor conference room at One Salem Green.
Debra Hurlburt
Chairperson
June 29, 2000
Please send bill to:
John J. Giardi
14 Sable Road West
Salem, MA 01970
O
'a SIDER:ems 1 anNor 2 for additional services. I also wish to receive the
m •complete Items 3,4a,and 4b. - following services(for an
4 •
Print your name and address on the reverse of this ton W that we can return this extra fee):
L card to you. a
•��this form to the from of the mallpieca,or on the back if apace does not 1. ❑ Addressee's Address Z
m •Wme'RetumReceipt Requested'onthe mellpiecebelow the article number. 2. 13 Restricted Delivery r$
•The Return Receipt will show to whom the article was delivered and the date
C delivered. consult poshnaster for fee. •$�
w 3.Article Addressed to: 4a.Article Number
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5.Received By: (Print Name) A U l7 1 (j ZOOO Addressee's Address(Only fl requested
ru and fee is paid)
g 6.Signature' A ease rA t
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PS FormZill1, December 1w 1b25se97-e-o179 Domestic Return Receipt
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UNITED STATES POSTAL SERVICE a :' Pr
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• Print your na_Y,allfe , and ZIP _ eC6d his b
C. R� A- w1
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$ SENDER:
•complete name t and/or 2 for additional services. I also wish to receive the
a
-complete items 3,4a,and 4b. following services(for an j
o •Pdm your name and address on the reverse of this form so that we can return this extra fee):
card to you. g
m •��this tom,to the from of the mallpiece,or on the back s specs does not 1. ❑ Addressee's Address t
•Wdte'Retum Receipt R tW on the mail ecs below the article number. m
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C delivered. Consult postmaster for fee. 9S
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5.Receive Print Name S.Addressee's Address(Only if requested
AUGDEP 11 2000 .t` and fee Is paid) C
g 6.Signature:(Addressee orggent)
T X
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PS Form 3811,December 1994 102595-97-e-0179 Domestic Return Receipt
UNITED STATES POSTAL SERVICE First-Class Mall
Postage&Fees Paid
USPS
Permit No.G-10
• Print your name, address, and ZIP Code in this box •
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Massachusetts Department of Environment4P-rotection __54L61V
Bureau of Resource Protection - Wetlands _C -R/EG cityTown
WPA Form 1 - Request for Determirlgtion of Applicability
Massachusetts Wetlands Protection Act M&. &"1 9?, §40 g: 5 !
A. General Information p�,l�j� ';'V1
Important:
When filling out 1. Applicant:
forms on the
computer, use
only the tab key Name E-Mail Address(if applicable)
to move your / .S y 1-6 D/9l� LvE fT
cursor-do not Mailing Address
use the return AL ENf //J/gsf O/ 9�Jpj
key. Citylrown State Zip Code
L r4's'"— ZZ ir � icabl Soot
nd hone Number ax Number(if applicable)
2. Representative (if any):
ava
r Firm
Contact Name E-Mail Address(if applicable)
Mailing Address
Citylrown State Zip Code
Phone Number Fax Number(if applicable)
B. Determinations
1. I request the 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.
2/b. whether the boundaries of resource area(s) depicted on plan(s) and/or map(s) referenced
below are accurately delineated.
mac. whether the work depicted on plan(s) referenced below is subject to the Wetlands Protection Act.
g] o. 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:
�A zZ/,Vl
Name of Municipality
❑ e. whether the following scope of alternatives is adequate for work in the Riverfront Area as
depicted on referenced plan(s).
WPA Fmmt Page 1 d 4
Rev.07100
IfMassachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands clty/rown
11 WPA Form 1 - Request for Determination of Applicability
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):
,5- SN
Street Address Citylrown
11��9 Lo���rr
Assessors Map/Plat Number ParceVLot Number
b. Area Description (use additional paper, if necessary):
c. Plan and/or Map Reference(s):
Title Date
2. a. Work Description (use additional paper and/or provide plan(s) f work, if necessary):
r
Z2
b. Identify provisions of the Wetlands Protection Actor 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).
WPA Foml Page 2&4
Rev.02/00
a
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands ctyRowR
WPA Form 1 - Request for Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. Project Description (cont.)
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.)
NPA Forml Page 3 of 4
Rev.02100
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands Citylrown
WPA Form 1 - Request for Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
D. Signatures and Submittal Requirements
I hereby certify under the penalties of perjury that the foregoing Request for Determination of Applicability
and accompanying plans, documents, and supporting data are true and complete to the best of my
knowledge.
I further certify that the property owner, if different from the applicant, and the appropriate DEP Regional
Office (see Appendix A)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:
,7—e 44Y T. GIzyed9/
Name
/�/ 1—f-12e3 ZL- Y 1190
Mailing Address
SALE/�J
Cityrrown
lyl�,ss L2/9 �o
State Zip Code
Signatures:
I also understand that notification of this Request will be placed in a local newspaper at my expense
in accordance with Section 10.05(3)(b)(1) of the Wetlands Protection Act regulations.
2 o T
Si twe o Applies to
Signature of Representative(if any) Date
VMA F.ml Page 4 of 4
Rev.07100
/1°
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LEVE6.SPREADER
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CHARLES ANGERAM
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SCENIC WAY oeR
E J., JR. & "'� AA EXTENSION
t A. CASEY � �
OT 443 87.43' 11.3.14 180.47'
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