11A WINTER ISLAND ROAD - CONSERVATION COMMISSION ll R IZA PtA
CITY OF SALEM
CONSERVATION COMMISSION
CONFIRMATION OF HAND DELIVERY
Document: 11R Winter Island Road termination of applicability
Recipient: Scott Patrowicz
Signature: Date: it
W�CUNUIT,/�4.5 ',
s CITY OF SALEM
CONSERVATION COMMISSION
November 18, 2011
Scott Patrowicz
14 Brown Street
Salem, MA 01970
Re: Determination of Applicability-11R Winter Island Road, Salem, MA
Dear Mr. Patrowicz:
Enclosed, please find the determination of applicability for the above referenced
property. Please be advised that work must comply with the attached special conditions
as issued by the Conservation Commission.
This document is effective for three years from its date of issuance. If you have any
further questions please feel free to contact me at 978-619-5685.
Sincerely,
Tom Devine
Conservation Agent/Staff Planner
Enclosures
CC: DEP Northeast Regional Office
I IR Winter Island LLC
f
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
only the tab Conservation Commission _ —
key to move To: Applicant Property Owner(If different from applicant):cursor-
do not use the 11 R Winter Island LLC "
return key. Name Name
30 Federal Street
Mailing Address Mailing Address
Salem MA 01970
reN4 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: r
Site Plan; 11R Winter Island Road 11/1/2011
Title - Date
Title - Date -
Ttle _ Date -
2. Date Request Filed:
November 4, 2011
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):
Demolition of existing house and removal of debris off-site. All work is outide resource areas. A snow
fence shall be installed to minimize wind blown debris. Staw wattle shall be installed for erosion control
and to serve as a limit of work line.
Project Location:
11 R Winter Island Road Salem _
Street Address City/Town
44 22
Assessors Map/Plat Number Parcel/Lot Number
wpaform2.doc•Oetermnaticn of Applicability.•rev.10/6/04 ..
.. Page 1 of 5
F
1
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.
Ll 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.
❑ 21b. 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
wpaform2.doc•Determination of Apoicabilily•rev.1016104 Y Page 2 of 5
LlMassachusetts 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 11a Notice QIf Intent, subject to the following conditions (if any).
❑ 4. The work described in the Request is not within an Area subject to protection under the Act
(including the Buffer Zone). Therefore, said work does not require the filing of a.Notice of Intent,
unless and until said work alters an Area subject to protection under the Act.
wpafcrm2.doc•Determination of Applicability•rev.1016/04. s -
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. ..
p' a
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
—
Daattd / 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 opy must be sent
to the appropriate DEP Regional Office (see htto://www.mass.pov/de tabout/r, on.fi d our.htm)and the
property owner rent from the applicant).
Sign tLI es:
Date
wpaiorm2.doc•Determination of Applicability•rev.1016104 - ,Pa9 e0 o(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 http://www.mass.gov/dep/about/region.findvour.htm) 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.
r
wpalormldac•Delermnalion of Applicabilily•rev.101&04 - Page 5 0!5
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
Request for Departmental Action Fee Transmittal Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. Request Information
Important:
When filling out 1. Person or party making request (if appropriate, name the citizen group's representative):
forms on the
computer, use Name
only the tab
key to move
your cursor- Mailing Address - —
do not use the
return key. Cdy/Town
State Zip Code
'd Phone Number Fax Number(if applicable)
Project Location
Mailing Address
Cityrrown state - Zip Code
2. Applicant(as shown on Notice of Intent(Form 3), Abbreviated Notice of Resource Area Delineation
(Form 4A); or Request for Determination of Applicability(Form 1)):
Name --
Malling Address - - -
Clty/Town -
State Zip Code
Phone Number Fax Number(if applicable)
3. DEP File Number:
B. Instructions
1. When the Departmental action request is for(check one):
❑ Superseding Order of Conditions ($100 for individual single family homes with associated
structures; $200 for all other projects)
❑ Superseding Determination of Applicability($100)
❑ Superseding Order of Resource Area Delineation ($100)
Send this form and check or money order for the appropriate amount, payable to the Commonwealth of
Massachusetts to:
Department of Environmental Protection
Box 4062
Boston, MA 02211
wpaform2.doc-Request for Departmental.Action Fee Transmittal Form•rev.10/6104
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Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
Request for Departmental Action Fee Transmittal Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Instructions (cont.)
2. On a separate sheet attached to this form, state clearly and concisely the objections to the
Determination or Order which is being appealed. To the extent that the Determination or Order is
based on a municipal bylaw, and not on the Massachusetts Wetlands Protection Act or regulations,
the Department has no appellate jurisdiction.
3. Send a copy of this form and a copy of the check or money order with the Request for a Superseding
Determination or Order by certified mail or hand delivery to the appropriate DEP Regional Office (see
http://www.massgov/dep/about/region/findyour htm).
4. 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.
H
w
wpaform2.doc•Request for Oepartmentat Action Fee Transmittal Form-rev.1015/04 Page 2 of 2
3y �aT CITY OF SALEM
CONSERVATION COMMISSION
November 18, 2011
Determination of Applicability for property located at I IR Winter Island Road, Salem, MA
SPECIAL CONDITIONS
I. If, following the demolition of the existing house, start of construction of the new house is
delayed beyond January 12, 2012, the disturbed area shall be stabilized.The disturbed area
shall be restored to the approximate grade of the seaward yard area using clean fill, and
loamed and seeded.
2. This determination does not permit the removal of the existing spruce tree located seaward of
the existing house.
3. The dumpster shall be located in the public way at least 50' from the coastal bank. However,
if overhead utility wires obstruct the delivery and removal of the dumpster at this location, it
may be placed no closer than 30' from the coastal bank.
4. Any materials containing asbestos shall be disposed of properly, per all applicable laws and
regulations.
t
D o
LAND DEVELOPMENT ENGINEERING
I
_. II
November 4, 201 1
Salem Conservation Commission
120 Washington Street
Salem, MA 01970
RE:Request for Determination of Applicability
Existing house demolition
#11 R Winter Island Road, Salem,MA
Assessor's Map 44, Lot 22
PLDE # 11-06
Dear Commission Members:
On behalf of 11 R Winter Island LLC(applicant and owner), I respectfully request that you review
the attached Request for Determination of Applicability (RFD),application for proposed work in
compliance with the Massachusetts Wetlands Protection Act and the City of Salem Wetlands
Protection and Conservation Ordinance.
Resource Areas:
The Top of Coastal Bank (TOCB) resource area is defined as the top of the existing seawall:..
(abutting Juniper Cove) using MassDEP Policy 92-1 Figure 4. Seaward of the Coastal Bank is Beach
resource area and Salt Marsh resource area. These coastal resource areas are shown on the
attached Site Plan.
The Mean HighWater.(MHW) line is elevation 4.4 (using datum:.NGVD of 1929). The MHW line is - .. .... . .
shown on the attached Site Plan.
The FEMA A-2 100-year flood zone (per FIRM Community Panel #250102 0002B dated August 5,
1985) is elevation 10 (using datum:NGVD of 1929). The FEMA Zone A-2 is shown on the attached
Site Plan. Below elevation 10 (NGVD of 1929) is "Land Subject to Coastal Storm Flowage".
The buffer zones depicting the Salem Conservation Commission's jurisdiction are measured from
the most landward resource area which is the Top of Coastal Bank. The 50-foot and 100-foot buffer
zones are shown on the attached Site Plan. When studying the Site Plan and buffer zones, one
can see that the entire site is within the 100-foot buffer zone, and therefore any work on this.lot is
subject to the approval of the Salem Conservation Commission.
14 Brown Street, Salem, Massachusetts 01970
Cell: 978-836-6400 Fax: 978-745-4110 Email: scott.patrowicz@verizon.net
Scope of Work Proposed and Impacts:
This Request for Determination application is for just the demolition of an existing single-family
house (including the cracked foundation). The owner/applicant has already received Zoning
Board and Historical Commission approval.
No work will.occur below mean high water. No work will occur in any coastal resource area. All
work is outside of ".Land Subject to Coastal Storm Flowage" (since it is up-gradient of the FEMA A-2
zone),The proposed work is only within the buffer zones as shown on the site plan.
The owner/applicant proposes to hire a professional.site.contractor to perform the following scope
of work:
1. Installation of a snow fence and straw waffle (120+/- LF) to serve as erosion control and limit
of work.. The proposed snow fence and straw wattle shall be located up-gradient of the
land subject to coastal storm Flowage as shown on the attached Site Plan.
2. Demolition of the existing house, walkways,concrete and asphalt on the subject lot. The
existing impervious area to be removed 1;720+/-SF. The existing utilitiy lines will be
temporarily capped. A large dumpster will be located on-site and/or in the driveway
(shown as "Way"on the Site Plan). The dumpster shall be covered at the end of each day
to minimize wind-blown debris.
Temporary impacts to the buffer zone which is mostly lawn, landscaping and pavement will occur :
during:construction with men working,walking,demolition and hauling materials, :Cleanliness is
paramount, therefore prior to the.completion of each day, an inspection will be performed to.,
pick-up all loose debris. Debris shall be removed from locus and properly dispose of off-site (and/or
contained.in a covered dumpster. Construction materials will.be.secured each day.(to minimize
wind-blown debris).
For these reasons,I believe that per#3 on WPA Form 2:the work described in the request is within
the buffer zone, but will not alter the wetland resource areas. The owner/applicant respectfully
seeks a negative determination.
RFD Submittal Material•
I respectfully submit eight (8) copies of the RFD application package to include the following:.:::
*RFD Application (WPA Form 1),
•City of Salem application fee $25
*Locus Map (USGS) scale 1:25,000 (approximately I" =2000');
*Bird's Eye View of the project site from Bing maps (with annotations),
*Site photograph (with annotations),
•Plan entitled: "Site Plan"prepared by NSSC dated 1 1/1/1 1, Scale: 1"= 10',
•Legal advertisement prepared by the Salem CC agent.
PATROWICZ LANDDEVELOPMENT'ENGINEERING
i
RFD Procedures:
It is my understanding that the Salem CC agent has submitted the legal advertisement to the local
newspaper (Salem Evening News) for publication of the hearing date (newspaper publication on
or before 11/10/11). 1 will receive the invoice for the legal advertisement.
One copy of the above RFD application package is being sent via certified mail to MassDEP-
Wetlands, Northeast Regional Office,205B Lowell Street, Wilmington, MA 01887.
Thank you for taking this matter under consideration. We look forward to the public hearing on
November 17, 2011. If you have any questions, please do not hesitate to call me.
Sincerely;
PATROWI AND DEVELOPMENT ENGINEERING
Scott Patrowicz, P.E.
cc. 11 R Winter Island LLC w/attachments -
cc. MossDEP Wetlands, Northeast Regional Office w/attachments
PATROWICZ LAND DEVELOPMENT ENGINEERING
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands Salem
City/town
WPA Form 1- Request for Determination of Applicability
Massachusetts:Wetlands Protection Act M.G.L:c. 131, §40
A:: General Information
Important: _
When filling out 1. Applicant'..
forms on the 11 R Winter Island LLC
computer, use : Name E-Mail Address
only the tab key -
to move your 30 Federal Street
cursor-do not Mailing Address
use the return Salem MA 01970
key. . City/Town State Zip.Code
Phone Number Fax Number(if applicable)
:::' ....
2 Representative (if any):
�4 PatrowiczlLand Development:Engineering
_. Firm
Scott Patrowicz, P.E. scoft.patrowicz@verizon.net
.''Contact Name E-Mail Address - -
14 Brown:Street
Mailing Address- -
Salem - MA 01970
.. .... . --Cityrrown ... - State. ... . Zip Code.
978-836-6400 978-745-4110
-Phone Number - - Fax Number(if applicable)
B. Determinations
1. .;1 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 Cod - : : Paget o{4
i
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands Salem
�
WPA Form 1- Request for Determination of Applicability City/Town
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. Project Description
1. a. Project Location(use maps and plans to identify the location of the area subject to this request):
11R Winter Island Road Salem
Street Address City/Town
44 22
Assessors Map/Plat Number Parcel/Lot Number
b. Area Description (use additional paper, if necessary):
The area of work is within the 100-foot buffer zone to a coastal bank(adjacent to Juniper Cove).
c. Plan and/or Map Reference(s):
Site Plan (prepared by North Shore Survey Corp, scale 1"= 10') 11/1/11
Title Date
Title Date
Title Date
2. a. Work Description (use additional paper and/or provide plan(s) of work, if necessary):
Demolition of an existing house and the removal (off-site)of debris. No work shall occur within any
coastal resource area (only buffer zone). A snow fence shall be installed to minimize wind blown debris.
A straw wattle shall be installed for erosion control and to serve as a limit of work line.
wpaforml.doc Page 2 or 4
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands Salem
�
WPA Form 1- Request for Determination of Applicability City/rown
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. Project Description (cont.)
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).
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.)
/ wPafO.1AM Page3N4
i
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:
11R Winter Island LLC
Name
30 Federal Street
Mailing Address
Salem
Cityrrown
MA 01970
State Zip Code
Signatures:
I al/undend that notification of this Request will be placed in a local newspaper at my expense
in awith Section 10.05(3)(b)(1) of the Wetlands Protection Act regulations.
nor -cue c� A✓ 61
Signature of Applicant ' Date
ZN CF MgSS9
SCOTT IAN n5G ' I ' �'
Signature of Representative(if any) o CIVIL -r' Date
,9 No.336 �+
wpaformt.doc Page 4 of 4
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AirCITY OF SALEM
We
CONSERVATION COMMISSION
Salem.Conservation Commission
978-619-5685
Will hold a public hearing for a Request for Determination of Applicability under the Wetlands
Protection Act MGL c 131§40 and Salem Wetlands Protection and Conservation Ordinance at the
request of 11R Winter Island LLC, 30 Federal St Salem MA. Purpose of hearing is to discuss
proposed demolition of single family house within buffer zone to`coastal bank;coastal beach and salt
marsh at 111 Winter Island Rd. Hearing will be Thursday,November 17,2011 at 6:00pm in the
Salem Five Community Room, 210 Essex St.
Julia Knisel
Chair
Please print legal ad on:
November 10, 2011
Please remit bill to:
Scott Patrowicz
Patrowicz Engineering
14 Brown St. .
Salem, MA 01970
978-836-6400
Project Status Sheet
Address: t�K DEP #:
Application Type: IaOJ� ov
Contact Name: 5 p4k �;c1 Phone: 3� G
Date Submitted: i\/S/�\
1�i-Application Complete
N-Correct Fee Received
a-Legal Notice Sent N Legal Notice Confirmed
Added to Agenda ❑ Agenda to Applicant
❑ Agent Comments to Commission
Hearing Opened: `l//-7 Continued: Site Visit:
—PAbutters Notic Confirmed
❑ Or Con ' ons Sent to Applicant and DEP
❑ Confirm livery
❑ Applicant Recorded Oo with Registry
Preconstruction Meeting:
❑ Certificate of Compliance Sent to Applicant and DEP
❑ Confirmation of Delivery
❑ Applicant Recorded CoC with Registry
Notes:
CITY OF SALEM
ASSESSOR'S CERTIFICATION OF ABUTTERS AND
PROPERTY OWNERS
BOARD/COMMISSION: Conservation Commission
PROJECT SITE: 11R Winter Island Road, Salem (44_ 0022_ 0)
DATE: 11/3/2011 {'
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
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.
Assessor's Signature: Date:
Number of initialed pages attached:
Once Certified, Return to: -
Tom Devine, Department of Planning and Community Development
f
l
Salem Web GIS - Map Page Page 1 of 1
. � Property Viewer
c VYel HIC to the CiryAa Srilern ati(assarhnsettsJr
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New Property Search Property Record Card ®HELP
µsr o° a]iy1 -rria7a Property ID 44_0022_0 c
y 's ° ,. Address 11-R WINTER ISLAND ROAD
° '��& F Owner KOZLOWSKI FRED T
Property ID 44_0037 0 .
Address BO FORT AVENUE
Owner MASS COMM OF -
Y
Property ID 44_0022 0
Address 11-R WINTER ISLAND ROAD R:"
Owner KOZLOWSKI FRED
Property ID 440034_0
1 o, Address 12 WINTER ISLAND ROAD
Owner JOHNSTON SCOTT R
-
�
Property 1O 46_0023_0 •� g
�F ' 6 + �. +d' y Address -15 WINTER ISLAND ROAD -
,p. "� `. ., Owner OSHEA PAUL C c
' �' ` ��1SF q_ Property ID 44_0024_0 -
0 "e`di M Address 19 WINTER ISLAND ROAD I-
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tya ❑'F 'n I Q � ��® Scale i".= 664 H.
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Mr.
Salem City Hall 93 Washington Street,Salem,MA 01970
Phone;Wnesday SAM
9595
City Hall Hours of Operation:Monday,Tuesday 8 Wednesday SAM-4PM Thursday SAM-]PM Friday BAM-12PM
Slte desisned Ey APPGeo. -
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http://host.appgeo.com/salemma/Map.aspx 11/3/2011
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44_0037_0 44_0036 0 - 1
MASS COMM OF - TRS OF PLUMMER FARM SCHOOL
100 CAMBRIDGE ST 37 WINTER ISLAND ROAD
BOSTON,MA 02202 SALEM,MA 01970 I
44_0022_0 44 0035_0 I
KOZLOWSKI FRED T { HARVEY KEVIN R # -
I I WINTER ISLAND RD 4 WINTER ISLAND ROAD I
SALEM,MA 01970 SALEM,MA 01970 ,
i
1 44_0034_0 I 44 0019_0
JOHNSTON SCOTT R ! MARY E.BALLOU REV TRUST THE
12 WINTER ISLAND RD _ 5 WINTER ISLAND RD
SALEM,MA 01970 - j SALEM,MA 01970
44_0023_0 ' 44_0020_0
OSHEA PAUL s PECEVICH ANN 1 1 - c
15 WINTER ISLAND RD 9 WINTER ISLAND ROAD
SALEM,MA 01970 SALEM,MA 01970
44 0024_0
KALGREN TERI -
! 19 WINTER ISLAND RD
1 SALEM,MA 01970 + =
44_00330 -
t
PAGE MARY F -
20 WINTER ISLAND RD -j
SALEM,MA 01970
44 0025_0
I I
I KARAM DOUGLAS .. ..
25 WINTER ISLAND ROAD -
SALEM,MA 01970
44 0026 0
I KARAM DOUGLAS - - -.
i
!i 25 WINTERISLAND ROAD ! -
SALEM,MA01970 i-
j
I 44_0027_0 I
MORIARTY EDWARD M
29 WINTER ISLAND RD l -
�! SALEM,MA 01970
i
44_0031_0 i.
MORIAR'rY EDWARD M -.
. 29 WIN"rER ISALND RD f s
SALEM.MA 01970 1
I
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City of Salem Department of Planning & Community Development
Check/Cash Receipt and Tracking Form
Please complete form and make two copies.
Date Received 11—
Amount Received
Form of Payment Check ❑ Cash
Client Information
CASH PAYMENTS: client initials
❑ Sign Permit Application Fee
Conservation Commission Fee
❑ /
Payment received for what Planning Board Fee ZBA
service? ❑ SRA/DRB Fee
❑ Copies
❑ Other:
Name of staff person receiving
payment
Additional Notes
1
- ..53]135- 13x ..,. 1003
9
WINTER ISLAND LLC DA E AI
a - Rql STREET,3RD FL _ - k
- S]i. EM,MA 01997.0
crb
PAYTOTHE
ORDER OF DOLLARS `•"""`" t.
•bV on
Da��
2
"'E"O11101,03
l: 2LL37L353�: 88 2013L47 '
i
Original Check and Form: DPCD Finance
Copy 1: Client
Copy 2: Application File