6 MARTIN LANE - WITCH HILL - CONSERVATION COMMISSION J _ _
,Vcoryb�tTS
�`,ATE CITY OF SALEM
CONSERVATION COMMISSION
December 17, 2012
Jeffrey Halloran
100 Cabot Street
Beverly, MA 01915
Re: Certificates of Compliance for DEP #64-504 (3 Martin Lane), #64-505 (4
Martin Lane), and #64-506 2 Martin Lane)
Determination of Applicability for 6 Martin Lane
Dear Mr. Halloran:
Enclosed, please find the certificates of compliance for 2, 3, and 4 Martin Lane. These
documents must be recorded at the Essex County Registry of Deeds. Please till out
and return the Recording Information on page 3 of each certificate, which will indicate to
the Salem Conservation Commission that the documents have been recorded.
Please also find the enclosed determination of applicability for 6 Martin Lane for your
file. Because this determination is issued for work that has already been completed, no
further action is needed.
If you have any further questions please feel free to contact me at 978-619-5685.
Sincerely,
j —
Coni Devine
Conservation Agent/Staff Planner
Enclosures
CC: DEP Northeast Regional Office
Eastern Land Survey Associates
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, useConservation---r------Co-mm--ission--o—n-- ------ --- -- ---
only the tab
key to move To: Applicant Property Owner (if different from applicant):
your cursor-
do not use the Jeffrey Halloran
return key. Name Name
100 Cabot Street
f°^ Mailing Address Mailing Address
Beverly MA 01915
P.),.,, City/Town State Zip Code Citylrown State Zip Code
rr�rwu w
1. Title and Date (or Revised Date if applicable) of Final Plans and Other Documents:
As-Built/Certificate of Compliance Plan of Land 12/3/2012
Title Date
Date
Title ---. _---- --- — —Date------
2 Date Request Filed:
12/3/2012
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):
Grading and stabilization of approximately 260 square feet within the outer buffer zone to a wetland
resource area_
Project Location:
6 Martin Lane_ Salem
Street Address City/Town
9 30 (partial)__
— — - - -
Assessors Map/Plat Number Parcel/Lot Number - -
wp3bn*2 doc-Delerminalion of Applicability-rev 10/6/04 Page 1 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
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 plans) 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 documents) 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 plans) 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
wpaforn12.doc-Determination of Applicability•rev.10/6/04 Page 2 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
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
1 P
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).
❑ 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.
wpalorn¢Aoc•Determination of Applicability•rev.1016104
Page 3 0!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
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)
25 6. The area and/or work described in the Request is not subject to review and approval by:
---- -- ---------------------
Name of Municipality - - -
P''u,,rs``u�ant pto a municipal wetlands ordinance or bylaw.
W-. - ie
Name Ordinance or Bylaw Citation
C. Authorization
This Determination is issued to the applicant and delivered as follows:
❑ by hand delivery on g by certified mail, return receipt requested on
\ r7Z
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 http://www.mass.gov/deD/about/reajon.findyour.litm) and the
property owner (if different from the applicant).
-
Date
wp fo,m2boc-Dmermmeron of A,,k.bdity-rev.1016104 Page 4 of 5
ILMassachusetts 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.findyour.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.
wpaform2.doc-Delermina lion of Applicability•rev.10/6104 Page 5 of 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. ... _.____- .. ...----
City/Town State Zip Code
e Phone Number Fax Number(if applicable)
+ .9
Project Location
Mailing Address - - - - - ----
City/Town 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
Mailing Address
City/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
rvpalorm2.doc•Requesl for Departmental Aclton Fee Transmittal Form•rev.1016104 Page t of 2
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
7L1, 0
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
httr)://www.mass.gov/dep/about/region/findVOLir.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.
�vpalorm2.doc•Request far Departmental Action Fee Transmillal Form•rev.10/6104 Page 2 of 2
Massachusetts Department of Environmental Protection
`t-- Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 64-504
� Provided by DEP
A. Project Information
Important:
When filling out 1. This Certificate of Compliance is issued to:
forms on the
computer, use Jeffrey Halloran
only the tab key Name
to move your 100 Cabot Street
cursor-do not
use the return Mailing Address
key. Beverly__________ MA 01915
City/Town State Zip Code
1V 2. This Certificate of Compliance is issued for work regulated by a final Order of
Conditions issued to:
}¢� Kenneth Steadman
rewn "s' Name
9/23/201.0 64-504
Dated DEP File Number
3. The project site is located at:
3 Martin Lane __ Salem
Street Address - City/Town
14 30 (Partial)
Assessors Map/Plat Number Parcel/Lot Number
the final Order of Condition was recorded at the Registry of Deeds for:
Kenneth Steadman
Property Owner(if different)
Essex South
County Book Page
518045
Certificate
4. A site inspection was made in the presence of the applicant, or the applicant's agent,
on:
11/28/2012
Date
wpafrmeb.doc-rev.12/23/09 wPA Form 9B,Cerlitimne or Compliance-Page 1 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 Pr-Pr
rovided by DEP
B. Certification
Check all that apply:
Complete Certification: It is hereby certified that the work regulated by the
above-referenced Order of Conditions has been satisfactorily completed.
❑ Partial Certification: It is hereby certified that only the following portions of work
regulated by the above-referenced Order of Conditions have been satisfactorily
completed. The project areas or work subject to this partial certification that have
been completed and are released from this Order are:
❑ Invalid Order of Conditions: It is hereby certified that the work regulated by the
above-referenced Order of Conditions never commenced. The Order of
Conditions has lapsed and is therefore no longer valid. No future work subject to
regulation under the Wetlands Protection Act may commence without filing a new
Notice of Intent and receiving a new Order of Conditions.
❑ Ongoing Conditions: The following conditions of the Order shall continue:
(Include any conditions contained in the Final Order, such as maintenance or
monitoring, that should continue for a longer period).
Condition Numbers:
C. Authorization
Issued by:
_t�vcv
nservaTon GOmmission Dat of Issuance
Co
This Certificate must be signed by a majority of the Conservation Commission and a
copy sent to the applicant and appropriate DEP Regional Office (See
http://www.mass..qov/dep/about/region/findyour.htm),
Signatures:
9 777
wpafrm8b.doc•rev.12/23109 WPA Farm 88,Certificate of Compliance•Page 2 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. 131 , 40 54-504
c. � Provided by_ _DEP_
_
D. Recording Confirmation
The applicant is responsible for ensuring that this Certificate of Compliance is recorded in
the Registry of Deeds or the Land Court for the district in which the land is located.
Detach on dotted line and submit to the Conservation Commission.
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
To:
Conservation Commission
Please be advised that the Certificate of Compliance for the project at:
Project Location DEP File Number
Has been recorded at the Registry of Deeds of:
for:
Property Owner --
and has been noted in the chain of title of the affected property on:
Date Book Page
If recorded land, the instrument number which identifies this transaction is:
If registered land, the document number which identifies this transaction is:
Document Number-- --------- -----—_--
Signature of Applicant
wpafrm0b.doc-rev.1223109 WPA Form 8E,Cemicate of Compliance•Page 3 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance 64-505
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
A. Project Information
Important:
When filling out 1. This Certificate of Compliance is issued to:
forms on the
computer, use Jeffrey Halloran
only the tab key Name
to move your 100 Cabot Street
cursor-do not
use the return Mailing Address
key. Beverly MA 01915
Citylrown State Zip Code
r rad 2. This Certificate of Compliance is issued for work regulated by a final Order of
Conditions issued to:
Kenneth Steadman
wn Name
9/23/2010 64-505
Dated DEP File Number
3. The project site is located at:
4 Martin La_ne _ Salem
Street Address City/Town
14 30 (Partial)
Assessors Map/Plat Number Parcel/Lot Number
the final Order of Condition was recorded at the Registry of Deeds for:
Kenneth Steadman
Property Owner(if different)
Essex South
County Book Page
518044
Certificate
4. A site inspection was made in the presence of the applicant, or the applicant's agent,
on:
11/28/2012
Date — — — -- ------ -
wp3frm8b.doc•rev.12123/09 WPA Farm 8B.Certificate of Compliance-Page 1 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance
64-505
Massachusetts Wetlands Protection Act M.G.L. c. 131 , §40 Prjaedby DEP
B. Certification
Check all that apply:
�j Complete Certification: It is hereby certified that the work regulated by the
above-referenced Order of Conditions has been satisfactorily completed.
❑ Partial Certification: It is hereby certified that only the following portions of work
regulated by the above-referenced Order of Conditions have been satisfactorily
completed. The project areas or work subject to this partial certification that have
been completed and are released from this Order are:
❑ Invalid Order of Conditions: It is hereby certified that the work regulated by the
above-referenced Order of Conditions never commenced. The Order of
Conditions has lapsed and is therefore no longer valid. No future work subject to
regulation under the Wetlands Protection Act may commence without filing a new
Notice of Intent and receiving a new Order of Conditions.
❑ Ongoing Conditions: The following conditions of the Order shall continue:
(Include any conditions contained in the Final Order, such as maintenance or
monitoring, that should continue for a longer period).
Condition Numbers:
C. Authorization
Issued by:
1 _ (2 G
Conservation Commission Dale 6f Issugrice
This Certificate must be signed by a majority of the Conservation Commission and a
copy sent to the applicant and appropriate DEP Regional Office (See
http:/iwww.mass.gov/dep/abOLIt/region/fiiidyour.htm).
Signz7
atur .,
� .
; C -
�1� 1.
wpafrm8b.doc rev.1223109 WPA Form 88,Cenificale of Compliance•Page 2 of 3
Massachusetts Department of Environmental Protection
`. Bureau of Resource Protection - Wetlands DEP File Number.
X: WPA Form 8B — Certificate of Compliance 64-505
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
D. Recording Confirmation
The applicant is responsible for ensuring that this Certificate of Compliance is recorded in
the Registry of Deeds or the Land Court for the district in which the land is located.
Detach on dotted line and submit to the Conservation Commission.
To:-- -—--- - ---— - - - -— - - - --- - —---—- - - - -- - - - - - - —---- - --- ---- --- --
Conservation Commission
Please be advised that the Certificate of Compliance for the project at:
Project Location DEP File Number
Has been recorded at the Registry of Deeds of:
County
for:
Property Owner
and has been noted in the chain of title of the affected property on:
Dale Book Page
If recorded land, the instrument number which identifies this transaction is:
If registered land, the document number which identifies this transaction is:
Document Number
Signature of Applicant
wpafrm8b.doc-rev.12123109 WPA Farm 813,Cenificate of Compliance•Page 3 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 813 — Certificate of Compliance
64-506
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 ProvidedbyoEP—
A. Project Information
Important:
When filling out 1. This Certificate of Compliance is issued to:
forms on the
computer, use Jeffrey Halloran
only the lab key Name
to move your 100 Cabot Street
cursor-do not ----
use the return Mailing Address
key. Beverly _ MA 01915
C� City/Town State Zip Code
2. This Certificate of Compliance is issued for work regulated by a final Order of
Conditions issued to:
Kenneth Steadman
raw,, Name
9/23/2010 64-506
Dated DEP File Number
3. The project site is located at:
2 Martin Lane _ Salem
Street Address City/Town
14 (Partial)
Assessors Map/Plat Number Parcel/Lot Number
the final Order of Condition was recorded at the Registry of Deeds for:
Kenneth Steadman
Property Owner(if different)
Essex South
County Book Page
518045
Certificate
4. A site inspection was made in the presence of the applicant, or the applicant's agent,
on:
11/28/2012
Date
wpalrm8odoc-rev 1223i09 WPA Form BB,Certificate of Compliance•Paget of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number.
WPA Form 8B — Certificate of Compliance 64-506
Massachusetts Wetlands Protection Act M.G.L. c. 131 , §40 Provided by DEP
B. Certification
Check all that apply:
Complete Certification: It is hereby certified that the work regulated by the
above-referenced Order of Conditions has been satisfactorily completed.
❑ Partial Certification: It is hereby certified that only the following portions of work
regulated by the above-referenced Order of Conditions have been satisfactorily
completed. The project areas or work subject to this partial certification that have
been completed and are released from this Order are:
❑ Invalid Order of Conditions: It is hereby certified that the work regulated by the
above-referenced Order of Conditions never commenced. The Order of
Conditions has lapsed and is therefore no longer valid. No future work subject to
regulation under the Wetlands Protection Act may commence without filing a new
Notice of Intent and receiving a new Order of Conditions.
❑ Ongoing Conditions: The following conditions of the Order shall continue:
(Include any conditions contained in the Final Order, such as maintenance or
monitoring, that should continue for a longer period).
Condition Numbers:
C. Authorization
Issued by:
4te of s t
Conservation ommission Da
This Certificate must be signed by a majority of the Conservation Commission and a
copy sent to the applicant and appropriate DEP Regional Office (See
http://www.mass.gov/dep/about/regioti/fitidyour.htm).
Signatures:
wpafrmtlb.doc-rev.12123/09
WPA Form 83,Cerlificafe of Compliance•Page 2 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - WetlandsLLI
DEP File Number:
WPA Form 8B — Certificate of Compliance 64-506
Massachusetts Wetlands Protection Act M.G.L. c. 131 , §40 Providedby DEP
D. Recording Confirmation
The applicant is responsible for ensuring that this Certificate of Compliance is recorded in
the Registry of Deeds or the Land Court for the district in which the land is located.
Detach on dotted line and submit to the Conservation Commission.
--- ----------------- - --------- ----------- - --------------------------- --------- -----------
To:
Conservation
--------
Conservation Commission
Please be advised that the Certificate of Compliance for the project at:
Project Location DEP File Number
Has been recorded at the Registry of Deeds of:
County - --------
for:
Property Owner
and has been noted in the chain of title of the affected property on:
Date -- Book _--_--_Page
If recorded land, the instrument number which identifies this transaction is:
If registered land, the document number which identifies this transaction is:
Document Number
Signature of Applicant
wpafrmdb doc•rev.12/23/09 WPA Form Be,Certificate of Compliance•Page 3 of 3
Project Status Sheet
Address: G Owd"' \4,k` �AVOEP #:
Application Type: Date Submitted: (�/,a
Contact Name: PAkit 14 Z Phone:
Proposed activity: 5"�` � s�P
❑ Application Complete
-Correct Fee Received
2!5,ZA�ter� er.ItresEed � Recr..ivP�_
Legal Ad Sent ❑ Legal Ad Confirmed Online
Added to Agenda Agenda to Applicant
Agent Comments to Commission
Hearing Opened: ( ( Vel) Continued: Site Visit:
o ice /onfirmed
Order of Conditions Sent to Applicant and DEP
0 Confirmation of Delivery
dded-te-calendar—
e--I:gkdded to database
n pp licant Recorded OoC with Registry
Preconstruction Meeting:
5ertificate of Compliance Sent to Applicant and DEP
confirmation of Delivery
�A.pplfeant Recorded CoC with Registry
Notes:
UNITED STATES t .Q� . ' .MA. ` .. ,
I 20 [xEC 2012 ry "" •Y.[:ilt'll
�: Permlt No G-10
• Sender: Please print our name, addre w#' t
y _ ` D
DEC 21 Z012
DEPT. O P-' Ari.NNG&
Salem Conservation Golfo Urf
120 Washington Street,3rd Fl
Salem,MA 01970
C, L�� Q(�A CoCs : ccl. - sir st
I i,,,,,,llLi„i,
SENDER: COMPLETE THIS SECTION COMPLETE THIS SEC rION ON
■ Complete items 1,2,and 3.Also complete A. Signature
item 4 if Restricted Delivery is desired. X ❑ gent
11Print your name and address on the reverse Adtlressee
so that we can return the card to you. B. Received (Prinam - C. Date of Deli ery
III Attach this card to the back of the mailpiece, �� (v
or on the front if space permits. ) -
D. Is delivery address different from item 1? ❑Ye
1. Article Addressed to: If YES,enter delivery address below: ❑ No
Gam`' C.' s
U \A Ol (L/
(r 3. Service Type
4WCertlfied Mail ❑Express Mail
❑Registered ❑Return Recelpt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number lit ((7010 2780] 0002 0.1581 9457, 1
(transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
�tti . ir,9,1
r�
a TY;IF
C} , AEIVI
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 cl31§40 and Salem Wetlands Protection & Conservation
Ordinance for Jeff Holloran, 100 Cabot Street, Beverly MA. Purpose of hearing is to discuss,
after-the-fact, grading and landscaping within buffer zone to a wetland resource area at 6
Martin Lane. Hearing will be held 12/13/12 at 6pm in City Hall Annex, Rm 313, 120
Washington St.
Please print legal ad on:
December 6, 2012
Please invoice:
Paul Herrick
500 Cummings Center
Suite 1550
Beverly, MA 01915
978-979-7900
D2omQ 61(Da) Bodo
Professional Land Surveyors& Civil Engineers
ESSEX SURVEY SERVICE 1958- 1986
OSBORN PALMER 1911 - 1970
BRADFORD&WEED 1885- 1972
December 3, 2012
Mr. Jeff Holloran
Holloran Companies
100 Cabot Street
Beverly,MA 01915
RE: F 11862
LOT 213
MARTIN LANE
SALEM, MA
Dear Jeff:
Pursuant to your request, please find attached the Request for Determination of
Applicability(WPA Form 1) and 15 copies of the As Built Plan.
These are provided for your use in filing with the Salem Conservation Commission.
Sincerely,
Christopher R. Mello,PLS
President
CRM:lc
Attachments
104 LOWELL STREET
PEABODY, MASS. 01960
TELEPHONE: 978-531-8121 FAX: 978-531-5920
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands Salem
WPA Form Ll1 - 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 Jeffrey Holloran
computer, use Name E-Mail Address
only the tab key
to move your 100 Cabot Street
cursor-do not Mailing Address
use the return Beverly MA 01915
key. City/Town State Zip Code
2-2544
Phone N
� Phone Number Fax Number(if applicable)
2. Representative (if any):
None
Firm
Contact Name E-Mail Address
Mailing Address
City/Town State Zip Code
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.do Page 7 of 4
LIMassachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands Salem
WPA Form 1 - Request for Determination of Applicability Cdy/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):
6 Martin Lane Salem
Street Address City/Town
Assessors Map 9 Part Lot 30
Assessors Map/Plat Number Parcel/Lot Number
b. Area Description(use additional paper, if necessary):
260± SF of buffer zone has been graded and stablized as lawn
c. Plan and/or Map Reference(s):
As Built Plan by Eastern Land Survey Associates Inc. Dec. 3, 2012
Title Date
Title Date
Title Date
2. a. Work Description(use additional paper and/or provide plan(s) of work, if necessary):
xyafomUm Page 2 of 4
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands Salem
�
WPA Form 1 - Request for Determination of Applicability CitylTown
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.)
wpaforml.tloc Page 3 of 4
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands Salem
/
WPA Form 1 - Request for Determination of Applicability Cilylfown
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:
Jeffery Holloran
Name
100 Cabot Street
Mailing Address
Beverly
Cityrrown
MA 01915
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.
Signature of Applicant Date
Signature of Representative(if any) Date
wpafo mtdot Page 4 of 4
RDA Photolog Witch Hill Subdivision Lot 213 — 6 Martin Lane
Photos by Tom Devine on 11/9/2012
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GENERAL NOTES NOTES:
MARTIN LANE CONSTRUCTION IS PURSUANT TO ORDER
OF CONDITIONS WITH DEP FILE 64-391.
1) THIS PLAN /S THE RESULT OF AN ON THE GROUND (FIELD
SURVEY AND PUBLIC AND PRIVATE PLANS. AS— BUILT CERTIFICATE OF COMPLIANCE
2) UTILITIES SHOWN ARE BASED UPON FIELD SURVEY AND LOT 211 CONSTRUCTION IS PURSUANT TO DEP FILE 64-506 PLAN OF LAND
RECORD PLANS AND ARE NOT NECESSARILY INDICATIVE OF LOT 212 CONSTRUCTION IS PURSUANT TO DEP FILE 64-505
UNDERGROUND COND/77ONS. LOT 214 CONSTRUCTION IS PURSUANT TO DEP FILE 64-504 LOCATED IN
3) THE CONTRACTOR SHALL BE RESPONSIBLE FOR VERIFYING AND
DETERMINING THE LOCATION, SIZE AND ELEVATION OF ALL ' , SALEM , MASS .
EXISTING UTILITIES, SHOWN OR NOT SHOWN ON THESE PLANS,
PRIOR TO ANY CONSTRUCTION. THE ENGINEER SHALL BE NOTIFIED LOCUS IS SHOWN ON DEFINITIVE SUBDIVISION PLAN OF LAND CHRISTOPHER PREPARED BY
IN WRITING OF ANY UTILITIES FOUND INTERFERING W17N THE BY EASTERN LAND SURVEY ASSOCS., REVISED TO DEC. 30, 2004. R.
' MELLO EASTERN LAND SURVEY ASSOCfATES, INC.
PROPOSED CONSTRUCTION AND APPROPRIATE REMEDIAL AC770N ' Qeo.3
BEFORE PROCEEDING WITH THE WORK. ASSES DISTRICT: R1 CHRISTOPHER R. MELLO, PLS
ASSESSORS MAP 9 PART PARCEL 30
4) THIS PLAN /S BASED ON THE REFERENCED PLANS, DEEDS
AND THE RESULTS OF A FIELD SURVEY AS OF THIS DATE i
104 LOWELL ST. PEABODY, MA. 01960
NO CERTIFICATION /S INTENDED AS TO PROPERTY T177E
OR AS TO THE EXISTENCE OF UNWRITTEN OR UNRECORDED
(978) 531 -8121
EASEMENTS. SCALE: 1 " = 20' DECEMBER 3, 2012
5) THE OWNER SHALL CONFIRM COMPLIANCE WITH ALL APPLICABLE
CODES AND REGULATIONS GOVERNING THE MATERIALS AND/OR
METHODS OF INS TALLAT70N OF ANY IMPROVEMENTS DEPICTED
ON THIS PLAN.
6) RESOURCE AREA DELINEA77ON PERFORMED BY R/MMER PHOTO REPRODUCTION OF THE ABOVE SEAL IS
ENVIRONMENTAL CONSULTING, SEPT. 20, 2000 AND INDICATIVE OF UNAUTHORIZED REPRODUCTION
OF THIS PLAN AND IS TO BE CONSIDERED A
WETLANDS & LAND MANAGEMENT, INC., ON MAY 24, 2001. COPYRIGHT INFRINGEMENT AND/OR FRAUD. A:317
ENFORCEMENT AUTHORITY SHALL NOT ACCEPT 0 10 20 40 60 80
PHOTO REPRODUCTION FOR ANY PURPOSE. F 11862
City of Salem Department of Planning & Community Development
Check/Cash Receipt and Tracking Form
Please complete form and make two copies.
Date Received
—Amount Received i
Form of Payment heck ❑ Cash
Client Information
CASH PAYMENTS: client initials
Sign Permit Application Fee
5.COnservatlon Commission Fee
Planning Board Fee/ ZBA
� Payment received for what
service? ❑ SRA/DRB Fee
It
Cj
Copies
❑ Other:
Name of staff person receiving
Additional Notes
1245
SALEM HOMEBUILDERS, LLC
PH.(978)902-2544 53-7214-2113
1 y..��`t 100 CABOT STREET _ l �L
_ "—„gfVERLY,MA01915_ DATE !�
10
r PAY Al
TO THE �-,.
ORDER OF—. /� _ DOLLARS 8' ^u`
10
BEVERLY
- _ COOPERATIVE
”. BAJVTK aver!y,MA01915 ` 1.
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: . FOR 11.00124511' 11: 21137214511: 063030L59u'
grigin.11 Ched< ,tnd form: !;Pt:D im u,.,;�
Copy t: