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64-232 - CAT ISLAND - CONSERVATION COMMISSION (� 64'-ZZZZ32'Ca`t land � bleheadjS�wampscott YMCA 1J Y , h 1 P 310 -CMR 10.99 DEP FdeNo. 64-232 e `~ (To be provided b/DEP) Form 5 cuy/rd.,a SALEM Appbtant M'Head/Swamysrntt YMCA - comomrealth of Massachusetts Order of Conditions 65•'10/95 03:28 Inst «:3 Massachuetts Wetlands Protect* 4+c301 fel P13 287 G.L. c. 131e $40 From SALEM CONSERVATION COMMISSION Issuing Authority To Marblehead/Swampscott YMCA Same (Name .of Applicant) (Name of property owner) Address104 Pleasant ST.Marb::ehead Address Same 01945 This order is issued and delivered as followst ® by hand delivery to applicant or Sepresentative on May 3, 1995 (date). ❑ by certified mail, return receipt requested on (date) This project is located at Cat Island The property is recorded at the Registry of Essex Book 4268 Page 441 certificate (if registered) N.A. The Notice of Intent for this project, was filed on April 13, 1995 (date) The public heariny was clris_d on- April 27,_.1995 _ (date) Findings The has reviewed the above-referenced Notice of Intent and plans and has held a public hearing on the project. Based on the information available to the Commission at this time, the Commission has determined that the area on which the proposed work is to be done is significant to the following interests in accordance with the Presumptions`of Significance set forth in the regulations for each Area subject to Protection under the Act (check as appropriate): Public water supply Flood Control Land containing shellfish Private water supply storm damage prevention Fisheries Ground water supply Prevention of pollutions Protection of Wildlife Habitat Total Filing Fee Submitted $50.00 State Share $12.50 (1/2 fee in excess of 225) City/Town share $37.50 Total Refund Due S City/Town Portion 637.50 State PortionS 12.50 (1/2 total) (1/2 total) Effective 11/10/89 5-1 BK 13016 PG 288' Therefore, the Commission hereby finds that the following comitions are necessary, in accordance with the Performance standards ag fprto in the regulations, to protect those interests checked above. The ommission 1. orders that all work shall be performed in accordance with said conditions and with the Notice of Intent referenced above. To the extent that the following conditions modify or differ from the plans, specifications or other proposals submitted with the Notice of intent, the conditions shall control. 1„ General conditions 1. P Failure. to comply with all conditions stated herein, and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this order. 2. The order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights. 3. This order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state or local statutes, ordinances, by-laws or regulations. 4. The work authorized tiereunder shall be completed within three years from the date of this order unless either of the following apply: (a) the work is a maintenance dredging project as provided for in the Act; or (b) the time for completion has been extended to a specified date more than three years, but less than five years, from the date of issuance and both that date and the special circumstances warranting the extended time period are set forth in this order. 5. This order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6 . Ary f' 11 used in conneaicn with thi,, reject -nasi be clna-.. fill, conta.a.ny no trash, refuse, rut�)ibh or dxt:iu, in:ludinq but Lot knit:: to lumber, bricks, plaster, wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles or parts of any of the foregoing. 7. No work shall be undertaken until all administrative appeal periods from this order have elapsed or, if such an appeal has been filed, until all proceedings before the Department have been completed. 8. No work shall be undertaken until the Final order has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. in the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done. in the case of registered land, the Final order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is tobe done. The recording informatin shall be submitted to the on the form at the end of this order prior to commencement of the work. 9. A sign shall be displayed at the site not less than two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection, File Number 64-232 10. Where the Department of Environmental Protection is requested to make a determination and to issue a superseding order, the conservation Commission shall be a party to all agency proceedings and hearings before the Department. 5-2 13 16 PG 289 11. upon completion of tho work described herein,. tte applicant shall forthwith request in writing that a Certificate of Compliance be issued stating that the work has been satisfactorily completed. 12. The work shall conform to the following plane and special conditions: Plane: Title Dated signed and stamped by: on File with: LOCUS PT.AN 1985 Conservation Commission "Prnnnsad nier restoration - Marblehead/Swampscott YMCA at CAT ISLAND" dated 3/17/95 by Daniel J. Lynch Engineers, 29 Commercial ST. , Marbtet par_- MA--&}9+S-4h tae-sheees,— �_.,,,,,_..,.« �........:....:.... Special Conditions (Use additional paper if necessary) 1. All work shall conform to the above-referenced Notice of In't"ent, stie plan and supporting documentstand those final specifications which shall be filed wit the Commission prior to construction. Any change made or intended to be made tc the approved plans shall require the applicant to inquire of the Commission in writing whether the change is substantial enough to require the filing of a new Notice of Intent. 2. Members and agents of the Commission shall have the right to enter and inspect the premises at all reasonable times to evaluate compliance with the conditions in this Order. The Commission may require the applicant to.;submit additional data or information necessary for the Commission to conduct that evaluation. 3.Upon completion of the project, the applicant shall submit, with the request for a Certification of Compliance, an affidavit, prepared by a professional engineer or land surveyor registered in the Commonwealth of Massachusetts, stating that the site has been developed in accordance with the requirements of this Order of Conditions7„elize Sp5e-de1jaaJkgite plan and supporting documents: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5-3A BK 13016 PG 290 P!ans: Title Dated signed and stamped by: on File with: special Conditions (use additional paper if necessary) (Leave space Blank) ' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . 5-3B Order of Conditions 1164-232 Salem Conservation Commission SpecialConditions Continued 4. This Order shall apply to every successor in control of successor in interest of the property described in the Notice of Intent and accompanying plans or part thereof. In the event this land or any part thereof changes ownership before or during construction, the current owner shall notify the new owner, by registered mail, of this Order prior to the trahsfer of ownership and shall forward proof of this notification to the Commission. 5. No spill or discharge of petroleum products or other pollutants will occur within 100 feet of any wetland resource area. L . BK 13 016 PG 299 Issued By SALEM Conservation Coam,ission Signature(a This order must be signed by a majority of the conservation commission. on this 27th day of April 19 95 , before me personally appeared the Cpmmissinn , to me known to be the person described in and who executed the foregoing instrument and acknowledged that he/she executed the same as his/her free act and deed. J otary Public Hy commission expires The applicant, the owner, any person agrrieved by this Order, any owner of land abutting the lard 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 Department of Environmental Protection to issue a Superseding order, providing the request is made by certified mail or hard delivery to the Department, with the appropriate filing fee and Fee Transmittal Form as provided in 310 CMR 10.03(7), within ten days from the date of issuance of this determination. A copy of the request shall at the sane time be sent by certified mail or hand delivery to the Conservation Commission and the applicant. Detach on dotted lire and submit to the Salem Conservation Commissimicr to commencement of work. ............................................................................................................ To Salem Conservation Commission Issuing Authority Please be advised that the Order of Conditions for the project at Cat Tsl and File Number 64-232 has been recorded at the Registry of DEEDS ESSEX and has been noted in the chain of title of the affected property in accordance with General Condition 8 on 19 if recorded lard, the instrument number which identifies this transaction is if registered land, the document nu. r which identifies this transaction is Signature Applicant 5-4A i� Xssued by the oeparcment of Environmental Protection signature on this day of 19 before me personally appeared to me known to be the person described in and who executed/the foregoing instrument and acknowledged that he/she executed the/same as his/her free act and deed. Notary Public my commission expires The applicant, the owner, any person aggrieved by the superseding order, any owner of Lard abutting the land upon which the proposed work is to be done, or arty ten parsons pursuant to G.L. c.30A 110A, are hereby - n,tified of their right to request an adjudicatory hearing prrnsnt to G.L. c.30A, 410, providing the request is made by certified mail or hard deliveryto the Department, with the appropriate filing fee and Fee Transmittal Form as provided in 310 CMR 10.03(7), within ten days from the date of issuance of this _ Superseding Order, and is addressed to: Docket Clerk, Office of Generai Counsel, Department of Environmental Protection, One Winter Street, Boston, MA 021080► A Copy of the request shell at the same time be sent by certified mail or hard delivery to the Cones ation Commission, the applicant, and any other party. A Notice of Claim for an Adjudicatory Nearing shall comply with the Department's Rules for Adjudicatory Proceedings, 310 CMR 1.01(6), and shall contain the following information: (a) the DEP Wetlands File Number, name%f the applicant and address of the project; (b) the complete name, address and tetaphone amber of the party filing the request, and, if represented by Counsel, the name and address/of the attorney; (c) the names and addresses of ell other parties, if known; (d) a clear and concise statement of (1) the facts which are grounds for the proceedings, (2) the objections to this Superseding/Order, including specifically the manner in which it is alleged to be inconsistent with the Department's Wetlands Reguiations (310 CMR 10.00) and does not contribute to the proc+ctmon of the intorects identified in the Act, and (3) the relief sought through the snjudicatory hearirs, sow,..ficatlty th! _.,anges desired in the Supersedinc oru • ie) a sratenent chat a c_oy of the requast,i har been sent to the appLwant, the oonser•ation commission and each other party or represent.l:ive of i/suun party, if known. Failure to submit all necessary information may result in a dismissal by the Department of the Notice of Claim for an Adjudicatory Nearing. Detach on dotted line and sLIbait to they prior to connmrlcement of work. .....................................I...................................................................... To / Issuing Authority. i Please be advised that the Order of Conditiors for the project at_ File Number has been recorded at the Registry of and has been noted in the chain ofititte of the affected property in accordance with General Condition 8 on f19 If recorded lend, the inst r�ument number which identifies this transaction is If registered tend, the document number which identifies this transaction is Signature Applicant C ' lo/LL�1itSor— ©�1.Q- s-ae sit � � 0197, r Commonwealth of Massachusetts Executive Office of Environmental Affairs JUN i1c 199J Department of Salem, rkwiving L)ept Environmental Protection Wiliam F.Weld Governor Trudy Coxe Secretary,EDEA David B. Struhs - Commissioner June 1, 1995 Marblehead/Swampscott YMCA c/o Mr. William H. Kelley Tucker' s Wharf, P.O. Box 212 Marblehead, MA 01945 Re : Waterways License Application No. W95-4173 : Dear Sir: The Waterways Regulation Program (WRP) has received your application requesting authorization to perform certain activities in state waterways pursuant to G.L. Chapter 91, Waterways Licensing. The WRP has assigned your filing with the referenced application number. IT IS IMPERATIVE THAT YOU REFER TO THIS APPLICATION NUMBER WHENEVER YOU SUBMIT OR REQUEST INFORMATION FOR THIS FILE. Attached is the WRP' s public notice for this application. You are required to publish this notice, at your expense, in the local newspaper (s) having circulation in the area affected by the proposed activity. This notice must be published no later than the designated "Notification Date" for at least one day in the local newspaper (s) . There is a prescribed public comment period imposed from the date of publication. You are required to submit proof of publication to the WRP by sending a copy of the newspaper notice showing the date of publication or a letter from the newspaper indicating the date the notice was published. t The WRP will concurrently notify the appropriate municipal officials of the proposed activity for their review and comment . The WRP cannot commence licensing review and authorization until at least forty-five (45) days. after the municipality has been notified of this application. Also, should this project exceed the MEPA waterways thresholds, thereby requiring completion of the MEPA review process, the WRP will publish the public notice in the Environmental Monitor. Furthermore, pursuant to 310 CMR 9 . 00, Licensees are required to provide compensation for private use of structures (or fill) on Commonwealth tidelands which interfere with the rights of the public to use such lands . Said compensation includes, but is not ' necessarily limited to, the allowance of the, public to pass on foot, for any lawful purpose, within the area of the subject property lying seaward of the high water mark. The WRP may contact the Applicant, if it has not already done so within the text of this letter, requesting information and/or possible revisions necessary to . ..comply with this requirement . One Winter Street • Boston, Massachusetts 02108 • FAX(617)556-1049 • Telephone(617)292-5500 10 Printed on Rerycled Paper DEPARTMENT OF ENVIRONMENTAL PROTECTION WATERWAYS REGULATION PROGRAM --------------- ------------------------------------- Notice of License Application pursuant to M.G.L. Chapter 91 Waterways License Application No. W95-4173 Marblehead/Swampscott YMCA Notification Date : June 21, 1995 Public Notice is hereby given of the application by the Marblehead/Swampscott YMCA to repair and maintain an existing pier, ramp and float at Cat Island in the Municipality of Salem in and over the waters of Salem Sound. The proposed use of the structure (s) and/or fill is to provide noncommercial docking and boating access to navigable waters and is a water-dependent use project . The Department will consider all written comments submitted thirty (30) days subsequent to the "Notification Date" in order to decide whether to grant authorization for the proposed activity pursuant to G.L. Chapter 91 . A public hearing may be held upon request by the Municipal Official . Furthermore, a municipality, ten citizen group or any aggrieved person that has submitted written comments may also petition to intervene to become a party before the close of the comment period. Failure to submit such petition will result in the waiver of any right to an adjudicatory hearing. Further information regarding this application may be obtained by contacting the Division at (617) 292- 5695 . Plans and documents for this application are on file with the Department for public viewing, by appointment only, at the address below. Written comments must be submitted to: John A. Simpson, Section Chief, DEP/Waterways Regulation Program, One Winter Street, 8th Floor, Boston, MA 02108 . t - 2 - Lastly, the WRP cannot begin review of this application for license issuance until the following information has been submitted to the file : X Proof of publication of the public notice X Expiration of the statutory 45 day comment period Should you have any question with regard to the foregoing, please contact me at (617) 556-1151 . pi erely E . Provencal nse Reviewer Waterways Regulation Program CC : Salem Mayor and City Council Salem Conservation Commission Andrew Syska, Harbormaster Office of Coastal Zone Management DEM, Ocean Sanctuaries DMF, Randall Fairbanks Division of Fish & Wildlife Massachusetts Historical Commission WRP Application File (2) Mamchumns Deparhnant of Environ enUt Protection 95750 . ............ Bureau o/Resource Protection— Waterways �rrnMiilri BRP WW 01 wateneays Uorms r or Permit Approval: r Except Projects Subject to Amnesty , .............. BRP WW 02 Waterways License or Permit Approval: Amnesty Projects facility PU fxarown) BRP WW 03 Waterways Amendment to License or Permit Approval General Walemays Application :aa irralree- N'"' op.'= 1 11111 estate Pro ect Information aampellee seetlen A•D.of 1• Which permit care po re you applying tor? S. The water body at the project site is: this farm O BRP WW 01 Jr BRP WW 02 O BRP WW 03 (cheek]or more of both a 6 b) _.._...._.._..................... A. TIdaI O Furled Tidelands ❑ Great Pond rr�taraeM `Boom 2. Applicant O PIVIdstream O Uncertain amrrmrr. — Marblehead/Swampscott YMCA b Nalural O Man-Made ❑ Uncertain wsee�._............. ANIM 7. Project description: : .................................. 104 Pleasant Street l eau w �senr i ........................ c'.. ---- Maintain &repair pier, ramp &float. ... ................._ ................I.................._...._..... 3. 'Authorized agent ................................................-........................................................... ............William H. Kelley . .......... e. Propow0 use(check one or more of both a and b): saner Tucker's Wharf, P.O. Box 212 a. PrWte O Commercial O Industrial ................................................................................................. O Government ❑ Facility of private tanancy Marblehead, MA 01945 O,,Dther pzplaln below) ................................................a......re....................... b. ,6daf Water-dependent elq•Aaen (617) 639-4454 Accessory O Nonwater-dependent ............................................................................................................ rree+ow g. Description of existing and proposed use(s): a. Property owner .................ACCs$3` f0" Yii1' PYi71TT"th'e"15TaTTif'" ............Mw.blehe6di. S.W..ea.O.lASG9tt_YMCA...._ erre .._.............. faC4tlt'y................_.._ ................-._dame...-.....I............................. pndsawenlOMneonM J1 ..........._........_................................................._...... _. _ ___....._..........._._.._.............._....__............ ........ --"—___. W p�Vlap 03(1 —�TCefs U( — 10.rWIN any public benefit be derived from tw ProNet? .a4 Yea O No ❑Uncertain O 0 answer la'Ya',explain below. Essex wow S. 5. Nome of the water body,and the water body it Is a tributary to,at the project location ...............................Salem•Sound....................................... Page 1 of 1e MameAraelts laic,_ 'bneol o/EmlronmentallrobeHoo Bureau o/Resource Protection-Waterways ' ...9575111 Waterways Llsefw or Permit Apprmh rransmiUl z BRP WW 01 Except Projects Subject to Amnesty BRP WW 02 Waterways Ucelme or Penult Approml:Aron"Projects Fac#WIDryAoe") BRP WW 03 Waterways Amendment to Llceese or Permit Approwal General Waterways Application 11. For nonwatrdependent projects attach a statement 16. Is this appgcatio or an Amnesty Interim Approvan giving the following information;how the project is p Ya No consistent with the Coastal Zone Management Program policies,and how t serves&proper public purpose and N'YU0,submit plans prepared in accordance with Appendix provides a greater benefit than a detriment to the public's A. rigid&in tidelands and prat ponds. 16.Approximately how long will it take to complete the project after all required permits have been issued? .........--.._--...................- --- - ---- 17. What is the approximate total cost of the project(mN-r- 12. Will these M any discharge(either direct or Indirect)ofmaterial;6 labor)? waste material or waste water Into State water from the construction orratan of the project? D Yes X No 16. Is the project eke located within one or mon of the following? 13. Nm you previously applied to.or obtained t t permit or C Ara of Critical Environmental Concern Miter authorization Irom,any agency(interstate,rydanl, State,or Local)for any portion of the project described in O Dcan sanpwry this application? O Dn*otd Pon Area O Yes VNo O Uncertain O Uncertain If IYISO,provide the following Information:Ueach a 19. le the project site In a municipality separate sheet for chapter 91 licenses for the property: with a two appmvad lest liana numbers,daft issued and recorded,book and Harbor Plan? page). O Yes �rplan Under Review ❑ No D Uaoartdn Salem Conservation Comm. „yes•is this propoal consistent with the plan? ay,�w o pwv4pmy O Yes ❑ No tjo�s�een Order of Conditions 20AN licenses luted by the Department wig aadain a condition awing the tam for which the license 6i Meal can - IMP # 64 23-2- a an extended term is desired,attack approprita docM mr- lation as rmird by 910 CMR 9.15(1)(b)(d)and dook here. ❑Mot ap10ho"to wtrdependad amaaty amerare Papa) V1doxO 01e 13 April 1995 21. List IM roma and complete mailing address of each abftr (attach additional chests,g necessary) 11. Has any work commenced or has any portion of the project for which you are now seeking approval been co npleld? 0 Yes NO e'Yu•,deeedbe below.State when the work was completed and who performed the work ee altacned see (Plane clearly d(Ilrattlsts on yon application drawings that portion of the work which tss been somplated tom tut twh;ch Is proposed.) Pape 2 of 13 Maftsaehosetty 0., irl3nent orEnrtronraertfillrotecf/on ;, Bureau of Resource Protection—Waterways BRP WW 01 waterways License or Pet,mit Approval: Except Projects Subject to Amnesty r BRP WW 02 waterways Licetse or Permit Approval:Amnesty Projects Faclay iD ta� 1. BRP WW 03 waterways Amendment to License or Permit Approval General Waterways Application 22. H the project consists of the maintenance or addition of 24. Will the docking facility be equipped to offload sewage from ten berths or more,indicate the number below: boata7 Wet Storage Dry Storage ❑ Yes �o N/A A. existing slips 25. 1 have attached project plans in accordance with the B. proposed or instruction contained in: additional 96011: A�N ❑ Appandia A(for Interim Approval applications) 23. Will petroleum products or other hazardous materials be ;tnclix oftB(for Permit applications) stanking d or hand!!t the doe"Way? C(for License applications) ❑ Yes A No' H yes",note on the application plans and describe on a Appendices A-C are found on pp.7 of this Application separate sheet any method(&)that will be used to prevent Package. possible spills,fires,explosions,Me. certification All applianu,property owners and authorized agents must sign this page.All future application correspondence may be signed by the authorized agent alone. I hereby make application for a permit or license to suthorkm the actftes I have described heroin.Upon my signature,l ague to allow the duly authorized represenualm of the Massachusetts Depammsm of Environmental Protection and the Mnuchu• setts Coastal Zone Management Program to enter upon the premises of the project site at reasonable times tar the purpose of inspection. I hereby certify that the Information submitted in this application is true and accurate to the best at my knowledge. a 14 A r w spa" Darrell Gallant Moes ✓1 tae Darrell Gallant r+ivernr arm ap�n William H. Kelley ............................_.._.»........................»._.__.»_..»...»»........._........._..__.............................................................»__. ...._, Page 3 of 13 GP aro n ti UPLAND5 Po-z- 4 �s`9ti °n co 0 n y n Z � m LOCU 5 MAP - f 9 D A4 VV HAW 0 FACE OF LEDGE as ° o T. , MLW i ELW l _ Zg x 20 m D D x .. > = F F v 0 • • D G1 F m - o J b' Z Z m s - f • N N O o o J ••• D •�• N m NEW FLOAT • NEW 12" ,0 PILE5 i CLAMPS 40 ' EXISTING PILE5 i CLAMPS MARBLEHEAD CHANNEL 30 15 0 30 TO SALEM 6. ' F T. SCALE 1" = 30' PLAN ACCOMPANYING PETITION OF SHEET I OF 2 MARBLEHEAD - 5WAMP5COTT YMCA FOR RESTORATION TO EX15TING PIER AT CAT ISLAND, 5ALEM , MA APRIL 13, 1995 P.J. LYNCH ENGINEER5 i LAND SURVEYORS P..O. BOX 1303, MARBLEHEAD, MA 01945 W _j; 0 W s „ * OSYMMETRIC q,1tjL O Obl . +J S Q O i W W k LL Z Q r W 4 r J 3 Z LL J �H 6 La 0 0 RELOCATED O F O W w N A SECTION O r 45TRINGER5 (x 18 LONG) W W 7Q z N Q N N W 408 BRACING 1Zn K u _ - - - LL0 N — J 24" ..,,., ..: n. 0 ANCOR O�e r5 �I I" LE EL III EMBEDDED CDI[SE DEPTH U = - IN LEDGE q Q Q Ni III ` as o J TYPICAL DRIVEN L PILE ON PILE I \ ZY e1 Z� LEDGE �� 3 oa x III w„ -co 0w CRO55 - SECTION �a� NOT TO SCALE ) WO III = Oen `m-2 E o o ^' NEW v8, SECTION oat 00Zi �W o 3uj \ xd 4 W G N s Huj Q o o o s o N N — PLAN ACCOMPANYING PETITION OF SHEET Z OF Z MARBLEHEAD — 5WAMP5CO7T YMCA FOR RESTORATION TO EX15TING PIER AT CAT I5LAND , SALEM , MA APRIL 13, 1995 D.J. LYNCH ENGINEER5 � LAND SURVEYORS P0. BOX 1303 I MARBLEHEAD MA 01945 I kiCommonwealth of Massachusetts Executive Office of Environmental Affairs Department of Environmental Protection 44Y 9:-19y� Metro BostoNNortheast Regional Office Baa William F. Weld Governor Trudy S.Coxe secretary,EDEA DEP File # 64-232 David B.Struhs Commissioner - RE: NOTIFICATION OF WETLANDS PROTECTION ACT FILE NUMBER Salem DATE: 5/3/95 (city/town) The Department of Environmental Protection has received a Notice of Intent filed in accordance with the Wetlands Protection Act (M.G.L. c. 131, §40) : Applicant :Marblehead/Swampscott YMCA Owner: ' Address : 104 Pleasant St . Address : Marblehead, MA 01945 Project Location: Cat Island IF CHECKED, THE FOLLOWING ITEMS) APPLY TO THIS NOTICE OF INTENT: A." This project has been assigned the following file Although a file # is being issued, please note the following: ISSUANCE OF A FILE NUMBER INDICATES ONLY COMPLETENESS OF SUBMITTAL, NOT r APPROVALOFAPPLICATION , B. No File # will be assigned to this project until the following missing information is sent to this office, to meet the minimum submittal requirements in accordance with the Wetlands Protection Regulations at 310 CMR 10 . 00 : 1 . ( ) _ copy(s) of a completed Notice of Intent (Form 3 or Form 4 of Sect . 10 . 99, whichever is applicable) and a copy of the Fee Transmittal Form, with a copy of the check for the State' s share of the Notice of Intent filing fee . 2 . ( ) _ copy(s) of plans, calculations, and other documentation necessary to completely describe the proposed work and mitigating measures to protect resource areas. 3 . ( ) _ copy(s) of an 8'hr' X 1111 section of the USGS map of the area. 4 . ( ) _ copy(s) of plans showing compliance with Title 5 of the State Environmental Code, 310 CMR 15 . 00 . 5. ( ) Proof that a copy of your Notice of Intent has been mailed or hand delivered to the Natural Heritage. and Endangered Species Program. COMMENTS : (see page 2for additional information) 10 Commerce Way a Woburn,Massachusetts 01801 a FAX(617)932-7615 0 Telephone(617)932-7600 C. (X) Other Regulatory Jurisdiction 1 . (X) Application has been forwarded to Waterways Regulatory Program to determine if a Chapter 91 License is required. 2 . ( ) Applicant is advised to forward a copy of the Notice of Intent to the Corps of Engineers for review (call 1-800-362-4367 for information). D. 401 Water Quality Certification The project, described-in your Notice of Intent', requires..a 401 Water:; , Quality Certification- from the Department of Environmental Protection and may require submittal of a 401 application form. See below for further details':, 1. ( ) Based upon the information submitted in and with your Notice, .of . Intent a separate 401 Water Quality Certification application form is not required. The Department of Environmental Protection has reviewed the plans submitted by the applicant and finds that there is reasonable assurance that the project or activity will be conducted in a manner that will not violate the Massachusetts Surface Water Quality Standards, provided that : a) the applicant receives and complies with a Final Order of Conditions from the local conservation commission or the Department; b) the Order of Conditions does not cause the loss of more than 5, 000 sq. ft . of bordering vegetated wetlands and land under water and/or the dredging of more than 100 cubic yards of land under water; c) any loss of vegetated wetlands has been mitigated with a minimum - replication of 1 : 1; and d) the project is not exempt from the M.G.L. c . 131, 54.0 the Wetlands Protection Act;. is not part of a subdivision; .' does not cause the loss of any wetlands designated as Outstanding Resource Waters; and does not cause; the 'los's of any salt marsh. '' . Therefore, provided that the above conditions are satisfied, ,.the Final Order of Conditions will serve as the Water Quality Certification for this project . This does not relieve the applicant of the duty to comply with any other statutes or regulations . 2 . ( ) Before the activity described in the Notice of Intent can commence, you must obtain a Water Quality Certification from this Regional Office . Please complete the enclosed 401 Water Quality Certification application form and file it with this Regional Office for review. 3 . ( ) Your project involves dredging of greater than 100 cubic yards of material or requires a permit from the Federal Energy Regulatory Commission for work in "waters of the Commonwealth. " Therefore, your proposed project is subject to 314 CMR 9 . 00 and requires a Water Quality Certification. Please complete the enclosed 401 Water Quality Certification application form and file it with the Department of Environmental Protection, Waterways Program, One Winter Street, Boston, MA 02108. Contact the Division of Waterways Program at 617-292-5655 if you have any questions . For more information please contact:Rachel Freed at (617) 932-7600 . Cc: Conservation Commission ( ) U.S . Army Corps of Engineers ( ) Owner ( ) Coastal Zone Management ( ) DEP - Water Pollution Control (X) Representative :William H. Kelley ( ) DEP - Waterways Tucker' s Wharf ( ) Other: Marblehead, MA 01945 2 G Pa'( =5 L A ►V p' °c" s r; 3 J J UJ .` YI t'O SYMMETRICAL — obt. W O 1 LL W Z LL 02 k r UJ o III J N Y — — — 0 RELOCATED WF c O N ' A SECTION w - D Y 4 STRINGERS (X 18 ' LONG) ZO — — — 7>. N Z a _ _ - a Z — — v' 4X8 K N W J BRACING 121 w — _cr I' 24l .. wi x. wJ lit xa I��{ Pi4. •� 0 III AN[OR Do 73 I 1" LE EL x III tAULSE 4' MIN. EMBEDDE DE lu IN LEDGE wm DEPTH A m I =!a u J TYPICAL TYPICAL PILE;ON DPILEEN p.. EF7 EZ pQ LEDGE III w„ r;v� ow CROSS - SECTION xw III ==sus ( NOT TO SCALE ) wzo 0 9 0" '.NF-W 7.8'_ .SECTION- 000 l9 .. OZZo ZUJ `�lF Uf M,J 3u-a tn`� in fJ I I W j l I I I J J. p q �J o n o n. 0 0 O S{ vui N 0 PLAN ACCOMPANYING PETITION OF SHEET Z OP Z MARBLEHEAD — 5WAMP5COTT YMCA FOR RESTORATION TO EXI5TING PIER AT CAT I5LAND , SALEM , MA APRIL 131 1995 D.J. LYNCH ENGINEER5 t LAND SURVEYORS P.O. BOX 1303 J MARBLEHEAD , MA 01845 • 310 CRR 10.99 DET PBe No (To be fro'isol by DEP) Form 3 . ary�onn Appllonl Commonwealth Depnrteent Of of Massachusetts Defense Visited states Notice of Intent of Amertea Under the Massachusetts Wetlands Protection Act, G.L. c. 131, 540 and Application for a Department of the Army Permit Part It Oeoeral Information 1 . Locations street Address_ CAT ISLAND (Salem City), Salem, Massachusetts Lot number �Map 050, Parcel 001 (assessor's map) 2. Project: TypolkPaillmailiL Description The applicant prrspnqPQ to repair/replace the existing deteriorating wood pier (150'+/-) with an existing aluminum ramp and new timber and piles as necessary, also replace ramp (5'x 40'), float (16' x 40'), 4"U duu new pie dolphins. Plans labeled Exhilift A. 3. Registry: County_&sex _ current Book t Page a, certificate (ii Registered Land) n.a. 0. Applicant Tel. Address 104 Pleasand St Marblehead MA 01945 s. Property owner same as above Tal. Address_ same as above 6. Representative Wm. H. Kelley Te(P17) 639-4454 Address Turlrvr'e Wharfxa hl head, 1144-91c4$ 7. a. Save the Conservation commission and the Department's Regional office each been sent, by certified mail or hand deliver, 2 copies of completed Notice of Intent, with supporting plans and documents? Yes W No ❑ b. Sas the fee been submitted? Yes � No ❑ C. Total Filing Fee submitted 6-0, 06 d. City/Town Share of Filing Fee '3 I, .Sa state share of Filing Fee /,�?. rO (sent to city/town) ('h of fee in excess of $25, sent to DEP) e. Is a brief statement attached indicating how the applicant calculated the fee? (� yes ❑ No Effective 11/20/92 3-1 B. Wive all obtainable pormit variances and apprn-alo required by lovel by-law been -Jbtained? res ❑ N o jQ Obtained Applied ion Not Applied Porn Buildi-5 Fermi. D.E.P. License trans. #95750 9. Is any portion of the site subject to a wetland• g�strictf,pgKorder pursuant to C.L. c. 131, S40A or C.L. c. 130, 5105? res U No c1( 30. List all plans and supporting documents submitted with this Notice of Tntent. Identifying Number/Letter Title, Date Exhibit A Locus Plan 1985 Exhibit B Plan accompanying petition of Marblehead/SwampscottYMCA' Titled: 'Proposed pier restoration- marblehead-Swampscott ynch, Engineers, 29 Commercial St., Marblehead MA 10945 in two ------------- 11. check those resource areas within which work is proposed: (a) 9/'Buffer zone (b) Inland: ❑ Bank- Land subject to Flooding ❑ Bordering vegetated Wetland* ❑ Bordering ❑ +nand Under water Body c waterway. ❑ Isolated (c) coastal: ❑ Land Under the ocean* ❑ Designated Port Area* ❑ coastal Beach- ❑ coastal Dune ❑ Barrier Beach* ❑ Coastal Bank ❑ Rocky Intertidal shore* ❑ salt marsh* ❑ Land under salt Pond- ❑ Land containing shellfish* ❑ Fish Run* � f.!-1a.ly SUG�'TL��TO l'OFfSf/i`c. S�KM *Likely to involve u.s. Army Corps of Engineers concurrent jurisdictions (/SCE see General Instructions for Completing Notice of Intent. 3-2 12. 1s the proje:t within esLimated habitat which is indicated on the most recent Estimated Habitat Map of State-Listed Aare wetlands wildlife (if any) published by the Natural Heritage and Endangered species Program? YES [ ) No ( Data printed on the�lEstimated Habitat Map NO MAP AVAILABLE ( (i f any) I Q y l _L—'J/TI QA/ If yes, have you sent a copy of the Notice of Intent to the Natural Heritage and Endangered species Program via the u.s. Postal service by certified or priority mail (or otherwise sent it in a manner that guarantees delivery within two days) no later than the data of the filing of this Notice of Intent with the conservation commission and the DEP regional office? YES [ ) No [ 1 1Ua i /Y PP)-'On k3 If yes please attach evidence of timely mailing or other delivery to the Natural Beritage and Endangered species Program. Part II: site Description Indicate which of the followin information has been provided (on a plan, in narrative description or -calculations) to clearly, completely and accurately describe existing site conditions. Identifying Number/Latter (of plan, narrative or calculations) Natural Features soils Vegetation — /r P3 Topography 1416 /T 13 open water bodies(including ponds and lakes) A) 0 Al F Flowing water bodies(including streams and rivers) UL1 (3i7 a Public and private surface water and ground water supplies on or within 100 feet of site --� Maximum annual ground water elevations with dates and location of test Lfl!)�lT iii Boundaries of resource areas checked under Part 1, item 11 above other Man-made Features: Structures (such as buildings,g , piers, towers and headwalls) Drainage and flood contrdl facilities at the site and immediately off the site, including culverts and open channels (with inverts), dams and dikes Subsurface sewage disposal systems Underground utilities 3-3 L-�1-b1 H t7' j3 Roadways and parking areas LN 1- 3 Pr,•par-_y bouncerie�. ea3-,.wnt.a and rights-of-Jwy Other Part IIIc Work Description Indicate which of the following information has been provided (on a plan, in narrative description or calculations) to clearly, completely and accurately describe work proposed within each of the resource areas checked in Part I, item 11 above. Identifying Number/Letter (of plan, narrative or calculations) Planviaw and Cross Section oft I_C1� I A IT 0 Structures(such as buildings, piers, towers and headwalls) Drainage and flood control facilities, including culverts and open channals(with inverts) , dams and dikes — subsurface sewage disposal systems i underground utilities Lj /6al 0/1- Filling, dredging and excavating, indicating volume and composition of material AS compensatory storage areas, where required in accordance with Part III, Section 10.57(4) of the regulations. Wildlife habitat restoration or ceplicaticn areas Other Point Source Discharge LA Description of characteristics of discharge from point source (both closed and open channel) , when point of discharge falls within resource area checked under Part I, item 11 above, as supported by standard engineering calculations, data and plans, including but not limited to the following+ I. Delineation of the drainage area contributing to the point of discharge; 2. pre-and post-devetopment peak run-off from the drainage ores, at the point of discharge, for at toast the 10-year and 100-year frequency store; 3. pre- and post-developKnt rate of infiltration contributing to the resource area checked under Part 1, Item 11 above•, t. Estlested water quality characteristics of pre- and post-development run-off at the point of discharge. 3-4 Port. IV: Mitigating Mess res 1. Clea iv, •�.olate!y rrd arcura)ely deacrf'v, with reference to supporting plans and calculations where necossary; . (a) All aruures and designs proposed to seat the perferarnce aterdords set forth under each resource aro specified in pert 11 or Fort 111 of the regulations, or (b) why the preaurptians set forth order each resource area speelf led In Fart is or Part III of the regulations do not pply. a" J� coastal Resource Area Types Identifying number or 'O Inland letter of support Land Subject to Coastal Storm Flowage documents The regulations promulgated under MGL C.131, S. 40 do not specify preformance standard for resource area. Exhibit B 0 coastal Resource Area Types Identifying number or 0 Inland letter of support documents 3_5 0 coastal Resource Area Typel ienti.fyidy number or ❑ Inland letter of support documents 2. Clearly, completely and accurately describe, with reference to supporting plans and calcutotioro where necessary: (a) all measures and designs to regulate work within the suffer Zone so as to ensure that said work does not otter an area specified in Pert I. Section 10.020)(x) of these regulations; or (b) If work in the puffer Zone will alter such an area, sit measures and designs proposed to Peet -he perfonoor:e standards ostr.:isheo fer tt: ed!acas• resource area, specified In Part 11 Q. Part III of these regulaticra. ❑/ coastal Resource Area Type Bordered Identifying number or Inland By 100—rest Discretionary Zones letter of support documents BANK The project is in the buffer zone to a resol irce Exhibit B area classified as Coastal Banl. The proposed work will not adversley effe t the stability of the coastal bank as required by 310 CMR 10.30 (6). 3-6 Part Vs Additional Information for a Department of the Army Permit 1. COE Application No. ito be provided by COE) 2. Salem Sound (Name of waterway) 3. Name@ and addresses of property owners adjoining your propertyt Town of Marblehead, Widger Road, Marblehead, MA 01945 City of Salem, City Hall, Salem, MA 01970 6. Document other project alternatives (i.e., other locations and/or . construction methods, particularly those that would eliminate the discharge Of dredged or fill material into waters or wetlands) . r:- 5. 8y" x 11" drawings in planview and cross-section, showing the resource area and the proposed 'activity within the resource area. Drawings must be to scale and should be clear enough for photocopying. Certification is required from the Division of water Pollution Control before the Federal permit can be issued. certification may be obtained by contacting the Division of water Pollution Control, i winter street, Banton, Massachusetts 02108. Where the activity will take place within the area under the Naseachusetts approved Coastal zone Management Program, the applicant certifies that his proposed activity complies with and will be conducted in a manner that is .:onsistent with the approved program. Information provided will be used in evaluating the application for a permit and is made a matter of public record through issuance of a public notice. Disclosure of this information is voluntary; however, if necessary information is not provided, the application cannot be processed nor can a permit be issued. I hereby certify under the pains and penalties of perjury that the foregoing Notice of Intent and accompanying plans, documents and supporting data are true n compl est of my knowledge. signature of Applicant Date signature of Applicant's Representative Date FORM "Exception to ENO /ors 6345 approved by MOUSACE, 6 May 1962" IED 100 (TEST) 1 KAY 62 "Thisdocument contains a )olnt Department of the Army and State of Massachusetts application for a permit to obtain permission to perform - activities in United States raters. The Office of Management and ludget(OO) hes approved thou questions required by the US Army Corps of Engineers. Olt Nurber 0702.0036 and expiration date of 30 September 1961 applies". This statement will be set In 6 point type. 3-7 NOrrCE OF T*►c'FTrr FEE nWS rrr1RL Fppr) DEPAROWn OF FNVI11"404PAL PRMWTION DIVISION OF WETLANDS AND WATZRKRYS NOTICE OF IHITNP (NOT) APPL1ClhNP: PPOPERlY. OWNERt Name Marblehead/Swampscott YMCA Name SAME IN Pleasant St. SAME Street Street City/Town Marblehead City/Town Beverly state MA Zip Code 01945 state MA Zip Code 01945 Phone Number (617) 631-1322 Project Location: Street/Lot NumberCat Island, Salem Sound city/Town Salem DEP FILE NUMBER (if available) NOI FIIJNG FEE DISPVrM FEE Total NOI Filing Fee: $ 60• — Total Disputed Fee: $ (as determined in Notice of State Share of Filing Fee: $ /2.3-0 Insufficient Fee letter from (1/2 of fee in excess of. $25.00) conservation commission) City/Town Share of State Share of Fee: $ Filing Fee: $ ���� S� (1/2 of total disputed fee) City/Town Share of Fee: $ (1/2 of total disputed fee) INSIRUCnONS 1. Send this Fee Transmittal form with a check or money order, payable to the Camonwealth of Massachusetts, to the DEP Lock Box at: Department of Environmental Protection Box 4062 Boston, MA 02211 2. Attach acry of this form to the Notice of Intent submitted to the local Conservation Ccamaission. 3. Attach a co of this form and a rop}t of the DFP check to each of the Notice of Intent forms sutmitted to the DFP regional office. 11/10/89 FILING FEE CALCULATION WORKSHEET plants, roadways/driveways NOT subject to 310 CMR I0.53(3e) SMALL NOT BE SUBJECT TO ADDITIONAL FEES CATEGORY 1 $55 PER ACTIVITY f No. If sold activities are reviewed under a SINGLE NOI L'. Construction of EACH ROAOWAY/DRIVEWAY within the _ _ A. Existing Mouse/reel dentlal lot (addition, deck, — Buller zone or Coastal Floodzone NOT reviewable gerage,pool, shed,or DRIVEWAY) under 310 CHR 10.53 (3e) and NOT associated with • SFN B. Site Preparation (ramovnl or vegetation, oxce- _ D. HAZARDOUS WASTE CLEANUP (except as noted In _ vstion grading where home construction isn't category 4) proposed under this NO[) C. Control of nuisance vegetation by removal, herb- — — TOTAL CATEGORY 3 ACTIVITIES ioldes, etc. within a Resource Area PER LOT pursuant to 310 CMR 10.53(4) CATEGORY 4 $725 PER ACTIVITY D. Resource Area Improvement pursuant to 310 CMR _ A. EACH WETLAND FILLING/CROSSING LIMITED PROJECT _ 10.53 (4) other then 1C above ACCESS ROADWAY/DRIVEWAY under 310 CMR 10.53 (3a) associated with COMMERCIAL, INDUSTRIAL, INSTITU- •E. SEPTIC SYSTEMS or any pert thereof/repairs, _ TIONAL DEVELOPMENT OR RESIDENTIAL SUBDIVISION replacement, UPGRADING CONSTRUCTION. (*see category Zg for SFH driveways*) F. Monitoring Wells/well _ — R. Flood.Control Structures (construction, REPAIR, - — TOTAL CATEGORY 1 ACTIVITIES and/or mnairicatlon)_ C. LANDFILLS-public A private _ CATEGORY 2 $250 PER ACTIVITY D. SAND A GRAVEL OPERATIONS _ A. EACH NEW single Family house (SFH) INCLUDING — E. NEW railroad lines or EXTENSIONS of EXISTING site preparation, retention/detention basins, lines utilities, SEPTIC SYSTEM, roadway/driveway other than those pursuant to 310 CHR 10.53(3e) F. Control of NUISANCE VEGETATION under 310CMR _ IF reviewed under a SINGLE NOT 10.53(4) other then on a SFH lot 8. •Petking lot/ ANY size — G. BRIDGES (construction, reconstruction, expansion,_ C. Beech Nourishment maintenance) ASSOCIATED with a SFH lot - _ D. Coairtal Activities pursuant to 310 CMR 10.24 11. Raising or lowering WATER LEVELS_ — (70-ie) including 7a-Electric Generation facilities, I, ALTERATION OF RESOURCE AREA A diversion of water 7b-PuL4ic Utilities, 7c-Coastal Limited Projects associated with HAZARDOUS WASTE CLEANUP, non . lncludLig REPAIR/MAINTENANCE of EXISTING piers, mosquito control project@, or for ANY OTHER PURPOSE bulidingte culverts, etc. NOT EXPRESSLY IDENTIFIED ELSEWHERE IN THIS FEE SCHEDULE E. LIMITED Ph+OJECT ACTIVITIES pursuant to 310 CMR — 10.53 (s-dA J. DREDGING ACTIVITIES not associated with a NEW (s-dAANO 310 CMR 10.53 (f-1) per footprint dock, pier or other structure described In category 3 F. NEW agricultu.ral/aquacuitursl projects — TOTAL CATEGORY 4 ACTIVITIES G. EACH WETLAND D- _ A IVEKAY CROSSING associated with a SFM pursuant':to 310 CMR 10.53(3x) CATEGORY S $2 PER LINEAR FOOT, TOTAL FEET NOT TO BE LESS H. ANY point source• discharge — THAN $50 NOR MORE THAN $1000 1. ANY OTHER ACTIVITY not described In categories A. Construction, reconstruction, REPAIR, or replace-, _ — ment of DOCKS, PIERS, REVETMENTS, DIKES, orother 1,3,4 A 5 engineering structures on COASTAL or INLAND RESOURCE TOTAL CATEGORY 2 ACTIVITIES AREAS Including the placement of RIP-RAP or other material on coastal or inland resource areae CATEGORY 3 $525 PER AI.TIVITY TOTAL CATEGORY 5 ACTIVITIES A. SITE PREPARATION for. ANY development other then TOTAL FILING FEE CALCULATED for a SFH INCLUDING removal of vegetation, PERSON C CULAIING TEE SCHEDULE (Print Nemo) excavation h grading when actual construction is / NGFE �/ /! Z—Zt N NOT proposed under this NOI - B. CONSTRUCTION OF EACH BUILDING 7//q r192dAt7_. BUILDING within commercial, _ y 7� Lndustriel, institutkonal, or apartment/condo/ TELEPHONE NUMB is In a BUFFER ZONE or RESOURCE AREA. Associated townhouse type of de.�elopment, ANY PART of which activities, site pr,ypsrstion retention/detention SIGNATURE DATE basin construction,peptic systems, perking lots, Utilities$ point aquroa discharges, eewarage treatment MAtx Newsktter 714361KELLEY MARINA DEVELOPMENT COMPANYP. O. BOX 212 MARBLEHEAD. MA019A5 �t(pfI /] ))RI R ` � '7�'� ./T..LG/Z.. ... -. - %/a �J T Walional Gmrd Bank • --^^ ✓{'inrblrhrrsd.✓tirsa. 1:0 L 1 301. 3001: 1160 L 17 304911• V. 36-- 1435 KELLEY MARINA DEVELOPMENT COMPANY P. O. BOX 212 r 53-430/113 01 MARBLEHEAD. MA 945 �/ d/���L ly//•� PAY TO T11r. RDFA Or 2, 3 V._ L L A R 5 Wafional Grand%f ank •••�^ ./�inrhlrhmd,.Airsaa. I ,(/C�'Z/`L(.. L�/� . 1:01L3043001: 11.010 304911' L1. 35 Sulam. Massachusetts 01970 yASS�N�� i;OFICF TO ABUTTERS,, NOTICE OF INTENT PUBLIC HCARTNG In accordance with the secr,;td parap_raph of Massachusetts General Laws, Chapter 131, Sectiur 40, you are hereby notified of the tollowiug. The Salem Conservation Commission will hold a p!iblic hearing on Thursday /APRIL a 9 _at x_30 P.M. at One Salem Gr^en, Second Floor Cunf•rence Room, i a Notice of huent filed under the Massachusetts Wetlands Protection Act (G.L. C.131, s.40). Marblehead/Swampscott YMCA p1.)fuses to —.— NAME OF APPLICANT L re air/re lace the_ existin>? deteriorating wood pier (150'+/_) with __ — aluminum ramp and new timber and piles as necessary, also replace ramp (5'x 40'), float (16' x 40'), and add new pile Cat Island, Salem Sound, Salem, Massachusetts LOCATION OF PROPERTY Plans and other infot mation are on file in the Conservation Cor. nission Office on the second floor of One Salew Green in the Plamting Department. For ft!rthe; assistance, ptease contact the Conservation Commission at 745-9595 x 311. All interested persons are in ited to the public hearing. jmdh\nomabm.l - AFFIDAVIT OF SERVICE Under the Massachusetts Wetlands Protection Act (to be submitted to the Massachusetts Department of Environmental Protection and the Conservation Commission when filing a Notice of Intent I, William H. Kelley, hereby certify under the pains and penalties of perjury that on y Y5� I gave notification to the abutters in compliance with the second paragraph of Massachusetts General Laws Chapter 131, Section 40, and the DEP Guide to Abutter Notification dated April 8, 1994, in connection with the following matter: A notice of Intent filed under the Masschusetts Wetlands Prot ctio Act by Marblehead/Swampscott YMCA with the City of Salem Conservation Commission on 5" for property located at Cat Island. Salem Sound, Salem MA The form of the notification, and a list of the abutters to whom it was given and their addresses, are attached to this Affidavit of Service. Name 7G Date List of Abutters Notified Notice of Intent Cat island, Salem, MA 11 April 1995 (Certified/return receipt mail) Town of Marblehead, Widger Road, Marblehead, MA 01945 City of Salem, City hall, Salem, MA 01970 ads of 844" AV Zi SENDECompiate Items t and/w 2 for additional services. I also wish to receive the• Complete item.3,and Oa a b. following services (for an extra • Print Your name end address on the reverse of this form so that we can feel:D return thla pard to You. fiI E does not parmh.�to the front of the mdlpiece,or on the beck 11 apace 1. ❑ Addressee's Address .I Write"Return Receipt Requested"on the mellplece below the enlal•number w2. ❑ Reatrlcted Delive x�`"r*ahI • RaWmReselpt vela claw to whomtha Welewes tlNiwrad andtbe iotary I c delivered. Consult postmaster for fee ip H'�y •" v 3. Article Addressed to: 4e. Article Number 4b. Service Type 1 W/U tl; Registered ❑ Insured_;!rA I , r�q �Q `9 Certified ❑ CODU.11 (/11,/�y Cv �� y�Y O/9�f ❑ Express Mail ❑ Return ac pt ford{ x.•.. Marche /IfYiQf6tZWh pj �" 7. Date of Delivery .- Q cc S. Signature (Addressee) S. Addressee's Address(Only If requested and fee Is paid) ac B. Signature (Agent) PS Form 3811, December 7991 waoPo ass as2auDOMESTIC RETURN RECEIPT' c � •SEomplate NDER: items 1 and/or 2 for additional serviaa. I also wish to receive the t I Y k 0 • Complete items 3,and 4s 6 bl following services Ifor an extra I • Print your name and address on the reverse of this form as,that we seni!C ' • return this card to you. feel: • Attach this form to the front of tbe maiiplece,or an the back If space 1. ❑ Addressee's Address E time not permit. L �;-'r:�`„ 1 Write"Return Receipt Requested"on the mallpiaaa bellow the number 2. ❑ Restricted Delivery ( • The Return Receipt vest show to whom the ankle was d red b a I ;. L , I e eenvered. Consult postmaster for fee. t ! :;:Y 3. Article Addressed to: 4s. Article Number I } sea ,' ,'=w E E + k� t 4br Service Type (� 7/TLL77 ❑ 9eglittered ❑ Insured y'�/ Certifled ❑ COD 'S I FA r / ❑ Express Mail ❑ Return Receipt for l I °"• 1 � 0/19"*Q 7. Date.of Delivery � I 1 = 5. Signature S. Addressee's Address if re uested t ••":'l�'n° ¢ 9 Y q ,, ..,,5..,y I 2 and tee is vein � , !` " cc 8. Signature (Agent) t �z'I PS Form 311B 1 9,84c"Ilf I?IV% *U.&QPo:uwa-2ssa/4 DOMESTIC RETLTI%QEC IPT �72 Receipt for 84 204Receipt for Certified Mail Certified Mail No Insnot u Coverage Provided No Insurance Coverage Provided Is not u i see for International Mail AV��.= Do not use for International Mail ISee Reversal (See Reversal Sent o DN — L Sent tAIC'ON snCr%TNa �! LC. Slreel and No. P.O.•Stele and ZIP Code. Q/7 C d P.O. I I an ZIP CCi 5,01-111. oda n Postage O Postage p Carried Poe $ Z Certified Fee ') Special Dallany Fee V LLO �� V , Resukud-Dslivarv,Fes _ t Return Receipt Showing Retwn Receipt Showing to Wham 6 Dale D•liveratl to Whom a Dale Delivered Return Receipt Showing to Whom, Return Receipt Showingto Whom, Dote,anTOTAL pd�FAddraeGe s AaMan Dere•and Addressae:a 'r'"Fe' G Fns r-1 �',i� v� Z f~t� TOTAL Poatag Q, ---- TOTAL Fees .). ! ^\ S z ._. 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