3A WINTER ISLAND ROAD - BUILDING INSPECTION 3A WINTER ISLAND ROAD
Sll1
llll
No. 153L-2
HASTINGS. MN
LOS ANGELES-CHICAGO-LOGAN.OH
MCGREGOR,TX-LOCUST GROVE.GA
U.S.A.
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p
Mastwchosetts Deparhnart of En bilulu rentat protecBon --
Bureau of Resource Protection—Waterways
BRP WW 01 Waterways License or Permit Approval:
Except Projects Subject to Amnesty
........._......._..
BRP WW 02 Waterways License or Permit Approval:Amnesty Projects Factl*ID(itmrown)
BRP WW 03 Waterways Amendment to License or Permit Approval
General Waterways Application
in trai s-
Uors an pp.12
a is before Project Information
completing
ndon A-B of 1. Which parmh category are you applying fort 6. The water body at the project site is:
this liam G BRP WW 01 XBRP WW 02 G BRP WW a1 (check 1yr mon of both a d b)
r.avrra.h a. Irrdal O FiNedTidelands G Great Pond
rim"" 2• Applicant D.M.H. Realty Trust D rMram O Uncertain
Peter Haywood, Trustee b. W'Nah,ml G Man-Made ❑ Uncertain
+� ar,. 3A Winter Island Road 7. Project description:
i lar..Me.._ „_ Y AM= , MA 01970 Maintain existing pier, ramp, floats,
Salem - marine-raitway;•seawatt;fitF,-rip-rap
cron,.n and slope protection.
............................ (508) 745-3797
INJO)MIOR) Im+l
3. Authorized agent
William H. Kelley
-- — B. proposed use(check one or re of both a and b):
Two Breakwater Drive A. O Private �'Commereial O Industrial
AM= _Chelsea, MA 02150 Governppllain beOiowj eiliry of private tenarrry
°"a00 617-884.6811 am — b. Water-dependent
❑ Accessory ❑ Nonwater-dependent
Irceae S. Description of existing and proposed use(s):
4. Property owner -AOG966- 41iaArays--_
D.M.H. Realty Trust
11e same
rxxnar aaia a oe oiaa,rdoa rn,:,
rreraererrarra.a
RA--
Lamm 10. Will any public benefit be derived from the p
"-3A—V&OJeX_JSIanrI Rnarl O Val ❑ No n
p� O N amwrr is'yss'.explain below.
calem ccev
ayAas
CAN*
5. Name of the wells body,and the wader body N Is a
tributary to,at the project location
Page 1 of 18
Atari shoselts Deportment of Earlronmental Proleotloo
Bureau of Resource Protection- Waterways TnnairidTi!%--'
01 Wcepo atsSbjteoAe :BRP WWFsP eectmnsty
BRP WW 02 Waterways License or Permit Apprttral:Amned:4 Projects Faciiryro(etImown)
BRP WW 03 Waterways Amendment to License or Permit Approval
General Waterways Application
11. For nonwaterdependent projects attach a statement IS. is this4ntion for app o an Amnesty Interim Approval?
giving the following information;how the project is C Yes
consistent with the coastal Zone Management Program p'Yu',wM i No
lane
policies•and how A Serves a proper public purpose and A p prepared in accordance with Appendix
provides a greater benefit than a detriment to the public's
rights in tidelands and great ponds. 16. Approximatey,how long will it take to complete the
N/A project after all required permits hm been issued?
NSA
James -----
.........._..__._......_._........ __.....__._.._.— 17. What is the approximate total cost of the project liner •°--
12. Will there be any discharge(either direct or indirect)of matensts d labor)? _ 0
waste material or waste water into State waters from the
construction o
......._..............._......................................................_......__.._._._..
,r(q�p_ematron of the project? .
D Yes Yt No 18. Is the project she located within one or more of the
13. Have you Previously applied
applied to,or obtained permit or NO
other authoriation from,any 89eney(Interstate.federal, C Area of Critical Environmental Concent
State.or Local)for any portion of the project described in 17 Ocean Sanctuary
this application?,( O Designated Port Area
C Yes yY No O Uncertain O Uncertain
tl'Yes'e provide the follochapter
1 intormatlon;(efthprop A 19. Is the project site in a municipality with a state approved
Separate sheet for chapter 91 licenses for the property; Harbor Plan?8d license numbers,dates issued and recorded,book and
page). C Yes C Plan Under Review C No Ofnm wn
See attached sheet it yes,is this proposal consistent with the plan?
amm ar ser pAaery C Yes O No
ryeearaeo 20. Ail licenses issued by the Department will contain a
condition stating the term for which the 8eeese is in enecL
esu II an etetded term is desired•attach appropriate doeumeo-
Cation as required by 310 CMR 9.15(1)(b}(d)and chat*
here. C(Not apptimble to walerdependem amnesty
Ammar pronto)
Am:aaar°' 21. List the name and complete mailing address of ash abutter
(attach additional sheds,a necessary)
14. Has any work commenced or has any portion of the
project for which you are now uekmo Approval been
completed?
C Yes 1r"(l NA See attached sheet
e'Yes'.Qeseribe below.State when the work was
completed and who performed the work.
(Plana clearly dinureellsts on your Application
drawings that portion of the work which h»a been
complaled from that wh;ch is propoad.)
Pape 2 of 13
Macnchasetls Doparbnont of Emhonme►Kit hobtcBon
Bureau of Resource Protection—Waterways
Waterways ctsSbor Permit WW 01 ceeat mnts ^----
BRP WW 02 Waterways License or Permit Approml:Amnesty Projects F«�i�r iD to wno�"v
BRP WW 03 Waterways Amendment to License or Permit Approval
General Waterways Application
22. If 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 bods? N/A
Wet Storage Dry Storage ❑ Yes ❑ No
A. existing slips N/A 25. 1 have attached project plana in a:cordance with the
B. proposed or instructions contained in:
additional slips: NIA ❑ Appendix A(for Interim Approval applications)
23. Will petroleum products or other hazardous materials be ❑ Appendix:B(for Permit applications)
stored or handyd u the docking fachty7 )(Appendix C(for Ucsnse appiicdions)
❑ Yea ~X No NIA
If'yei,note on the application plans and describe on a Appendices A-C are found on pp.7 of this Application
separate sheet any mrthod(s)that will be used to prevent Package.
possible spills,fires,explosions,ate.
certification
All applicants.property owners and authorized agents must sign this Piga.All future application correspondence may be
signed by the authorized agent alone.
I hereby make application for a permit or license to authorize the activities I have described heroin.Upon my signature,I agree
to allow the duly authorized representatives d the Massachusetts Department of Environmental Protection and the Mawchu.
am Coastal Zone Management Program to enter upon the promises of the project she at reasonable times for the purpose of
inspection.
I hereby certify that the information submitted in this application is true and accurate to the beat of my knowledge.
eaevrssvrw
Peter Haywood, Trustee
AMOVOWNIMOVIUM
Peter Haywood, Trustee
Preleara //////
Gf/� Ace � 'oymrl
4"ft won
William H. Kelley
_..........................._...._.__._..._......_...._.. ____ ......._.....................___............................_......_...._............
..........__._ _ _ --•
Haeaene
Pape 3 d 13
Massachusetts Department of fnrtrom oodal Prefectlon
Bureau of Resource Protection—Waterways T; ;(�}---`
BRP WW 01 waterways Ueenu or Permit Approval:
Except Projects Subject to Amnesty
BRP WW 02 waterways ucense or Permit Approval:Amnesty ProjectsKiTro
BRP WW 03 waterways Amendment to license or Permit Approval
General Waterways Application
Waterways Dredging Addendum
Pyne type or 1. Waterways File
pmt dearly all
information
provided an
IN tori. t. Provide a description of the dredging project.
3. What is the purpose of the dredging?
4. What is the volume(cubic yards)of materiel lobe dredged?
S. What method Will be used to dredge?
---....__r..........._......_.._._._.._ __.__-._._._..__.._.............................................._.
6. Describe the disposal method thed will be used and give the disposal location(include a separate disposal site bWion map).
7. Applicant
ser
a�
ne
Pape 4 of 19
Massachmift eeparWent of fnrtromwobt Probeeon
Bureau of Resource Protection—Waterways
BRP WW 01 Waterways License or Permit Approval: Tnnsmiful
l
Except Projects Subject to Amnesty
BRP WW 02 waterways License or Permit Approval:Amnesty Projects facility ID(eanown)
BRP WW 03 Waterways Amendment to License or Permit Approval
General Waterways Application
' Municipal Zoning Certificate
please gpor amrwar+ven
Print Way au
bli nnabon Peter Haywood, Trustee
provided on caws
town. Reef wsws
3A Winter Island Road
ftjwtx raawea
Salem, MA
Salem Sound
WWW t, _.
slope protection.
Maintain existing pier, ramp, floats, marine railway, seawall, fill, rip rap &
amipanrvweeoseasuaroewo:
lk�g4j=rag..0
To be completed by municipal clerk or appropriate municipal official.•
I hereby cwtilythat the project described above and more fully detailed In the applicant's waterways license application and
plans not in violation of local zoning ordinances and bylaws.
l-". - Y
nrarsr �
01
SgnMdfaeeol�fir
pe/tanr
�7
a�
Pages of 13
R maebasetdP Department of Enrlronmenta/Protectlon
Bureau of Resource Protection—Waterways
BRP WIN 01 Waterways ucefse or Permit approval:
Except Projects Subject to amnesty
BRP WW 02 Waterways Llcerse or Permit Approval:Amnesty Projects faraifyin ill known)
BRP WW 03 Waterways Amendment to license or Permit Approval
General Waterways Application
Municipal Planning Board Notification
Puree type or print
cWd/ellwolms. _._.._...............
—_._.--.__.._.._.....__.........__— .._.. __.__....__..____....__........_......_._.r_...
bon provided on this ft"WNuen
form. Peter Haywood, Trustee
NIUMtoAfiPikent: aeeraarpeaa
This Municipal
PUMN ears 3A Winter Island Road
Notification aeea
muetbesubmitted Rmecrfror:ale"a _� -----
alOeQ With lap°it Salem MA
onpislappaeeea ,
maiarm.if 4
cannot be signed by C y.9a-
she appf fills Salem Sound
municipal official it
theeme of delivery, ..............................».............._...._._.................__. _..........._.
,yam _.
the appliwd should
mh ung he or she
ronin-me
maw sipnebm
before submitting ,..
wet completed
aooeeaeal p Qe To be completed by municipal clerk or appropriate municipal o>ficiat
b OEP.
I hereby certify that A copy of the completed waterways license application and plans described above was submitted by the
Applice at to the municipal planning board on
_di....._.._._....._..._..__ r
d4yfeaa....
Do
Page$of 13
PERMIT APPLICATION 71806
BRP WW 02 ,.nI"
D.M.H. Realty Trust Foalr ID (if known)
Peter Haywood, Trustee
3A Winter Island Road, Salem, MA
ADDITIONAL INFORMATION
Question #13. Chapter 91 licenses for the property.
License # Date issued & recorded Book and Page
None found
PERMIT APPLICATION
BRP WW 02 anamtte
D.M.H. Realty Trust Feelfity !D (b knownl
Peter Haywood. Trustee
3A Winter Island Road, Salem, MA
ADDITIONAL INFORMATION
Question #21. List the name and complete mailing address of each abutter.
Block Lot Name Address
044/019 Mary Ballou 5 Winter Island Road, Salem, MA
044/017 Overlook Trust 3 Winter Island Road, Salem, MA
044/015 Allan R. Stummer, Et Al 5 Columbus Avenue, Salem, MA
044/153 Frederick W. Simpson 20 Columbus Avenue, Salem, MA
044/152 Duncan McInnes 22 Columbus Avenue, Salem, MA
044/151 Dionne, Jean P. 26 Columbus Avenue, Salem, MA
044/014 Diane Haywood 3 Winter Island Road, Salem, MA
PERMIT APPLICATION 71806
BRP WW 02 re tt
D.M.H. Realty Trust Fedut—y tv ritnow
Peter Haywood, Trustee
3A Winter Island Road, Salem. MA
ADDITIONAL INFORMATION
Proof of Pre-1984 existence:
Attached please find a copy of the Salem Board of Assessors Record of
Ownership for the applicant pre-dating 1984.
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PERMIT APPLICATION 71806
BRP WW 02 .nsmtt
D.M.H. Realty Trust FSMIY W 0 knDMV
Peter Haywood, Trustee
3A Winter Island Road, Salem, MA
ADDITIONAL INFORMATION
Proof of Post-1984 use:
Attached please find an affidavit from the abuttor affirming use without
changes since 1 January 1984.
Mrs. Mary E. Ballou
5 Winter Island Road
Salem, MA 01970
28 October 1993
Ms. Jill Provencal
D.E.P. , Waterways Division
One Winter Street
Boston, MA 02108
Re: 3A Winter Island Road, Salem, MA, D.E.P. Amnesty License
Application.
Dear Ms. Provencal:
Mr. Peter S. Haywood of 3A Winter Island Road, Salem, MA has
informed me that he is applying to the D.E.P. , Waterways Division
for an Amnesty License for his site at 3A Winter Island Road,
Salem, Mass. (Map 044, Lot 013) . He further stated that this
license involves no site work or alterations.
The existing pier, ramp, floats marine railway, seawall, fill, rip-
rap and slope protection configuration was in place prior to 1
January 1984 .
Very ,lAruly you .
1 .
Ma E. Ballou
Pr perty abuttor
at 5 Winter Island Road, Salem, MA
Notary Seal
41W01
PERMIT APPLICATION 71806
BRP WW 02
D.M.H. Realty Trust
Peter Haywood, Trustee
3A Winter Island Road, Salem. MA
ADDITIONAL INFORMATION
Conservation Commission report of status
KMARINA
DEVELOPMENT CO.
k"tAftwaftN
2 BEAKCHELSEA.ATMA qy O�O
199'
TO: Ms. Debbie Hurlbert `y VG��
Salem Conservation Commission
City Hall
Salem, MA 01915
FROM: William H. Kelley, Agent
DATE: 28 October 1993
SUBJECT: D. E. P. Chapter#91, Amnesty License Application
LOCATION: Man:044 Lot 013
Street: 3A Winter Island Road
OWNER: Peter S. Hatwood
DESCRIPTION: Boatyard
CONCOMM INFO: 3A w'-nke Tsland -QoLAj recew,cd an Orde< Ce�d lrm s o �2��a<y
Con`Itfic64c, db Coy-vl-q"E :i550ed-
REQUEST: Please be informed that the application for licensing under the provisions of
Chapter #91, Public Waterfront Act is underway Please research your files
for past Orders and or Certificates of Compliance at this site.
Please address your findings in letter form to the Department of
Environmental Protection, Waterways Division. Return to me and I will
forward same with the aoalication
Thank you for your time and attention.
VervA sin rely;
Enc: Topographic Map Willia . Ka y,
Agent for Own
MARINAS - FROM CONCEPT TO COMPLETION . 617-884.6811 • FAX 617-884-1103
Form 5 MOE Fite No. 64-14 5
`sem (To be provided by DEOE)
ry`1 City/Town
Salem MA
Commonwealth
of fJiassachusetts
AppGcwt
�+ '-Va
Order of Conditions
Nliassachusetts \Wetlands Protection Act
G.L. c. 131 , §40
From Conservation Commission
Peter Haywood
. TO DP41 Realty Trust -Pornr Nay,.,nnA or a1 trs.
(Na!'ne of Applicant) (Name of property owner)
Address 3A Winter Island Road, Salem, PLA Address 4 Columbus So. . Salem. PIA
This Order is Issued and delivered as follows:
❑ Iby hand delivery to applicant or representative on (date)
U by certified mail, return receipt requested on Januarv,, 16 1987 (date)
This project is located at 1A Winter Tqlnnrl Rnatj c i em MA
The property is recorded at the Registry of Essex South -
Book 6658 Page 484
Certificate (if registered) Winter Island Yacht Yard Inc.
' .The Notice of Intent for this project was filed on 1 /9/87 (date)
The public hearing was closed on 1/16/87 (date)
Findings
The Conservation Commission 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
Commision 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 ® Storm damage prevention
❑ Private water supply ❑ Prevention of pollution
❑ Ground water supply ❑ Land containing shellfish
❑ Flood control ❑ Fisheries
5.1
Th-refore, the Congprua r i nn Cnaimi sslon hereby finds that the following conditions are
necessary, in accordance with the Performance Standards set forth in the regulations,to protect those inter-
ests checked above. The Commission 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 fol-
lowing conditions modify or differ from the plans, specifications or other proposals submitted with the Notice
of Intent, the conditions shall control.
General Conditions
1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory meas-
ures, shall be deemed cause to revoke or modify this Order.
2. This 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 hereunder 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. Any fill used in connection with this project shall be clean fill, containing no trash, refuse, rubbish or de-
bris, including but not limited 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,it
such an appeal has been filed, until all proceedings before the Department have been completed.
8. No work shall be undertaken urOl 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 to be done. The recording information shall be submitted to the rnm—i s si nn
on the form at the end of this Order prior to commencement of the work.
9. A sion 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 Quality Engineering,
File Number 64-145
10. Where the Department.,of Environmental Quality Engineering 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.
11 . Upon completion of the work described herein, the 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 plans and special conditions: l
f
5-2
Plans:
Title Dated Sicned and Stamped by: On File with:
Proposed Imnrrn+a—vs 7[,URS n T T :• -i� II.�.i-. = c t r' ^n.commisioi
tinter Island Yacht Yard
Special Conditions(Use additional paper it necessary)
Work shall conform to the above referenced plans and Notice of Intent
All ccnstrurtion shall take place on the landward side of the project
, 1
...................................................................................................................................................................................
(Leave Space Blank)
(
5.3A
Issued Ey °' P ''AConservation Commission -
Signature(s�-%,I'��
f/ J
This Order must be sioned by a ma;ority of the Conservation Commission.
On this jLth day of T 19 gr before me
personally appeared Peer Ha,?vmod to me known to be the
person described in and who executed the foregoing instrument and acknowledged that he/she executed
the e as his/ter free act
and deed.
Notary Public My commission expires
The applicant,the owner,cny person aggrieved by this Order,any owner of land ebutling 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 Department
of Environmental Quality Engineering to issue aSuperseding Order,providing the request is made by certified mail or hand delivery to
the Department within ten days from the date of issuance of this Order.A copy of the request shall at the same time be sent by certified
mail or hand delivery to the Conservation Commission and the applicant.
Cetach on dotted line cnd submit to the F-` (-nnco,--•--+.... r..F?
� v
SUN
EL W D .�
W�rteR xs1.ANo aD.
30O•� LOCUS MAP a
es�� A9�c Jv��pER c\
t2 c �MeU�ON DVE
AV&F
Fi4F SUS AVE$ ' ��F A' x 16' ALUL4.
2p OFR�C ' S4CFMh 4
RAMP
�T� o
k M
FL6oA WOOD
Mq Ave. l c
r (L) 5'6" x 10' WOOD
ALLAN, R. STUAMIER,ET.AL FLOgTS
S COLUMBUS 5Q. `
SALE.U , AAA. 1r
HHVV MARY E. SALLOU
RIPcy 5 WINTER NAND
ROAD
\TIIASEF� SALEM MA.
®'/'►u LALNJCNING
N rF S4 ' -�v PLATFORM
OVERLOOK NOMINEE
TRUST
3 WINTER =SLAND ROAD 144, 1g ,
SALEM , MA.
Ovo 9°• WINTER =BLAND ROAD
t.
NOTE' TH5 RAN NOT BASED ON 0 60 120
AN INSTRUMENT SURVEY AND 910ULD
NOT BE USED FOR DETERMINATION
OF PROOERTY LINES.
SCALE 141 , 601
PLAN Ac a.Imu*NG PETITION OF
-MUST PLAN SHEET I OF 3
_FPIFT X& A 4 aK WOOD, 'TRU'iT'm
3A WINTER ISLAND RD., SALEM,MA.,
EX157ING PIER RAMP, FLQAT5,
A�
MARINE RWIiAY, 9E/Wib4L"L, FILL ,
RIP RAP d SLOPE PR4y MCTIGN
DANIEL J . LYNCH Auo s, I.
PROFESSIONAL EWINEER9 <
.......... 4 ORS _. .�.�..w.___....Y.�,•_.__.M. �
x
g
� 0
b "
n - -ion 1452
�a ;4; g
1 u O JUNIPER COVE
WOOD PIER, SHEDS, CRANE,
MARINE R.R., RAMP, FLOATS 4'x i6' 8'1 E4' wOOD
.. . ° ALIM. ; FLOAT
6.4' 1AHW
/ IN4RMdE R.R 9 IM1LW*0.0
1' ELW
v (2) 3'6' x 20'
N WOOD RATS
[ L
f
SECTION B - B I
O 40 80
Q4
Z n f SCALE 1 " = 40'
In x e
oN
T \
W
3•
Lfto_N00CCKF.d5
E
8'6"
CTION A-A'
'i LONG AVG.
MHW V
8' CONCRETE BLOCK5
"HW 5ECTION C -CI
4 X 50"t LONG AVG.
"MARINE R.R.
5'
RIP RAP
MHW
51 5ECT1 ON D- D f
x 30'= LONG AVG.
O 6 I Z
5CALE t V • 6'
PLAN. .__ NYING PETITION OF
Q.M-N,iCEAL Y lltu&r SECTIONS SHEET 3 of 3
Prt6 1-}��wl OOD, 'r`R.USTiE
3A WINTER ISLAND RD., SALEM,MA•, A7
EXISTING PIER , RAMP, FLOATS,
MARINE RAILWAY, SEAWALL, FILL,
RIP RAP f SLOPE PROTECTION
DANIEL J. LYNCH Aya s, Ift
PROFESSIONAL a GINEERS 4 YIDR5
I
Massachusetts Department of Emrlronmental Protection '
Bureau of Resource Protection—Waterways Program Transm-- ittall
BRP WW 01 Waterways License or Permit: Non Amnesty
l BRP WW 02 Waterways Amnesty license or Interim Approval
BRP WW 03 Waterways Amendment to License or Permit
General Waterways Application
Municipal Zoning Certificate
Please type or .__
print dearly all Nmeol��Dllrrnr
information �.�-�,
mis °" C3 form. l �,
prposeverawfass
Gly/roan
�^ I
wdferaay
..............................
......
_....
_................
_.....
__.__.._._.......
Dg$Wpeon Mpropasen ese or cAry In use
��. .sao ....y�. .. ..}.......11avl_,.... _-
............. Q��� S.....,....._ . ......................................._._........_......................................................_...__...._--
R,
To be completed by municipal clerk or appropriate municipal official:
I hereby certify that the project described above and more fully detailed in the applicant's waterways license appicalim
and plans is not in violation of local zoning ordinances and bylaws.'
Pont One of NrJpel 1
soma arMeMtlparmcaf
TWO
rdKOW
Page 4 of 8
Rev.2193
�u(
80 aa
Form 2 o odEfa�e rdo.
be provided by DEOE)
` (P� c f, I'4(To
d
9YIPF iU.Sa11em,
Commonwealth . Peter Hayward
of Massachusetts Appiivnt
Determination of Applicability
Massachusetts Wetlands Protection Act, G.L. c. 131, §40
Fro Salem Conservation Commission Issuing Authority
. . .,>Pet�rHaywaxd same
T
(Name of property owner)
(Name of person making request)
12 .Columbus• Square: Address 3A Winter Island Road
Address
This determination is issued and delivered as follows: .
D b hand delivery to person making request on 'date)
1 certified marl,return receipt requested on (date)
Pursuant to the authority of G.L c. 131, §40,the
Salem Conservation Commission
has considered your request for a Determination of Applicability and its supporting documentation,and has
made the following determination(check whichever is applicable):
This Determination is positive:
011 The area described below,which includes all/part of the area described in your request, is an Area
Subject to Protection Under the Act.Therefore, any removing,filling, dredging or altering of that
area requires the filing of a Notice of Intent
2 p The"work described below,which includes all/part of the work described in you�'request,a within,
an Area Subject to Protection Under the Act and will remove, fill, dredge or,alter that are
said work requires the filing of a Notice of Intend.
2-1
81
3. ❑ The work described below,which includes all/part of the work described in your request;is within
the Buffer Zone as defined in the regulations,and will alter an Area Subject to Protection Under
the Act Therefore,said work requires the filing of a Notice of Intent
This Determination is negative:
1. ❑ The area described in your request is not an Area Subject to Protection Under the Act.
2. ❑ The work described in your 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 your 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
4. ❑ The area described in your request is Subject to Protection Under the Act,but 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:
Issued by rQ Cons ivation Commission
Signatures �� J
i�tz&
'This Determination must be signed by a majority of the Conservation Commission.
• On this day of u 19 " �o before me .
personalty appeared LLSLe to me known to be the
person described in, and who executed,the foregoing instrument,and acknowledged that he/she executed
the sa a as his/heree act a deed.
Al -y4F
-blic My commission expires
"'. •T* etermtnation does not relieve the applicant from complying with all other applicable federal,state or local statutes,ordinances.
byviaw•e or regulations.This Determination shall be valid for three years form the date of issuance. -
The applicant,the 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;own in which such land is located,are hereby notified of their right to request the
Department of Environmental Quality Engirieering to issue a Superseding Determination of Applicability,providing the request is made
by certified mail or hand delivery to the Department within ten days from the date of issuance of this Determination.A copy of the request
shall at the same time be sent by certified ma,l or hanc delivery to the Conservation Commission and the applicant.
2.2A
Form 2
D E ile Mm
(To be provided by DEGE)
CommonwealthCITYt7Y BF �.,fF 5"YA
I.7�1I
+;l = of Massachusetts Applicant Peter S. Haywood
-�
Determination of Applicability
Massachusetts Wetlands Protection Act, G.L. c. 131, §40
From SALEM CONSERVATION COMMISSION Issuing Authority
TO Peter S. Haywood DMH Realty Trust
(Name of person making request) (Name of property owner)
Address 4 Columbus Square Address 3A Winter Island Road
This determination is issued and delivered as follows:
❑ by hand delivery to person making request on (date)
r 01 by certified mail, return receipt requested on (date)
Pursuant to the authority of G.L.c. 131, §40,the SALEM CONSERVATION COMMISSION
has considered your request for a Determination of Applicability and its supporting documentation,and has
made the following determination(check whichever is applicable):
This Determination is positive:
1. ❑ The area described below,which includes all/part of the area described in your request,is an Area
Subject to Protection Under the Act.Therefore,any removing,filling,dredging or altering of that
area requires the filing of a Notice of Intent.
2. ❑ The work described below, which includes all/part of the work described in your request,is within
an Area Subject to Protection Under the Act and will remove,fill,dredge or alter that area.There-
fore, said work requires the filing of a Notice of Intent.
C
2-1
3. ❑ The work described below,which includes all/ art of the work described in your request,
is within
h Buffer Zone as defined in the regulations, and will alter an Area Subject to Protection Under
to g
the Act.Therefore,said work requires the filing of a Notice of Intent.
This Determination is negative:
1. ❑ The area described in your request is not an Area Subject to Protection Under the Act.
2. ❑ The work described in your 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. 0 The work described in your 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.
4. ❑ The area described in your request is Subject to Protection Under the Act,but 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:
Issued by sAL�n�;7 %�� Conservation Commission
Signature(s)
—�Xv
This Determination-mustbe signed b majority of the Conservation Commission.
On this day of 19 -.before me
personally appeared ,to me known to be the
person describecUn, 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
This Determination does not relieve the applicant from complying with all other applicable federal,state or local statutes,ordinances,
by-laws or regulations.This Determination shall be valid for three years form the date of issuance.
The applicant,the 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
Department of Environmental Quality Engineering to issue a Superseding Determination of Appllcabitity,providing the request is made `
by certified mail or hand delivery to the Department within ten 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 the applicant.
2-2A
GEORGE O. LEWIS CO., INC.
Insurance Adjusters
50 Howe Street
Ipswich, Massachusetts 01938
(617) 356-;'W59 , q 5d;
Form of Notice of Casualty Loss to Building
Under Mass.Gen.Laws, Ch. 139, Sec.313
TO: Building Commissioner or Board of Health or
I Spector of Buildings Board of Selectmen
r,
N1o. q ;,,
)
addresses
RE: Insured: r- pci'4 C_ i:'5 lx
Property Address:
r
Insuror and Policy Number: "'t ,� +� �_ ,•,+ d - �s .
Date of Loss:
Insuror' s Claim Number:
Claim has been made involving loss, damage or destruction
of the above-captioned property, which may either exceed $1, 000.00
or cause Mass.Gen.Laws Chapter 143, Section 6 to be applicable.
If any notice under Mass.Gen.Laws, Chapter 139, Section 3B is
appropriate please direct it to the attention of the writer and
include a reference to the captioned insured, location, insuror
and policy number, date of loss and claim number.
/� UJr
�nf�t�- (1. � �a
I Adjuster
On this date, I caused copies of this notice to be sent to
the persons named above at the addresses indicated above by
first class mail. 4 71
I
� Signature
Date