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64-388 - 7 BROOKS STREET - CONSERVATION COMMISSION 6y-388 13rwo s,-ee j S,:Uk- +nj6� duel�l�- Y 01-0 Q 00 C w Ad- 6j 1Ze J�Dllt&yt� �Omwy�SSlvn Issued q new S�hec/j 'Pej OOC Di-) i a 3 i CITY OF SALEM ''ry fr CONSERVATION COMMISSION July 16, 2008 LonelPelletier 7 Brooks Street Salem,MA 01970 Re: Certificate of Compliance—DEP #64-388—7 Brooks Street, Salem, MA Dear Mr. Pelletier. Enclosed, please find the Certificate of Compliance for the above referenced project. This Document must be recorded at the Essex County Registry of Deeds, Shetland Park 45 Congress Street, Suite 4100 Salem, Massachusetts. Please fill out and return the Recording Information on page 4 of the Certificate of Compliance, which will indicate to the Salem Conservation Commission that the document has been recorded. If you have any further questions please feel free to contact me at (978) 619-5685. Sincerely, Carey Du es Conservation Agent/ Staff Planner Enclosures CQ DEP Northeast Regional Office a Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance 64-388 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 Lionel Pelletier computer, use Name only the tab key to move 7 Brooks Street _ your cursor- Mailing Address do not use the Salem MA 01970 return key. City/Town State Zip Code 1 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: Lionel Pelletier Name February 24 2005 64-388 Dated DEP File Number 3. The project site is located at: 7 Brooks Street Salem Street Address Cityf town Map 24 Lot 228 Assessors Map/Plat Number Parcel/Lot Number the final Order of Condition was recorded at the Registry of Deeds for: Lionel Pelletier Property Owner(if different) Essex 24815 212 County Book Page Certificate 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: May 22, 2008 Date 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: wpaform 8b.doc•rev.7113104 Page 1 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance sa-saa Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP B. Certification (cont.) ❑ 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: Salem July 10, 2008 Conservation Commission Date of Issuance This Certificate must be signed by a majority of the Conservation Commission and a copy sent to the applicant and appro Hate DEP ional Office (See Attachment). Signature � � �/�✓ " `-'`� I V �' U�/ I/ wpaform Be.tloc•rev.7113104 Page 2 of 4 J Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance 64-388 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP C. Authorization (cont.) Notary Acknowledgement Commonwealth of Massachusetts County of Essex On this 10 Of July 2008 Day Month Year before me, the undersigned Notary Public, personally appeared K. Cornacchio, M. Blier, D. Summer, K. Glidden, and A. Hamilton, Name of Document Signer proved to me through satisfactory evidence of identification, which was/were personally known Description of evidence of identification to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he/she signed it voluntarily for its stated purpose. As member of Salem Conservation Commission City/Town G1REY R.WUOMM NDWYPdAc 0MAWNSWNMy mE*k � Signature Notary Public Carey R. Duques Printed Name of Notary Public August 16, 2013 My Commission Expires(Date) Place notary seal and/or any stamp above Signature of Notary Public wpaforra Oodoc•rev.7113104 - Page 3 of 4 l Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance i , 64-388 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: Salem Conservation Commission Please be advised that the Certificate of Compliance for the project at: 7 Brooks Street 64-388 Project Location DEP File Number Has been recorded at the Registry of Deeds of: Essex County for: Lionel Pelletier 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 wpaform 8b.doc•rev,7113104 Page 4 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP Regional Addresses Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Mail transmittal forms and DEP payments,payable to: Commonwealth of Massachusetts Department of Environmental Protection Box 4062 Boston, MA 02211 DEP Western Region Adams Colrain Hamden Monroe Pittsfield Tynngham 436 Dwight Street Agawam Conway Hancock Montague Plainfield Wales Alford Cummngton Hatfield Monterey Richmond Ware Suite 402 Amherst Dalton Hawley Montgomery Rowe Warwick Springfield,MA 01103 Ashfield Deerfield Heath Monson Russell Washington Phone:413-784-1100 Becket Easthampton Hinsdale Mount Washington Sandisfield Wendell Belchertown East Longmeadow Holland New Ashford Savoy Westfield Fax:413-784-1149 Bemardslon Egremonl Holyoke New Marlborough Sheffield Westhamplon Blandford Erving Huntington New Salem Shelburne West Springfield Brimbeld Florida Lanesborough North Adams Shueesbury West Stockbrdge Buckland Gill Lee Northampton Southampton Whately Charemont Goshen Lenox Northfield South Hadley Wilbraham Cheshire Granby Livered Orange Southwick m k Williasburg Chester Granville Leyden Olis Springfield Williamstown Chesterfield Great Barington Longmeadow Palmer Stockbridge Windsor Chicopee Greenfield Ludlow Pelham Sunderland Worthington Clarksburg Hadley Middlefield Pew Tolland DEP Central Region Acton Charlton Hopkinton Millbury Rutland Uxbndge 627 Main Street Ashburnham Clinton Hubbardston Millville Shirley Warren Ashby Douglas Hudson New Braintree Shrewsbury Webster Worcester, MA 01608 Athol Dudley Holliston Northborough Southborough Westborough Phone:508-792-7650 Auburn Dunstable Lancaster Northbridge Southbridge West Boylston Fax:508-792-7621 Ayer East Brookfield Leicester North Brookfield Spencer West Brookfield Barre Fitchburg Leominster Oakham Staining Westford TDD:508-767-2788 Bellingham Gardner Littleton Oxford slow Westminster Berlin Grafton Lunenburg Paxton Sturbridge Winchendon Blackstone Grogan Matlbara ugh. Pepperell Sultan Worcester Bolton Harvard Maynard Petersham Templeton Boxborough Hardwick Medway Phillipston Townsend Boylston Holden Mention Princeton Tyngsbarough Brookfield ,Hopedale Milford Royalstpn Upton DEP Southeast Region Abington Dartmouth Freetown Maltapoisett Provincelown Tisbury 20 Riverside Drive Acushnet Dennis Gay Head Middleborough Raynham Truro Attleboro Dighton Gosnold Nantucket Rehoboth Wareham Lakeville,MA 02347 Avon Duxbury Halifax New Bedford Rochester Weill eel Phone:508-946-2700 Barnstable Eastham Hanover North Attleborough Rockland West Bridgewater Fax:508-947-6557 Berkley East Bridgewater Hanson Norton Sandwich Westport Bourne Easton Harwich Norwell Scituate West Tisbury TDD:508-946-2795 Brewster Edgard. Kingston Oak Bluffs Seekonk Whitman Bridgewater Fairhaven Lakeville Orleans Sharon Wrentham Brockton Fall River Mansfield Pembroke Somerset Yarmouth Carver Falmouth Marion Plainville Stoughton Chatham Foxborough Marshfield Plymouth Swansea Chilmark Franklin Mashpee Plym en Taunton DEP Northeast Region Amesbury Chelmsford Hingham Merrimac Quincy Wakefield 1 Winter Street Andover Chelsea Holbrook Methuen Randolph Walpole Arington Cohassel Hull Middleton Reading Waltham Boston,MA 02108 Ashland Concord Ipswich Millis Revere Watertown - Phone:617-654-6500 Bedford Danvers Lawrence Mdtw Rockport Wayland Fax: 617-556-1049 Belmont Dedham Lexington Natant Rowley Wellesley Beverly Dover Lincoln Natick Salem Wenham TDD:617-574-6868 Blllenca Dracut Lowell Needham Salisbury West Newbury Boston Essex Lynn Newbury Saugus Weston Boxford Everett Lynnfeld Newburypon Sherbom Westwood Braintree Framingham Malden Newton Somerville Weydrouth Brookline Georgetown Manchester-By-The-Sea Norfolk Stoneham Wilmington Burlington Gloucester Marblehead North Andover Sudbury Winchester CamNridge Groveland Medfield North Reading Swampscott Winthrop Canton Hamilton Medford Norwood Tewksbury Woburn Carlisle Haverhill Melrose Peabody Topsfield wpaform8b.doc•DEP Addresses•rev.7I15I08 Page 1 of 1 • • • • : ' � � ; f °? � •'� 'l f ,' Y� � � '.�.r I� yam-:':. �} � �� Sn'{ i:t'• - 7 w �, � l i t, � _ •.-. l�_He '�t 1P ®9 �� . �... �t � , �. _ `� �I�► ��s`�::� ''�,� ! s � � � r 4r •' .ei �% � �+ t"tf�y �'. fie'� - err�'Ql� � . ,.� 1� � � � } �F �.� 3 �, t ^.h� B P' '' � _ . N}�+ y �� «— � 3JK"d 6k � :i J �� i� Y^ S TIR' ar� PHOTO LOG Request for a Certificate of Compliance 7 BROOKS STREET,SALEM,MASSACHUSETTS nummoxv�v oxs/n/ce aruxax�up�az.Cotowvwmxi Am+r/stus�+eama i 7 Brooks Street,final site design has i different driveway than that proposed and approved. mom �n�El West side of the house,where a driveway was not proposed. Current driveway material are pavers. Page 1 of 4 . • : " •. ; " 1 Y THY �F1 F aJx d i �k 1 d ' Lr COL Y4 i M 4f r rr F S A 1,F,M ro N ERVATION COMMISSION S June 3, 2008 Lionel Pelletier 7 Brook Street Salem, MA 01970 Re: Request for a Certificate of Compliance—DEP #64-388— 7 Brook Street, Salem, MA Dear Mr. and Mrs. Pelletier: The Conservation Commission met during their regularly scheduled meeting on May 22, 2008 to review your request for a Certificate of Compliance for an open Order of Conditions DEP #64-388 at the above referenced address. After reviewing the photos of the site and discussing the project, the Commission has denied the request for a full Certificate of Compliance. The Commission came to this decision based on the changes made to the site as compared to the approved site plan. The Commission has requested that you provide a set of "as-bat" plans to the Conservation Commission so it is clear what differs between the approved plan and what was built. Jim Fleming, who dropped off the Request for a Certificate of Compliance, was notified on June 3, 2008 of this request and agreed to submit as-built plans within the next few weeks to the Conservation Agent. Upon receipt and review of the as-built plans during a regularly scheduled meeting, the Cornrru'ssion will determine if a Certificate of Compliance is appropriate. If you have any further questions please feel free to contact me at (978) 619-5685. Sincerely, CareyD ques C�tonsery tion Agent/ Staff Planner Enclosures CC:- DEP Northeast Regional Office LlMassachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands WPA Form 8A — Request for Certificate of Compliance , Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEPP A. Project Information Important: When filling out 1. This request is bein made by: . forms on the L 10 yv..� �y�I L�t 2.r computer, use Name only the tab rV okL �+ V_ �t key to move J f your cursor- Mailing Address ��/� do not use the Ses 1 rr V° t� 0 19�0 return key. Cityrrown State Zip Code '6 Phone Number 2. This request is in reference to work regulated by a final Order of Conditions issued to: U,bhJi� Applicant Dated DEP File Number Upon completion of the work 3. The project site is located at: authorized in an Order Street Address City/Town Conditions,s,the � & a-L/ / / 4 property owner W a.r'{- OZZ-$' must request a Assessors Map lat Numb r Parcel/Lot Number Certificate of Compliance 4. The final Order of Conditions was recorded at the Registry of Deeds for:from the issuing L/ a r z i P,I L,4i- .r- authority stating property Owner(if different) _ that the work or C S 5 e� i/815 2 portion of the work has been County Book Page satisfactorily completed. Certificate(if registered land) 5. This request is for certification that (check one): 5d the work regulated by the above-referenced Order of Conditions has been satisfactorily completed. ❑ the following portions of the work regulated by the above-referenced Order of Conditions have been satisfactorily completed (use additional paper if necessary). ❑ the above-referenced Order of Conditions has lapsed and is therefore no longer valid, and the work regulated by it was never started. ,vpaform8a.doc•rev.7113104 Page 1 of 2 Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands WPA Form 8A — Request for Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP A. Project Information (cont.) 6. Did the Order of Conditions for this project, or the portion of the project subject to this request, contain an approval of any plans stamped by a registered professional engineer, architect, landscape architect, or land surveyor? ❑ Yes If yes, attach a written statement by such a professional certifying substantial compliance with the plans and describing what deviation, if any, exists from the plans approved in the Order. ❑ No B. Submittal Requirements Requests for Certificates of Compliance should be directed to the issuing authority that issued the final Order of Conditions (OOC). If the project received an OOC from the Conservation Commission, submit this request to that Commission. If the project was issued a Superseding Order of Conditions or was the subject of an Adjudicatory Hearing Final Decision, submit this request to the appropriate DEP Regional Office (see Attachment). wpaform8a.doc•rev.7/13/04 Page 2 of 2 C� �v CITY OF SALEM n � CONSERVATION COMMISSION January 30, 2006 Lionel Pellider 173 Ocean Avenue Salem, MA 01970 Re: Enforcement Order—DEP #64-388-7 Brook Street, Salem Massachusetts Dear Mr. Pellitier: Enclosed you will find an Enforcement Order for the above referenced property. As you may or may not be aware, there are activities being conducted on your property in violation of the approved Order of Conditions PEP #64-388). You are directed to cease and desist from any further activity on site and bring all violations into compliance within the allotted timeframe, as outlined in the enclosed Enforcement Order. Once you have brought your site into compliance, you are directed to notify me at 978-745- 9595 x3l l to arrange a site inspection. Sincerely 4�" xan aor a lanner/Conservation Agent cc: Massachusetts Department of Environmental Protection, NERO Salem Conservation Commission enclosure 1 120 WASHINGTON STREET, SALEM, MASSACHUSETPS 01970 • TEL: 978.745.9595 FAx: 978.740.0404 WWW.SALEM.COM 'y Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands WPA Form 9A - Enforcement Order #64-388 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP A. Violation Information Important: When filling out This Enforcement Order is issued by: forms on the Salem January 30, 2006 computer,use Conservation Commission(Issuing Authority) Date only the tab key to move To: your cursor- do not use the Lionell Pellitier return key. Name of Violator 173 Ocean Avenue, Salem, MA 01970 m Address 1. Location of Violation: nm Property Owner(if different) 7 Brook Street Street Address Salem 01970 Cityrrown Zip Code MAP 24 portion of LOT 179 Assessors Map/Plat Number Parcel/Lot Number 2. Extent and Type of Activity(if more space is required, please attach a separate sheet): Erosion control measures are not installed appropriately and a potion is in disrepair. Site is not stabilized and the existing stormdrain structure is not being protected properly to ensure that sediment will not enter the structure. B. Findings The Issuing Authority has determined that the activity described above is in violation of the Wetlands Protection Act(M.G.L. c. 131, §40)and its Regulations(310 CMR 10.00), because: ❑ the activity has been/is being conducted without a valid Order of Conditions. the activity has been/is being conducted in violation of the Order of Conditions issued to: Lionell Pellitier February 24, 2005 Name Dated wpdormea.doe•rev.7/14104 Pape 1 of 3 F. Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands WPA Form 9A — Enforcement Order #64-388 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP #64-388 #24, #26, #28,#34, #37, #42 File Number Condition number(s) B. Findings (cont.) ❑ Other(specify): C. Order The issuing authority hereby orders the following (check all that apply): The property owner, his agents, permittees, and all others shall immediately cease and desist from the further activity affecting the Buffer Zone and/or wetland resource areas on this property. ❑ Wetland alterations resulting from said activity should be corrected and the site returned to its original condition. ❑ Complete the attached Notice of Intent. The completed application and plans for all proposed work as required by the Act and Regulations shall be filed with the Issuing Authority on or before Date No further work shall be performed until a public hearing has been held and an Order of Conditions has been issued to regulate said work. a The property owner shall take the following action to prevent further violations of the Act: Shall re-establish the erosion control barrier, per the approved site plans. The stormdrain structure shall be cleaned and protected by hay bales and siltation fencing. The site shall be stabilized with a temporary rye or grass to prevent further erosion and sedimentation. The applicant shall contact the Conservation Agent prior to February 17, 2006 to inspect the site and check for compliance. Failure to comply with this Order may constitute grounds for additional legal action. Massachusetts General Laws Chapter 131, Section 40 provides: "Whoever violates any provision of this section (a) shall be punished by a fine of not more than twenty-five thousand dollars or by imprisonment for not more than two years, or both, such fine and imprisonment; or(b) shall be subject to a civil penalty not to exceed twenty-five thousand dollars for each violation". Each day or portion thereof of continuing violation shall constitute a separate offense. waskm9e.doc•n3v.7/14104 Pegg 2 of 3 f . Massachusetts Department of Environmental Protection DEP File Number. Bureau of Resource Protection - Wetlands WPA Form 9A - Enforcement Order #64-388 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP D. Appeals/Signatures An Enforcement Order issued by a Conservation Commission cannot be appealed to the Department of Environmental Protection, but may be filed in Superior Court. Questions regarding this Enforcement Order should be directed to: Frank Taormina, Planner/Conservation Agent Name (978) 745-9595 x311 Phone Number Monday-Wednesday 8am4pm, Thursdays 8am-7pm Friday 8am-12pm(noon) Hours/Days Available Issued by: Salem Conservation Commission In a situation regarding immediate action, an Enforcement Order may be signed by a single member or agent of the Commission and ratified by majority of the members at the next scheduled meeting of the Commission. Sign res: W03 leao oao e�95 1W Signature of delivery person or certified mail number wpalonnga. x•rev.7114104 Page 3 o/3 CITY OF SALEM s T CONSERVATION COMMISSION March 14, 2005 Lionel Pelletier 173 Ocean Avenue Salem, MA 01970 Re: Order of Conditions—DEP #64-388-7 Brook Street Dear Mr. & Mrs. eA e y"`, Enclosed, please find the Order of Conditions for 7 Brook Street (DEP 464-388). Following the 10-day appeal period, this document and the attached Special Conditions must be recorded at the Essex County Registry of Deeds. Once recorded, please return a copy of Page 9 of the Order of Conditions, which will indicate to the Salem Conservation Commission that the document has been recorded. If you have any further questions or concerns, please feel free to contact me at 978-745- 9595 x 311. Sincerely, AT Conservation Agent Enclosures 120 W.i�s'-in(;IW� Sn.Er:r_ SALEM. MAs;�cnusferr, 01970 . 'FEi.: 978.745.9595 F.�\: 978_740,0I 9 ai.; Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions #64-388 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. General Information Important: Salem When filling From: f.Conservation Commission out forms on the computer, 2.This issuance is for(check one): ® Order of Conditions ❑ Amended Order of Conditions use only the tab key to 3.To: Applicant: move your cursor-do not Lionel Pelletier use the return a. First Name b.Last Name c.Company key. 173 Ocean Avenue -- - - _ d. Mailing Address - �tl Salem MA 01970 e.City/Town f.State g.Zip Code 4. Property Owner(if different from applicant): a. First Name b. Last Name c.Company d. Mailing Address e.City/Town f.State g.Zip Code 5. Project Location: 7 Brook Street/ 173 Ocean Ave West Salem a.Street Address b.Cityrrown MAP 24 Portion of LOT 179 c.Assessors Map/Plat Number d.Paroel/Lot Number Latitude and Longitude, if known (note: electronic filers will click for GIS locator): e.Latitude f.Longitude 6. Property recorded at the Registry of Deeds for(attach additional information if more than one parcel): Essex a.County b.Certificate(if registered land) 23557 259 c.Book d.Page 2/10105 2/24/05 2/24/05 7. Dates: a. Date Notice of Intent Filed b.Date Public Hearing Closed c. Date of Issuance 8. Final Approved Plans and Other Documents (attach additional plan or document references as needed): Site Development Permit Plan, 7 Brook Street a.Plan Title Eastern Land Survey Associates, Inc. Christopher R. Mello b.Prepared By c.Signed and Stamped by November 3, 2004 1" = 20' d. Final Revision Date e.Scale I.Additional Plan or Document Title g.Date 9. Total WPA Fee Paid: $500.00 $237.00 $262.50 a.Total Fee Paid b.State Fee Paid c.City/Town Fee Paid wpa1o.5.00c• rev.W/O Page 1 of 9 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions #64-386 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Findings 1. Findings pursuant to the Massachusetts Wetlands Protection Act: Following the review of the above-referenced Notice of Intent and based on the information provided in this application and presented at the public hearing, this Commission finds that the areas in which work is proposed is significant to the following interests of the Wetlands Protection Act. Check all that apply: a. ❑ Public Water Supply b. ❑ Land Containing Shellfish c. ® Prevention of Pollution d. ❑ Private Water Supply e. ❑ Fisheries- _. f. ❑ Protection of Wildlife Habitat - g. ® Groundwater Supply h. ® Storm Damage Prevention i. ® Flood Control z. This Commission hereby finds the project,as proposed,is:(check one of the following boxes) Approved subject to: ® the following conditions which are necessary in accordance with the performance standards set forth in the wetlands regulations. This Commission orders that all work shall be performed in accordance with the Notice of Intent referenced above, the following General Conditions, and any other special conditions attached to this Order. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, these conditions shall control. Denied because: ❑ the proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations. Therefore, work on this project may not go forward unless and until a new Notice of Intent is submitted which provides measures which are adequate to protect these interests, and a final Order of Conditions is issued.A description of the performance standards which the proposed work cannot meet is attached to this Order. ❑ the information submitted by the applicant is not sufficient to describe the site, the work, or the effect of the work on the interests identified in the Wetlands Protection Act. Therefore,work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides sufficient information and includes measures which are adequate to protect the Act's interests, and a final Order of Conditions is issued. A description of the specific information which is lacking and why it is necessary is attached to this Order as per 310 CMR 10.05(6)(c). Inland Resource Area Impacts: Check all that apply below. (For Approvals Only) Resource Area Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 3. ❑ Bank i linearfeet b.linearfeet c.linearfeet d.linear feet 4. ❑ Bordering Vegetated Wetland a.square feet b.square feet c.square feet d.square feet 5. ❑ Land Under a.square feet b.square feet c.square feet d.square feet Waterbodies and Waterways e.cu.yd dredged f,cu.yd dredged wpafc"5.dm• rev.3r7/05 Page 2 of 9 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions #64-388 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Findings (cont.) Resource Area Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 6. ❑ Bordering Land Subject to Flooding a.square feet b.square feet c.square feet d.square feet Cubic Feet Flood Storage e.cubic feet f.cubic feet g.cubic feet h.cubic feet 7. ❑ Isolated Land Subject to Flooding a.square feet b.square feet Cubic Feet Flood Storage c.cubic feet d.cubic feet- - - e.cubic feet- f.cubic feet - - 8. ❑ Riverfront area a.total sq.feet b.total sq.feet Sq ft within 100 ft c.square feet d.square feet Sq ft between 100-200 ft e.square feet f.square feet Coastal Resource Area Impacts: Check all that apply below. (For Approvals Only) 9. ❑ Designated Port Areas Indicate size under Land Under the Ocean, below 10. ❑ Land Under the Ocean a.square feet b.square feet c.cu.yd dredged d.cu.yd dredged 11. ❑ Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes below 12. ❑ Coastal Beaches a square feet b.square feet c.dy nourishmt d.dy noudshmt. 13. ❑ Coastal Dunes a.square feet b.square feet c.dy nourishmt, d.dy nourishmt 14. ❑ Coastal Banks a.linear(feet b.linear feet 15. ❑ Rocky Intertidal Shores a.square feet b.square feet 16. El Salt Marshes a.square feet b.square feet c.square feet d.square feet 17. ❑ Land Under Salt Ponds a.square feet b.square feet c.cu.yd dredged d.cu.yd dredged 16. ❑ Land Containing Shellfish a.square feet b.square feet c.square feet d.square feet 19. ❑ Fish Runs Indicate size under Coastal Banks, inland Bank, Land Under the Ocean, and/or inland Land Under Waterbodies and Waterways, above a.cu.yd dredged b.cu.yd dredged 20. ❑ Land Subject to Coastal Storm Flowage a.square feet b.square feet wwfonn5.doc• rev.3r1105 Page 3 of 9 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions #64-388 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 C. General Conditions Under Massachusetts Wetlands Protection Act (only applicable to approved projects) 1. 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, bylaws, 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. If this Order is intended to be valid for more than three years, the extension date and the special circumstances warranting the extended time period are set forth as a special condition 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. Any fill shall contain no trash, refuse, rubbish, or debris, 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. This Order is not final until all administrative appeal periods from this Order have elapsed, or if such an appeal has been taken, until all proceedings before the Department have been completed. 8. No work shall be undertaken until the Order has become final and then 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 the 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 done. The recording information shall be submitted to this Conservation Commission on the form at the end of this Order, which form must be stamped by the Registry of Deeds, prior to the commencement of work. 9. A sign shall be displayed at the site not less then two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection" [or, "MA DEP"J "File Number #64-388 " wpaform5.doc• rev.Y7/05 Page 4 of 9 ILIMassachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions #64-388 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 C. General Conditions Under Massachusetts Wetlands Protection Act 10. Where the Department of Environmental Protection is requested to issue a Superseding Order, the Conservation Commission shall be a party to all agency proceedings and hearings before DEP. 11. Upon completion of the work described herein, the applicant shall submit a Request for Certificate of Compliance (WPA Form 8A)to the Conservation Commission. 12. The work shall conform to the plans and special conditions referenced in this order. 13. Any change to the plans identified in Condition#12 above shall require the applicant to inquire of the _ _ Conservation Commission.in writing whether the change is significant enough to require the filing of a new Notice of Intent. 14. The Agent or members of the Conservation Commission and the Department of Environmental Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours to evaluate compliance with the conditions stated in this Order, and may require the submittal of any data deemed necessary by the Conservation Commission or Department for that evaluation. 15. This Order of Conditions shall apply to any successor in interest or successor in control of the property subject to this Order and to any contractor or other person performing work conditioned by this Order. 16. Prior to the start of work, and if the project involves work adjacent to a Bordering Vegetated Wetland, the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden stakes or flagging. Once in place, the wetland boundary markers shall be maintained until a Certificate of Compliance has been issued by the Conservation Commission. 17. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully stabilized with vegetation or other means. At no time shall sediments be deposited in a wetland or water body. During construction, the applicant or his/her designee shall inspect the erosion controls on a daily basis and shall remove accumulated sediments as needed. The applicant shall immediately control any erosion problems that occur at the site and shall also immediately notify the Conservation Commission, which reserves the right to require additional erosion and/or damage prevention controls it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of work line has been approved by this Order. Special Conditions: If you need more See Attached space for additional conditions, select box to attach a text document wpafmm5.dm- rev.317105 Page 5 of 9 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions #64-388 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 D. Findings Under Municipal Wetlands Bylaw or Ordinance t. Furthermore,the hereby finds (check one that applies): Conservation Commission 2. ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw specifically: a.Municipal Ordinance or Bylaw b.Citation Therefore,work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides measures which are adequate to meet these standards, and a final Order of Conditions is issued. 3. ❑ that the following additional conditions are necessary to comply with a municipal ordinance or bylaw: a.Municipal Ordinance or Bylaw b.Citation The Commission orders that all work shall be performed in accordance with the following 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. If you need more space for c. The special conditions relating to municipal ordinance or bylaw are as follows: additional conditions, select box to attach a text document ❑ wpafor 5.dm• rev.3O/05 Page 6 of 9 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions #64-388 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 E. Issuance This Order is valid for three years, unless otherwise specified as a special March 10, 2005 condition pursuant to General Conditions#4, from the date of issuance. 1.Date of issuance Please indicate the number of members who will sign this form: This Order must be signed by a majority of the Conservation Commission. 2.Number of signers The Order must be mailed by certified mail (return receipt requested) or hand delivered to the applicant. A copy also must be mailed or hand delivered at the same time to the appropriate Department of Environmental Protec ion Regional Office, if not filing electronically, and the property owner, if different from applicant. Signatures: — r Notary Acknowledgement Commonwealth of Massachusetts County of On this ( Y of l,� &C 64 0 0S Day Month Year Before me, the undersigned Notary Public, personally appeared Name of Document Signer proved to me through satisfactory evidence of identification, which was/were Description of ev' ence of identification to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he/she signed it voluntarily for its stated purpose. As member of `S N "'� -e )---7 Conservation Commission Cityrrown - Notary Public C ea h Massachusetts MY Commission on Expires Si ature of Notary Public My Co May 5, 2011 Printed Name of Notary Public Place notary seal and/or any stamp above My Commission Expires(Date) This Order is issued to the applicant as follows: ��// El by hand delivery on m by certified m il,return receipt requested,on 3ITZI)0S Date Date � wpaforrn5.doc• rev.3M05 Page 7 of 9 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions #64-388 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 F. Appeals The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject to this Order, 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 DEP Regional Office to issue a Superseding Order of Conditions. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and a completed Request of Departmental Action Fee Transmittal Form, as provided in 310 CMR 10.03(7)within ten business 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 to the applicant, if he/she is not the appellant. _The request shall state clearly and concisely the objections to the Order which is being appealed and how the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act, (M.G.L. c. 131, §40) and is inconsistent with the wetlands regulations (310 CMR 10.00). To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. Section G, Recording Information is available on the following page. wpafo"5 dm• rev.Y7105 Page B of 9 i Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions #64-388 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 G. Recording Information This Order of Conditions must be 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 subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions. The recording information on Page 7 of this form shall be submitted to the Conservation Commission listed below. Salem Conservation Commission Detach,on dotted line, have stamped by the Registry of Deeds and submit to the ConservationCommission. --------------------------------------------- ---------- -------------------------------- -------=--------------------- To: Salem Conservation Commission Please be advised that the Order of Conditions for the Project at: 7 Brook Street #64-388 Project Location DEP File Number Has been recorded at the Registry of Deeds of: County Book Page for: Property Owner and has been noted in the chain of title of the affected property in: Book Page In accordance with the Order of Conditions issued on: Dale If recorded land, the instrument number identifying this transaction is: Instrument Number If registered land, the document number identifying this transaction is: Document Number Signature of Applicant wpafcrmUm- rev.3/7I05 Page 9 of Attachment to Order of Conditions# 64-388 Page ilof 5; SALEM CONSERVATION COMMISSION DEP FILE #64-388 7 Brook Street City of Salem,Massachusetts ADDITIONAL FINDINGS Based on the Estimated Habitats of Rare Wildlife and Certified Vernal Pools Map(June 2003)by Natural Heritage & Endangered Species Program (NHESP) of the Massachusetts Division of Fisheries and Wildlife, it has been determined that this project does not include_habitat of rare wildlife,nor does it contain certified vernal pools,and is- therefore in compliance with the rare wildlife species section of the Massachusetts Wetlands Protection Act Regulations(310 CMR 10.58(4)(b),& 10.59). This Order is issued under the Massachusetts Wetlands Protection Act,M.G.L.Chapter 131,Section 40 and the City of Salem Wetlands Protection Ordinance, Salem Code Chapter 34, Section 34-1 —34-13. This Order permits the construction of a single-family dwelling,driveway,and associated utilities at 7 Brook Street. SPECIAL CONDITIONS I. This Order.of Conditions must be recorded in its entirety(all 5 pages)at the Essex 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; and recording information must be submitted to the Salem Conservation Commission in writing,before any work approved in this Order commences. 2. Approval of this application does not constitute compliance with any law or regulation other than M.G.L Chapter 131, Section 40,Wetlands Regulations 310 CMR 10.00. 3. All work shall be performed in accordance with this Order of Conditions and approved site plan(s). No alteration of wetland resource areas or associated buffer zones, other than that approved in this Order, shall occur on this property without prior approval from the Commission. 4. Prior to any work commencing, a sign shall be displayed showing DEP File#64-388, and not placed on a living tree. 5. No work approved in this Order may commence until the ten(10)day appeal period has lapsed from the date of the issuance of this Order. 6. The term"Applicant'as used in this Order of Conditions shall refer to the owner, any successor in interest or successor in control of the property referenced in the Notice of intent, supporting documents and this Order of Conditions. The Commission shall be notified in writing within 30 days of all transfers of title of any portion of the property that takes place prior to issuance of the Certificate of Compliance. 7. It is the responsibility of the applicant to procure all other applicable federal, state and local permits and approvals associated with this project. These permits may include but are not necessarily limited to the following: Attachment to Order of Conditions A 64-388 Page'gof 5 (1) Section 404 of the Federal Water Pollution Control Act(P.L. 92-500, 86 stat. 816),U.S.Army Corps of Engineers. (2) Water Quality Certification in accordance with the Federal Water Pollution Control under authority of sec. 27(5)of Chapter 21 of the Massachusetts General Laws as codified in 314 CMR 9.00. (3) The City of Salem Wetlands Protection Ordinance and its Regulations 8. If there are conflicting conditions within this Order, the stricter condition(s) shall rule. 9. All work shall be performed so as to ensure that there will be no sedimentation into wetlands and surface waters during construction or after completion of the project. 10. The Commission and its Administrator shall have the discretion to modify the erosion/siltation control methods and boundary during construction if necessary. 11. The Commission or its Administrator,officers,or employees shall have the right to enter and inspect the property at any time for compliance with the conditions of this Order,the Wetlands Protection Act MGL Chapter 131, Section 40,the Wetlands Regulations 310 CMR 10.00,and shall have the right to require any data or documentation that it deems necessary for that evaluation. 12. The Commission or its Administrator shall have the discretion to modify the erosion/siltation control methods and boundary during construction if necessary. 13. The Commission reserves the right to impose additional conditions on portions of this project or this site to mitigate any actual or potential impacts resulting from the work herein permitted. 14. The work shall conform to the following attached plans and special conditions: Final Approved Plans Site Development Permit Plan, 7 Brook Street Title November 3, 2004 Dated Christopher R. Mello Signed and Stamped by City of Salem Conservation Commission On file with 15. Any proposed changes in the approved plan(s)or any deviation in construction from the approved plan(s)shall require the applicant to file a Notice of Project Change with the Commission. The Notice shall be accompanied by a written inquiry prior to their implementation in the field, as to whether the change(s)is substantial enough to require filing a new Notice of Intent or a request to correct or amend this Order of Conditions. A copy of such request shall at the same time be sent to the Department of Environmental Protection. 16. In conjunction with the sale of this property or any portion thereof before a Certificate of Compliance has been issued,the applicant or current landowner shall submit to the Commission a statement signed by the buyer that he/she is aware of an outstanding Order of Conditions on the property and has received a copy of the Order of Conditions. Attachment to Order of Conditions# 64-388 Page 13of 5 17. Condition Number as indicated shall continue in force beyond the Certificate of Compliance,in perpetuity,and shall be referenced to in all future deeds to this property. PRIOR TO CONSTRUCTION 18. Prior to the commencement of any activity on this site other than activities listed above,there shall be a PRE-CONSTRUCTION MEETING between the project supervisor, the contractor responsible for the work, and a member of the Conservation Commission or its Administrator to ensure that the requirements of the Order of Conditions are understood. The staked erosion control line shall be adjusted,if necessary,during the pre-construction meeting. Please contact the Conservation Commission Agent at(978)745-9595 ext 311 at least forty-eight(48)hours prior to any activity to arrange for the pre-construction meeting. 19. Prior to the pre-construction meeting and commencement of any activity on this site, sedimentation and erosion control barriers shall be installed as shown on the approval plan(s)and detail drawings. The Commission and/or its Administrator shall inspect and approve such installation at the pre-construction meeting. 20. No clearing of vegetation,including trees,or disturbance of soil shall occur prior to the pre-construction meeting. Minimal disturbance of shrubs and herbaceous plants shall be allowed prior to the pre- construction meeting if absolutely necessary in order to place erosion control stakes where required. 21. There shall be_hay bales and wooden stakes under cover on the site to be used only for emergency erosion control. EROSION CONTROL 22. Appropriate erosion control devices shall be in place prior to the beginning of any phase of construction, and shall be maintained during construction in the wetland areas and buffer zones. The erosion control specifications provided in the Notice of Intent and the erosion control provision in the Order will be the minimum standards for this project; the Commission may require additional measures. 23. All debris, fill and excavated material shall be stockpiled a location far enough away from the wetland resource areas to prevent sediment form entering wetland resource areas. 24. Erosion and sedimentation control devices shall be inspected after each storm event and repaired or replaced as necessary. Any accumulated silt adjacent to the barriers shall be removed. 25. The area of construction shall remain in a stable condition at the close of each construction day. 26. Any de-watering of trenches or other excavation required during construction shall be conducted so as to prevent siltation of wetland resource areas. All discharge from de-watering activities shall be filtered through hay bale sediment traps, silt filter bags or other means approved by the Commission or its Administrator. 27. Within thirty(30) days of completion of construction on any given portion of the project, all disturbed areas in the completed portion of the site shall be permanently stabilized with rapidly growing vegetative cover, using sufficient top soil to assure long-tern stabilization of disturbed areas. 28. If soils are to be disturbed for longer that two months, a temporary cover of rye or other grass should be established to prevent erosion and sedimentation. If the season is not appropriate for plant growth, exposed surface shall be stabilized by other appropriate erosion control measures, firmly anchored,to prevent soils from being washed by rain or-flooding. Attachment to Order of Conditions k 64-388 Page'�4;of 5 DURING CONSTRUCTION 29. A copy of this Order of Conditions and the plan(s)approved in this Order shall be available on site at all times when work is in progress. 30. No alteration or activity shall occur beyond the limit of work as defined by the siltation barriers shown on the approved plan(s). 31. All waste products,grubbed stumps,slash;construction materials,etc. shall be deposited at least 100 feet from wetland resource areas and 200 feet from river. 32. Cement trucks shall not be washed out in any wetland resource or buffer zone area,nor into any drainage system. Any deposit of cement or concrete products into a buffer zone or wetland resource area shall be immediately removed. 33. All exposed sub-soils shall be covered by a minimum of three(3)inches of quality screened loam topsoil prior to seeding and final stabilization. 34. Immediately following drainage structure installation all inlets shall be protected by silt fence,haybale barriers and/or silt bags to filter silt from stormwater before it enters the drainage system. 35. There shall be no pumping of water from wetland resource areas. 36. All equipment shall be inspected regularly for leaks. Any leaking hydraulic lines,cylinders or any other components shall be fixed immediately. 37. During construction,all drainage structures shall be inspected regularly and cleaned as necessary. 38. The applicant is herby notified that failure to comply with all requirements herein may result in the issuance of enforcement actions by the Conservation Commission including,but not limited to,civil administrative penalties under M.G.L Chapter 21A,section 16. AFTER CONSTRUCTION 39. Upon completion of construction and final soil stabilization,the applicant shall submit the following to the Conservation Commission to request a Certificate of Compliance (COC): (1) A Completed Request for a Certificate of Compliance form(WPA Form 8A or other form if required by the Conservation Commission at the time of request). (2) A letter from a Registered Professional Engineer certifying compliance of the property with this Order of Conditions. (3) An "As-Built"plan signed and stamped by a Registered Professional Engineer or Land Surveyor showing post-construction conditions within all areas under the jurisdiction of the Massachusetts Wetlands Protection Act. This plan shall include at a minimum: (a) All wetland resource area boundaries with associated buffer zones and regulatory setback areas taken from the plan(s)approved in this Order of Conditions; (b) Locations and elevations of all stormwater management conveyances, structures and best management designs,including foundation drains,constructed under this Order within any wetland resource area or buffer zone; Attachment to Order of Conditions N 64-388 Page 5of 5 (c) Distances from any structures constructed under this Order to wetland resource areas- "structures"include,but are not limited to,all buildings,septic system components,wells, utility lines,fences,retaining walls,and roads/driveways; (d) A line delineating the limit of work-"work"includes any filling,excavating and/or disturbance of soils or vegetation approved under this Order; 40. When issued, the Certificate of Compliance must be recorded at the Essex County Registry of Deeds and a copy of the recording submitted to the Salem Conservation Commission. 41. If the completed work differs from that in the original plans and conditions,the report must specify how the work differs; at which time the applicant shall first request a modification to the Order. Only upon --- - --.---- -review and approval by the Commission,-may the applicant request in writing a Certificate of Compliance as described above. 42. Erosion control devices shall remain in place and properly functioning until all exposed soils have been stabilized with final vegetative cover and the Conservation Commission and/or its Administrator has authorized their removal. Massachusetts Department of Environmental Protection DEP File Number: Bureau bf Resource Protection - Wetlands ILI WPA Form 5 - Order of Conditions #64-388 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 G. Recording Information This Order of Conditions must be 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 Registrys Grantor Index under the name of the owner of the land subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions. The recording information on Page 7 of this form shall be submitted to the Conservation Commission listed below. Salem Conservation Commission Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission. To: Salem Conservation Commission Please be advised that the Order of Conditions for the Project at: 7 Brook Street #64-388 Project Location DEP File Number Has been recorded at the Registry of Deeds of: County Book Page for: Property Owner and has been noted in the chain of title of the affected property in: ' 9 c-�2 i ,)- Book Page In accordance with the Order of Conditions issued on: g Date If recorded land, the instrument number identifying this transaction is: I('�2 Instrument Number If registered land, the document number identifying this transaction is: Document Number at o41ica7/ wpaform5.doc• rev.9(7/05 Page 9 of 9 A fir. Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions #64-368 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. General Information III I IIIIIIII I IIIIIIIII1111IIIIIIIIIIIIIII Important: Salem 2005091200169 Bk;24815 Pg;212 When filling From: 1.Conservation Commission 09112/2005*10:48:00 OTHER Pg 1/13 . out forms on the computer, 2. This issuance is for(check one): ® Order of Conditions ❑ Amended Order of Conditions use only the 1 _tab, 3 Fo: Applicant. _._ move your . cursor-do not Lionel Pelletier use the return a. First Name b. Last Name c.Company key. 173 Ocean Avenue d. Mailing Address �n� m Salem MA 01970 �I e.City/Town f.State g.Zip Code �^ 4. Property Owner (if different from applicant): a. First Name b. Last Name c.Company ai in e.City/rown I.State g.Zip Code 5. Project Location: 7 Brook Street/173 Ocean Ave West Salem a.Street Address b.City/rown MAP 24 Portion of LOT 179 c.Assessors Map/Plat Number d.Parcel/Lot Number Latitude and Longitude, if known (note: electronic filers will click for GIS locator): — e.Lat&ude--" — --- I. Longitude 5. Property recorded at the Registry of Deeds for(attach additional information if more than one parcel): Essex a.County b.Certificate(if registered land) 23557 259 c. Book d. Page 2/10/05 2/24/05 2/24/05 7. Dates: a. Date Notice of Intent Filed b. Date Public Hearing Closed c.Date of Issuance s. Final Approved Plans and Other Documents (attach additional plan or document references as needed): Site Development Permit Plan 7 Brook Street a. Plan Title Eastern Land Survey Associates Inc. Christopher R. Mello b. Prepared By c.Signed and Stamped by November 3, 2004 V =20' d. Final Revision Date - e.Scale f.Additional Plan or Document Title g. Date 9. Total WPA Fee Paid: $500.00 $237.00 $262.50 a.Total Fee Paid b.State Fee Paid c.Cityaown Fee Paid Maforc5Aoc• rev.9/7m Pace 1 of 9