64-507 - 30 COLUMBUS AVENUE - CONSERVATION COMMISSION o �nI ✓S _
w CITY OF SALEM
CONSE
RVATION COMMISSION
September 9, 2011
Robert& Anthie Jackson
30 Columbus Ave.
Salem, MA 01970
Re: Certificate of Compliance DEP #64-507— 30 Columb
us Ave.
Dear Mr. and Mrs. Jackson:
Enclosed, please find the Certificate of Compliance for the above referenced property.
This Document must be recorded at the Essex County Registry of Deeds. Please fill out
and return the Recording Information on page 3 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,
Tom Devine
Conservation Agent/Staff Planner
Enclosures
CC: DEP Northeast Regional Office
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP Fite Number.
WPA Form 8B — Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 sa-5o7
7 Provided by DEP
A. Project Information
Important:
When filling out 1. This Certificate of Compliance is issued to:
forms on the
computer,use Robert and Anthie Jackson
only the tab key Name
to move your 30 Columbus Avenue
cursor-do not
use the return Mailing Address
key. Salem MA 01970
City/Town State Zip Code
d 2. This Certificate of Compliance is issued for work regulated by a final Order of
Conditions issued to:
Robert and Anthie Jackson
Name
10/14/2010 64-507
Dated DEP Fite Number
3. The project site is located at
30 Columbus Avenue Salem
Street Address City/Town
44 150
Assessors Map/Plat Number Parcel/Lot Number
the final Order of Condition was recorded at the Registry of Deeds for:
Property Owner(if different)
Essex South 29878 386
County Book Page
Certificate
4. A site inspection was made in the presence of the applicant, or the applicant's agent,
on:
8/30/11
Date
wper�,so.aa�• w.rvzaos
VJPAFwm aB,Certificate of Compliance•PB78 r of 3
4
Massachusetts Department of Environmental Protection
T - Bureau of Resource Protection - Wetlands DEP File Number
WPA Form 86 — Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 sa-5o7
Provided by DEP
B. Certification
Check all that apply:
® Complete Certification: It is hereby certified that the work regulated by the
above-referenced Order of Conditions has been satisfactorily completed.
❑ Partial Certification: It is hereby certified that only the following portions of work
regulated by the above-referenced Order of Conditions have been satisfactorily
completed.The project areas or work subject to this partial certification that have
been completed and are released from this Order are:
❑ Invalid Order of Conditions: It is hereby certified that the work regulated by the
above-referenced Order of Conditions never commenced. The Order of
Conditions has lap
sed 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 1
Conservation Commission Date of Issuance
This Certificate must be signed by a majority of the Con serva n Commission and a
copy sent t ap icant and appropriate DEP Regional Offj, (Se
hit :hw .mass. ov de /about/reg ion/find vour.htm). l
Signatu es:
wpafnn8b.doc rev.12/23109 WPA Form Be,Cerlincate of Compliance•Page 2 of 3
d
t a
Massachusetts Department of Environmental Protection
`, -- Bureau of Resource Protection - Wetlands DEP File Number:
? WPA Form 8B — Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 64507
Provided by DEP
D. Recording Confirmation
The applicant is responsible for ensuring that this Certificate of Compliance is recorded in
the Registry of Deeds or the Land Court for the district in which the land is located.
Detach on dotted line and submit to the Conservation Commission.
To: --- ---- --- --- - --- - ------- --------- ------ -- - - --- --- - --- --- ------ -- -----
Conservation Commission
Please be advised that the Certificate of Compliance for the project at:
Project Location DEP File Number
Has been recorded at the Registry of Deeds of:
County
for:
Property Owner
and has been noted in the chain of title of the affected property on:
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
wpalrm8b.dci.12/23109 WPA Form 88,Cemfcale of Compliance•Page 3 of 3
Massachusetts Department of Environmental Protection
-- Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance
07
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 pro5dedby 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:-- ---- ------------------------- - -------------------- ----- - - - - - -----------------------
r \ 1 '� of
Conservation Commission J.
Please be advised that the Certificate of Compliance for the project at:
Project Location DEP File Number
Has been recorded at the Registry of Deeds of:
-
County
for:
Property Owner
and has been noted in the chain of title of the affected property on:
Date BOOF Page
If recorded land, the instrument number which identifies this transaction is:
If registered land, the document number which identifies this transaction is:
Docum Num er
S Lure pli an
wpafrmeb.doe rev.12/23/09 WPA Form 8B,Certificate of Compliance-Page 3 of 3
RECEIVEM
The AUG 0 8 2011
Neve -Morin DEPT.OF PLANNING&
Group, Inc. OOlAl*U 1TY DEVELOPMENT
August 4, 2011
Conservation Commission
120 Washington Street
City Hall Annex
Salem, MA 01970
Re: DEP File No. 64-507
30 Columbus Avenue
Owner/Applicant: Robert & Anthie Jackson
Dear Commission Members:
In accordance with General Condition 12 of the WPA Order of Conditions issued on October 14,
2010, and in accordance with General Condition 39 of the Additional Findings attached to the
Order of Conditions, find enclosed an As-Built Site Conditions plan for the above-referenced
project. Also enclosed is the Form 8A—Request for Certificate of Compliance.
By examining the as-built plan you will note that the approved patio at the rear of the dwelling
was not construction, and the stair system associated with the rear deck was reduced from what
was approved. The entrance on the northerly side of the dwelling was modified slightly and
several flagstone walkways were constructed around the structure. Also, two stone dust parking
strips were constructed on the southerly side of the dwelling; note that only a portion of the strips
are located within 100 feet of the coastal bank. The runoff from these strips flows toward
Columbus Avenue.
Based on the above you will see that the elimination of the patio and reduction in the stair system
for the rear deck mitigates the minor changes in the side entrance, the addition of the flag stone
walks and the construction of the stone dust parking strips.
I hereby certify that all work has been satisfactorily completed in accordance with the approved
plans and your Order, with the exception of the items mentioned above which, as stated, should
not result in any adverse impact to the resource area; therefore, at this time we are requesting that
the Commission issue a Certificate of Compliance.
ENGINEERS a SURVEYORS • ENVIRONMENTAL CONSULTANTS • LAND USE PLANNERS
447 Old Boston Road (U.S. Route 1), Topsfield, MA 01983 978-887-8586 FAX 978-887-3480
Providing Professional Services Since 1978
www.nevemorin.com
Conservation Commission Page 2
August 4, 2011
If you should have any questions regarding this matter please do not hesitate to contact our
office.
Sincerely,
THE NEVE-MORIN GROUP, INC.
John M. Morin, PE
President, CEO
JMM/kmm
Enclosures
cc: Robert & Anthie Jackson
Frank Howard
F:\KATHMHoward 2921 W OI\CoC Request Undoe
CITY OF SALEM
CONSERVATION COMMISSION
October 15, 2010
Robert& Anthie Jackson
13 Highland Rd.
Boxford, MA 01921
Re: Order of Conditions—DEP #64-507
30 Columbus Ave.
Dear Mr. Holloran:
Enclosed, please find the Order of Conditions for the above referenced project.
Following the 10-day appeal period (as of October 15, 2010), this document and the
attached Special Conditions must be recorded at the Essex County Registry of Deeds
(Shetland Park 45 Congress Street, Suite 4100 Salem, Massachusetts). Once recorded,
please return a copy of Page 12 of the Order, which will indicate to the Commission that
the document has been recorded.
As indicated in the Order, prior to any work commencing:
1. this Order must be recorded,
2. a sign shall be displayed showing DEP File#64-507 within public view, and
3. contact me at least 48 hours prior to any activity to schedule a pre-construction
meeting to review the Order with your hired contractor.
If you have any further questions, please feel free to contact me at 978-619-5685.
Sincerely,
Tom Devine
Conservation Agent/ Staff Planner
Enclosures
CC: DEP Northeast Regional Office
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands 64-507
WPA Form 5 — Order of Conditions MassDEP File#
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction#
Salem
Clty/rown
A. General Information
Important: Salem
When filling 1. From: Conservation Commission
out forms
on the z. This issuance is for computer, (check one): a.®Order of Conditions b.❑Amended Order of Conditions
use only the
tab key to 3. To: Applicant:
move your
cursor-do Robert&Anthie Jackson
not use the a.First Name b.Last Name
return key. Go The Neve-Morin Group, Inc.
c.Organization
VQ 447 Boston Street
d.Mailing Address
T
opsfield MA 01983
e.City/rown f.State g.Zip Code
4. Property Owner(if different from applicant):
a.First Name b.Last Name
c.Organization
d.Mailing Address
e.City/rown f.State g.Zip Code
5. Project Location:
30 Columbus Avenue Salem
a.Street Address b.City/Town
44 150
c.Assessors Map/Plat Number d.Parcel/Lot Number
Latitude and Longitude, if known: d m s it m s
d.Latitude e.Longitude
wpeforrn&A - rev.12r23N9 Page i of 12
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands 64-507
} WPA Form 5 — Order of Conditions MassDEP File#
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction#
Salem _
City/Town
A. General Information (cont.)
6. Property recorded at the Registry of Deeds for(attach additional information if more than
one parcel):
Essex South
a.County - b.Certificate Number(if registered land)
29671 323
c. Book d. Page
�. Dates: 9/13/2010 10/14/2010 10/14/2010
a.Dale Notice of Intent Filed b. Date Public Hearing Closed c. Date of Issuance
a. Final Approved Plans and Other Documents (attach additional plan or document references
as needed):
Plan of Land in Salem, Mass. SHowing Proposed Lot Development, 30 Columbus Avenue
prepared for Robert &Anthie Jackson
The Neve-Morin Group, Inc. John M. Morin, PE & Paul Donohoe, PLS
b. Prepared By c.Signed and Stamped by
9/10/2010 1"=10'
d. Final Revision Date e.Scale
f.Additional Plan or Document Title g. Date
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 (the Act). Check all that apply:
a. ❑ Public Water Supply b. ❑ Land Containing Shellfish c. ® Prevention of
Pollution
d. El Private Water Supply e. ❑ Fisheries Wi Protection of
Wildlife
g. ❑ Groundwater Supply n. ® Storm Damage Prevention i. ® Flood Control
2. This Commission hereby finds the project, as proposed, is: (check one of the following boxes)
Approved subject to:
a. ® 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.
wpaform5.doo•,rev.12M,09 Page 2 of 12
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands 64-507
WPA Form 5 — Order of Conditions MassDEP File#
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction#
Salem
City/Town
B. Findings (cont.)
Denied because:
b. ❑ 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 the interests of the Act, 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.
c. ❑ 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)
3. ❑ Buffer Zone Impacts: Shortest distance between limit of project a.linear feet
disturbance and Bank or Bordering Vegetated Wetland boundary (if
available)
Resource Area Proposed Permitted Proposed Permitted
Alteration Alteration Replacement Replacement
4. ❑ Bank i.linearfeet b. linearfeet c.linear feet d.linear feet
5. ❑ Bordering
Vegetated Wetland a.square feet, b.square feet c.square feet d.square feet
6. ❑ Land Under
Waterbodies and a.square feet b.square feet c.square feetd.square feet
Waterways
e.c/y dredged f.Gy dredged
7. ❑ 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
6. ❑ 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
wpafornr5 coc• rev.12123,09 _ Page 3 of 12
Massachusetts Department of Environmental Protection Provided by MassoEP:
Bureau of Resource Protection - Wetlands 64-507
WPA Form 5 — Order of Conditions MassoEPFile#
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 euEP Transaction tt
Salem
Cityfrown
B. Findings (cont.)
Resource Area Proposed Permitted Proposed Permitted
Alteration Alteration Replacement Replacement
9. ❑ Riverfront Area a.total sq.feet b. total sq.feet
Sq ft within 100 ft c.square feet d.square feet e.square feet f.square feet
Sq It between 100-
200 ft g.square feet h.square feet i.square feet j.square feet
Coastal Resource Area Impacts: Check all that apply below. (For Approvals Only)
1o. ❑ Designated Port Indicate size under Land Under the Ocean, below
Areas
11. ❑ Land Under the
Ocean a.square feet b.square feet
c.c/y dredged d.c/y dredged
12. ❑ Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes
below
13, El Coastal Beaches cu yd
a.square feet b.square feet c.nourishment
d.nourishment
cu yd
14. El Coastal Dunes __cu yd
a.square feel b.square feet c.nourishment d.nourishment
15. ❑ Coastal Banks a. linear feet b. linear feet
16. ❑ Rocky Intertidal _
Shores a.square feet b.square feel
17. ❑ Salt Marshes a.square feet b.square feet c.square feet d.square feet
18. ❑ Land Under Salt _
Ponds a.square feet b.square feet
c.c/y dredged d.c/y dredged
19. ❑ Land Containing _
Shellfish a.square feet b.square feet c.square feet d.square feet
20. ❑ Fish Runs Indicate size under Coastal Banks, Inland Bank, Land Under
the Ocean, and/or inland Land Under Waterbodies and
Waterways, above
a.c/y dredged b.c/y dredged
21. ® Land Subject to 1,875 1,875
Coastal Storm a.square feet b.square feet
Flowage
npalorin5.doc• iev.12123109 Page 4 of 12
Massachusetts Department of Environmental Protection Provided by MassDEP:
�._ Bureau of Resource Protection - Wetlands 64-507
WPA Form 5 — Order of Conditions MassDEP File#
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction#
Salem
City/Town
B. Findings (cont.)
22. ❑ Restoration/Enhancement:
a.square feet of BVW b.square feet of salt marsh
23. ❑ Stream Crossing(s):
a. number of new stream crossings b. number of replacement stream crossings
C. General Conditions Under Massachusetts Wetlands Protection Act
The following conditions are 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. If this Order constitutes an Amended Order of Conditions, this Amended Order of
Conditions does not extend the issuance date of the original Final Order of Conditions and
the Order will expire on 10/14/2013 unless extended in writing by the Department.
7. 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.
8. 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.
wpalormSdoc rev.M23109 Page 5 of 12
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands 64-507
WPA Form 5.— Order of Conditions MassDEP File# —
If! Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction#
Salem
City/Town
C. General Conditions Under Massachusetts Wetlands Protection Act (cont.)
9. 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 the
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.
10. 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, "MassDEP"]
"File Number 64-507 "
11. 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 MassDEP.
12. Upon completion of the work described herein, the applicant shall submit a Request for
Certificate of Compliance (WPA Form 8A) to the Conservation Commission,
13. The work shall conform to the plans and special conditions referenced in this order.
14. 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.
15. 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.
16. 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.
17. 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.
woaform5.doc• rev.12f2109 Page 6 of 12
Massachusetts Department of Environmental Protection Provided by MassDEP:
._ Bureau of Resource Protection - Wetlands 64-507
WPA Form 5 — Order of Conditions MassDEP Pile# —
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction#—
Salem
City/Town
C. General Conditions Under Massachusetts Wetlands Protection Act (cont.)
18, 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.
NOTICE OF STORMWATER CONTROL AND MAINTENANCE REQUIREMENTS
19. The work associated with this Order (the "Project') is (1)❑ is not (2)® subject to the
Massachusetts Stormwater Standards. If the work is subject to the Stormwater
Standards, then the project is subject to the following conditions:
a) All work, including site preparation, land disturbance, construction and redevelopment,
shall be implemented in accordance with the construction period pollution prevention and
erosion and sedimentation control plan and, if applicable, the Stormwater Pollution
Prevention Plan required by the National Pollution Discharge Elimination System
Construction General Permit as required by Stormwater Condition 8. Construction period
erosion, sedimentation and pollution control measures and best management practices
(BMPs) shall remain in place until the site is fully stabilized.
b) No stormwater runoff may be discharged to the post-construction stormwater BMPs
unless and until a Registered Professional Engineer provides a Certification that:
i. all construction period BMPs have been removed or will be removed by a date certain
specified in the Certification. For any construction period BMPs intended to be converted
to post construction operation for stormwater attenuation, recharge, and/or treatment, the
conversion is allowed by the MassDEP Stormwater Handbook BMP specifications and that
the BMP has been properly cleaned or prepared for post construction operation, including
removal of all construction period sediment trapped in inlet and outlet control structures;
ii. as-built final construction BMP plans are included, signed and stamped by a Registered
Professional Engineer, certifying the site is fully stabilized;
iii. any illicit discharges to the stormwater management system have been removed, as per
the requirements of Stormwater Standard 10;
iv. all post-construction stormwater BMPs are installed in accordance with the plans.
(including all planting plans)approved by the issuing authority, and have been inspected to
ensure that they are not damaged and that they are in proper working condition;
v. any vegetation associated with post-construction BMPs is suitably established to
withstand erosion.
wpatorm5.doc- tev.1212109 Page 7 of 12
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands 64-507
WPA Form 5 — Order of Conditions MassDEP FIIe#
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction#
Salem
city/Town
C. General Conditions Under Massachusetts Wetlands Protection Act (cont.)
c) The landowner is responsible for BMP maintenance until the issuing authority is
notified that another party has legally assumed responsibility for BMP maintenance. Prior
to requesting a Certificate of Compliance, or Partial Certificate of Compliance, the
responsible party (defined in General Condition 18(e)) shall execute and submit to the
issuing authority an Operation and Maintenance Compliance Statement ("O&M Statement)
for the Stormwater BMPs identifying the party responsible for implementing the stormwater
BMP Operation and Maintenance Plan ("O&M Plan") and certifying the following: i.) the
O&M Plan is complete and will be implemented upon receipt of the Certificate of
Compliance, and ii.)the future responsible parties shall be notified in writing of their
ongoing legal responsibility to operate and maintain the stormwater management BMPs
and implement the Stormwater Pollution Prevention Plan.
d) Post-construction pollution prevention and source control shall be implemented in
accordance with the long-term pollution prevention plan section of the approved
Stormwater Report and, if applicable, the Stormwater Pollution Prevention Plan required by
the National Pollution Discharge Elimination System Multi-Sector General Permit.
e) Unless.and until another party accepts responsibility, the landowner, or owner of any
drainage easement, assumes responsibility for maintaining each BMP. To overcome this
presumption, the landowner of the property must submit to the issuing authority a legally
binding agreement of record, acceptable to the issuing authority, evidencing that another
entity has accepted responsibility for maintaining the BMP, and that the proposed
responsible party shall be treated as a permittee for purposes of implementing the
requirements of Conditions 18(f)through 18(k)with respect to that BMP. Any failure of the
proposed responsible party to implement the requirements of Conditions 18(f) through
18(k)with respect to that BMP shall be a violation of the Order of Conditions or Certificate
of Compliance. In the case of stormwater BMPs that are serving more than one lot, the
legally binding agreement shall also identify the lots that will be serviced by the stormwater
BMPs. A plan and easement deed that grants the responsible party access to perform the
required operation and maintenance must be submitted along with the legally binding
agreement.
f) The responsible party shall operate and maintain all stormwater BMPs in accordance
with the design plans, the O&M Plan, and the requirements of the Massachusetts
Stormwater Handbook.
b
wpaform5.doc• rev,12/23/09 Page 8 of 12
Massachusetts Department of Environmental Protection Provided by MassDEP:
_ Bureau of Resource Protection - Wetlands 64-507
WPA Form 5 — Order of Conditions MassDEP File" —
.1 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP—Tr
ansaceon# -
Salem
City/Town
C. General Conditions Under Massachusetts Wetlands Protection Act (cont.)
g) The responsible party shall:
1. Maintain an operation and maintenance log for the last three (3) consecutive
calendar years of inspections, repairs, maintenance and/or replacement of the
stormwater management system or any part thereof, and disposal (for disposal the
log shall indicate the type of material and the disposal location);
2. Make the maintenance log available to MassDEP and the Conservation
Commission ("Commission") upon request; and
3. Allow members and agents of the MassDEP and the Commission to enter and
inspect the site to evaluate and ensure that the responsible party is in compliance
with the requirements for each BMP established in the O&M Plan approved by the
issuing authority.
h) All sediment or other contaminants removed from stormwater BMPs shall be disposed
of in accordance with all applicable federal, state, and local laws and regulations.
i) Illicit discharges to the stormwater management system as defined in 310 CMR 10.04
are prohibited.
j) The stormwater management system approved in the Order of Conditions shall not be
changed without the prior written approval of the issuing authority.
k) Areas designated as qualifying pervious areas for the purpose of the Low Impact Site
Design Credit(as defined in the MassDEP Stormwater Handbook, Volume 3, Chapter 1,
Low Impact Development Site Design Credits) shall not be altered without the prior written
approval of the issuing authority.
1) Access for maintenance, repair, and/or replacement of BMPs shall not be withheld.
Any fencing constructed around stormwater BMPs shall include access gates and shall be
at least six inches above grade to allow for wildlife passage.
Special Conditions (if you need more space for additional conditions, please attach a text
document):
See attached
wpalormS.du• rev_12123109 Page 9 of 12
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands 64-507
WPA Form 5 — Order of Conditions MassDEP File#
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction#--
Salem
City/Town
D. Findings Under Municipal Wetlands Bylaw or Ordinance
1. Is a municipal wetlands bylaw or ordinance applicable? ® Yes ❑ No
2. The Salem hereby finds (check one that applies):
Conservation Commission
a. ❑ that the proposed work cannot be conditioned to meet the standards set forth in a
municipal ordinance or bylaw, specifically:
1. Municipal Ordinance or Bylaw 2. 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.
b. ❑ that the following additional conditions are necessary to comply with a municipal
ordinance or bylaw:
T. Municipal Ordinance or Bylaw 2.Citation
3. 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.
The special conditions relating to municipal ordinance or bylaw are as follows (if you need
more space for additional conditions, attach a text document):
•opaform5.doc• rev.12/23/05
Page 10 of 12
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands 64-507
WPA Form 5 — Order of Conditions MassDEP File#
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction#
Salem
Cily/Town
E. Signatures
This Order is valid for three years, unless otherwise specified as a special 10/14/2010 _
condition pursuant to General Conditions#4,from the date of issuance. i. Date of Issuance
Please indicate the number of members who will sign this form. 7
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 t e same time to the appropriate Department of
Environmental Protection Regional Office, if n filing electronically, and the property owner, if different
from applicant.
Signatures: —
C
❑ by hand delivery on by certified mail, re rn receipt
requested,on
Date Date
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 MassDEP 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.
Any appellants seeking to appeal the Department's Superseding Order associated with this appeal
will be required to demonstrate prior participation in the review of this project. Previous participation
in the permit proceeding means the submission of written information to the Conservation
Commission prior to the close of the public hearing, requesting a Superseding Order, or
providing written information to the Department prior to issuance of a Superseding Order.
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.
wreform5.dcc• rev.12/23109 Page 11 of 12
Massachusetts Department of Environmental Protection Provided by MassDEP:
\ _ Bureau of Resource Protection - Wetlands 64-507
I� , WPA Form 5 - Order of Conditions MassDEP-File#
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
eDEP Transaction#
Salem
City/Town
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 this page 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.
----------I----------------------------------------------------------------------
To:
Salem
_ Conservation Commission
Please be advised that the Order of Conditions for the Project at:
30 Columbus Avenue 64-507
Project Location MassDEP 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:
10/14/2010
Date
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 — —
wparorm5.ao, rev.1223/09 Page 12 0l 12
Attachment to Order of Conditions # 64-507
Page Iof 5
SALEM CONSERVATION COMMISSION
DEP FILE #64-507
30 Columbus Ave.
City of Salem Massachusetts
ADDITIONAL FINDINGS
Based on the Estimated Habitats of Rare Wildlife and Certified Vernal Pools Map (June 1, 2003) from Natural
Heritage & Endangered Species Program(NHESP)of the Massachusetts Division of Fisheries and Wildlife, it has
been determined that this project does not occur near any habitat of state-listed rare wildlife species nor contains any
vernal pools.
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 demolition of an existing single family structure and construction of a new single family
structure within Land Subject to Coastal Storm Flowage, within a Buffer Zone to a Coastal Bank, and within a
Buffer Zone to a Salt Marsh. The footprint of the new structure will be no larger than the footprint of the existing
dwelling, pool, and shed, so as not to alter the 100 year flood plain volume. The work permitted will alter 1,875
square feet of Land Subject to Coastal Storm Flowage, Buffer Zone to a Coastal Bank, and Buffer Zone to a Salt
Marsh.
GENERAL CONDITIONS
1. This Order of Conditions must be recorded in its entirety(including all 5 pages of Special Conditions)
at the Essex County Registry of Deeds or the Land Court for the district in which the land is located,
after the expiration of the 10-day appeal period and within 30 days of the issuance. A copy of the
recording information must be submitted to the Salem Conservation Commission 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 and the City of Salem Wetlands
Protection Ordinance, Salem Code Chapter 34,Section 34-1 —34-13.
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 on site,a DEP Sign showing DEP File#64-507 must be installed at the
entrance to the site and seen from the public way, but 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. With respect to this Order,the Commission designates the Conservation Agent as its agent with powers
to act on its behalf in administering and enforcing this Order.
Attachment to Order of Conditions# 64-507
P Page 2of 5
7. The Commission or its Agent,officers,or employees shall have th
e right to enter and inspect
pest the property at
an time for compliance Y pl ance 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.
8. 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
I Y
transfers of title of any portion of the property that takes lace prior to issuance of the
Compliance. P P Certificate of
9. It is the responsibility of the applicant to procure all oth
er applicable federal,, stale and local permits and
approvals associated with this project. These permits may include but are not necessarily limited to the
following:
(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) Sewer Extension Permit from the DEP Division of Water Pollution Control under G. L. Ch. 21 A ss7
and 314 CM
R 7.00. Any Board of Health permit for septic system P p y m design for any portion of the
septic system within 100 feet of wetlands shall be submitted to the Commission prior to
construction initiation.
(4) Design Requirements for Construction in Floodplains under the State Building Code(780 CMR
744.).
10. If there are conflicting conditions within this Order,the stricter condition(s)shall rule.
11. 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.
12. The Commission or its Agent 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
Plan of Land in Salem, Mass. Showing Proposed Lot Development, 30 Columbus Avenue,
prepared for Robert& Anthie Jackson
(Title)
9/10/2010
(Dated)
Paul J. Donohoe,John M.Morin
(Signed and Stamped by)
City of Salem Conservation Commission
(On file with)
g"�N Attachment to Order of Conditions # 64-507
,r ,Page 5
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.
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
must be a Pre-Construction Meeting on site between the project supervisor,the contractor responsible
for the work,and the Conservation Agent and/or a member of the Conservation Commission 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 Agent at
(978)619-5685 at least forty-eight(48)hours prior to construction 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 Agent 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 stored under cover on the site to be used for emergency
erosion control purposes.
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 any wetland resource area and/or buffer zones. The
erosion control measures shown on the approval plan(s)and provisions in the Order will be the minimum
standards for this project; the Commission or its Agent 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 from 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.
Attachment to Order of Conditions # 64-507
Page 4of S
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-term stabilization of disturbed areas.
28. If soils are to be disturbed for longer that two(2)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.
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 aheration 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).
€ t Attachment to Order of Conditions # 64-507
Page 5of 5
(2) A letter from a Registered Professional Engineer certifying compliance of the property with this
Order of Conditions.
(3) An "As-Buih"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;
(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 Agent has authorized
their removal.
ADDITIONAL CONDITIONS
43. Prior to construction,a filter sock shall be installed along the street side of the property,except at the
construction vehicle entrance,where a gravel berm shall be installed. The filter sock proposed between
the work area and the seawall may be eliminated.
44. No soils or construction debris may be stockpiled on the site. These materials shall be removed daily
from the site and disposed of legally.
45. Catch basins on Columbus Avenue shall be protected from sedimentation and debris from the worksite.
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands
MassDEP File Number
WPA Form 3 - Notice of Intent
Document Transaction Number
Ll Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem
City/Town
Important:filling out When fillin A. General Information
forms on the
computer,use 1. Project Location (Note: electronic filers will click on button to locate project site):
only the tab key
to move your 30 Columbus Avenue Salem
cursor-do not use the return a.Street Address b.City/Town c.Zip Code
key. Latitude and Longitude:
d. Latitude e. Longitude
� Map 44 Parcel 150
f.Assessors Map/Plat Number g. Parcel/Lot Number
2. Applicant:
Robert&Anthie Jackson
a. First Name b. Last Name
Note: c/o The Neve-Morin Group Inc.
Before c.Organization
completing this 447 Boston Street
form consult
your local d.Street Address
Conservation Topsfield MA 01983
Commission e.Cityrrown f.State g.Zip Code
regarding any municipal bylaw 978-887-8586 978-887-3480 greg@nevemorin.com
or ordinance. h. Phone Number i. Fax Number j.Email Address
3. Property owner(required if different from applicant): ❑ Check if more than one owner
a. First Name b. Last Name
c.Organization
d. Street Address
e.City/Town f.State g.Zip Code
h. Phone Number i. Fax Number j. Email address
4. Representative (if any):
Greg Hochmuth
a.First Name b.Last Name
The Neve-Morin Group Inc.
3 M c.Company
m m 447 Boston Street
Z M 2 d.Street Address
� m Topsfield MA 01983
e. City/Town f.State g.Zip Code
Z 978-887-8586 978-887-3480 greg@nevemorin.com
m Z ry d
Z o h. Phone Number i. Fax Number j.Email address
v go o fi
m g° M 5. Total WPA Fee Paid (from NOI Wetland Fee Transmittal Form):
$500.00 $237.50 $262.50
a.Total Fee Paid b.State Fee Paid c.City/rown Fee Paid
wpaform3.doc•rev. 11/16/09 Page 1 of 8
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands
MassDEP File Number
WPA Form 3 — Notice of Intent Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem
Cityrrown
A. General Information (continued)
6. General Project Description:
Proposal is to raze the existing dwelling, deck, pool and shed and construct a new dwelling,deck&patio. The
project also includes the removal of existing pavement and the construction of a small portion of pavement. All
work is located within 100 feet of a coastal bank and located within the 100 year flood plain. The space occupied
by the proposed structure does not exceed the space occupied by the existing dwelling, pool and shed,therefore,
Thor.ie nn nrnnne.rl.If.mfinn fn The inn ,..r flnnrf Whin vnL gym.
7a. Project Type Checklist:
1. ® Single Family Home 2. ❑ Residential Subdivision
3. ❑ Limited Project Driveway Crossing 4. ❑ Commercial/Industrial
5. ❑ Dock/Pier 6. ❑ Utilities
7. ❑ Coastal Engineering Structure 8. ❑ Agriculture (e.g., cranberries, forestry)
9. ❑ Transportation 10. ❑ Other
7b. Is any portion of the proposed activity eligible to be treated as a limited project subject to 310 CMR
10.24 (coastal) or 310 CMR 10.53 (inland)?
1. ❑ Yes ❑ No If yes, describe which limited project applies to this project:
2. Limited Project
8. Property recorded at the Registry of Deeds for:
Essex South
a.County b.Certificate#(if registered land)
29671 323
c.Book d. Page Number
B. Buffer Zone & Resource Area Impacts (temporary & permanent)
1. ❑ Buffer Zone Only—Check if the project is located only in the Buffer Zone of a Bordering
Vegetated Wetland, Inland Bank, or Coastal Resource Area.
2. ® Inland Resource Areas (see 310 CMR 10.54-10.58; if not applicable, go to Section B.3,
Coastal Resource Areas).
Check all that apply below. Attach narrative and any supporting documentation describing how the
project will meet all performance standards for each of the resource areas altered, including standards
requiring consideration of alternative project design or location.
For all projects
affecting other Resource Area Size of Proposed Alteration Proposed Replacement(if any)
Resource Areas,
please attach a
narrative a. ❑ Bank 1.linear feet 2. linear feet
explaining how b. ❑ Bordering Vegetated
the resource
area was Wetland 1.square feet 2.square feet
delineated.
c. ❑ Land Under 1,square feet 2.square feet
Waterbodies and
.Waterways 3.cubic yards dredged
wpaform3.doc•rev. 11/16/09 Page 2 of 8
Massachusetts Department of Environmental Protection Provided by MassDE P'.
Bureau of Resource Protection -Wetlands MassDEP File Number
WPA Form 3 — Notice of Intent
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem
City/Town
B. Buffer Zone & Resource Area Impacts (temporary & permanent) (cont'd)
Resource Area Size of Proposed Alteration Proposed Replacement(if any)
d. ® Bordering Land 1,875sf 0
Subject to Flooding 1.square feet 2.square feet
0(see attached sheet)
3.cubic feet of flood storage lost 4.cubic feet replaced
e. ❑ Isolated Land
Subject to Flooding 1.square feet
2.cubic feel of flood storage lost 3.cubic feet replaced
f. ❑ Riverfront Area 1.Name of Waterway(if available)
2.Width of Riverfront Area (check one):
❑ 25 ft. - Designated Densely Developed Areas only
❑ 100 ft. - New agricultural projects only
❑ 200 ft. -All other projects
3. Total area of Riverfront Area on the site of the proposed project: square feet
4. Proposed alteration of the Riverfront Area:
a.total square feet b.square feet within 100 ft. c.square feet between 100 ft.and 200 ft.
s. Has an alternatives analysis been done and is it attached to this NOI? ❑ Yes❑ No
6. Was the lot where the activity is proposed created prior to August 1, 1996? ❑ Yes❑ No
3. ® Coastal Resource Areas: (See 310 CMR 10.25-10.35)
Check all that apply below. Attach narrative and supporting documentation describing how the project
will meet all performance standards for each of the resource areas altered, including standards
requiring consideration of alternative project design or location.
Online Users:
Include your Resource Area Size of Proposed Alteration Proposed Replacement (if any)
document
transaction a. ❑ Designated Port Areas Indicate size under Land Under the Ocean, below
number
(provided on
your receipt b. ❑ Land Under the Ocean
page)with all 1.square feet
supplementary
information you 2.cubic yards dredged
submit to the
Department. c. ❑ Barrier Beach Indicate size under Coastal Beaches and/or Coastal Dunes below
d. ❑ Coastal Beaches 1.square feet 2.cubic yards beach nourishment
e. ❑ Coastal Dunes 1.square feet 2.cubic yards dune nourishment
wpaform3.doc•rev. 11/16/09 Page 3 of 8
B. 2. d. 3 & B. 3. 1. 1.
The space occupied by the proposed structure does not exceed the space occupied by the
existing dwelling, pool and shed, therefore, there is no proposed alteration to the 100 year
flood plain volume.
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau Of Resource Protection -Wetlands MassDEP File Number
1 WPA Form 3 — Notice of Intent
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem
City/Town
B. Buffer Zone & Resource Area Impacts (temporary & permanent) (cont'd)
Size of Proposed Alteration Proposed Replacement (if any)
f. ❑ Coastal Banks 1. linear feet
g. ❑ Rocky Intertidal
Shores 1.square feet
h. ❑ Salt Marshes 1.square feet 2.sq ft restoration, rehab.,creation
i. ❑ Land Under Salt
Ponds 1.square feet
2.cubic yards dredged
i. ❑ Land Containing
Shellfish 1.square feet
k. ❑ Fish Runs Indicate size under Coastal Banks, inland Bank, Land Under the
Ocean, and/or inland Land Under Waterbodies and Waterways,
above
1.cubic yards dredged
1. 0 Land Subject to 1,875sf (see attached sheet)
Coastal Storm Flowage 1.square feet
4. ❑ Restoration/Enhancement
If the project is for the purpose of restoring or enhancing a wetland resource area in addition to the
square footage that has been entered in Section B.2.b or B.3.h above, please enter the additional
amount here.
a.square feet of BVW b.square feet of Saft Marsh
5. ❑ Project Involves Stream Crossings
a. number of new stream crossings b. number of replacement stream crossings
C. Other Applicable Standards and Requirements
Streamlined Massachusetts Endangered Species Act/Wetlands Protection Act Review
1. Is any portion of the proposed project located in Estimated Habitat of Rare Wildlife as indicated on
the most recent Estimated Habitat Map of State-Listed Rare Wetland Wildlife published by the Natural
Heritage and Endangered Species Program (NHESP)? To view habitat maps, see the Massachusetts
Natural Heritage Atlas or go to
http://www.mass.gov/dfwele/dfw/nhesp/regulatory review/priority habitat/online viewer.htm.
a. ❑ Yes ® No If yes, include proof of mailing or hand delivery of NOI to:
Natural Heritage and Endangered Species Program
Division of Fisheries and Wildlife
Oct. 1, 2008 Route 135, North Drive
b. Date of map Westborough, MA 01581
wpaform3.doc•rev. 11/16/09 Page 4 of 8
B. 2. d. 3 & B. 3. 1. 1.
The space occupied by the proposed structure does not exceed the space occupied by the
existing dwelling, pool and shed, therefore, there is no proposed alteration to the 100 year
flood plain volume.
Massachusetts Department of Environmental Protection Provided by MassoEP:
Bureau of Resource Protection - Wetlands MassDEP File Number
WPA Form 3 — Notice of Intent
Document Transaction Number
Ll Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem
Cityrrown
C. Other Applicable Standards and Requirements (contrd)
If yes, the project is also subject to Massachusetts Endangered Species Act(MESA) review(321
CMR 10.18). To qualify for a streamlined, 30-day, MESA/Wetlands Protection Act review, please
complete Section C.1.C, and include requested materials with this Notice of Intent(NOI); OR
complete Section C.1.d, if applicable. If MESA supplemental information is not included with the NOI,
by completing Section 1 of this form, the NHESP will require a separate MESA filing which may take
up to 90 days to review(unless noted exceptions in Section 2 apply, see below).
1. c. Submit Supplemental Information for Endangered Species Review`
1. ❑ Percentage/acreage of property to be altered:
(a)within wetland Resource Area percentage/acreage
(b) outside Resource Area percentage/acreage
2. ❑ Assessor's Map or right-of-way plan of site
3. ❑ Project plans for entire project site, including wetland resource areas and areas outside of
wetlands jurisdiction, showing existing and proposed conditions, existing and proposed
tree/vegetation clearing line, and clearly demarcated limits of work**"
(a)❑ Project description (including description of impacts outside of wetland resource area &
bufferzone)
(b) ❑ Photographs representative of the site
(c)❑ MESA fling fee (fee information available at:
http://www.mass.gov/dfwele/dfw/nhesp/regulatory review/mesa/mesa fee schedule.htm).
Make check payable to"Commonwealth of Massachusetts- NHESP" and mail to
NHESP at above address
Projects altering 10 or more acres of land, also submit:
(d)❑ Vegetation cover type map of site
(a)❑ Project plans showing Priority & Estimated Habitat boundaries
d. OR Check One of the Following
1. ❑ Project is exempt from MESA review.
Attach applicant letter indicating which MESA exemption applies. (See 321 CMR 10.14,
http://www.mass.gov/dfwele/dfw/nhesp/regulatory review/mesa/mesa exemptions.htm;
the NOI must still be sent to NHESP if the project is within estimated habitat pursuant to
310 CMR 10.37 and 10.59.)
2. ❑ Separate MESA review ongoing. a.NHESP Tracking# b.Date submitted to NHESP
Some projects not in Estimated Habitat may be located in Priority Habitat,and require NHESP review(see
http://www.mass.gov/dfwele/dfw/nhesp/nhesl).htm, regulatory review tab). Priority Habitat includes habitat for state-listed plants and
strictly upland species not protected by the Wetlands Protection Act.
" MESA projects may not be segmented (321 CMR 10.16).The applicant must disclose full development plans even if such plans are
not required as part of the Notice of Intent process.
wpaform3.doc•rev. 11/16/09 Page 5 of 8
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands
MassDEP File Number
WPA Form 3 — Notice of Intent
Ll Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Document Transaction Number
Salem
cityrrowo
C. Other Applicable Standards and Requirements (cont'd)
3. ❑ Separate MESA review completed.
Include copy of NHESP"no Take"determination or valid Conservation & Management
Permit with approved plan.
2. For coastal projects only, is any portion of the proposed project located below the mean high water
line or in a fish run.
a. ® Not applicable—project is in inland resource area only
b.❑ Yes ❑ No If yes, include proof of mailing or hand delivery of NOI to either:
South Shore-Cohasset to Rhode North Shore- Hull to New Hampshire:
Island, and the Cape&Islands:
Division of Marine Fisheries- Division of Marine Fisheries-
Southeast Marine Fisheries Station North Shore Office
Attn: Environmental Reviewer Attn: Environmental Reviewer
1213 Purchase Street—3rd Floor 30 Emerson Avenue
New Bedford, MA 02740-6694 Gloucester, MA 01930
Also if yes, the project may require a Chapter 91 license. For coastal towns in the Northeast Region,
please contact MassDEP's Boston Office. For coastal towns in the Southeast Region, please contact
MassDEP's Southeast Regional Office.
3. Is any portion of the proposed project within an Area of Critical Environmental Concern (ACEC)?
Online users: a. ❑ Yes ® No If yes, provide name of ACEC (see instructions to WPA Form 3 or MassDEP
Include your Website for ACEC locations). Note: electronic filers click on Website.
document
transaction b.ACEC
number
(provided on 4. Is any portion of the proposed project within an area designated as an Outstanding Resource Water
your receipt (ORW)as designated in the Massachusetts Surface Water Quality Standards, 314 CMR 4.00?
page)with all
supplementary a. ❑ Yes ® No
information you
submit to the 5. Is any portion of the site subject to a Wetlands Restriction Order under the Inland Wetlands
Department. Restriction Act(M.G.L. c. 131, §40A) or the Coastal Wetlands Restriction Act(M.G.L. c. 130, § 105)?
a. ❑ Yes ® No
6. Is this project subject to provisions of the MassDEP Stormwater Management Standards?
a. ❑ Yes. Attach a copy of the Stormwater Report as required by the Stormwater Management
Standards per 310 CMR 10.05(6)(k)-(q) and check if:
1. ❑ Applying for Low Impact Development(LID) site design credits (as described in
Stormwater Management Handbook Vol. 2, Chapter 3)
2.❑ A portion of the site constitutes redevelopment
3. ❑ Proprietary BMPs are included in the Stormwater Management System.
b. ® No. Check why the project is exempt:
1.® Single-family house
wpaform3.doc•rev. 11/16/09 Page 6 of 8
Massachusetts Department of Environmental Protection Provided by MassDEP:
LBureau of Resource Protection -Wetlands MassDEP File Number
WPA Form 3 — Notice of Intent
1 Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem
City/Town
C. Other Applicable Standards and Requirements (cont'd)
2. ❑ Emergency road repair
3. ❑ Small Residential Subdivision (less than or equal to 4 single-family houses or less than or
equal to 4 units in multi-family housing project)with no discharge to Critical Areas.
D. Additional Information
Applicants must include the following with this Notice of Intent(NOI). See instructions for details.
Online Users: Attach the document transaction number(provided on your receipt page) for any of the
following information you submit to the Department.
1. ® USGS or other map of the area (along with a narrative description, if necessary) containing
sufficient information for the Conservation Commission and the Department to locate the site.
(Electronic filers may omit this item.)
2. ® Plans identifying the location of proposed activities (including activities proposed to serve as a
Bordering Vegetated Wetland [BVW] replication area or other mitigating measure) relative to
the boundaries of each affected resource area.
3. ❑ Identify the method for BVW and other resource area boundary delineations (MassDEP BVW
Field Data Form(s), Determination of Applicability, Order of Resource Area Delineation, etc.),
and attach documentation of the methodology.
4. ® List the titles and dates for all plans and other materials submitted with this NOI.
Plan of Land in Salem, Mass. Showing Proposed Lot Development, 30 Columbus Avenue
prepared for Robert &Anthie Jackson
The Neve-Morin Group, Inc. John M. Morin, PE & Paul Donohoe, PLS
b.Prepared By c.Signed and Stamped by
September 10, 2010 1" = 10'
d.Final Revision Date e.Scale
f.Additional Plan or Document Title g. Date
5. ❑ If there is more than one property owner, please attach a list of these property owners not
listed on this form.
6. ❑ Attach proof of mailing for Natural Heritage and Endangered Species Program, if needed.
7. ❑ Attach proof of mailing for Massachusetts Division of Marine Fisheries, if needed.
8. ® Attach NOI Wetland Fee Transmittal Form
9. ❑ Attach Stormwater Report, if needed.
wpaform3.doc rev. 11/16/09 Page 7 of 8
LlMassachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands MassDEP File Number
WPA Form 3 - Notice of Intent
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Document Transaction Number
Salem
Cityrrown
E. Fees
1. ❑ Fee Exempt: No filing fee shall be assessed for projects of any city, town, county, or district of
the Commonwealth, federally recognized Indian tribe housing authority, municipal housing
authority, or the Massachusetts Bay Transportation Authority.
Applicants must submit the following information (in addition to pages 1 and 2 of the NOI Wetland Fee
Transmittal Form)to confirm fee payment:
20001 9/9/10
2.Municipal Check Number 3.Check date
20002 9/9/10
4.State Check Number 5.Check date
The Neve-Morin Group, Inc.
6. Payor name on check: First Name 7. Payor name on check: Last Name
F. Signatures and Submittal Requirements
I hereby certify under the penalties of perjury that the foregoing Notice of Intent and accompanying plans,
documents, and supporting data are true and complete to the best of my knowledge. I understand that
the Conservation Commission will place notification of this Notice in a local newspaper at the expense of
the applicant in accordance with the wetlands regulations, 310 CMR 10.05(5)(a).
I further certify under penalties of perjury that all abutters were notified of this application, pursuant to the
requirements of M.G.L. c. 131, §40. Notice must be made by Certificate of Mailing or in writing by hand
delivery or certified mail (return receipt requested) to all abutters within 100 feet of the property line of the
project location.
M rYlo Lea 9 - 1�3-Id
1.Signature of Applicant 014 �J 2. Date
3.Si nature of Property Owner(if ifferent) 4.Date
VGJAW m, tYl G-13 -!a
5.Signature of Representative(if any) 6.Date
For Conservation Commission:
Two copies of the completed Notice of Intent(Form 3), including supporting plans and documents, two
copies of the NOI Wetland Fee Transmittal Form, and the city/town fee payment, to the Conservation
Commission by certified mail or hand delivery.
For MassDEP:
One copy of the completed Notice of Intent(Form 3), including supporting plans and documents, one
copy of the NOI Wetland Fee Transmittal Form, and a copy of the state fee payment to the MassDEP
Regional Office (see Instructions) by certified mail or hand delivery.
Other:
If the applicant has checked the"yes" box in any part of Section C, Item 3, above, refer to that section
and the Instructions for additional submittal requirements.
The original and copies must be sent simultaneously. Failure by the applicant to send copies in a
timely manner may result in dismissal of the Notice of Intent.
wpaform3.doc•rev. 11/16/09 Page 8 of 8
;. 20001
- - - TD BANKNORTH
The -' 447 OLD.BOSTON ROAD 53-7054-2113 + '
Neve Mmin. . TOPSFIELD.MA 01983.
Grovp.Inc."(08)847-86M - CHI.
ECK DATE
E.
9/9/10
o
PAY
Two Hundred sixty.two & -- ----50/100 dollars
t �
TO City of Salem $262 50 �4
� n 3
HOW2921 i.(K�yA1C0➢1 f Y
;.
AL TTOHIZED SSONATUff
1110 2000 lul 1: 2 L L 3 ?0 545I: 8 244148884u■
Location: 30 Columbus Ave, alem '" '
r2000-2
' TD BANKNORTH
T7h�e7 " 44T OLD BOSTON ROAD 53 7054-2113 -
tVeVe"MOIZII1 .r TOPSFIEID MA 01983
,. Grougilnc (97a1 ee7a59s :` CHECK DATE w.
a
o y.
a,µ" ,
PAY
Two hundred thirty 'seven & ;-, -- - - -- 50/100 dollars
- TO
Commonwealth of Massachusetts �, $237 SQf
k
1
AUTHOAREOSSI DAT�URE
Ir0 200020 1: 2 1 L 3 ?054 5P: El 244 L48884n'
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
NOI Wetland Fee Transmittal Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Important: A. Applicant Information
When filling out
forms on the 1. Applicant:
computer, use
only the tab key Robert&Anthie Jackson
to move your a.First Name b.Last Name
cursor-do not
use the return c/o The Neve-Morin Group, Inc.
key. c.Organization
Boston Street
d. M
m d. Mailing Address
Topsfield MA 01983
e.City/Town f.State g.Zip Code
978-887-8586 978-887-3480 greg@nevemorin.com
h.Phone Number i. Fax Number I. Email Address
2. Property Owner(if different):
a. First Name b. Last Name
c.Organization
d. Mailing Address
e. City/Town I.State g.Zip Code
It.Phone Number i. Fax Number j. Email Address
3. Project Location:
30 Columbus Avenue Salem
a.Street Address b.Cityrrown
To calculate B. Fees
filing fees, refer
to the category The fee should be calculated using the following six-step process and worksheet. Please see
fee list and 9 9 P
examples in the Instructions before filling out worksheet.
instructions for
filling out WPA Step 1/Type of Activity: Describe each type of activity that will occur in wetland resource area and
Form 3(Notice of
Intent). buffer zone.
Step 2/Number of Activities: Identify the number of each type of activity.
Step 3/Individual Activity Fee: Identify each activity fee from the six project categories listed in the
instructions.
Step 4/Subtotal Activity Fee: Multiply the number of activities (identified in Step 2)times the fee per
category (identified in Step 3) to reach a subtotal fee amount. Note: If any of these activities are in a
Riverfront Area in addition to another Resource Area or the Buffer Zone, the fee per activity should be
multiplied by 1.5 and then added to the subtotal amount.
Step 5/Total Project Fee: Determine the total project fee by adding the subtotal amounts from Step 4.
Step 6/Fee Payments: To calculate the state share of the fee, divide the total fee in half and subtract
$12.50. To calculate the city/town share of the fee, divide the total fee in half and add $12.50.
Wpaform3.doe•Welland Fee Transmittal Form•rev.20108 Page 1 of 2
L7 Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
NOI Wetland Fee Transmittal Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Fees (continued)
Step 1/Type of Activity Step 2/Number Step Step 4/Subtotal Activity
of Activities 3/Individual Fee
Activity Fee
Category 2.a. 1 $500.00 $500.00
Step 5/Total Project Fee: $500.00
Step Wee Payments:
Total Project Fee: $5 F
a.ToTotaltal Fee from Step. 1 5
State share of filing Fee: b /2 T 0
b. 1/2 Total Fee less$12.50
City/Town share of filling Fee: c. 1/2 T 0
1/2 Total Fee plus$12.50
C. Submittal Requirements
a.) Complete pages 1 and 2 and send with a check or money order for the state share of the fee, payable to
the Commonwealth of Massachusetts.
Department of Environmental Protection
Box 4062
Boston, MA 02211
b.) To the Conservation Commission: Send the Notice of Intent or Abbreviated Notice of Intent; a copy of
this form; and the city/town fee payment.
To MassDEP Regional Office (see Instructions): Send a copy of the Notice of Intent or Abbreviated Notice of
Intent; a copy of this form; and a copy of the state fee payment. (E-filers of Notices of Intent may submit these
electronically.)
Wpafcrm3.doc•WeVand Fee Transmittal Fen•rev.2121108 Page 2 of 2
he
Neve -Morin
AT n
Group, Inc.
AFFIDAVIT OF SERVICE
Under the Massachusetts Wetlands Protection Act
(to be submitted to Mass. DEP and the Conservation Commission
when filing a Notice of Intent)
I, Kathleen M. Molina of The Neve-Morin Group, Inc., hereby certify under the pains and
penalties of perjury that on September 13, 2010 I gave notification to 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 was filed under the Massachusetts Wetlands Protection
Act by Robert & Anthie Jackson with the City of Salem Conservation
Commission on September 13,2010 for property located at 30 Columbus
Avenue (Assessors Map 44,Parcel 150).
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.
Kathleen M. Molina Date
The Neve-Morin Group, Inc.
447 Boston Street
Topsfield, MA 01983
ENGINEERS a SURVEYORS e ENVIRONMENTAL CONSULTANTS o LAND USE PLANNERS
447 Old Boston Road (U.S. Route 1), Topsfield, MA 01983 978-887-8586 FAX 978-887-3480
Providing Professional Services Since 1978
www.nevemorin.com
CITY OF SALEM CONSERVATION COMMISSION
NOTICE OF PUBLIC HEARING
NOTIFICATION TO ABUTTERS
Under the Massachusetts Wetlands Protection Act
& the City of Salem Wetlands Protection Ordinance
A Public Hearing will be held at Salem City Hall Annex, 120 Washington St, 3rd fl., Salem, MA at 6pm
on: September 23,2010
To consider a Notice of Intent for:
Robert& Anthie Jackson
For the property located at 30 Columbus Ave. (Assessors Map 44, Parcel 150)
Proposal is to raze the existing dwelling deck, pool and shed and construct a new dwelling, deck& patio.
The project also includes the removal of existing pavement and the construction of a small portion of
pavement. All work is located within 100 feet of a coastal bank and located within the 100 year flood
plain. The space occupied by the proposed structure does not exceed the space occupied by the existing
dwelling, pool and shed, therefore, there is no proposed alteration to the 100 year flood plain volume.
This is a public hearing under the requirements of G.L. Ch 131 Section 40, as amended, and the Salem
Wetlands Protection Ordinance and Regulations. Plans are available at the City of Department of
Planning and Community Development, City Hall Annex, 120 Washington Street, 3`d floor, Salem, MA
from 8am-4pm Mondays thru Wednesdays, 8am-7pm on Thursdays, and 8am-12pm(noon) on
Fridays. For more information please contact the City of Salem Conservation Agent at 978-619-5685.
Note: Notice of the public hearing,including its date,time and place,will be published at least a week prior to
the meeting date in The Salem News.
Note: Notice of the public hearing, including its date,time,place,will be posted on the Public Meetings Bulletin
Board in Salem City Hall,93 Washington Street, Salem,Mass not less than 48-hours in advance.
Note: Please submit written comments to the Salem Conservation Commission, City Hall Annex, 120
Washington Street, Salem, MA 01970 by the public hearing date. Comments can also be emailed. Please
contact the Conservation Agent at 978-619-5685 to confirm email address.
Note: You also may contact the nearest Department of Environmental Protection (DEP) Regional Office for
more information about this application or regarding the Massachusetts Wetlands Protection Act.
To contact DEP call:
Central Region: (508) 792-7650 *Northeast Region: (978)694-3200
Southeast Region: (508)946-2714 Western Region: (413)784-1100
CITY OF SALEM
ASSESSOR'S CERTIFICATION OF ABUTTERS AND
PROPERTY OWNERS
BOARD/COMMISSION: Conservation Commission
PROJECT SITE: 30('olumbus .k%e. (44-0150-II)
DATE: September 2, 2010
DESCRIPTION OF REQUIREMENT: All abutters and any property owner
within 100 feet of the property line of the land where the activity is proposed
including if land is separated by a public or private street or a body of water and
not unreasonably distant from the project site.
This is to certify that the time of the last assessment for taxation made by the City of
Salem, the names and addresses of those listed on the attached sheets are"abutters and
property owners"(as defined by Wetlands Protection Act 310 CMR 10.05(4)(a))to the
parcel(s)of land listed above as th Project site.
+
Assessor's Signature: �� �— G L G
g ! Date: G /
Number of initialed pages attached:
Once Certified, Return to:
Frank Taormina,Department of Planning and Community Development
R E C
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CITY OF SALEM
n
CAR CONSERVATION COMMISSION
SITE VT /S�T�T FARM
PROJECT LOCATION: �L a(��u /Q°tom DATE OF SITE VISIT 7
PROJECT PROPONENT: (2a (S - �,— DEP FILET NUMBER: 6(('
PROPOSED WORK:
IN A NV
CommissionAgent O r Abutters:
/ ✓{t t
App •an[ Property Owner/R presentative:
i I
SITE,VISIT�PURPOSE ,:
❑Request for Determination ❑Abbreviated Notice of Resource Area Delineation 5-Notice of Intent
❑Certificate of Compliance ❑Enforcement/Violation ❑Emergency ❑ Informal
AREAS OF JURISDICTION
INLAND RESOURCE AREAS COASTAL RESOURCE AREAS
❑Bank [and Subject to Coastal ❑Land Under the Ocean
• Storm Flowage
ElBordering Vegetated Wetland
❑ Designated Port Area ❑Coastal Beach
❑Land Subject to Flooding
❑ Coastal Dune ❑Barrier Beach
❑Land Under Water Bodies or Waterway
Name: -Coastal Bank ❑Rocky Intertidal Shore
❑Riverfront Area ❑ Salt Marsh ❑ Land Under Salt Pond
❑Vernal Pools ❑ Land Containing ❑Anadromous/Cata-
Shellfish dromousFish'Run
❑ Bordering Vegetated Wetland in Coastal Area
120 WASHINGTON STRtiIET, SALEFI, MASSACHUStiTT5 01970 TEL: 978.745.9595 FAX: 978.740.0404 0 WWW.SALEM.COM
BUFFER ZONE-;(within_100-feet)
❑Water Body ❑ Bordering Vegetated Wetland O Bank ❑ Coastal Beach ❑Coastal Dune
INTERESTS PROTECTED.
❑Protection of Water Supply ❑ Protection of Groundwater Supply riiFlood Control
Storm Damage Prevention Prevention of Pollution ❑Protection of Fisheries
❑ Protection of Wildlife Habitat ❑ Protection of Land Containing Shellfish
Is this an exempt project: If so,why?
Are resource area boundaries delineated correctly? If not,explain.
SITE VISDTbOCUMENTATION
❑Photos ❑ Site Map ❑Other:
OBSERVATIONS-OM'
�.'(,",
Take into account relevant aspects or features such as: natural or piped drainage or obvious pollution;
topography; existing vegetation; possible alternative sites; signs of wildlife, possible vernal pools, rare species
habitat; landmarks; recent or historical disturbances; proximity to other water bodies or drainage areas;
A.aacent land uses. ^ p
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