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Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance 64-320
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:
20 Commercial Street 64-320
Project Location DEP File Number
Has been recorded at the Registry of Deeds of:
Essex
County
for:
Elizabeth S. Bradt
Property Owner
and has been noted in the chain of title of the affected property on:
September 28, 2006 26125 259
Date Book Page
If recorded land, the instrument number which identifies this transaction is:
21
If registered land, the document number which identifies this transaction is:
Document Number
Signature of Applicant
Npeform 8b.dw•rev.7113/04 Page 4 of 4
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands DEP File Number.
WPA Form 813 — Certificate of Compliance 64-320
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
A. Project Information
Important
nfilli filling out
When filg 1. This Certificate of Compliance is issued to:
W
fors on the Elizabeth S. Bradt
computer,use Name
the tab
key to move 22 Larohmont Road
key
your cursor- Mailing Address
do not use the Salem MA 01970
return
key. Cilylrown State Zip Code
ufl M I I 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to:
Elizabeth S. Bradt
Name
°1s March 28, 2002 64-320
Dated DEP File Number
3. The project site is located at
20 Commercial Street Salem
Street Address Cityfrovm
Map 26 Lot 0050
Assessors MaptPlat Number Parcel/Lot Number
the final Order of Condition was recorded at the Registry of Deeds for.
Property Owner(d different)
Essex 18592 431
County Book Page
Certificate
4. A site inspection was made in the presence of the applicant, or the applicant's agent, on:
September 14 2006
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:
wpol Bb.dw•rev.7113M4 Pepe 1 of 4
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands DEP File Number.
WPA Form 813 — Certificate of Compliance 64_320
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provded 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 September 14, 2006
Conservation Commission Date of Issuance
This Certificate must be igned by a majority of the Conservation Commission and a copy sent to the
applicant and appropria DEP Regional Offi See Attachment).
Signatures:
wpefam eb.da:•rev.7113004 Pape 2 a4
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands DEP File Number.
WPA Form 8B — Certificate of Compliance 64-320
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
C. Authorization (cont.)
Notary Acknowledgement
Commonwealth of Massachusetts County of Essex
14 Of September 2006
On this Day Month Year
before me, the undersigned Notary Public, personally appeared
Carey R. Duques,
Name of Document Signer
proved to me through satisfactory evidence of identification,which wastwere
personally known
Description of evidence of identiflation
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
cityrrown
CARE1r R.DtNiUEB
OF
�v�ro I
Signature of tary Public
Carey R. E uques
Printed Name of Notary Public
Aug4st,16, 2013
MI' tiasion Expi
Place notary seal and/or any stamp above Signature of N t ry Public
wynfam Bb.doc•fw.711304 Pope 3 of 4
LAIMassachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands DEP File Number.
WPA Form 8B — Certificate of Compliance 64-320
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:
20 Commercial Street 64-320
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:
Data 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 Applicarn
wpdb 8b.dw•m.7M304 Pape 4 of
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
DEP Regional Addresses
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Mall transmittal forms and DEP payments,payable to:
Commonwealth of Massachusetts
Department of Environmental Protection
Box 4062
Boston,MA 02211
DEP Westem Region Adams costs Hampden Monve Pumtwd Ty-VhW
436 Dwight Street Aa"ann Conway Herod, Montalrra Ptrrdim Wales
Afford DHatheld
R�dW Suite 402 Amhert ar Rows, Warwtr
Springfield,MA-1103 Be"Ashfudd Densities E am H �
Phone:413.784-1100 eednstarr � lea. Holland New Aynlord SSVOY weasels
Fax 413-784-1149 ernrd4m EwemnN Horydr New Mrboaph &-AWeM WasOwrplon
aWdfrd FIVine H-bo- New stem gmtu wife Swrow
Windiest Florida Laesbo:cO North Actions Std Wed Sladitndge
Buddand CA Lee Nwewn em SOWharrolon VVhddy
lxrenrmd Golan Loner Noamm South Hadley WiMdwn
Cheshire GrrOy Leveret 0100e SaWroidc VVaaimrrp
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Chesterfield Great errnithn Logresdaw Paerm Siotldtridje vwdeo
Cmrpes Greenfield Ludlow PeBan Surtlririd wWhtrgtrn
Ctedrabrr9 Hadley Middlefield Pain Todar d
DEP Central Region AA wrrtrnr C WBrae mid" Warren,
tage
627 Main Street an,
Worcester,MA 01608 AAM DL`dIeVte' Ho n Nre boo-O Scat Westborough
Phone:5092-76 1 AyerA ^ Dun� �Nofft Brocidield Spenser �Brookfield
Boylston
Fax:508.792-7821 a" Ftmaw9 Leominster oaldsm Sanest weeurd
TDD:508-767-2788 ean,phre cares Limemn Gerd stow vVesbnMnbr
Bern Grafton Lunrleu9 Pwdon Slnabrld9e UAnUsrndarr
Bladetore Groton Mersorrph P<pparefi Sreten VVarmlr
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BoAaoeh Hmdalyd Medway Phayfeon Townsend
Soyston Hoiden Mrrdm Prwwebrr Tyrgeborrayn
Broddbld Hapadela Milled Royablon UPM
DEP southeast Region Aurivw Dennismanna gh Rerrnhem T>�
20 Riverside Drive Attleboro D#drr coarow Neneart Rehoboth Wa can
Lakeville,MA 02347 Aeon oebxy HaMrc New Bedford RDd*Ster Weabd
Pho wag ancipwater
Fax:5 -947-6.2700 H NHanover otion Sa Aftlaborough ndwich v+esom
Fax:508-947�557 SoLene Eadrr Hrwodr Nrml 9tlesb wad Tax"
TDD:508-946.2795 Brewster Ed9aibwrn lapmn Oak Bbdr Sedrre Vasbnrn
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Crwr Faenondh Melon PM'am is SWUW-
Chathem FoxIM04 Mefedleld Pymadh Swansea
Otteral, FrenHen mmtpw Plymprn Taodan
DEP Nortlreast Region Aroesary Chatindord Hinyan Mrrimec oayoy Wambold
1 Winter Street Andover Chem° Horrook McBsen Ra do" VVepoa
Boston,MA 02106 AsNand NWOM cc d go min ekW eton Knew, wReading ear
Phone:617-6544MW Bedford Drwes Lanus Mate Rrdprt Wglyd
Fax 617-556.1049 Seko10rt Godwin LwmVbon Raised Rowley VVdbdey
aerMy Doren Lessen ma do Sabin VVerdan
TDD:617-574.6868 Blimice Draan Lowell Nesairn Sods" wed Nae,ry
Boston Ease Lyon NOW" Sag Wedm
Boded Everad Lymesld Newbu)porl Sherbrn Westwood
BrahWes FIeNn9haln Maiden Newlin SOMWW* Wa)rrwM
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Sorn9lon Gloucester Marblehead North Andowx Sudery Winchester
Cairbld9e Groreaid MoSNld North Reading Swrrobooe NadhaP
Crdon Hairston Medford Norwood Tewkebry Walser,
calms rbrrta Whose Peabody TapeBdd
wpermlib.doc-DEP Addresses•rw.9114M Page 1 Of 1
CERTIFICATE OF COMPLIANCE PHOTO LOG
20 COMMERCIAL STREET,SALEM,MASSACHUSETTS
ALLxrnaTn[dON9/1�/l6ar(euvQrt.®.(C.®anntxi.lmrt/A.wfl_w�
g. 7..�_. k ;L
t dX
View of 20 Commerdal Street fadng nortlrvwast. Rowerbed exists In the front of the
building as well as parldng for four ran
aA
n y
View of hunt of building facing north.
Page 1 of 2
- ;sue preM
spa p
i
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y.
s a y
View of bulidirg and parking by fadng north.
h
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P
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View of parldng lot The number of proposed spaces corresponds with observed conditions of 14 spaces.
Page 2 of 2
All Creatures Dr. Elizabeth Bradt
Veterinary House Calls
P.O. Box 8535, Salem, MA 01971-8535 (978)740-0290
March 13, 2002
Mr. Cefalo and Members of the Conservation Commission,
Lasts spring I was ranted a DEP#64320 after a hearing before the Salem Conservation
p g g g
Commission. The Order of Conditions concerned building a 6800 square foot veterinary
practice at 20 Commercial Street on an existing 6500 square foot concrete slab.Two
additional side entryways and a front entryway with a wheelchair ramp were approved last
spring.
Due to the high price of the original bids I have redesigned the building with the help of
Martins Construction. The new design is 5096 square feet. The large front and side
entryways have been eliminated.The existing slab will be utilized but 1700 square feet of it
will be eliminated at the front of the building so the building will be set back 20 feet further
away from the front property line than it is currently.A small set of stairs will be removed
and another small set of stairs will replace those on the east side of the building. A wheel
chair ramp will be built for handicap access to the entryway on the west side of the
building.The wheelchair ramp will require an additional 337 square feet. Overall we will
be removing 1700-337= 1363 square feet from the concrete slab foundation of the
building. We will remove footings supporting this foundation and therefore increase the
volume of space available for groundwater absorption in the floodplain.
Enclosed are the site detail plans for 20 Commercial Street approved last spring and the site
detail plans currently proposed. I believe the new plans will provide Salem with a better
looking building that fits into the floodplain in a more ecologically sound manner than the
plan already approved by the Conservation Commission.
Respectfully,
Liz Bradt`bVM
Id
�U J r,•l n'
r. .
- ... I_ ^�('1,-�li '
- ------ LJ r.l DEVFile Number:
Ju 64'-320
� � Massachusetts Department of Environmental Protection t�
...
Bureau of Resource Protection -Wetlands r':Prpvidedlby DEP
- WPA Form 57_Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. General Information ryppgp�pry' p��ryryN���/pp����►► Hp p��ryry
Important: �IIIIIIUIt1I�Iart11IlIBII1UIIII�IIII�
_When filling
From: 28019418907816k:18591 P
out forms on Salem - 04/16/2002 15:52:00 BT .R 9'431
- the computer, Conservation commission" _ Po 1/10 '
use only the
tab key to This issuance if for(check one):
move your
cursor-do ❑ Order of Conditions
not use the
return key. ® Amended Order of Conditions (March 28, 2002)
VAGg To. Applicant: Property Owner(if different from applicant):
Elizabeth S. Bradt Same
Name Name
22 Larchmont Road
Mailing Address Mailing Address
Salem MA 01970
.Cityrrown State Zip Code Cityrrown State Zip Code
1. Project Location:
20 Commercial Street Salem
Street Address Cityrrown -
Map 26 Lot 0050
Assessors Map/Plat Number ParceVCot Number
2. Property recorded at the Registry of Deeds for:
Essex South 16418 448
County - Book Page
Certificate(if registered land)
3. Dates: Amended March 28, 2002 Amended March 28, 2002
April 12 2001 May 10, 2001 May 10 2001
Date Notice of Intent Filed Date Public Hearing Closed Date of Issuance
4. Final Approved Plans and Other Documents (attach additional plan references as needed):
Amended Topographical Plan of Land 20 Commercial Street Salem 02/02/02
Title Date
5. Final Plans and Documents Signed and Stamped by:
Gail L. Smith
Name
6. Total Fee:
$525.00
DEP File Number:
i'j,husetts Department of Environmental Protection 64-320
f j of Resource Protection -Wetlands Provided by DEP
/A Form 5 - Order of Conditions
'Asachusetts Wetlands Protection Act M.G.L. c. 131, §40
If registered land, the document number identifying this transaction is:
Document Number
i
Signature of [cant
i�
jI
f
Page 8 of e
45
ju DEP File Number:
-�
Massachusetts Department of Environmental Protection 64-320
Bureau of Resource Protection -Wetlands Provided by DEP
WPA Form 5 - Order of Conditions
' Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. General Information
Important:
When filling From:
out forms on Salem
the computer, Conservation Commission
use only the
tab key to This issuance if for(check one):
move your
cursor-do ❑ Order of Conditions
not use the
return key. ® Amended Order of Conditions (March 28, 2002)
To: Applicant: Property Owner(if different from applicant):
Elizabeth S. Bradt Same
Name Name
22 Larchmont Road
Mailing Address Mailing Address
Salem MA 01970
City/Town State Zip Code Cityfrown State Zip Code
1. Project Location:
20 Commercial Street Salem
Street Address CityrTown
Map 26 Lot 0050
Assessors Map/Plat Number Parcel/Lot Number
2. Property recorded at the Registry of Deeds for:
Essex South 16418 448
County Book Page
Certificate(if registered land)
3. Dates: Amended March 28, 2002 Amended March 28, 2002
April 12, 2001 May 10, 2001 Amended May 10, 2001
Date Notice of Intent Filed Date Public Hearing Closed Date of Issuance
4. Final Approved Plans and Other Documents (attach additional plan references as needed):
Amended Topographical Plan of Land 20 Commercial Street Salem 02/02/02
Title Date
5. Final Plans and Documents Signed and Stamped by:
Gail L. Smith
Name
6. Total Fee:
$525.00
(from Appendix B:Wetland Fee Transmittal Form)
WPA Form 5 Page t of 8
Rev.02100
• 45
ju DEP File Number:
IN Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands 64-320
Provided by DEP
up,
WPA Form 5 - Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. General Information
Important:
When filling From:
out forms on Salem
the computer, Conservation Commission
use only the
tab key to This issuance if for(check one):
move your
cursor-do ❑ Order of Conditions
not use the
return key. ® Amended Order of Conditions (March 28, 2002)
rm To: Applicant: Property Owner(if different from applicant):
Elizabeth S. Bradt Same
Name Name
22 Larchmont Road
Mailing Address Mailing Address
Salem MA 01970
City/Town State Zip Code City/Town State Zip Code
1. Project Location:
20 Commercial Street Salem
Street Address Citylrown
Map 26 Lot 0050
Assessors Map/Plat Number Parcel/Lot Number
2. Property recorded at the Registry of Deeds for:
Essex South 16418 448
County Book Page
Certificate(if registered land)
3. Dates: Amended March 28, 2002 Amended March 28, 2002
April 12 2001 May 10, 2001 May 10, 2001
Date Notice of Intent Filed Date Public Hearing Closed Date of Issuance
4. Final Approved Plans and Other Documents (attach additional plan references as needed):
Amended Topographical Plan of Land 20 Commercial Street, Salem 02/02/02
Title Date
5. Final Plans and Documents Signed and Stamped by:
Gail L. Smith
Name
6. Total Fee:
$525.00
(from Appendix B:Wetland Fee Transmittal Form)
WPA Form 5 page 1 of 8
Rev.02100
45
ju DEP File Number:
Massachusetts Department of Environmental Protection
64-320
Bureau of Resource Protection - Wetlands Provided by DEP
WPA Form 5 - Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Findings
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:
❑ Public Water Supply ❑ Land Containing Shellfish ❑ Prevention of Pollution
❑ Private Water Supply ❑ Fisheries ❑ Protection of Wildlife Habitat
❑ Groundwater Supply ❑ Storm Damage Prevention ® Flood Control
Furthermore, 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, to protect those interests checked above. 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 to protect those interests checked above. 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.
❑ 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).
General Conditions (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.
WPA Form 5 Page 2 of 8
Rev.'02100
45
DEP File Number:
ju
T Massachusetts Department of Environmental Protection
64-320
Bureau of Resource Protection - Wetlands Provided by DEP
WPA Form 5 - Order of Conditions
y
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Findings (cont.)
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"]
"File Number 64-320 1.
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
VVPA Form 5 Page 3 of 8
Rev.MOD
45
ju DEP File Number:
Massachusetts Department of Environmental Protection 64-320
Bureau of Resource Protection -Wetlands Provided by DEP
WPA Form 5 - Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Findings (cont.)
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 (use additional paper, if necessary):
See Attached
Findings as to municipal bylaw or ordinance
Furthermore, the Salem hereby finds (check one that applies):
Conservation Commission
❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal
ordinance or bylaw specifically:
Name Municipal Ordinance or Bylaw-
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.
❑ that the following additional conditions are necessary to comply with a municipal ordinance or bylaw,
specifically:
WPA Forth 5
Rev.02100 Page 4 of 8
45
ju DEP File Number:
Massachusetts Department of Environmental Protection 64-320
Bureau of Resource Protection -Wetlands Provided by DEP
4 y WPA Form 5 - Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
s W
Name Municipal Ordinance or Bylaw
The Commission orders that all work shall be performed in accordance with the said additional
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.
B. Findings (cont.)
Additional conditions relating to municipal ordinance or bylaw:
This Order is valid for three years, unless otherwise specified as a special condition pursuant to General
Conditions#4, from the date of issuance.
M� o zoo
Date
This Order must be signed by a majority of the Conservation Commission. The Order must be mailed by
certified mail (retu t requested) or hand delivered to the applicant. A copy also must be mailed or
hand delivere a sam time to the appropriate Department of Environmental Protection Regional
Office (se pp i nd the property owner(if different from applicant).
Signat res:"
i
On Of 2 Z
Day Month and Year
before me personally appeared
to me known to be the person described in and who executed the foregoing instrument and
acknowledged that he/she executed the same as his/her free act and deed.
WPA Form 5 Page 5 of a
Rev.02/00 -
45
ju
DEP File Number:
Massachusetts Department of Environmental Protection 64-320
UJBureau of Resource Protection -Wetlands Provided by DEP
WPA Form 5 - Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
cop �� 2 yo-�—
No Public My Corhmission Expire
s
es - - -
TFis Order is issued to the applicant as follows:
❑ by hand delivery on by certified mail, return receipt requested, on
Date Dat
C. 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 Appendix E: 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.
D. 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 Form 5 shall be submitted to the Conservation Commission listed below.
Salem
Conservation Commission
WPA Form 5 Page 6 of 8
Rev.02/00
45
ju DEP File Number:
Massachusetts Department of Environmental Protection 64-320
Bureau of Resource Protection - Wetlands Provided by DEP
WPA Form 5 - Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
µ°ve
D. Recording Information (cont.)
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:
20 Commercial Street Amended 64-320
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:
Date
If recorded land, the instrument number identifying this transaction is:
Instrument Number
WPA form 5
Rev.0900 Page 7 or 8
45
1D DEP File Number:
Massachusetts Department of Environmental Protection 64-320
Bureau of Resource Protection - Wetlands Provided by DEP
WPA Form 5 - Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
�w
If registered land, the document number identifying this transaction is:
Document Number
Signature of Applicant
WPA Form 5 Page 8 of 8
Rev.02/00
Salem Conservation Commission
AMENDED SPECIAL CONDITIONS—DEP FILE # 64-320
20 Commercial Street, Salem, MA
1. The Conservation Agent will be notified 48 hours prior to commencement of construction activities(978-745-
9595 ext. 311). Members and agents of the Salem Conservation Commission(Commission)shall have the right
to enter and inspect the premises to evaluate and ensure compliance with the conditions and performance
standards stated in this Order,the Notice of Intent,the referenced plans,the Act,and 310 CMR 10.00,and may
require any information,measurements,photographs,observation and/or materials or may require the submittal
of any data or information deemed necessary by the Commission, agent,or DEP determines that any of the
work is not in compliance with this Order of Conditions. Work shall not resume until the Commission is
satisfied that the work will comply,and has so notified the applicant in writing.
2. Approval of this application does not constitute compliance with any law or regulation other than MGL Chapter
131, Section 40,and Wetlands Regulations 310 CMR 10.00.
3. This Order shall apply to any successor in control or successor in interest of the property described in the Notice
of Intent and accompanying plans. These obligations shall be expressed in covenants in all deeds to succeeding
owners or portions of the property.
4. The form provided at the end of this Order shall be completed and stamped at the Registry of Deeds after the
expiration of the 10-day appeal period and within 30 days of the issuance if no request for appeal has been filed
with the Department of Environmental Protection. This form shall be returned to the Commission within 21
days of recording accordance and prior to commencement of any activities subject to the Order of Conditions.
5. Prior to any work commencing,a sign shall be displayed showing DEP file#64-321,and not placed on a living
tree.
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:
(1) Section 404 of the Federal Water Pollution Control Act(P.L. 92-500, 86 stat. 816),U.S. Army Corp 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
(3) Flood Plain
(4) Grading Ordinance
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. All work shall be performed in accordance with this Order of Conditions and approved site plans(s). No
alteration of wetland resource areas or associated buffer zone,other than that approved in this Order,shall occur
on this property without prior approval from the Commission.
12. If any changes are made in the above-described plan(s)which may or will alter an area subject to protection
under the Wetlands Protection Act, or any changes in activity subject to regulations under G.L.Ch. 131, Section
40,the applicant shall inquire from this Commission in writing,prior to their implementation in the field,
whether the change(s)is significant enough to require the filing of a new Notice of Intent. Any error in the
plans or information submitted by the applicant shall be considered changes and the above procedures shall be
followed. A copy of such request shall at the same time be sent to the Department of Environmental Protection.
13. 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 signed statement 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.
14. Conditions number NA as indicated shall continue in force beyond the Certificate of Compliance,in
perpetuity,and shall be referred to in all future deeds to this property.
PRIOR TO CONSTRUCTION
15. Prior to commencement of any activity on this site,there shall be a PRECONSTRUCTION MEETING
between the project supervision;the contractor responsible for the work or its administrator to and phone
numbers of all responsible parties shall be registered with the Commission at the pre-construction meeting.
16. 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 Commssion and/or
its Administrator shall inspect and approve such installation at the pre-construction meeting.
17. Prior to the commencement of any activity on this site,the applicant or current landowner shall submit to the
Commission in writing a construction schedule/sequence of work to complete this project.
18. Prior to any work on site,the proposed limits of work shall be clearly marked with stakes or flags and shall be
confirmed by the Commission or its Administrator. Such markers shall be checked and replaced as necessary
and shall be maintained until all construction is complete. Workers shall be informed that no use of machinery,
storage of machinery or materials,stockpiling of soil or construction activity is to occur beyond this line at
anytime.
19. Prior to commencement of construction on site,the limits of wetland resource areas closest to construction
activity shall be flagged with surveyor's tape and shall remain in place during construction. The limits of areas
to be impacted and the limits of work in the replication area(s)shall be clearly flagged.
20. There shall be NA hay bales and wooden staked stored under cover on the site to be used only for emergency
erosion control.
EROSION CONTROL
21. Appropriate erosion control devices shall be in place prior to the beginning of any phases of construction, and
shall be maintained during construction in the wetland areas and buffer zones. The erosion control specification
provided in the Notice of Intent and the erosion control provision in the Order will be the minimum standards
for this project; additional measures may be required by the Commission.
22. 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.
23. 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.
24. The areas of construction shall remain in a stable condition at the close of each construction day.
25. Any de-watering of trenches or other excavations required during construction shall be conducted so as to
prevent siltation of wetland resource areas. All discharges from de-watering activities shall be filtered through
haybale sediment traps,silt filter bags or other means approved by the Commission or its Administrator.
26. Within thirty 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.
27. If soils are to be disturbed for longer than 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
surfaces shall be stabilized by other appropriate erosion control measures, firmly anchored,to prevent soils
from being washed by rain or flooding.
DURING CONSTRUCTION
28. A copy of the Order of Conditions,construction plans, and copies of the documents and reports cited in
Condition# 11,shall be on the site upon commencement and during any site work for contractors to view and
adhere to.
29. 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.
30. Only clean fill, free of masonry, stumps,asphalt,and any other kind of waste material shall be used on the site.
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 rivers.
32. All filling or removal of waste material from the site shall be done in accordance with the regulations of the
City of Salem Health Department.
33. Cement trucks shall not be washed out in any wetland resource or buffer zone area. Any deposit of cement or
concrete products into a buffer zone or wetland resource area shall be removed by hand.
34. No fuel,oil, or other pollutants shall be stored in any resource area or the buffer zone thereto,unless specified
in this Order of Conditions.
35. There shall be no pumping of water from wetland resource areas.
36. During construction,all drainage structures shall be inspected regularly and cleaned as necessary.
37. The project shall not cause an increase in run-off onto adjacent properties,either during construction or when
completed.
38. The applicant is hereby 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.
POST CONSTRUCTION
39. All disturbed areas,slopes and proposed landscape areas shall be loamed and seeded or stabilized through the
use of erosion control blankets or other approved means. All disturbed areas will be graded, loamed,and
seeded prior to November 1 of each year, if possible. No disturbed areas or stockpiled material will be left
unprotected or without erosion controls during the winter.
40. Upon completion of construction,the applicant or current landowner shall submit the following to the
Commission to request a Certificate of Compliance:
(1) A letter requesting a Certificate including the following information:
a. Name and address of current landowner;
b. Name and address of the individual/trust or other entity to whom the Certificate is to be issued:
c. Street address and lot number for the project; and
d. DEP file number
(2) A letter from a Registered Professional Engineering or Land Surveyor certifying compliance of the
property with this Order of Conditions
(3) An"As-Built"plan signed and stamped by a Registered Professional Engineer showing post-construction
conditions and:
a. As-built elevations of all drainage ways constructed within 100 feet of any wetland resource area;
b. As-built elevations and grades of all filled or altered wetland resource areas,buffer zones and
replicated areas; and
c. Distances to all structures within 100 feet of any wetland resource area.
41. When issued,the Certificate of Compliance must be recorded at the Essex County Registry of Deeds.
42. 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.
43. Erosion control devices shall remain in place and properly functioning until all exposed soils have been
stabilized with final vegetative cover and the Commission and/or its Administrator has authorized their
removal.
a
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands 64-320
WPA Form 5 - Order of Conditions
a - � Provided by DEP
a" Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
yx
D. Recording Information (cont.)
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 Ordei of Conditions ioi the Frojecf at
20 Commercial Street 64-320
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:
Date
If recorded land, the instrument number identifying this transaction is:
2�
Instrument Number
If registered land,the document number identifying this transaction is:
Document Number
Signature(o4Appl6K7Z
WPA Forth 5 Page 7 of 7
Rev.02100
'j Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands 64-320
" WPA Form 5 - Order of Conditions Provided by DEP
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
LQ A. General Information
t Important: From: -
When filling
out forms on Salem
the computer, Conservation Commission
use only the
tab key to This issuance if for(check one):
move your
C U i - L/7 Order of Crnc'Ifion^
not use the
return key. ❑ Amended Order of Conditions
To: Applicant: Property Owner(if different from applicant):
Elizabeth S. Bradt Same
Name Name
22 Larchmont Road
Mailing Address Mailing Address
Salem MA 01970
City/Town State Zip Code City/Town State Zip Code
1. Project Location:
20 Commercial Street Salem
Street Address city/Town
Map 26 Lot 0050
Assessors Map/Plat Number Parcel/Lot Number
2. Property recorded at the Registry of Deeds for:
Essex South 16418 448
County Book Page
Certificate(if registered land)
3. Dates:
April 12, 2001 May 10, 2001 May 10, 2001
Date Notice of Intent Filed Date Public Hearing Closed Date of Issuance
4. Final Approved Plans and Other Documents (attach additional plan references as needed):
Topographical Plan of Land, 20 Commercial Street, Salem 2/13/01
Title Date
5. Final Plans and Documents Signed and Stamped by:
Gail L. Smith
Name
6. Total Fee:
$525.00
(from Appendix B:Welland Fee Transmittal Form)
WPA Form 5 Page 1 of 7
Rev.02100
1
Massachusetts Department of Environmental Protection DEP File Number:
lugBureau of Resource Protection - Wetlands 64-320
WPA Form 5 - Order of Conditions Provided by DEP
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. General Information
Important: From:
When filling
out forms on Salem
the computer, Conservation Commission
use only the
tab key to This issuance if for (check one):
move your
cursor do [7. Order of Conditions
not use the
return key. ❑ Amended Order of Conditions
To: Applicant: Property Owner(if different from applicant):
+, Elizabeth S. Bradt Same
® Name Name
22 Larchmont Road
Mailing Address Mailing Address
Salem MA 01970
Cily/rown state Zip Code City/Town State Zip Code
1. Project Location:
20 Commercial Street Salem
Street Address City/Town
Map 26 Lot 0050
Assessors Map/Plat Number Parcel/Lot Number
t the Registry 2. Property recorded a g ry of Deeds for:
P Y
Essex South 16418 448
County Book Page
Certificate(if registered land)
3. Dates:
April 12, 2001 May 10, 2001 May 10, 2001
Date Notice of Intent Filed Date Public Hearing Closed Date of Issuance
4. Final Approved Plans and Other Documents (attach additional plan references as needed):
Topographical Plan of Land, 20 Commercial Street, Salem 2/13/01
Title Date
5. Final Plans and Documents Signed and Stamped by:
Gail L. Smith
Name
6. Total Fee:
$525.00
(from Appendix B:Wetland Fee Transmittal Forth)
WPA Form 5 Page 1 of 7
Rev.02/00
•a
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands 64-320
WPA Form 5 - Order of Conditions Provided by DEP
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Findings
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:
❑ Public Water Supply ❑ Land Containing Shellfish ❑ Prevention of Pollution
❑ Private Water Supply ❑ Fisheries ❑ Protection of Wildlife Habitat
❑ Groundwater Supply ❑ Storm Damage Prevention ® Flood Control
Furthermore,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, to protect those interests checked above. 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 to protect those interests checked above.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.
❑ 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).
General Conditions (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.
WPA Form 5 Page 2 of 7
Rev.02J00
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands 64-320
WPA Form 5 - Order of Conditions Provided by DEP
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Findings (cont.)
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 format 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 64-320 "
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.
Page 3 of 7
V PA Forth 5
Rev.OVOO
r
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands 64-320
WPA Form 5 - Order of Conditions Provided by DEP
-' Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Findings (cont.)
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
CerlificEle of C omnlioncc has been issues' by 1hr, 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 (use additional paper, if necessary):
See Attached
Findings as to municipal bylaw or ordinance
Furthermore, the hereby finds (check one that applies):
Conservation Commission
❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal
ordinance or bylaw specifically:
Name Municipal Ordinance or Bylaw
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.
❑ that the following additional conditions are necessary to comply with a municipal ordinance or bylaw,
specifically:
Name Municipal Ordinance or Bylaw
The Commission orders that all work shall be performed in accordance with the said additional
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.
Page 4 of 7
WPA Forth 5
Rev.02/00
Massachusetts Department of Environmental Protection DEP File Number.
Bureau of Resource Protection -Wetlands b4_32-o
WPA Form 5 - Order of Conditions Provided by DEP
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Findings (cont.)
Additional conditions relating to municipal ordinance or bylaw:
This Order is valid for three years, unless otherwise specified as a special condition pursuant to General
Conditions#4,from the date of issuance.
� 2
Date
This Order must be signed by a majority of the Conservation Commission.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 Protection Regional
Office (see Appendix A) and the property owner(if different from applicant).
Sign /
On ar. Of O0
Day Month an Y ar
before me personally appeared
me own to be the person described in and who executed the foregoing instrument and
a-kr I ged that he/ e e ec a he me as his/her free
/act and deed.
Public. My commidsion Expires
This Order is issued to the applicant as foliows:
❑ by hand delivery on by certified mail, return receipt requested, on
2`-t
Date Date
Pepe 5 or 7
WPA F"5
Rev.02M
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands 64-320
WPA Form 5 - Order of Conditions Provided by DEP
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. 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 Appendix E: 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 PppllcPnl, if he/Fhe is not the appellenl
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.
D. 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 Form 5 shall be submitted to the Conservation Commission listed below.
Salem
Conservation Commission
WPA Form 5 Page 6 W 7
Rev.02100
�— Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands 64-320
r WPA Form 5 - Order of Conditions Provided by DEP
Massachusetts Wetlands Protection Act M.G.L. c. 131 , §40
D. Recording Information (cont.)
Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission.
---------------------------------------------------------------------------------------------------------------------------
To:
Salem
Conservation Commission
Please be advisea that the Order of Conditions ioi tine Project at:
20 Commercial Street 64-320
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:
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
WPA Fom 5 Page 7 of 7
Rev.07JO0
Salem Conservation Commission
SPECIAL CONDITIONS—DEP FILE # 64-320
20 Commercial Street, Salem, MA
1. The Conservation Agent will be notified 48 hours prior to commencement of construction activities(978-745-
9595 ext. 311). Members and agents of the Salem Conservation Commission(Commission) shall have the right
to enter and inspect the premises to evaluate and ensure compliance with the conditions and performance
standards stated in this Order,the Notice of Intent,the referenced plans,the Act,and 310 CMR 10.00, and may
require any information,measurements,photographs,observation and/or materials or may require the submittal
of any data or information deemed necessary by the Commission,agent,or DEP determines that any of the
work is not in compliance with this Order of Conditions. Work shall not resume until the Commission is
satisfied that the work will comply, and has so notified the applicant in writing.
2. Approval of this application does not constitute compliance with any law or regulation other than MGL Chapter
1?L Se.Ction 40..and Ad7CiITnd5 RE,eulatjons P10 CN1R 10.00
3. This Order shall apply to any successor in control or successor in interest of the property described in the Notice
of Intent and accompanying plans. These obligations shall be expressed in covenants in all deeds to succeeding
owners or portions of the property.
4. The form provided at the end of this Order shall be completed and stamped at the Registry of Deeds after the
expiration of the 10-day appeal period and within 30 days of the issuance if no request for appeal has been filed
with the Department of Environmental Protection. This form shall be returned to the Commission within 21
days of recording accordance and prior to commencement of any activities subject to the Order of Conditions.
5. Prior to any work commencing,a sign shall be displayed showing DEP file#64-321,and not placed on a living
tree.
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:
(1) Section 404 of the Federal Water Pollution Control Act(P.L.92-500, 86 star. 816),U.S.Army Corp 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
(3) Flood Plain
(4) Grading Ordinance
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. All work shall be performed in accordance with this Order of Conditions and approved site plans(s). No
alteration of wetland resource areas or associated buffer zone other than that approved in this Order, shall occur
PP ,
on this property without prior approval from the Commission.
12. If any changes are made in the above-described plan(s)which may or will alter an area subject to protection
under the Wetlands Protection Act,or any changes in activity subject to regulations under G.L. Ch. 131,Section
40,the applicant shall inquire from this Commission in writing,prior to their implementation in the field,
whether the change(s)is significant enough to require the filing of a new Notice of Intent. Any error in the
plans or information submitted by the applicant shall be considered changes and the above procedures shall be
followed. A copy of such request shall at the same time be sent to the Department of Environmental Protection.
13. 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 signed statement 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.
14. Conditions number NA as indicated shall continue in force beyond the Certificate of Compliance,in
perpetuity,and shall be referred to in all future deeds to this property.
1`RI OP 7 U 0J,\ ;'i i G Tk0iC
15. Prior to commencement of any activity on this site,there shall be a PRECONSTRUCTION MEETING
between the project supervision;the contractor responsible for the work or its administrator to and phone
numbers of all responsible parties shall be registered with the Commission at the pre-construction meeting.
16. 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 Commssion and/or
its Administrator shall inspect and approve such installation at the pre-construction meeting.
17. Prior to the commencement of any activity on this site, the applicant or current landowner shall submit to the
Commission in writing a construction schedule/sequence of work to complete this project.
18. Prior to any work.on site, the proposed limits of work shall be clearly marked with stakes or flags and shall be
confirmed by the Commission or its Administrator. Such markers shall be checked and replaced as necessary
and shall be maintained until all construction is complete. Workers shall be informed that no use of machinery,
storage of machinery or materials,stockpiling of soil or construction activity is to occur beyond this line at
anytime.
19. Prior to commencement of construction on site,the limits of wetland resource areas closest to construction
activity shall be flagged with surveyor's tape and shall remain in place during construction. The limits of areas
to be impacted and the limits of work in the replication area(s)shall be clearly flagged.,
20. There shall be NA hay bales and wooden staked stored under cover on the site to be used only for emergency
erosion control
EROSION CONTROL
21. Appropriate erosion control devices shall be in place prior to the beginning of any phases of construction,and
shall be maintained during construction in the wetland areas and buffer zones. The erosion control specification
provided in the Notice of Intent and the erosion control provision in the Order will be the minimum standards
for this project;additional measures may be required by the Commission.
22. 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.
23. 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 rem
oved.
24. The areas of construction shall remain in a stable condition at the close of each construction day.
t
' 25. Any de-watering of trenches or other excavations required during construction shall be conducted so as to
prevent siltation of wetland resource areas. All discharges from de-watering activities shall be filtered through
haybale sediment traps, silt filter bags or other means approved by the Commission or its Administrator.
26. Within thirty 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.
27. If soils are to be disturbed for longer than 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
surfaces shall be stabilized by other appropriate erosion control measures,firmly anchored,to prevent soils
from being washed by rain or flooding.
DURING CONSTRUCTION
28. A copy of the Order of Gonowons, consnucuon plans, and copies of the docinnents and reports cited in
Condition# 11,shall be on the site upon commencement and during any site work for contractors to view and _
adhere to.
29. 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.
30. Only clean fill,free of masonry, stumps, asphalt,and any other kind of waste material shall be used on the site.
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 rivers.
32. All filling or removal of waste material from the site shall be done in accordance with the regulations of the
City of Salem Health Department.
33. Cement trucks shall not be washed out in any wetland resource or buffer zone area. Any deposit of cement or
concrete products into a buffer zone or wetland resource area shall be removed by hand.
34. No fuel,oil,or other pollutants shall be stored in any resource area or the buffer zone thereto,unless specified
in this Order of Conditions.
35. There shall be no pumping of water from wetland resource areas.
36. During construction,all drainage structures shall be inspected regularly and cleaned as necessary.
37. The project shall not cause an increase in run-off onto adjacent properties,either during construction or when
completed.
38. The applicant is hereby 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.
POST CONSTRUCTION
39. All disturbed areas,slopes and proposed landscape areas shall be learned and seeded or stabilized through the
use of erosion control blankets or other approved means. All disturbed areas will be graded,learned,and
seeded prior to November I of each year,if possible. No disturbed areas or stockpiled material will be left
unprotected or without erosion controls during the winter.
i
t
t
40. Upon completion of construction,the applicant or current landowner shall submit the following to the
Commission to request a Certificate of Compliance:
(1) A letter requesting a Certificate including the following information:
a. Name and address of current landowner;
b. Name and address of the individual/trust or other entity to whom the Certificate is to be issued:
c. Street address and lot number for the project;and
d. DEP file number
(2) A letter from a Registered Professional Engineering or Land Surveyor certifying compliance of the
property with this Order of Conditions
(3) An"As-Built'plan signed and stamped by a Registered Professional Engineer showing post-construction
conditions and:
a. As-built elevations of all drainage ways constructed within 100 feet of any wetland resource area;
b. As-built elevations and grades of all filled or altered wetland resource areas,buffer zones and
renlicated areas: and
c. Distances to all sunctures WIL11m 100 lee' 01 any wetland resource area..
41. When issued,the Certificate of Compliance must be recorded at the Essex County Registry of Deeds.
42. 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.
43. Erosion control devices shall remain in place and properly functioning until all exposed soils have been
stabilized with final vegetative cover and the Commission and/or its Administrator has authorized their
removal.
i �
I �, Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 3 - Notice of Intent yDEP
Provided b
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem, MA
P=c` Town
A. General Information
Important:
When filling out 1. Applicant:
forms on the Elizabeth S. Bradt AOL:acvhcl
computer use
use
only the ta Name E-Mail Address(if applicable)
key to move 22 Larchmont Road
your cursor- Mailing Address
do not use the Salem MA 01970
return key. City/Town State Zip Code
(978) 740-0290 (978) 744-9732
m' Phone Number Fax Number(if applicable)
2. Representative (if any):
Sommer Env. Tech., Inc
Firm
Paul Sommer psommer64 hotmail com
Note: Contact Name E-Mail Address(if applicable)
Before 64 Livingstone Ave.
completing this Mailing Address
form consult
your local Beverly MA 01915
Conservation City/Town State Zip Code
Commission (978) 9222144 (978) 9228335
regarding any Phone Number Fax Number(if applicable)
municipal bylaw
or ordinance. 3. Property Owner(if different from applicant):
SAME
Name
Mailing Address
City/Town State Zip Code
4. Total Fee:
(from Appendix B:Wetland Fee Transmittal Form)
5. Project Location:
20 Commercial Street Salem
Street Address City/Town
Map 26, Lot 0050 0050
Assessors Map/Plat Number Parcel/Lot Number
6. Registry of Deeds:
Essex South District 16418 448
County Book Page
Certificate(if Registered Land)
WPA Form 3
Rev.0100 Page 1 of a
Massachusetts Department of Environmental Protection DEP File Number:
Y Bureau of Resource Protection -Wetlands
WPA Form 3 — Notice of Intent Provided by DEP
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Salem, MA
Town
A. General Information (cont.)
7. Summary of Project Impacts:
a. Is any work being proposed in the Buffer Zone?
❑ Yes If yes, how many square feet?
® No
b. List the impacts of proposed activities on each wetland resource areas (temporary and permanent
impacts, prior to restoration and mitigation):
Resource Area Size of e.Impact .
D ( 9 . s q ft.)
Bordering Land Subject to Flooding Existing Lot within "A"Zone
B. Project Description
1. General Project Description:
Renovation of existing building
2. Plan and/or Map References:
Topographic Plan of Land 2/13/01
Title Date
Soil Volume Displacement Calculations 1/24/01
WPA Fom 3 Page 2 of 8
Rev.0200
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection -Wetlands
WPA Form 3 — Notice of Intent
Provided by DEP
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem, MA
Town
C. Activities Subject to Regulation
1. a. Check the applicable resource areas if work is to be conducted in an associated Buffer Zone:
Inland Resource Areas Coastal Resource Areas
❑ Inland Bank ❑ Coastal Beach ❑ Barrier Beach
❑ Bordering Vegetated Wetland (BVW) ❑ Rocky Intertidal Shore ❑ Coastal Dune
❑ Salt Marsh ❑ Coastal Bank
b. Complete for all proposed activities located, in whole or in part, in Wetland Resource Area(s).
Inland Resource Areas:
Bordering Vegetated Wetlands: Bordering Land Subject to Flooding:
- 105 Cu. Feet
Square Feet altered Volume of Flood Storage Lost(cubic feet)
Square Feet replaced Volume of Flood Storage Compensation(cubic feet)
Land Under Water Bodies: Isolated Land Subject to Flooding:
Square Feet altered Volume of Flood Storage Lost(cubic feet)
Cubic Yards dredged Volume of Flood Storage Compensation(cubic feet)
Bank:
Linear Feet altered
Coastal Resource Areas:
Coastal Dune: Land Under Salt Pond:
Square Feet altered Square Feet altered
Cubic YardsNolume removed Cubic Yards dredged
Salt Marsh: Rocky Intertidal Zone:
Square Feet altered Square Feet altered
Coastal Bank: Designated Port Area:
Linear Feet altered Square Feet altered
WPA Forth 3
Rev 02100 Page 3 of a
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection -Wetlands
WPA Form 3 — Notice of Intent
' Provided by DEP
Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 Salem, MA
Town
C. Activities Subject to Regulations (cont.)
Fish Run:
Land Containing Shellfish:
Linear Feet altered Square Feet altered
Land Subject to Coastal Storm Flowage: Beach:
Square Feet altered Square Feet altered
Land Under Ocean:
Square Feet altered
Cubic Yards dredged
Riverfront Area:
a. Name of Waterway (if available):
North River
b. Width of Riverfront Area (check one):
® 25 ft. - Designated Densely Developed Areas only
❑ 100 ft. - New agricultural projects only
❑ 200 ft. -All other projects
c. Describe how the Mean Annual High-Water Line was determined:
FEMA
d. Distance of proposed activity closest to the Mean Annual High-Water line:
Feet
e. Total area of Riverfront Area on the site of the proposed project:
0
Square Feet
f. Proposed alteration of the Riverfront Area:
0 0
Total Square Feet Square Feet within 100 ft. Square Feet between 100 ft.and 200 ft.
WPA Forth 3 Page 4 d 9
R..02100
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection -Wetlands
WPA Form 3 — Notice of Intent by DEP
Provided b
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem, MA
Town
C. Activities Subject to Regulation (cont.)
2. Check all methods used to delineate the Bordering Vegetated Wetland (BVW) boundary:
❑ Final Order of Resource Area Delineation issued by Conservation Commission or DEP (attached)
❑ DEP BVW Field Data Form (attached)
❑ Final Determination of Applicability issued by Conservation Commission (attached)
❑ Other Methods for Determining the BVW boundary (attach documentation):
❑ 50% or more wetland indicator plants
❑ Saturated/inundated conditions exist
❑ Groundwater indicators
❑ Direct observation
❑ Hydric soil indicators
❑ Credible evidence of conditions prior to disturbance.
3. a. Is any portion of the proposed project located in estimated habitat as indicated on the most
recent Estimated Habitat Map of State-Listed Rare Wetland Wildlife published by the Natural
Heritage and Endangered Species Program?
❑ Yes If yes, include proof of mailing or hand delivery of NO]to
Natural Heritage and Endangered Species Program
Division of Fisheries and Wildlife
Route 135, North Drive
Westborough, MA 01581
® No
Date of Map
b. Is any portion of the proposed project within an Area of Critical Environmental Concern (ACEC)?
❑ Yes If yes, provide name of ACEC (see Appendix D for ACEC locations):
® No
c. Is any portion of the site subject to a Wetlands Restriction Order under the Inland Wetlands
Restriction Act(M.G.L. c. 131, § 40A) or the Coastal Wetlands Restriction Act (M.G.L. c. 130, § 105)?
❑ Yes
® No
WPA Fom 3
Page 5 of 8
Rev.02100
Massachusetts Department of Environmental Protection DER, File Number:
Bureau of Resource Protection -Wetlands
WPA Form 3 — Notice of Intent yDEP
Provided b
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Salem, MA
A r� Town
D. Performance Standards
1. Is any portion of the proposed activity eligible to be treated as a limited project subject to 310 CMR
10.24 or 310 CMR 10.53?
❑ Yes If yes, describe which limited project applies to this project:
® No
2. Is any activity within any Resource Area or Buffer Zone exempt from performance standards of the
wetlands regulations, 310 CMR 10.00.
❑ Yes If yes, describe which exemption applies to this project:
® No
3 a. Is the project located in the Riverfront Area?
❑ Yes If yes, indicate the proposed project purpose:
❑ Single Family House ❑ Industrial Development
❑ Residential Subdivision ❑ Commercial Development
❑ Transportation ❑ Other(describe)
b. Was the lot where the activity is proposed created prior to August 1, 1996?
® Yes
❑ No
4. a. Describe 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.Attach
narrative and supporting documentation.
b. Is this project exempt from the DEP Stormwater Policy?
® Yes If yes; explain why the project is exempt:
Zero change in impervious area
❑ No If no, stormwater management measures are required. Applicants are encouraged to
complete Appendix C: Stonnwater Management Form and submit it with this form.
WPA Fom 3 Page 8 of a
Rm 02100
Massachusetts Department of Environmental Protection DEP File Number:
j ( Bureau of Resource Protection -Wetlands
WPA Form 3 — Notice of Intent Provided by DEP
i Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem, MA
Town
E. Additional Information
Applicants must include the following with this Notice of Intent(NOI):
• 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.
• 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.
• Other material identifying and explaining the determination of resource area boundaries shown on
plans (e.g., a DEP BVW Field Data Form).
• List the titles and final revision dates for all plans and other materials submitted with this NOI.
F. Fees
The fees for work proposed under each Notice of Intent must be calculated and submitted to the
Conservation Commission and the Department (see Instructions and Appendix B.Wetland Fee
Transmittal Form).
No fee shall be assessed for projects of the federal government,the Department, or cities and towns of
the Commonwealth.
Applicants must submit the following information (in addition to pages 1 and 2 of Appendix B) to confirm
fee payment:
7283 & 7284 _ 4/2/01
Check Number Check date
Elizabeth S. Bradt , D . V.M. Same
Payor name on check Applicant name(if different from payor)
G. 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 in writing by hand delivery or certified mail
(return receipt requested) o all abutters ithi 100 feet of the property line of the project location.
signature of Alp' a Date
Signa aZepres
caner if rent) Dat
Z 0
ig ture any) ate
WPA Farm 3 Page 7 of 8
Rev.02100
' _.. DEP File Number:Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
J WPA Form 3 — Notice of Intent
Provided by DEP
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem, MA
Town
G. Signatures and Submittal Requirements (cont.)
For Conservation Commission:
Two copies of the completed Notice of Intent (Form 3), including supporting plans and documents; two
copies of pages 1 and 2 of Appendix B; and the city/town fee payment must be sent to the Conservation
Commission by certified mail or hand delivery.
For DEP:
Two copies of the completed Notice of Intent (Form 3), including supporting plans and documents; two
copies of pages 1 and 2 of Appendix B; and a copy of the state fee payment must be sent to the DEP
Regional Office (see Appendix A) 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.
WPA Fmm 3 Page a of B
Rev.0200
Massachusetts Department of Environmental Protection
K. Bureau of Resource Protection -Wetlands
WPA Appendix B — Wetland Fee Transmittal Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. Applicant Information
Important: 1. Applicant:
When filling out forms on the Elizabeth S. Bradt
computer, use Name
only the tab 22 Larchmont Road
key to move Mailing Address
your cursor- Salem MA 01970
do not use the City/Town State Zip Code
return key. 978-740-0290
m Phone Number
2. Property Owner(if different):
Name
Mailing Address
Cityrrown State Zip Code
Phone Number
3. Project Location:
20 Commercial Street Salem
Street Address Citylrown
B. Fees
To calculate
filing fees, refer Abbreviated Notice of Resource Area Delineation (Form 4A):
to the category
fee list and The fee is calculated as follows (check applicable project type):
examples in
Section D of
this form. ❑ single family house project
X $1.00=
(feet of BVW) Total fee(not to exceed$100)
❑ all other projects
X $1.00=
(feet of BVW) Total fee(not to exceed$1,000)
State share of filling fee:
(112 of total fee less$12.50)
City1rown share of filling fee:
(1/2 of total fee plus$12.50)
WPA Appendix S Page 1 of e
Rev.0200
Massachusetts Department of Envir
onmental Protectio
n
} Bureau of Resource Protection -Wetlands
WPA Appendix B — Wetland Fee Transmittal Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Fees (cont.)
Abbreviated Notice of Intent (Form 4) or Notice of Intent (Form 3):
The fee should be calculated using the following six-step process and worksheet:
Step 1fType of Activity: Describe each type of activity (see Section D for a list of activities) that will
occur in wetland resource area and 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 in Section D.
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.
Step 1/Type of Activity Step 2/Number Step 3/Individual Step 4/Subtotal
of Activities Activity Fee Activity Fee
Renovation of existing structure 1 525.00 525.00
Step 5/Total Project Fee:525.00
Step 6/Fee Payments:
Total Project Fee 525.00
(Total fee from Step 5)
State share of filing fee 250.00
(12 total fee less$12.50)
City/Town share of filling fee 275.00
(12 total fee plus$12.50)
WPA Appendix B
Rev.02100 Page 2 of 6
.... Massachuset
ts Department of Environmental Protection
I0.1 Bureau of Resource Protection - Wetlands
WPA Appendix B — Wetland Fee Transmittal Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Fees
Abbreviated Notice of Intent (Form 4) or Notice of Intent (Form 3):
The fee should be calculated using the following six-step process and worksheet:
Step 1/Type of Activity: Describe each type of activity (see Section D for a list of activities) that will
occur in wetland resource area and 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 in Section D.
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.
Step 1/Type of Activity Step 2/Number Step 3/Individual Step 4/Subtotal
of Activities Activity Fee Activity Fee
Renovation of existing structure 1 525.00 525.00
Step 5/Total Project Fee:525.00
Step 6/Fee Payments:
Total Project Fee 525.00
(Total fee from Step 5)
State share of filing fee 250.00
(1/2 total fee less$12.50)
W LPaCity/Town share of filling fee 275.00
(12 total fee plus$12.50)
PA Appendix 9
Rev.VlAO
ge 2 of 9
7284
ELIZABETH S. BRADT, D.V.M. EASTERN BANK 301
DBA ALL CREATURES VETERINARY HOUSE CALLS LYNN,MA 01901
22 LARCHMONT RD. PH.(978)740-0290 53-179-113
SALEM,MA 01970-2438
PAY Two Hundred Seventy-Five and No/100 Dollars
DATE AMOUNT
TO THE 4/2/01 $275.00
ORDER OF
City of Salem
P.O.Box 430
Salem, Ma 01970
Memo: \VPA Appendix B -Wetland Fee Transmittal Form
11300728to, 1:0113017981: 09 497S 2112
7283
ELIZABETH S. BRADT, D.V,M. EASTERN BANK 301
DBA ALL CREATURES VETERINARY HOUSE CALLS LYNN,MA 01901
22 LARCHMONT RD. PH.(978)740-0290 53-179-113
SALEM,MA 01 970-2 438
PAY Two Hundred Fifty and No/100 Dollars
TO THE DATE AMOUNT
ORDER OF 4/2/01 $250.00
Commonwealth of Massachusetts
Massachusetts DOR
P.O. Box 7043
Boston, MA 02204
77
Memo: Wpa Appendix B Wetaand Transmittal Form
11100728311° 1:011300981: 09 497S 2112
--------------
Massachusetts Department of Environmental Protection
r; Bureau of Resource Protection -Wetlands
WPA Appendix C - Stormwater Management Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. Property Information
Important:
When filling out 1. The proposed project is:
forms on the
computer, use
only the tab New development ❑ Yes
key to move
your cursor- ® No
do not use the
return key.
m
Redevelopment ® Yes
❑ No
Combination ❑ Yes (If yes, distinguish redevelopment components from new
development components on plans).
❑ No
Note:
This February 2. Stormwater runoff to be treated for water quality are based on which of the following calculations:
2000 version of
the Stormwater ❑ 1 inch of runoff x total impervious area of post-development site for discharge to critical areas
Management (Outstanding Resource Waters, recharge areas of public water supplies, shellfish growing areas,
Form supersedes swimming beaches, cold water fisheries).
earlier versions
including those
contained in ❑ 0.5 inches of runoff x total impervious area of post-development site for other resource areas.
DEP's
Stormwater 3. List all plans and documents (e.g. calculations and additional narratives) submitted with this form:
Handbooks. Topographic Plan of Land February 13, 2001
Soil Volume Displacement Calculations January 24 2001
B. Stormwater Management Standards
DEP's Stormwater Management Policy (March 1997) includes nine standards that are listed on the
following pages. Check the appropriate boxes for each standard and provide documentation and
additional information when applicable.
Standard#1: Untreated stormwater
® The project is designed so that new stormwater point discharges do not discharge untreated
stormwater into, or cause erosion to, wetlands and waters.
wan APpendlxC -
Page 7 of 5
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
WPA Appendix C — Stormwater Management Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Stormwater Management Standards (cont.)
Standard #2: Post-development peak discharges rates
® Not applicable—project site contains waters subject to tidal action.
Post-development peak discharge do not exceed pre-development rates on the site at the point of
discharge or downgradient property boundary for the 2-yr and 100-yr, 24-hr storms.
® without stormwater controls
❑ with stormwater controls designed for the 24-hr, 2-yr, and 10-yr storms.
❑ The project's stormwater design will not increase off-site flooding impacts from the 100-yr, 24-hr stonn.
Standard #3: Recharge to groundwater
Amount of impervious area (sq. ft.) to be infiltrated:
Volume to be recharged is based on:
❑ The following Natural Resources Conservation Service hydrologic soils groups (e.g. A, B, C, D, or
UA) or any combination of groups:
(%of impervious area) (Hydrologic soil group) (%of impervious area) (Hydrologic soil group)
(%of impervious area) (Hydrologic soil group) (%of impervious area) (Hydrologic soil group)
❑ Site specific pre-development conditions:
Recharge rate Volume
Describe how there calculations were determined:
List each BMP or nonstructural measure used to meet Standard#3. (e.g. dry well, infiltration trench).
The annual groundwater recharge for the post-development site approximates the annual recharge from
existing site conditions.
❑ Yes
❑ No
WPA Appendix C
Rev.02MO Page 2 of
Massachusetts Department of Environmental Protection
�j Bureau of Resource Protection -Wetlands
WPA Appendix C — Stormwater Management Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Stormwater Management Standards (cont.)
Standard#4: 80% TSS Removal
❑ The proposed stormwater management system will remove 80% of the post-development site's
average annual Total Suspended Solids (TSS) load.
Identify the BMP's proposed for the project and describe how the 80% TSS removal will be achieved.
If the project is redevelopment, explain how much TSS will be removed and briefly explain why 80%
removal cannot be achieved.
Standard#5: Higher potential pollutant loads
Does the project site contain land uses with higher potential pollutant loads (See Stormwater Policy
Handbook—Vol. I, page 1-23, for land uses of high pollutant loading).
❑ Yes If yes, describe land uses:
® No
Identify the BMPs selected to treat stormwater runoff. If infiltration measures are proposed, describe the
pretreatment. (Note: If the area of higher potential pollutant loading is upgradient of a critical area,
infiltration is not allowed.
Standard#6: Protection of critical areas
Will the project discharge to or affect a critical area? (See Stormwater Policy Handbook—Vol. 1, page I -
25, for critical areas).
❑ Yes If yes, describe areas:
® No
Identify the BMPs selected for stormwater discharges in these areas and describe how BMPs meet
restrictions listed on pages 1-27 and 1-28 of the Stormwater Policy Handbook—Vol. I:
WPA Appand!x C
Rev 02100 Page 3 of 5
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
WPA Appendix C — Stormwater Management Form
Massachusetts Wetlands Protection Act M.G.L. c. 131 §40
B. Stormwater Management Standards (cont.)
Note:
components of Standard #7: Redevelopment projects
redevelopment
projects which Is the proposed activity a redevelopment project?
plan to develop
previously
undeveloped ® Yes If yes, the following stormwater management standards have been met:
areas do not fall
under the scope Decrease in displacement of floodwater volume
of Standard 7.
❑ No
The following stolmwater standards have not been met for the following reasons:
❑ The proposed project will reduce the annual pollutant load on the site with new or improved
stormwater control.
Standard #8: Erosion/sediment control
® Erosion and sediment controls are incorporated into the project design to prevent erosion, control
sediments, and stabilize exposed soils during construction or land disturbance.
Standard #9: Operation/maintenance plan
❑ An operation and maintenance plan for the post-development stormwater controls have been
developed.The plan includes ownership of the stormwater BMPs, parties responsible for operation
and maintenance, schedule for inspection and maintenance, routine and long-term maintenance
responsibilities, and provision for appropriate access and maintenance easements extending from a
public right-of-way to the stormwater controls.
Plan/Title Date
Plan/Title Date
C. Submittal Requirements
DEP recommends that applicants submit this form, as well as, supporting documentation and plans, with
the Notice of Intent to provide stormwater management information for Commission review consistent
with the wetland regulations (310 CMR 10.05 (6)(b)) and DEP's Stormwater Management Policy(March
1997). If a particular stormwater management standard cannot be met, information should be provided to
demonstrate how equivalent water quality and water quantity protection will be provided. DEP encourages
engineers to use this form to certify that the project meets the stormwater management standards as well
as acceptable engineering standards. For more information, consult the Stormwater Management Policy.
WPA Appendix C
Rev.02= Pape 4 of 5
Massachusetts Department of Environmental Protection
I Bureau of Resource Protection -Wetlands
WPA Appendix C — Stormwater Management Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
D. Signatures
Dvm 5 //��
Applicant Date
Signatur -�—T—
✓Kv t(yo2— 2 L�
:Represe ativ Date
Signature
wvn Appendix c
Rev.03100 Page 5 of 18
FROM STRUCTURES NORTH �" FAX NO. : 9787456067 Apr. 02 2001 11:41AM P2
All Creatures
20 Commercial Street, Salem, MA
Volume Displacement Calculations
Calculations:
Discussion,p. 1
Individual Footings,p.2
Front Entrance,p.3
Ramp Foundations,p.3
Stair Tower Footings,p.4
Summary and Conclusions,p.5
Faandation Key Plan,1 of 2,SKS-1
Foundation Key Plan,2 of 2,SKS-2
Foundation Sections,SKS-3 and SKS-4
Prepared by:
Structures North Consulting Engineers, Inc.
60 Washington Street
Salem, Massachusetts 01970
(978) 745-6817
(978) 745-6057 fax
Date- NO
24 January 2001
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