14 BUENA VISTA AVENUE - BUILDING JACKETor
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Certificate No: 146-06 Building Permit No.: 146-06
Commonwealth of Massachusetts
City of Salem
Building Electrical Mechanical Permits
This is to Certify that the RESIDENCE located at
Dwelling Type
0014 BUENA VISTA AVENUE in the CITY OF SALEM
- -
----------- ----------------- ---------------- ----------------------------------------------------------------
Address Town/City Name
IS HEREBY GRANTED A PERMANENT CERTIFICATE OF
OCCUPANCY
14 BUENA VISTA AVENUE
This permit is granted in confortnity with the Statutes and ordinances relating thereto, and
expires .................. ------------
. unless sooner suspended or revoked.
Expiration Date
Issued On:Wed Feb 20,2008 - --- -
-------...- - - -- - - -
GeoTMS®2008 Des Lauriers Municipal Solutions,Inc. -----------" "--------------"- ------------
nQVE AO
CITY OF SALEM
BUILDING PERMIT
0014 BUENA VISTA AVENUE 146-06
GIs#: -o�a5 ' COMMONWEALTH OF MASSACHUSETTS
Map: 10009 CITY OF SALEM
Block: -
Lot: 10296
Category: 101 New Single family
Permit# - 146- BUILDING PERMIT
Project# JS 2006 0219
Est.Cost: _$350,000.00
Fee: 1$2,105.00
Const.Class: PERMISSION IS HEREBY GRANTED TO:
Use Group: Contractor: License:
Lot Size(sq.ft): DANCO MANAGEMENT INC. STATE-043536
IZonmg: Owner: SIDERIDI COSTOS t
Units Gained: Applicant: DANCO MANAGEMENT INC.
Units Lost:
Dig Safe#: -�AT: 0014 BUENA VISTA AVENUE
ISSUED ON. 09-Aug-2005 AMENDED ON: EXPIRES ON: 09-Feb-2006
TO PERFORM THE FOLLOWING WORK:
146-06 NEW SINGLE HOME TJS
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Electric Gas Plumbing Building
Underground: Underground: Underground: Excavation:
Service: Meter: Footings:
Rough: #jq/pe Roug2�1`, Rougp{ 7\ t,Cl.� Y Foundation: 7
�r'�{{ (
FinaL•!.i�/� /� /�/Q/ Final Q(I, r3 etc
Final:�7 r� -7,- o--0 �" Rough Framr J
Y D`- •fY � T O- b
Fireplac hii c�:
D.P.W. Fir Health / �3 d �I
(t
Insulation::l 7/
Meter: Oil:
/ Final:
(louseSmoke: a,� ^�
Treasury:
Water: Alarm:
Sewer. Sprinklers: ,
THIS PERMIT MAY BE REVOKED BY THE CITY OF SALEM UPON VIOLATION OF ANY OF ITS
RULES AND REGULATIONS.
Sinature: I't
,I 4E 4t
v
Fee Type: Receipt No: - Date Paid: Check No: Amount:
BUILDING REC-2006-000253 09-Aug-05 6241 $2,105.00
Cali for Permit to Occupy
GeoTMS®2005 Des Lauriers M, Imn Si tinni,tnc.
BEVERIDGE
&DIAMOND :dao
The Environmental, Land Use, 2006
and Litigation Law Firm
Washington;D.C. Maryland Newyork Massachusetts New Jersey Texas California
www.bdiaw.com
0
CITY OF SALEM
?s CONSERVATION COMMISSION
January 12, 2007
JG & G Realty Trust
Julianna Tache, Trustee
208 Derby Street
Salem, Massachusetts 01970
Sent via Certified Mail 7005 3110 0000 7176 6035
Dear Ms. Tache:
In accordance with the Massachusetts Wetlands Protection Act and the City of Salem
Wetlands Bylaws, you are in violation for the current work that is occurring at 14 Buena Vista
West, due to the fact that the Order of Conditions, DEP#64-358, has expired. After visiting
the site on January 9, 2007 it was also determined that there were several violations occurring
pursuant to the Order of Conditions, DEP#64-358, see attached photo log. The conditions
that were in violation included#s 5, 19, 21, 22, 23, 29, 30, 44, and 49, see attached Order of
Conditions. Most importantly work was being performed without proper erosion control
measures in place.
Because this project has not been completed and you are working under an expired Order of
Conditions the Salem Conservation Commission must issue the enclosed Enforcement Order ,
attached, requiring you to cease and desist from any further activity on site. In order for the
cease and desist to be lifted and for you to complete your project you must file a Notice of
Intent (NOI) and all the submittal requirements with the Conservation Commission and the
Massachusetts Department of Environmental Protection (DEP).
On October 10, 2006 the Salem Conservation Agent sent you a letter advising you that the
Order of Conditions would expire on December 11, 2006 (see attached letter). The letter
stated"If this development project has not been completed, than you must submit a written
request for an extension of the existing Order of Conditions to the Commission at least 30-
days prior to the expiration of the order, as required in the Wetland Protection Act. If the
project has not been completed and your Order of Conditions expires, you will be required to
file a new Notice of Intent to complete this previously approved project." Enclosed is a
Notice of Intent application, which must be filed with the Conservation Commission by
January 25, 2007.
The Conservation Commission discussed this matter at their regularly scheduled meeting held
on Thursday January 11, 2007. Based on the information described above and photographs
provided to the Commission from the site visit conducted on January 9, 2007, the
120 WASHINGTON STREET, SALEM, MASSACHUSFTTS 01970 • TEL: 978.745.9595 FAx: 978.740.0404 ♦ WWW.SALEM.COM
C,
Commission voted to issue an enforcement order to cease and desist immediately. If work
continues on the property fines shall be enforced at up to $200 per day.
Upon receiving this notice you will have 24 hours to contact me to discuss this matter
further. If I am not contacted within 24 hours, the Commission will commence issuing
fines of up to $200 a day. Fines will continue to accrue until I am contacted.
The Commission also requires that you submit a Notice of Intent by January 25, 2007.
Please be advised, that if you fail to submit an Notice of Intent application within the
allotted timeframe without first notifying the Commission in writing at least 48 hours in
advance, demonstrating good cause for inability to submit the application, the
Commission will enforce fines of up to $200 a day until a Notice of Intent is received by
the Commission.
In the meantime, the Salem Conservation Commission requests that you appear before
the Commission at their next regularly scheduled meeting to discuss this matter further.
The next meeting is scheduled for January 25, 2007 at 6:00 PM, 120 Washington
Street, 3rd Floor. If you cannot attend this meeting please contact me at 978-619-5685.
Sincerely,
Carey Duques
Conservation Agent/Staff Planner
Cc: Kevin Comacchio, Chairman
Lynn Duncan, Director Planning and Community Development
IThomas7St-Pierre,—Buildifig-Inspector
ti
Beth Rennard, City Solicitor
Massachusetts DEP, Northeast Regional Office
Encl.
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 9A — Enforcement Order 64-358
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
A. Violation Information
Important: This Enforcement Order is issued b
When filling out Y:
forms on the Salem January12, 2007
computer, use Conservation Commission(Issuing Authority) Date
only the tab
key to move To:
your cursor-
do not use the JG & G Realty Trust, Julianna Tache, Trustee
return key. Name of Violator
208 Derby Street
VQ Address
1. Location of Violation:
Property Owner(if different)
14 Buena Vista West
Street Address
Salem 01970
City/Town Zip Code
_Map 9 Lot 93
Assessors Map/Plat Number Parcel/Lot Number
2. Extent and Type of Activity(if more space is required, please attach a separate sheet):
The current work occuring at 14 Buena Vista West is in violation because the Order of Conditions,
issued under DEP# 64-358, expired on December 11, 2006. The Salem Conservation Commission
Agent sent a letter on October 10, 2006 notifying the applicant/landowner. However,the Agent received
no response from the applicant/landowner. Therefore the Salem Conservation Commission issues a
cease and desist. After visiting the site on January 9, 2007, it was determined that there were several
violations per the previous Order of Conditions DEP#64-358. The conditions that were in violation
included #s 5, 19, 21, 22, 23, 29, 30, 44, and 49.
B. Findings
The Issuing Authority has determined that the activity described above is in violation of the Wetlands
Protection Act (M.G.L.c. 131, §40) and its Regulations (310 CMR 10.00), because:
® the activity has been/is being conducted without a valid Order of Conditions.
w aform9a.dx•rev.7/14/04 Page 1 of 3
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 9A — Enforcement Order 64.358
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
® the activity has beenfis being conducted in violation of the Order of Conditions issued to:
JG & G Realty Trust, Julianna Tache, Trustee December 11, 2003
Name Dated
64-358 5, 19, 21, 22, 23, 29, 30,44, and 49
File Number Condition number(s)
B. Findings (cont.)
❑ Other(specify):
C. Order
The issuing authority hereby orders the following (check all that apply):
® The property owner, his agents, permittees, and all others shall immediately cease and desist
from the further activity affecting the Buffer Zone and/or wetland resource areas on this property.
❑ Wetland alterations resulting from said activity should be corrected and the site returned to its
original condition.
® Complete the attached Notice of Intent. The completed application and plans for all proposed
work as required by the Act and Regulations shall be filed with the Issuing Authority on or before
January 25, 2007
Date
No further work shall be performed until a public hearing has been held and an Order of Conditions
has been issued to regulate said work.
❑ The property owner shall take the following action to prevent further violations of the Act:
Failure to comply with this Order may constitute grounds for additional legal action. Massachusetts
General Laws Chapter 131, Section 40 provides: "Whoever violates any provision of this section (a)
nafor�a.doc•rev.7/14/04 Page 2 of 3
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 9A - Enforcement Order 64-358
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
D. Appeals/Signatures
An Enforcement Order issued by a Conservation Commission cannot be appealed to the Department of
Environmental Protection, but may be filed in Superior Court.
Questions regarding this Enforcement Order should be directed to:
Carey Duques
Name
978-619-5685
Phone Number
Monday, Tuesday,Wednesday 8 am -4 pm; Thursday 8 am-7 pm; and Friday 8 am-12 pm
Hours/Days Available
Issued by:
Salem
Conservation Commission
In a situation regarding immediate action, an Enforcement Order may be signed by a single member or
agent of the Commission and ratified by majority of the members at the next scheduled meeting of the
Commission.
Signatures,
4005 3110 00W (,03-5-
Signature of delivery person or certified mail number
wpaform9a.doc•rev.7/14/04 Page 3 of 3
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�cJ; ^7? 'k Ei �'`k 'Y s,`w J ".@tfrT ;^�L Jfr�p:✓nb .' �RS"r by
Massachusetts Department of Environmental Protection DEP File Number.
IIJBureau of Resource Protection -Wetlands 64-358
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, Conservaga+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
go To: Applicant: Property Owner(if different from applicant):
JG &G Realty Trust, Julianne Tache,Trustee Same
Name Name
�m 208 Derby Street
Mailing Address Mailing Address
Salem MA 01970
Cityrrown state zip Cade City?own State Zip Code
1. Project Location:
Lot 1 Buena Vista Avenue Salem
Street Address City/Town
Map 9 Lot 93
Assessors Map/Plat Number Paroal/Lot Number
2. Property recorded at the Registry of Deeds for:
Essex South 7199 111
County Book Page
NA
Certificate IN registered land)
3. Dates:
October 9, 2003 December 11, 2003 December 11, 2003
Date Notice M Intent Filed Date Public Hearing Closed Date of Issuance
4. Final Approved Plans and Other Documents (attach additional plan references as needed):
Site Development Permit Plan Located in Salem, Mass. Prepared by Eastern Land Revised
Survey Associates, Inc. 12/3/03
5. Final Plans and Documents Signed and Stamped by:
Christopher R. Mello(Survey)and Clayton A. Morin (Civil)
Name
6. Total Fee:
$250.00
(from Appendix 8:Wetland Fee Transmittal Form)
WPA Fa 5 Page 1 CO 7
Rev.02100
Massachusetts Department of Environmental Protection DEP File Number.
r ^ �}� Bureau of Resource Protection -Wetlands
64358
r"`
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 Acts 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 rause 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 Farm 5 Paget of 7
Rev.WOO
Massachusetts Department of Environmental Protection DEP Fite Number.
Bureau of Resource Protection -Wetlands 64.356
WPA Form 5 - Order of Conditions PmvldedbyDEP
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. 9 this Order is intended to be valid for more than three
years,the extension date and the special circumstances warranting the extended time period are
set forth as a special condition In this Order.
5. This Order may be extended by the issuing authority for one or more periods of up to three years each
upon application to the issuing authority at least 30 days prior to the expiration date of the Order.
6. Any fill used in connection with this project shall be clean fill. Any fill shall contain no trash, refuse,
rubbish, or debris, including but not limited to lumber,bricks, plaster,wire, lath, paper, cardboard,
pipe,tires,ashes, refrigerators, motor vehicles,or parts of any of the foregoing.
7. This Order is not final until all administrative appeal periods from this Order have elapsed,or If such
an appeal has been taken, until all proceedings before the Department have been completed.
8. No work shall be undertaken until the Order has become final and then has been recorded in the
Registry of Deeds or the Land Court for the district in which the land is located,within the chain of title
of the affected property. In the case of recorded land,the Final Order shall also be noted in the
Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to
be done. In the case of the registered land, the Final Order shall also be noted on the Land Court
Certificate of Title of the owner of the land upon which the proposed work Is done.The recording
information shall be submitted to this Conservation Commission on the form at the end of this Order,
which form must be stamped by the Registry of Deeds, prior to the commencement of work.
9. A sign shall be displayed at the site not less then two square feet or more than three square feet in
size bearing the words,
"Massachusetts Department of Environmental Protection"[or,"MA DEP"j
"File Number 64358 "
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.
WPA Farm 5 Page 0 017
Rev.07/00
Massachusetts Department of Environmental Protection DEP File Number
Bureau of Resource Protection -Wetlands 64-356
WPA Form 5 — Order of Conditions Provided
by0EP
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:
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 1017
WPA Fa 5
Rev.07A0
Massachusetts Department of Environmental Protection DEP File Number
Bureau of Resource Protection -Wetlands 04— 35ir
A 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 K from the date of issuance.
NN&C—a-.,\*A - t\12o43
Data
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 Ap dix and the roperty owner 'tf different from ppli nt).
Signatures:
On E/�YLnl�+ Of iJe is X 2t 2.003
Day Month and Year
before me personally appeared
�eo y c. 1Jo,rn.c.,5
to me known to be the person described in and who executed the foregoing instrument and
acknowledged that he/sh executed the same as his/her free
act and deed.
r-" w5t- SO zo o
Notary Public My ComMission Expires
This Order is issued to the applicant as follows:
❑ by hand delivery on by certified mail, return receipt requested,on
lla��z.r�-.bcr 22l 7�'"3
Date Date
WPA Form 5 Page 5 017
Rev.02MO
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection -Wetlands 64-358
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 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
Page 6 of 7
WPA Fa 5
Rev.07/0
Massachusetts Department of Environmental Protection DEP File Number.
Bureau of Resource Protection -Wetlands 64-358
WPA Form 5 - Order of Conditions ProhdeObyDEP
s 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 advised that the Order of Conditions for the Project at:
Lot 1 Buena Vista Avenue 64358
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 Fa 5 Page 7d7
Rev.0200
/ Salem Conservation Commission
SPECIAL CONDITIONS—DEP FILE #64-358
City of Salem,Lot 1 Buena Vista Avenue
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#64358 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 noted 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.
r 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_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 Comtttssion 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. Thereshallbe 25_hay bales and wooden staked stored undercover 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.
r 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 ram 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. Immediately following drainage structure installation,all inlets shall be protected by silt fence,hayblae barriers
and/or silt bags to filter silt from stormwater before it enters die drainage system.
38. The project shall not cause an increase in run-off onto adjacent properties,either during construction or when
completed.
39. 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 21 A,section 16.
POST CONSTRUCTION
40. 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.
,+ 41. 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 individualltrust 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.
42. When issued,the Certificate of Compliance must be recorded at the Essex County Registry of Deeds.
43. 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.
44. 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.
45. The following condition(s)shall extend beyond the Certificate of Compliance,in perpetuity,and shall
be recorded as such on the Certificate of Compliance and in all future deeds to this property:
PERPETUAL CONDITIONS
46. There shall be no dumping of leaves,grass clippings,hash or any kind of refuse in the resource area.
47. Herbicides shall not be applied within 100 feet of the wetland.
48. No sodium-based products shall be used for control of ice or snow within 100 feet or the wedand.
ADDITIONAL CONDITIONS
49. No work and/or disturbance shall extend beyond the limits s of the staked hay bale line during construction.
CITY OF SALEM
`F CONSERVATION COMMISSION
October 10, 2006
JG&G Realty Trust
Juliana Tache,Trustee
208 Derby Street
Salem,Massachusetts 01970
Re: DEP #64357 and 358—Construction of portions of two single-family dwellings
Lots 1 and 2-12 and 14 Buena Vista Avenue,Salem,Massachusetts
Dear Ms. Tache:
Please be advised that the Order of Conditions for the above referenced project will expire
on December 11,2006. If this development project is complete,you should Request a
Certificate of Compliance (enclosed forms) from the Salem Conservation Commission.
If this development project has not been completed,than you must submit a written request
for an extension of the existing Order of Conditions to the Commission at least 30-days
prior to the expiration of the order,as required in the Wetland Protection Act If the project
has not been completed and your Order of Conditions expires,you will be required to file a
new Notice of Intent to complete this previously approved project.
Please contact me at(978) 745-9595 extension 311 if you have any questions.
Sincerely,
Carey Duques
Conservation Agent Planer
Enclosures
Cc: Attorney Scott Grover
120 WASHINGTON STREET, SALEM, NIASSACHUSETTs 01970 • TEL: 978.745.9595 FAx: 978.740.0404 W iR'..PALEM.COM
Massachusetts Department of Environmental Protection Provided by DEP:
Bureau of Resource Protection - Wetlands DEP File Number
WPA Form 3 - Notice of Intent Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
City/Town
Important' A. General Information
When filling out
forms on the
computer,use 1. Project Location (Note: electronic filers will click on button for GIS locator):
only the tab key
to move your
cursor-do not
use the return a.Street Address b.City/Town c.Zip Code
key.
{ ���n�
y. Latitude and Longitude:
—I� d. Latitude e.Longitude
f.Assessors Map/Plat Number g. Parcel/Lot Number
2. Applicant:
a.First Name b.Last Name c.Company
Note:
Before d.Mailing Address
completing this
form consult
your local e.City/Town f.State g.Zip Code
Conservation
Commission In.Phone Number i. Fax Number j.Email address
regarding any
municipal bylaw 3. Property owner (if different from applicant): ❑ Check if more than one owner
or ordinance.
a.First Name b. Last Name c.Company
d.Mailing Address
e.City/Town f.State g.Zip Code
In.Phone Number i. Fax Number j. Email address
4. Representative (if any):
a.Firm
b.Contact Person First Name c.Contact Person Last Name
d. Mailing Address
e.City/Town f.State g.Zip Code
In.Phone Number i. Fax Number j. Email address
5. Total WPA Fee Paid(from NOI Wetland Fee Transmittal Form):
a.Total Fee Paid b.State Fee Paid c.City/Town Fee Paid
6. General Project Description:
wpaform3.doc•rev.3129/05 Page 1 of 7
Massachusetts Department of Environmental Protection Provided by DEP:
Bureau of Resource Protection Wetlands DEP File Number
WPA Form 3 - Notice of Intent
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Document Transaction Number
City/Town
A. General Information (continued)
7. Project Type Checklist:
a. ❑ Single Family Home b. ❑ Residential Subdivision
c. ❑ Limited Project Driveway Crossing d. ❑ Commercial/Industrial
e. ❑ Dock/Pier I. ❑ Utilities
g. ❑ Coastal Engineering Structure h. ❑ Agriculture—cranberries,forestry
i. ❑ Transportation j. ❑ Other
8. Property recorded at the Registry of Deeds for:
a.County b.Page Number
c.Book d.Certificate p(if registered land)
9. Has work been performed on the property under an Order of Resource Area Delineation involving
Simplified Review within 3 years of the date of this application?
a. ❑ Yes b. ❑ No
10. Buffer Zone Only- Is the project located only in the Buffer Zone of a bordering vegetated wetland,
inland bank, or coastal resource area?
a. ❑ Yes-answer 11 below, then skip to Section C.
b. ❑ No - skip to Section B.
If yes, no Notice of Intent or Request for Determination of Applicability may be filed for work within the
50-foot-wide area in the Buffer Zone along the resource area during the three-year term of an Order
of Resource Area Delineation, or any Extended Order, or until the applicant receives a Certificate of
Compliance, whichever is later.
11. Buffer Zone Setback— For projects that involve work only in the buffer zone, select the applicable
adjacent resource area (check one):
a. ❑ BVW b. ❑ inland bank c. ❑coastal resource area
The distance between the closest project disturbance and the associated resource area is:
d.linear feet
wpaform3.doc•rev.3/29/05 Page 2 of 7
Massachusetts Department of Environmental Protection Provided by DEP:
Bureau of Resource Protection - Wetlands DEP File Number
WPA Form 3 - Notice of Intent
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Document Transaction Number
Cily/rown
B. Resource Area Effects
1. Inland Resource Areas
Check all that apply below. Attach narrative and any supporting documentation describing how the
project will meet all performance standards for each of the resource areas altered, including
standards requiring consideration of alternative project design or location.
Include Users:
Include your Resource Area Size of Pr000sed Alteration Proposed Replacement(if any)
document
transaction a. ❑ Bank 1.linear feel 2.linear feet
number b. ❑ Bordering Vegetated
(provided on Wetland 1.square feet 2.square feet
your receipt
page) with all c. ❑ Land Under 1.square feet 2.square feet
supplementary Waterbodies and
information you Waterways
3.cubic yards dredged
submit to the d. ❑ Bordering Land
Department. Subject to Flooding 1.square feet 2.square feet
3.cubic feet of flood storage lost 4.cubic feet of flood storage replaced
e. ❑ Isolated Land Subject
to Flooding 1.square feet
2.cubic feet of flood storage lost 3.cubic feet of flood storage replaced
f. ❑ Riverfront area 1.Name of Waterway(if available)
1.Width of Riverfront Area (check one):
❑ 25 ft. - Designated Densely Developed Areas only
❑ 100 ft. - New agricultural projects only
❑ 200 ft. -All other projects
2. Total area of Riverfront Area on the site of the proposed project: Square Feet
3. Proposed alteration of the Riverfront Area:
a.Total Square Feet b. Square Feet within 100 N. c.Square Feet between 100 ft.and 200 ft.
4. Has an alternatives analysis been done and is it attached to this NOI? ❑ Yes❑ No
5.Was the lot where the activity is proposed created prior to August 1, 1996? ❑ Yes❑ No
wpaform3.doc•rev.3/29!05 Page 3 of 7
Massachusetts Department of Environmental Protection Provided by DEP:
Bureau of Resource Protection - Wetlands
DEP File Number
WPA Form 3 - Notice of Intent
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 6o umentrransactionNumber
City/Town
B. Resource Area Effects
2. Coastal Resource Areas:
Check all that apply below. Attach narrative and supporting documentation describing how the
project will meet all performance standards for each of the resource areas altered, including
standards requiring consideration of alternative project design or location.
Online Users: Resource Area
Include your Size of Proposed Alteration Proposed Replacement (if anvl
document
transaction a. ❑ Designated Port Areas Indicate size under Land Under the Ocean, below
number
(provided on b. ❑ Land Under the Ocean 1.square feet
your receipt
page)with all 2.Cubic yards dredged
supplementary
information you c. ED Barrier Beach Indicate size under Coastal Beaches and/or Coastal Dunes submit to the below
Department. d. ❑ Coastal Beaches 1.Square feet
q 2.Cubic yards beach nourishment
e. ❑ Coastal Dunes 1.Square feel
q 2.Cubic yards dune nourishment
f. ❑ Coastal Banks
i.Linear feet
g. ❑ Rocky Intertidal Shores 1.Square feet
h.❑ Salt Marshes 1.Square feet
q 2. Sq tt restoration,rehab.,or creation
i. ❑ Land Under Salt Ponds 1.square feet
2.Cubic yards dredged
j. [I Land Containing
Shellfish 1. Square feet 2. Square feet restoration,rehab.
k. ❑ Fish Runs Indicate size under Coastal Banks, inland Bank, Land Under the
Ocean, and/or inland Land Under Waterbodies and Waterways,
above
1.Cubic yards dredged
i. ❑ Land Subject to Coastal
Storm Flowage 1. square feet
3. Limited Project:
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?
a. ❑ Yes ❑ No If yes, describe which limited project applies to this project:
b.Limited Project
wpaform3.doc•rev.3/29/05
Page 4 of 7
Massachusetts Department of Environmental Protection Provided by DEP:
Bureau of Resource Protection - Wetlands DEP File Number
WPA Form 3 - Notice of Intent
Massachusetts Wetlands Protection Act M.G.L. c. 131 , §40 Document Transaction Number
City/town
C. Bordering Vegetated Wetland Delineation Methodology
Check all methods used to delineate the Bordering Vegetated Wetland (BVW) boundary:
Online Users: 1. ❑ Final Order of Resource Area Delineation issued by Conservation Commission or DEP
Include your (attached)
document
transaction 2. ❑ DEP BVW Field Data Form (attached)
number
(provided on 3. ❑ Final Determination of Applicability issued by Conservation Commission or DEP (attached)
your receipt
page) with all 4. ❑ Other Methods for Determining the BVW Boundary(attach documentation):
supplementary
information you a. ❑ 50%or more wetland indicator plants
submit to the
Department. b. ❑ Saturatedfinundated conditions exist
c. ❑ Groundwater indicators
d. ❑ Direct observation
For all projects
affecting other e. ❑ Hydric soil indicators
Resource
Areas, please r. ❑ Credible evidence of conditions prior to disturbance
attach a
narrative 5. Other resource areas delineated:
explaining how D.D. OtherApplicable Standards and Requirements
the resourcePP q
area was
delineated. 1. 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?
a. ❑ Yes ❑ No If yes, include proof of mailing or hand delivery of NOI to:
Natural Heritage and Endangered Species Program
Division of Fisheries and Wildlife
Route 135, North Drive
b.Date of Map Westborough, MA 01581
2. For coastal projects only, is any portion of the proposed project located below the mean high water
line or in a fish run?
a.❑ Yes ❑ No If yes, include proof of mailing or hand delivery of NOI to:
Massachusetts Division of Marine Fisheries
251 Causeway Street, Suite 400
Boston, MA 02114
b. ❑ Not applicable—project is in inland resource area only
3. is any portion of the proposed project within an Area of Critical Environmental Concern (ACEC)?
a. ❑ Yes ❑ No If yes, provide name of ACEC (see instructions to WPA Form 3 or DEP
Website for ACEC locations). Note: electronic filers click on Website.
b.ACEC
wpaform3.doc•rev.3/29/05 Page 5 of 7
Massachusetts Department of Environmental Protection Provided by DEP:
Bureau of Resource Protection - Wetlands DEP File Number
WPA Form 3 — Notice of Intent 6ument Transact=Numbw
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C ty/Tovm
D. Other Applicable Standards and Requirements
Online Users: 4. Is any portion of the site subject to a Wetlands Restriction Order under the Inland Wetlands
Include your Restriction Act (M.G.L.c. 131, §40A) or the Coastal Wetlands Restriction Act (M.G.L.c. 130, § 105)?
document a ❑ Yes ❑ No
transaction
number
(provided on
your receipt 5. Is any activity within any Resource Area or Buffer Zone exempt from performance standards of the
page) with all wetlands regulations, 310 CMR 10.00.
supplementary
information you a. ❑ Yes ❑ No If yes, describe which exemption applies to this project:
submit to the
Department. b.Exemption
6. Is this project subject to the DEP Stormwater Policy? a. ❑ Yes ❑ No
If yes, stormwater management measures are required. Applicants should complete the Stormwater
Management Form and submit it with this form.
b. If no, explain why the project is exempt:
E. Additional Information
Applicants must include the following with this Notice of Intent (NOI). See instructions for details.
Online Users: Attach the document transaction number (provided on your receipt page)for any of
the following information you submit to the Department.
i. ❑ USGS or other map of the area (along with a narrative description, if necessary) containing
sufficient information for the Conservation Commission and the Department to locate the site.
(Electronic filers may omit this item.)
2. ❑ Plans identifying the location of proposed activities (including activities proposed to serve as
a Bordering Vegetated Wetland[BVW] replication area or other mitigating measure) relative
to the boundaries of each affected resource area.
3. ❑ Other material identifying and explaining the determination of resource area boundaries
shown on plans (e.g., a DEP BVW Field Data Form).
4. ❑ List the titles and dates for all plans and other materials submitted with this NOI.
5. ❑ If there is more than one property owner, please attach a list of these property owners not
listed on this form.
6.❑ Attach proof of mailing for Natural Heritage and Endangered Species Program, if needed.
7. ❑ Attach proof of mailing for Massachusetts Division of Marine Fisheries, if needed.
a. ❑ Attach N01 Wetland Fee Transmittal Form
9. ❑ Attach Stormwater Management Form, if needed.
wpaform3.doc•rev.3/29/05 Page 6 of 7
Massachusetts Department of Environmental Protection Provided by DEP:
Bureau of Resource Protection - Wetlands DEP File Number
WPA Form 3 - Notice of Intent
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
citydrown
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 NOI Wetland Fee Transmittal
Form).
No filing fee shall be assessed for projects of any city,town, county, or district of the Commonwealth,
federally recognized Indian tribe housing authority, municipal housing authority, or the Massachusetts
Bay Transportation Authority.
Applicants must submit the following information (in addition to pages 1 and 2 of the NOI Wetland
Fee Transmittal Form)to confirm fee payment:
1.Municipal Check Number 2.Check date
3.State Check Number 4.Check date
5.Payor name on check:First Name S.Payor name on check:Last Name
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) to all abutters within 100 feet of the property line of the project location.
Signature of Applicant Date
Signature of Property Owner(if different) Date
Signature of Representative(if any) Date
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 the NOI Wetland Fee Transmittal Form; and the city/town fee payment must be sent to the
Conservation Commission by certified mail or hand delivery.
For DEP:
One copy of the completed Notice of Intent(Form 3), including supporting plans and documents; one copy of
pages 1 and 2 of the NOI Wetland Fee Transmittal Form; and a copy of the state fee payment must be sent to
the DEP Regional Office(see Instructions)by certified mail or hand delivery. (E-filers may submit these
electronically.)
Other:
If the applicant has checked the"yes"box in any part of Section D, Item 3,above, refer to that section and the
Instructions for additional submittal requirements.
The original and copies must be sent simultaneously. Failure by the applicant to send copies in a timely
manner may result in dismissal of the Notice of Intent.
wpaform3.doc•rev.3/29/05 Page 7 of 7
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
NOI Wetland Fee Transmittal Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Important: A. Applicant Information
When filling out
forms on the 1. Applicant:
computer, use
only the tab
key to move a. First Name b.Last Name c.Company
your cursor-
do not use the d.Mailing Address
return key.
mVQ e.Cityfrown f.Stele g.Zip Code
h. Phone Number
m,. 2. Property Owner(if different):
a.First Name b.Last Name c.Company
d.Mailing Address
e.City/rown I.State g.Zip Code
h. Phone Number -
3. Project Location:
a.Street Address b.City/Town
To calculate B. Fees
filing fees, refer
to the category Notice of Intent (Form 3)or Abbreviated Notice of Intent(Form 4):
fee list and
examples in the The fee should be calculated usinnsructg p the following six-step process and worksheet. Please see
filling out WPA 9
instructions for Instructions before fillip out worksheet.
Form 3(Notice of
Intent). Step 1/Type of Activity: Describe each type of activity 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 listed in the
instructions.
Step 4/Subtotal Activity Fee: Multiply the number of activities (identified in Step 2) times the fee per
category (identified in Step 3)to reach a subtotal fee amount. Note: If any of these activities are in a
Riverfront Area in addition to another Resource Area or the Buffer Zone, the fee per activity should be
multiplied by 1.5 and then added to the subtotal amount.
Step 51Totai 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.
W palorrtq.dm•NOI W eUand Fee Transmnal Forth•rev.3/1/05 Page 1 o12
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
NOI Wetland Fee Transmittal Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Fees (continued)
Step II/Type of Activity Step?/Number Step Step 4/Subtotal Activity
of Activities 3/Individual Fee
Activity Fee
Step 5/7otai Project Fee:
Step 6/Fee Payments:
Total Project Fee: a.Total fee from Step 5
State share of filing fee: b. 1/2 total fee less$22.50
City/Town share of filling fee: c. 1/2 total fee plus$22.50
C. Submittal Requirements
a.) Complete pages 1 and 2 and send with a check or money order for the state share of the fee,
payable to the Commonwealth of Massachusetts.
Department of Environmental Protection
Box 4062
Boston, MA 02211
b.) To the Conservation Commission: Send the Notice of Intent or Abbreviated Notice of Intent;
a copy of this form; and the city/town fee payment.
c.) To DEP Regional Office (see Instructions): Send a copy of the Notice of Intent or Abbreviated
Notice of Intent; a copy of this form; and a copy of the state fee payment. (E-filers of Notices of
Intent may submit these electronically.)
W palorn 1doc•N01 W eland Fee Transn"al Form•rev.all 105 Page 2 o12
CITY OF SALEM
CONSERVATION COMMISSION
Mr. Manuel Silva
121 Green Lane
Middletown R.I. 02842
Sent via Certified Mail 7005 3110 0000 7176 6042
January 12, 2007
Dear Mr. Silva:
In accordance with the Massachusetts Wetlands Protection Act and the City of Salem
Wetlands Bylaws, you are in violation for the current work that is occurring on Tinkers Island,
due to the fact that a Notice of Intent was not filed with the Conservation Commission and an
Order of Conditions has not been obtained.
The Salem Conservation Commission received a letter notifying them that construction is
occurring on Tinkers Island, see attached letter. The Commission does not have any permits
on record stating that this work has been permitted.
The Conservation Commission discussed this matter at their regularly scheduled meeting held
on Thursday January 11, 2007. Based on the information described above the Commission
voted to issue an Enforcement Order, attached, to cease and desist from any future activity of
the site, requiring that you stop all work immediately. If work continues on the property
fines shall be enforced at $200 per day.
Upon receiving this notice you will have 24 hours to contact me to discuss this project. If the
agent is not contacted within 24 hours the fines will begin to accumulate at $200 per day until
you contact me.
In order to be in compliance you will have to file a Notice of Intent (NOI) and all the
submittal requirements with the Conservation Commission and the Massachusetts Department
of Environmental Protection (DEP). Enclosed is a Notice of Intent application, which must be
filed with the Conservation Commission by January 25, 2007. Please be advised, that if you
fail to submit an Notice of Intent application within the allotted timeframe without first
notifying the Commission in writing at least 48 hours in advance, demonstrating good cause
120 WASHINGTON STREET, SALEM, MASSACHUSETTS 01970 .TEL: 978.745.9595 FAx: 978.740.0404 0 WWW.SALEM.COM
for inability to submit the application, the Commission will enforce fines of$200 a day until a
Notice of Intent is received by the Commission.
The Salem Conservation Commission requests that you appear before the Commission at their
next regularly scheduled meeting to discuss this issue. The next meeting is scheduled for
January 25, 2007 at 6:00 PM, 120 Washington Street, 3rd Floor. If you do not appear before
the Commission on January 25, 2007 the Commission will issue fines of$200 per day. If you
cannot attend this meeting please contact me at 978-619-5685.
Sincerely,
Carey Dugquu3s
Conservation Agent/Staff Planner
Cc: Kevin Cornacchio, Chairman
Lynn Duncan, Director Planning and Community Development
Thomas St Pierre, Building Inspector
Beth Rennard, City Solicitor
Massachusetts DEP Northeast Regional Office
Encl.
L1Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands
1 WPA Form 9A - Enforcement Order
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
A. Violation Information
Important: This Enforcement Order is issued b
When filling out Y:
forms on the Salem January 12, 2007
Computer, use Conservation Commission(Issuing Authority) Date
only the tab
key to move To:
your cursor-
do not use the Manuel Silva
return key. Name of Violator
121 Green Lane Middletown, RI 02842
VQ
Address
1. Location of Violation:
Property Owner(if different)
Tinkers Island
Street Address
Salem 01970
City/Town Zip Code
Assessors Map/Plat Number Parcel/Lot Number
2. Extent and Type of Activity(if more space is required, please attach a separate sheet):
The current work occuring on Tinkers Island is being done without an Order of Conditions issued by
the Salem Conservation Commission. Therefore the work is being completed in violation of the Wetlands
Protection Act.
B. Findings
The Issuing Authority has determined that the activity described above is in violation of the Wetlands
Protection Act (M.G.L. c. 131, §40) and its Regulations (310 CMR 10.00), because:
the activity has been/is being conducted without a valid Order of Conditions.
❑ the activity has been/is being conducted in violation of the Order of Conditions issued to:
Name Dated
wpaform9a.00c•rev.M VO4 Page 1 of 3
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 9A - Enforcement Order
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
File Number Condition number(s)
B. Findings (cont.)
❑ Other (specify):
C. Order
The issuing authority hereby orders the following (check all that apply):
0 The property owner, his agents, permittees, and all others shall immediately cease and desist
from the further activity affecting the Buffer Zone and/or wetland resource areas on this property.
❑ Wetland alterations resulting from said activity should be corrected and the site returned to its
original condition.
■ Complete the attached Notice of Intent.The completed application and plans for all proposed
work as required by the Act and Regulations shall be filed with the Issuing Authority on or before
January 25 2007
Date
No further work shall be performed until a public hearing has been held and an Order of Conditions
has been issued to regulate said work.
❑ The property owner shall take the following action to prevent further violations of the Act:
Failure to comply with this Order may constitute grounds for additional legal action. Massachusetts
General Laws Chapter 131, Section 40 provides: 'Whoever violates any provision of this section (a)
shall be punished by a fine of not more than twenty-five thousand dollars or by imprisonment for not
more than two years, or both, such fine and imprisonment; or(b) shall be subject to a civil penalty not
to exceed twenty-five thousand dollars for each violation". Each day or portion thereof of continuing
violation shall constitute a separate offense.
"aforvv9a.dw•rev.7/14/04 Page 2 of 3
Massachusetts Department of Environmental Protection
DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 9A — Enforcement Order
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
D. Appeals/Signatures
An Enforcement Order issued by a Conservation Commission cannot be appealed to the Department of
Environmental Protection, but may be filed in Superior Court.
Questions regarding this Enforcement Order should be directed to:
Carey Duques
Name
978-619.5685
Phone Number
Monday,Tuesday, Wednesday 8 am -4 pm; Thursday 8 am-7 pm; and Friday 8 am-12 pm.
Hours/Days Available
Issued by:
Salem
Conservation Commission
In a situation regarding immediate action, an Enforcement Order may be signed by a single member or
agent of the Commission and ratified by majority of the members at the next scheduled meeting of the
Commission.
Signatures:
V
3110 dtYx� �1�(a (ob�1Z
Signature of delivery person or certified mail number
w afcrm9a.doc•rev.7/14/04 Page 3 of 3
January 03 2007 VE
Massachusetts Coastal Zone Management JAI" b 9 21,007
251 Causeway Street DEPT. OF PLANNING&
Boston, MA 02114-2136 GONM IUNITYOEVELOPP.1ENT
Massachusetts Department of Environmental Protection
One Winter Street
Boston, MA 02108
City of Salem Conservation Commission
Salem City Hall
93 Washington St.
Salem, MA 01970
City of Salem Public Properties/Building Department
Salem City Hall
(3 Washington St.
Salem, MA 01970
City of Salem Legal Department
Elizabeth Renard,Esq. Acting City Solicitor
Salem City Hall
93 Washington St.
Salem, MA. 01970
To whom it may concern,
It recently came to my attention that a new building (approximately 20' x 30') is being
built on the Southwesterly end of Tinkers Island. Tinkers Island is located off the coast of
Marblehead and is part of the City of Salem. I was surprised to see a house being built at
that location and have done some investigation: The structure is located in the Velocity
Zone on ledges between the rocky beach and the top of the coastal bank. No order of
conditions has been issued by Salem Conservation Commission or by D.E.P. No
building permit has been issued by the Salem Building Department. The island has no
municipal services( i.e. sewer and water) and no permit to install a septic system has
been issued by the Board of Health. Furthermore I believe that the building is being built
on land owned by the City of Salem.
I trust that you will look into these matters and see to it that all applicable laws and
regulations are followed.
Massachusetts Department of Environmental Protection Provided by DEP:
Bureau of Resource Protection - Wetlands
DEP Fie Number
WPA Form 3 - Notice of Intent
LAI Massachusetts Wetlands Protection Act M.G.L. a 131, §40 Document Transaction Number
City/rows
Important:
When filling out A. General Information
forms on the
computer,use 1. Project Location (Note: electronic filers will click on button for GIS locator):
only the tab key
to move your
cursor-do not a.Street Address b.Ci !Town C.Zi Code
use the Tatum tY P
key' Latitude and Longitude:
d.Latitude e.Longitude
Q
f.Assessors Map/Plat Number g. Parcel/Lot Number
2. Applicant:
a. First Name b.Last Name c.Company
Note:
Before d.Mailing Address
completing this
form consult
your local e.city/Town f.State g.Zip Code
Conservation
Commission h. Phone Number I.Fax Number j. Email address
regarding any
municipal bylaw 3. Property owner (if different from applicant): ❑ Check if more than one owner
or ordinance.
a.First Name b.Last Name c.Company
d.Mailing Address
e.City/Town I.State g.Zip Code
h. Phone Number i. Fax Number I.Email address
4. Representative (if any):
a. Firm
b.Contact Person First Name c.Contact Person Last Name
d.Mailing Address
e.City/rown I.State g.Zip Code
h.Phone Number i. Fax Number I.Email address
5. Total WPA Fee Paid (from NOI Wetland Fee Transmittal Form):
a.Total Fee Paid b.State Fee Paid c.City/Town Fee Paid
6. General Project Description:
wpaform3.doc•rev.3/29/05 Page 1 of 7
Massachusetts Department of Environmental Protection Provided by DEP:
Bureau of Resource Protection Wetlands
DEP File Number
WPA Form 3 - Notice of Intent
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Document Transaction Number-
City/Town
A. General Information (continued)
7. Project Type Checklist:
a. ❑ Single Family Home b. ❑ Residential Subdivision
c. ❑ Limited Project Driveway Crossing d. ❑ Commercial/Industrial
e. ❑ Dock/Pier I. ❑ Utilities
g. ❑ Coastal Engineering Structure h. ❑ Agriculture—cranberries, forestry
i. ❑ Transportation i. ❑ Other
8. Property recorded at the Registry of Deeds for:
a.County b. Page Number
c. Book d.Certificate#(if registered land)
9. Has work been performed on the property under an Order of Resource Area Delineation involving
Simplified Review within 3 years of the date of this application?
a. ❑ Yes b. ❑ No
10. Buffer Zone Only- Is the project located only in the Buffer Zone of a bordering vegetated wetland,
inland bank, or coastal resource area?
a. ❑ Yes - answer 11 below, then skip to Section C.
b. ❑ No- skip to Section B.
If yes, no Notice of Intent or Request for Determination of Applicability may be filed for work within the
50-foot-wide area in the Buffer Zone along the resource area during the three-year term of an Order
of Resource Area Delineation, or any Extended Order, or until the applicant receives a Certificate of
Compliance, whichever is later.
11. Buffer Zone Setback—For projects that involve work only in the buffer zone, select the applicable
adjacent resource area (check one):
a. ❑ BVW b. ❑ inland bank c. ❑coastal resource area
The distance between the closest project disturbance and the associated resource area is:
d.linear feet
wpaform3.doc•rev.3/29/05 Page 2 of 7
Massachusetts Department of Environmental Protection Provided by DEP:
Bureau of Resource Protection - Wetlands
DEP File Number
WPA Form 3 — Notice of Intent
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Document Transaction Number
City/Town
B. Resource Area Effects
1. Inland Resource Areas
Check all that apply below. Attach narrative and any supporting documentation describing how the
project will meet all performance standards for each of the resource areas altered, including
standards requiring consideration of alternative project design or location.
Online Users: Resource Area
Include your Size of Proposed Alteration Proposed Replacement (if any)
document
transaction a. ❑ Bank 1.linear feet
2.linear feet
number b. ❑ Bordering Vegetated
(provided on Wetland 1.square feet 2.square feet
your receipt
page) with all c. ❑ Land Under 1.square feet
supplementary Waterbodies and q 2.square feet
information you Waterways 3.cubic yards dredged
submit to the
Department. d. ❑ Bordering Land
Subject to Flooding 1.square feet 2.square feet
cubic feet of flood 4.storage lost cubic feet of flood storage replaced
e. [J Isolated Land Subject 3.
to Flooding 1.square feet
2.cubic feet of flood storage lost 3.cubic feet of flood storage replaced
f. ❑ Riverfront area
1.Name of Waterway(if available)
1.Width of Riverfront Area (check one):
❑ 25 ft. - Designated Densely Developed Areas only
❑ 100 ft. - New agricultural projects only
❑ 200 ft. - All other projects
2.Total area of Riverfront Area on the site of the proposed project:
Square Feet
3. Proposed alteration of the Riverfront Area:
a.Total Square Feet b.Square Feet within 100 ft. c.Square Feet between 100 ft.and 200 ft.
4. Has an alternatives analysis been done and is it attached to this NOI? ❑ Yes❑ No
5. Was the lot where the activity is proposed created prior to August 1, 1996? ❑ Yes❑ No
wpaform3.doc•rev.3/29/05 Page 3 of 7
L11Massachusetts Department of Environmental Protection Provided by DEP:
Bureau of Resource Protection - Wetlands DEP Fila Number
WPA Form 3 - Notice of Intent
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Document Transaction Number
Cityrrown
B. Resource Area Effects
2. Coastal Resource Areas:
Check all that apply below. Attach narrative and supporting documentation describing how the
project will meet all performance standards for each of the resource areas altered, including
standards requiring consideration of alternative project design or location.
Online Users:
Include your Resource Area Size of Proposed Alteration Proposed Replacement(if any)
document
transaction a. ❑ Designated Port Areas Indicate size under Land Under the Ocean, below
number
(provided on b. ❑ Land Under the Ocean 1.Square feet
your receipt
page) with all 2.Cubic yards dredged
supplementary
information you c. Barrier Beach Indicate size under Coastal Beaches and/or Coastal Dunes
❑
submit to the below
Department. d. ❑ Coastal Beaches 1. Square feet 2.Cubic yards beach nourishment
e. ❑ Coastal Dunes 1,Square feet
q 2.Cubic yards dune nourishment
f. ❑ Coastal Banks
1. Linear feet
g. ❑ Rocky Intertidal Shores 1.square feet
h.❑ Salt Marshes 1.Square feet
Q 2. Sq ft restoration,rehab.,or creation
i. ❑ Land Under Salt Ponds 1.Square feet
2.Cubic yards dredged
j. ❑ Land Containing
1.
Shellfish Square feet 2.Square feet restoration,rehab.
k. ❑ Fish Runs Indicate size under Coastal Banks, inland Bank, Land Under the
Ocean, and/or inland Land Under Waterbodies and Waterways,
above
1.Cubic yards dredged
i. ❑ Land Subject to Coastal
Storm Flowage 1.Square feet
3. Limited Project:
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?
a. ❑ Yes ❑ No If yes, describe which limited project applies to this project:
b. Limited Project
wpaform3.doc•rev.3/29/05
Page 4 of 7
\ Massachusetts Department of Environmental Protection Provided'byDER -
j�— Bureau of Resource Protection - Wetlands DEP Pile Number
\^1\ WPA Form 3 - Notice of Intent
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
City/Town
C. Bordering Vegetated Wetland Delineation Methodology
Check all methods used to delineate the Bordering Vegetated Wetland (BVW) boundary:
Online Users: t. ❑ Final Order of Resource Area Delineation issued by Conservation Commission or DEP
Include your (attached)
document
transaction 2. ❑ DEP BVW Field Data Form (attached)
number
(provided on 3 ❑ Final Determination of Applicability issued by Conservation Commission or DEP (attached)
your receipt
page) with all 4. ❑ Other Methods for Determining the BVW Boundary(attach documentation):
supplementary
information you a. ❑ 50% or more wetland indicator plants
submit to the
Department. b. ❑ Saturated/inundated conditions exist
c. ❑ Groundwater indicators
d. ❑ Direct observation
For all projects
affecting other e. ❑ Hydric soil indicators
Resource
Areas, please f. ❑ Credible evidence of conditions prior to disturbance
attach a
narrative 5. Other resource areas delineated:
explaining how D. Other Applicable Standards and Requirements
the resource pp Q
area was
delineated. 1. 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?
a. ❑ Yes ❑ No If yes, include proof of mailing or hand delivery of NOI to:
Natural Heritage and Endangered Species Program
Division of Fisheries and Wildlife
Route 135, North Drive
b. Date of Map Westborough, MA 01581
2. For coastal projects only, is any portion of the proposed project located below the mean high water
line or in a fish run?
a. ❑ Yes ❑ No If yes, include proof of mailing or hand delivery of NOI to:
Massachusetts Division of Marine Fisheries
251 Causeway Street, Suite 400
Boston, MA 02114
b. ❑ Not applicable—project is in inland resource area only
3. Is any portion of the proposed project within an Area of Critical Environmental Concern (ACEC)?
a. ❑ Yes ❑ No If yes, provide name of ACEC (see instructions to WPA Form 3 or DEP
Website for ACEC locations). Note: electronic filers click on Website.
b.ACEC
wpaform3.doc•rev.3/29/05 Page 5 of 7
Massachusetts Department of Environmental Protection Provided by DEP:
Bureau of Resource Protection - Wetlands oEPFaeNumber
WPA Form 3 - Notice of Intent
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
cityfrown
D. Other Applicable Standards and Requirements
Online Users: 4. Is any portion of the site subject to a Wetlands Restriction Order under the Inland Wetlands
Include your Restriction Act (M.G.L. c. 131, §40A) or the Coastal Wetlands Restriction Act(M.G.L. c. 130, § 105)?
document
transaction a. ❑ Yes ❑ No
number
(provided on
your receipt 5. Is any activity within any Resource Area or Buffer Zone exempt from performance standards of the
page) with all wetlands regulations, 310 CMR 10.00.
supplementary
information you a. ❑ Yes ❑ No If yes, describe which exemption applies to this project:
submit to the
Department.
b. Exemption
6. Is this project subject to the DEP Stormwater Policy? a. ❑ Yes ❑ No
If yes, stormwater management measures are required. Applicants should complete the Stormwater
Management Form and submit it with this form.
b. If no, explain why the project is exempt:
E. Additional Information
Applicants must include the following with this Notice of Intent (NOI). See instructions for details.
Online Users: Attach the document transaction number (provided on your receipt page) for any of
the following information you submit to the Department.
t. ❑ USGS or other map of the area (along with a narrative description, if necessary) containing
sufficient information for the Conservation Commission and the Department to locate the site.
(Electronic filers may omit this item.)
2. ❑ Plans identifying the location of proposed activities (including activities proposed to serve as
a Bordering Vegetated Wetland [BVW] replication area or other mitigating measure) relative
to the boundaries of each affected resource area.
3. ❑ Other material identifying and explaining the determination of resource area boundaries
shown on plans (e.g., a DEP BVW Field Data Form).
4. ❑ List the titles and dates for all plans and other materials submitted with this NOI.
5. ❑ If there is more than one property owner, please attach a list of these property owners not
listed on this form.
6.❑ Attach proof of mailing for Natural Heritage and Endangered Species Program, if needed.
7. ❑ Attach proof of mailing for Massachusetts Division of Marine Fisheries, if needed.
6. ❑ Attach N01 Wetland Fee Transmittal Form
9. ❑ Attach Stormwater Management Form, if needed.
wpaform3.doc•rev.3/29/05 Page 6 of 7
Massachusetts Department of Environmental Protection Provided by DEP:
Buret]au/�ofResource Protection - Wetlands DEP File Number
WPA Form — Notice of Intent Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
City/Town
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 NOI Wetland Fee Transmittal
Form).
No filing fee shall be assessed for projects of any city, town, county, or district of the Commonwealth,
federally recognized Indian tribe housing authority, municipal housing authority, or the Massachusetts
Bay Transportation Authority.
Applicants must submit the following information (in addition to pages 1 and 2 of the NOI Wetland
Fee Transmittal Form)to confirm fee payment:
1.Municipal Check Number 2.Check date
3.State Check Number 4.Check date
5.Payor name on check: First Name 6. Payor name on check:Last Name
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) to all abutters within 100 feet of the property line of the project location.
Signature of Applicant Date
Signature of Property Owner(if different) Date
Signature of Representative(if any) Date
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 the NOI Wetland Fee Transmittal Form; and the city/town fee payment must be sent to the
Conservation Commission by certified mail or hand delivery.
For DEP:
One copy of the completed Notice of Intent(Form 3), including supporting plans and documents; one copy of
pages 1 and 2 of the NOI Wetland Fee Transmittal Form; and a copy of the state fee payment must be sent to
the DEP Regional Office (see Instructions) by certified mail or hand delivery. (E-tilers may submit these
electronically.)
Other:
If the applicant has checked the"yes"box in any part of Section D, Item 3, above, refer to that section and the
Instructions for additional submittal requirements.
The original and copies must be sent simultaneously. Failure by the applicant to send copies in a timely
manner may result in dismissal of the Notice of Intent.
wpaform3.doc•rev.3129105 Page 7 of 7
L11Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
NOI Wetland Fee Transmittal Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Important: A. Applicant Information
When filling out
forms on the 1. Applicant:
computer, use
only the tab
key to move a.First Name b. Last Name c.Company
your cursor-
do not use the d.Mailing Address
return key.
wVQ e.City/Town I.State g.Zip Code
h. Phone Number
2. Property Owner(if different):
a. First Name b. Last Name c.Company
d. Mailing Address
e.City/Town f.State g.Zip Code
h, Phone Number
3. Project Location:
a.Street Address b.City/Town
To calculate B. Fees
filing fees, refer
to the category Notice of Intent (Form 3) or Abbreviated Notice of Intent(Form 4):
fee list and
examples in the The fee should be calculated using the following six-step instructions for 9 g p process and worksheet. Please see
filling out WPA Instructions before filling out worksheet.
Form 3(Notice of
Intent). Step 1lrype of Activity: Describe each type of activity 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 listed in the
instructions.
Step 4/Subtotal Activity Fee: Multiply the number of activities (identified in Step 2) times the fee per
category (identified in Step 3)to reach a subtotal fee amount. Note: If any of these activities are in a
Riverfront Area in addition to another Resource Area or the Buffer Zone, the fee per activity should be
multiplied by 1.5 and then added to the subtotal amount.
Step 5/Total Project Fee: Determine the total project fee by adding the subtotal amounts from Step 4.
Step 6/Fee Payments: To calculate the state share of the fee, divide the total fee in half and subtract
$12.50. To calculate the city/town share of the fee, divide the total fee in half and add$12.50.
Wpaform3.dm•NO]Wetland Fee Transmittal Form•rev.311/05 Page t of 2
L11Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
NOI Wetland Fee Transmittal Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Fees (continued)
Step 1lrype of Activity Step 2/Number Step Step 4/Subtotal Activity
of Activities 3/Individual Fee
Activity Fee
Step 5frotal Project Fee:
Step 6/Fee Payments:
Total Project Fee: a.Total fee from step 5
State share of filing fee: b. 1/2 total fee fess$12.50
Cityfrown share of filling fee: c. 1/2 total fee plus$12.50
C. Submittal Requirements
a.) Complete pages 1 and 2 and send with a check or money order for the state share of the fee,
payable to the Commonwealth of Massachusetts.
Department of Environmental Protection
Box 4062
Boston, MA 02211
b.) To the Conservation Commission: Send the Notice of Intent or Abbreviated Notice of Intent;
a copy of this form; and the city/town fee payment.
c.) To DEP Regional Office (see Instructions): Send a copy of the Notice of Intent or Abbreviated
Notice of Intent; a copy of this form; and a copy of the state fee payment. (E-filers of Notices of
Intent may submit these electronically.)
Wpalorm3.doc•NOI Welland Fee Transftnal Farm•rev.9/1/05 Page 2 o12
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TO THE II�SPEC�'�Fi OF BUILDIN(3S: '•
Ths �r�pned he►eby appNes tor a ps►mit to build aoco�ip,tp ths toppwiny
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CITY OF SALEM
120UTING SLIP �
NEW CONSTRUCTION
CERTIFICATE OF OCCUPANCY
LOCATION: I� U N/� U iA �U t �"U DATE � � Z— � �
APPLICANT• G l�u �r �ay�� J�a,ra��e� , �'��
ASSESSORS � ' U ' ZG- O ;
FRANK KULIK �� DATE:
(93 Washington Street) �
CITY CLERK
CHERYL LAPOINTE . � DATE:
(93 Washington Street) '
PUBLICE SERVICES
, BRUCE THIBODEAU ' � ATE: � D�
(120 Washington Street)4'"Floor � y��/ �� �E�`r-ii� / Ny
��O�c�l�7�l�QL. � Y1c9�/4G.a� �r I
, WATER � S� °l- LLYt Ltrq N
DOTTIE THIBODEAU DATE: ;
(I20 Washington Street)4'�Floor � O �
CROSS CONNECT SUPERVISOR
,� c�p� BRIAN THIBODEAU DATE:
(5 Jefferson Avenue)
PLANIVING � � �
VALERIE GINGRICH DATE:
(120 Washington Street)3 oor
CONSERVATION COMMISSI� N .
FRANK TAORMINA DATE: 8 � �S
�� � (120 Washingron Streey 3`d F7oor
ELECTRICAL
{ ' `'� JOHN GIARDI ' DATE:_c�7�Gi��
(48 Lafayette S
FIREPREV ION �,,,���/� ' �
"! i ERIN GRIFFIN DATE: " �` S �i�
(29 Fort Avenue) �'
� :
HEALTH < �
JOANNE SCOTT DATE: O)' � "v 5
(120 Washington Street Floor
' BUILD[NG � �
THOMAS ST.PIERRE i� DATE:�S
(120 Washington Street)3`d Floor
�
• -- ::� � ✓� ��,�on���,�� �.�,���
!�_ Board otEui�ding Regwatioos and Standards License or registratlon valid for individul use only
� HOME IMPROVEMENT CONTRACTOR before the ezpiration date. If fouod retum to: �
Registration __�pg�7� Board of Buildiug Regulations and Standards
___ _
. _ _ . _ . .. . . Ezpi�atwn:=g/3/ppp�__.____ _ _ One Ashburton Place Rm 1301
_. - -- - - - -Boston,Ma 02108 -- ----__-----------_-. - _ - --
: ,;
� . Type: Private Coryoration
DANCO BUILDERS ING '
Daniel Tremblay•;
2 Margin Ter ' '� - �p _. , � ` ���
Peabody,A4A 01960 � ar���•�
AdminisVator Not v id withoUt Signety e � �
( . . _'__.. ._,_�_.._ . .�.._. - � .
!� " ...:. �e �omrmwna�e¢�c o�./�.aaa¢a/eevella �'� s"
�- BOARD OF BWL�ING REGULATIONS � �
a ';
�`' License: CONSTRUCiION SUPE-RVISOR 'i
Num�,.GS O43536 ��,
�i��-���l6�/1960 � � '�.
. �,�s�)�606 Tr.no: 52q0.0:
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� 2 MARGIN TER��F._:-z,� G-.
� PEABODY, MA 01960�:::'..- � � �__���,�
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Q I am a homeowner performing ell work myself. - � . .
� 1-am a sole proprietor and have no onc working in any capaciry � � � -
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! che followmg wor6ers compensahon polices �
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unc�aun'impriionmrnl�i wdl us tivil penal(iit in-IA�furm of a$'fOP\VORK ORDER�nJ e fine ofS100.00�Ouy s�oiml me. I unOmnnd IAaI a,
aupr of i�u am�amml muy 0<_furwordo0lo 1�<OIT�ce uf Iminiealion�o!Ihe DU for�orcrapv rarifiution. . �
/Ao hrie6y erni under Ihr pnin,rp annl(irt f prrjury(hot Ihe informa�ion p.ovided abov�it true and torrrrG
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Signature � Dnte � U'�I 6 � ��S
Prini namc �'11R l � hY. Q � Phone M- � ��-- 2-b `
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Mar-09-O6 11 :49A Dan Hur�lay InsurancQ ( )
C6R �7L wtelMuiwrrm7
A RD_ CERTIFICATE OF LIAI�ILI7Y IN3URANCE o�wcow, o� oslos
rnoouceR THIS CERTFIGITF 18188UED A8 A MR'REII OF INPOMAATION
----- — Dan-Hus1�y=lA�urano��AQ�noy_--�.. _ }�-,-.-- _ �..___ �ONLY AND CONFERS NO R16NT6 UPON THE CERTIFIGATE
Che�tnnt Gta�, 8uit� 2� HOLOER.THI6`CERTiFICATl-DQE�•MOr�AMENDrE7fTENDOR-�=--_�-- ------
B�v��1 C�d�xal etr�at ALTER THE COVERA6E AFfORDEO BY 1HE POLICIE6 BELOW.
Danv�rs FU� 01929-3fi20 �
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�� \� � ��� a /!_G o� � � �— --- �� N �s 4) TH/S PLAN lS BASED OJN THE REFERENCED PLANS, DEEDS ,
� • AND 7HE RESULrS OF ,A F1ELD SURVEY AS OF THIS DArE.
� � � — �O RIPRAP LEVEL SPREADER
� r �( \ — _ — �— O , _ _ _ — —_ -- — � NO CER17F/CArION IS 1NJTENDED AS TO PROPERTY 7/7LE
\ -�� � LOT 57A \ \� � et �Z _ 9� 6" TO 12' STONE, OR AS TO THE EXIS7EM/CE OF UNWRITTEN OR UNRECORDED
SEE P,'LAN BY EASTERN LAND SUR l/EY �\ \ 9� h 9v � a �` 30 SF. M I N I M�M EASEMENrS.
% \ \ ` ,� _ / �9'3 z \ FCIyqR -- — �� v
� F4ElilSED TO JAN. 27, 200.3 \ 9y = ��/ ` QR�Q G`� ����� 5) RESOURCE AREA DELIN�EATIDN BY RI,NMER ENV/RONMENTAL
1 � 9� \ / � � �\ �_ — -� _ �y CONSULTING, NEWBURY, MASS, APRIL 1, 2002.
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� NOTES
���� 1. ZON/NG D/STRICT R1 /4ES/DENTIAL
2. ASSESSORS MAP 9 P.AR r PARCEL 93
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T \ \ '0p �Sr� N� � 9a , Q � j0 4. DEED REFERENCE: BGJOK 7199 PAGE 111
� U90 �,o \ � �• , �f(�q R. -- � � , '� � 5. PLAN REFERENCE.• PL.AN BY EASTERN LAND SURIiEY
R 10j d. � LOT 2 ASSOCS. DATED APRIIL 23, 2003
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REQUIREMENTS OF THE CITY OF SALEM \ �06� �\ �o \ �`Z
— IIII — IIII PUBLIC WORKS DEPARTMENT. �08 � � � LOCATED IN
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L E G E N D
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o SMH EXISTiNG SEWER MANHOLE 100x0 PROPOSED SPOT GRADE � �a. � \ � i
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s• � `� �,�►�: ; 104 LOWELL ST. PEABODY MA. 01960
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100.00 EXISTING SPOT GRADE �\ i ;�o " ME��o ' I' o ► — t
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3 — STORMTECH SC-310 CHAMBERS '9!� �y � u � � c� CIVIL � ►
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LIGHT ON POST EXCAVA710N �\ T -��6 'Fp �` \ 9\!q��ST� �,+° • 1400 9F�iS7E�`�" �7' �
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FENCE \ � '
RESOURCE AREA BOUNDARY � � 1 OF THIS PLAN AND IS TO BE CONSIDERED A '
A10 RESOURCE AREA BOUNDARY FLAG ��8 /06 \ �. � �..� COPYRIGHT INFRINGEMENT AND�OR FRAUD. r �
� `S � � ENFORCEMENT AUTHORITY SHALL NOT ACCEPT 0 10 20 40 60 80 -" n:i48
��z S \ PHOTO REPRODUCTION FOR ANY PURPOSE. REVISED I2-3-03
GEOTEXTILE FABRIC ��`� 1 � � � F 12526
LINED EXCAVATION