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64-342 - 116 LEACH STREET - CONSERVATION COMMISSION i 1 ,.j, S - UPC 10350 No. 155E IiA STiN,S. MM1I _._.:_ : ._. ...:.sx....u_�..r. ...�.s.aua...r....................::®.x.:..�.ru tee:..... H.�.......... _.,.......:v.:n:wew:a.e_w..,.h...m._._.;.w�..�.,...�. r.,,,,:su:.,..—..: _., IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII 1111 2014110400404 B03652 Pg;5 11/04/2014 02:18 COMPLI Ps 1/2 Return to: Ronald D. Segal, Esq. 172 Newbury St., 5th Fl Boston,N4A 02116 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance 64-342 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP A. Project Information Important: When filling out 1. This Certificate of Compliance is issued to: forms on the computer,use Kathryn Neuman only the tab key Name to move your 116-118 Leach Street cursor-do not use the return Mailing Address key. Salem MA 01970 "ICY Cityrrown State Zip Code 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: Charles R. & Kathy O'Connell Name 12/12/2002,amended 12/11/2003 64-342 Dated DEP File Number 3. The project site is located at: 116-118 Leach Street Salem Street Address City/rown 33 0547-801 (Unit 116)&0547-802(Unit 116) Assessors Map/Plat Number Parcel/Lot Number the final Order of Condition was recorded at the Registry of Deeds for: Charles R. &Kathy O'Connell Property Owner(if different) , Essex S. Registry of Deeds 19860 472 County Book Page i Certificate 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: N/A Date I I II wpafmmE.doc•rev.SUW14 WPA Fmm 88.Cerfdwte of CmnPll m•Page1 of Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP File Number. WPA Form 8B — Certificate of Compliance 64-342 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP B. Certification Check all that apply: ❑ Complete Certification: It is hereby certified that the work regulated by the above-referenced Order of Conditions has been satisfactorily completed. ❑ Partial Certification: It is hereby certified that only the following portions of work regulated by the above-referenced Order of Conditions have been satisfactorily completed.The project areas or work subject to this partial certification that have been completed and are released from this Order are: ® Invalid Order of Conditions: It is hereby certified that the work regulated by the above-referenced Order of Conditions never commenced.The Order of Conditions has lapsed and is therefore no longer valid. No future work subject to i 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 9 A Conservation Commission Me of Issuance This Certificate must be signed by a majority of the Conservation Commission and a copy sent to the applicant and appropriate DEP Regional Office(See http://www.mass.gov/eea/agencies/massdeo/about/contactsffind-the-massdeo- region aloffice-for-your-city-or-town.htm 11. Is mul A - c 9/4 "af m3b.doc-ray.529114 WPA Forth ea,Cefdoate of ConipSance•Page 2 of3 I IIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII � ® 2@14@62000044 Bk,3335@ Pg;367 06/20/2014 09:18 COMPLI Pg 1/2 J L 01 o��uaQME 00110 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B - Certificate of Compliance 64-342 Massachusetts Wetlands Protection Act M.G.L. c. 131 §40 Provided'.y DEP A. Project Information Important: When filling out 1. This Certificate of Compliance is issued to: forms on the computer, use Kathryn Neuman only the tab key Name to move your 116-118 Leach Street cursor-do not use the return Mailing Address key. Salem MA 01970 City/Town State Zip Code �e 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: Charles R. O'Connell ream Name 12/12/2002. amended 12/11/2003 64-342 Dated DEP File Number 3. The project site is located at: 116-118 Leach Street Salem Street Address Citylrown 33 546, 547 Assessors Map/Plat Number Parcel/Lot Number the final Order of Condition was recorded at the Registry of Deeds for: Charles R. O'Connell Property Owner(if different) 933 j-p �?�q South Essex ,936& 12-3- County Book Page Certificate 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: NA Date wpafrm8b.Ccc•rev.5129114 WPA Forth 8B,Cenificale of Compliance•Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 813 — Certificate of Compliance 64-342 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: ------------------------------ C/ rY Ot= "cl)-i Conservation Commission Please be advised that the Certificate of Compliance for the project at: i 1 cT 11 � l�Ae�f s% (0�-ayz Project Lot ,^�® !9� DEP File Number /71 Has bbeee2tn[re—corded�at the Registry of Deeds of: Sow1A &-" 6S5if 1?,-CU )L14 07� �eecd County ^� for: kflrK�z/� N�vrn�� Property Owner and has been noted in the chain of title of the affected property on: Date - Book Page If recorded land, the instrument number which identifies this transaction is: If registered land, the document number which identifies this transaction is: Document Number Signature of Applicant wpafrm8b.doc•rev.5/29114 WPA Fonn 813,Certifcate of Compliance•Page 3 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number. WPA Form 813 — Certificate of Compliance 64-342 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP B. Certification Check all that apply: ❑ Complete Certification: It is hereby certified that the work regulated by the above-referenced Order of Conditions has been satisfactorily completed. ❑ Partial Certification: It is hereby certified that only the following portions of work regulated by the above-referenced Order of Conditions have been satisfactorily completed. The project areas or work subject to this partial certification that have been completed and are released from this Order are: Invalid Order of Conditions: It is hereby certified that the work regulated by the above-referenced Order of Conditions never commenced. The Order of Conditions has 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 / Conservation Commission D to of ls6uance This Certificate must be signed by a majority of the Conservation Commission and a copy sent to the applicant and appropriate DEP Regional Office (See hft ://www.mass. ov/eea/a encies/massde /about/contacts/fin -the-m D- regional-office-for-you r-city-or-town.html). r�s: I/ 2TT32S}tiaA22`!:S'�Nl. '> `'•," V M *"o 22AM lA3:3A2, 7 7 ^• ' .v Lc"X3223 ltS QPf�aiA iDY-'+i .,.,r i ,r T23TTA .. y, wpafrmeb tloc•STY:5gS114 ; WPA Form Be,Certificate of Compliance•Page 2 of 3 l COMMONWEALTH OF MASSACHUSETTS ESSEX REGISjRy OF DEEDS,SO.DIST.,SALEM,MASS ESSIX SS J COPY OF RE OpD: ZO BOOK SOFAGE_ 6 7 ATTEST: -T REGISTER i CITY OF SALEM e CONSERVATION COMMISSION July 25, 2014 Ronald D. Segal, Esq. 172 Newbury St., 5th Fl. Boston, MA 02116 Re: Certificates of Compliance—DEP #64-268 and64-342— 116-118 Leach Street Dear Mr. Segal: Enclosed, please find the Certificates of Compliances for the above referenced properties. These documents must be recorded at the South Essex County Registry of Deeds. Please fill out and return the Recording Information on page 3 of the certificates, which will indicate to the Salem Conservation Commission that the documents have been recorded. If you have any further questions please feel free to contact me at 978-619-5685. Sincerely, Tom Devine Conservation Agent Enclosure CC: DEP Northeast Regional Office Kathleen M. LaBonte Kathryn Neuman 9 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance 64-268 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP A. Project Information Important: When filling out 1. This Certificate of Compliance is issued to: forms on the computer, use Kathleen M. LaBonte only the tab key Name to move your 118 Leach Street, Unit 118 cursor-do not use the return Mailing Address key. Salem MA 01970 City/rown State Zip Code VQ 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: Charles R. O'Connell Name September 11 1997 64-268 Dated DEP File Number 3. The project site is located at: 116-118 Leach Street Salem Street Address City/rown 33 0547-801 (Unit 116) &0547-802 (Unit 118) Assessors Map/Plat Number Parcel/Lot Number the final Order of Condition was recorded at the Registry of Deeds for: Charles R. O'Connell Property Owner(if different) Essex South District Registry of Deeds 14786 134 County Book Page Certificate 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: Dat wpefrmBb.doc•rev.5/29114 WPA Form 8B,Certificate of Compliance•Page 1 of 3 :r Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP File Number: WPA Form 86 — Certificate of Compliance 64-268 1 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP B. Certification Check all that apply: ® Complete Certification: It is hereby certified that the work regulated by the above-referenced Order of Conditions has been satisfactorily completed. ❑ Partial Certification: It is hereby certified that only the following portions of work regulated by the above-referenced Order of Conditions have been satisfactorily completed.The project areas or work subject to this partial certification that have been completed and are released from this Order are: ❑ Invalid Order of Conditions: It is hereby certified that the work regulated by the above-referenced Order of Conditions never commenced. The Order of Conditions has 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 Conservation Commission 7101 / Conservation Commission 06te of Is uance This Certificate must be signed by a majority of the Conservation Commission and a copy sent to the applicant and appropriate DEP Regional Office(See hftp://www.mass.gov/eea/agencies/massdep/abouttcontacts/find-the-massdeo- regional-office-for-your-city-or-town.html). t I S' ? MIS w afrrnft doc•rev.5/29114 WPA Fonn 8B,Certificate of Compliance•Papa 2 of 3 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance 64-268 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 provided--by 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 Conservation Commission Please be advised that the Certificate of Compliance for the project at: 116-118 Leach Street, Salem, MA 01970 64-268 Project Location DEP File Number Has been recorded at the Registry of Deeds of: Essex South District County for. Kathleen M. LaBonte Property Owner and has been noted in the chain of title of the affected property on: Date Book Page If recorded land, the instrument number which identifies this transaction is: If registered land, the document number which identifies this transaction is: Document Number Signature of Applicant v Pafrm3b.doc•rev.5129/14 WPA Form ea,Certificate of Compliance•Page 3 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance 64-342 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP A. Project Information Important: When filling out 1. This Certificate of Compliance is issued to: forms on the computer,use Kathryn Neuman only the tab key Name to move your 116-118 Leach Street cursor-do not use the return Mailing Address key. Salem MA 01970 City/Town State Zip Code 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: Charles R. & Kathy O'Connell "0m Name 12/12/2002, amended 12/11/2003 64-342 Dated DEP File Number 3. The project site is located at: 116-118 Leach Street Salem Street Address City/Town 33 0547-801 (Unit 116)&0547-802(Unit 118) Assessors Map/Plat Number Parcel/Lot Number the final Order of Condition was recorded at the Registry of Deeds for: Charles R. &Kathy O'Connell Property Owner(if different) Essex S. Registry of Deeds 19860 472 County Book Page Certificate 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: N/A Date wpafrm8b,doc•rev.529114 WPA Farm 8B,Ceitfrate of Compliance•Page 1 of 3 t G Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 813 — Certificate of Compliance 64-342 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP B. Certification Check all that apply: ❑ Complete Certification: It is hereby certified that the work regulated by the above-referenced Order of Conditions has been satisfactorily completed. ❑ Partial Certification: It is hereby certified that only the following portions of work regulated by the above-referenced Order of Conditions have been satisfactorily completed.The protect areas or work subject to this partial certification that have been completed and are released from this Order are: ® Invalid Order of Conditions: It is hereby certified that the work regulated by the above-referenced Order of Conditions never commenced. The Order of Conditions has 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 '9 4 Conservation Commission Me of Issuance This Certificate must be signed by a majority of the Conservation Commission and a copy sent to the applicant and appropriate DEP Regional Office (See hfp://www.mass.gov/eea/agencies/massdep/about/contacts/find-the-massdep- regional-office-for-you r-city-or-town.htmI . Is: P- uU, D A wpafrm90 d=•rev.U29116 WPA Form 8B,Certificate of Compliance•Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: y WPA Form 8B — Certificate of Compliance 64-342 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 Conservation Commission Please be advised that the Certificate of Compliance for the project at: 116-118 Leach Street, Salem, MA 01970 64-342 Project Location DEP File Number Has been recorded at the Registry of Deeds of.- Essex South District County for: Kathryn Neuman Property Owner and has been noted in the chain of title of the affected property on: Date Book Page If recorded land, the instrument number which identifies this transaction is: If registered land, the document number which identifies this transaction is: Document Number Signature of Applicant wParrm8b.doc-rev.529114 VVPA Foot 8B,CeNficste&C=Pliance•Page 3 or 3 ` Massachusetts Department of Environmental Protection DEP File Number. Bureau of Resource Protection - Wetlands 64-342 WPA Form 5 - Order of Conditions Provided by DEP 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 (December 11,2003) To: Applicant: Property Owner(if different from applicant): Charles R. O'Connell Same Name Name 116 Leach Street Mailing Address Mailing Address Salem MA 01970 Cityrrown State Zip Code Cityrrown state Zip Code 1. Project Location: 116 Leach Street Salem Street Address Cityrrown Map 33 Lot 0546 &0547 Assessors Map/Plat Number Parcel/Lot Number 2. Property recorded at the Registry of Deeds for: Essex 9365 123 County Book Page NA Certificate(if registered land) 3. Dates: Amended December 11, 2003 November 14, 2002 December 12, 2002 December 12, 2002 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): Chapter 91 Plans, 1 of 2 and 2 of 2—Charles& Kathy O'Connell, 116 Leach Street, Revs, Dec. 1, Salem, MA 2003 5. Final Plans and Documents Signed and Stamped by: NA Name 6. Total Fee: $155.00 (from Appendix B:Wetland Fee Transmittal Form) WPA Form 5 Pagel of 7 Rev.02/00 a Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection -Wetlands 64-342 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 0 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 Page 2 of Rev.02100 a '\ Massachusetts Department of Environmental Protection DEP File Number: ° Bureau of Resource Protection -Wetlands 64-342 t 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 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"for, "MA DEP'J "File Number 64-342 " 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 Fom 5 Rev.07100 - Page 3 of 7 Massachusetts Department of Environmental Protection DEP File Number: Uf Bureau of Resource Protection - Wetlands64-342 WPA Form 5 - Order of Conditions Provided byDEPMassachusetts 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. WPA Fom 5 Page 4 or 7 Rev.02100 . Massachusetts Department of Environmental Protection DEP File Number: ` Bureau of Resource Protection - Wetlands f�1-3'12 WPA Form 5 - Order of Conditions Provided by DEP ug 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. 19SN�Q av� �c.(�yr.�o�ri\�2,2002 i pjW�St.+nc,Q,c�: �a.C3-+w`rycr�� �00 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 Ap ndi A)and the property owner(if different from applicant). Signatures: On —of Day Month and Year before me personally appeared so me known to be the person described in and who executed the foregoing instrument and cckno ged that els et cuted he ame as his/her free act and deed.Notary Public My Commis ion Expires This Order is issued to the applicant as follows: ❑ by hand delivery on '� by certified mail, return receipt requested,on Date Date NPA Farm 5 Page 5 o17 Rev.07/00 ` \ Massachusetts Department of Environmental Protection DEP File Number: ` Bureau of Resource Protection -Wetlands 64-342 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 an ten residents of the city or town in which such land is located are here notified Y tY by o fied 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 Fom 5 Page 6 of 7 Rev.02/00 _ Massachusetts Department of Environmental Protection DEP File Number Y Bureau of Resource Protection - Wetlands 64-342 WPA Form 5 - Order of Conditions Provided by DEP vp 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: 116 Leach Street 64-342 Project Location DEP File Number Has been recorded at the Registry of Deeds of: County Book Page it 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 Farts 5 Page 7 of 7 Rev.02/00 - Salem Conservation Commission AMENDED SPECIAL CONDITIONS—DEP FILE #64-342 City of Salem, 116 Leach Street 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#64-342 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. 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 the 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 21A,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 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. 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,trash 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 wetland. ADDITIONAL CONDITIONS 49. Before work can commence,the Applicant shall obtain all the necessary Federal,State and Local permits and or approvals needed to construct this project. I Massachusetts Department of Environmental Protection DEP He Number. Bureau of Resource Protection - Wetlands WPA Form 7 r Extension Permit for Orders of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Pmvided by DEP A. General Information Important When filling out 1. Applicant forms on the Robert DeNisco computer,use Name only the tab key to move 10 Bailey Terrace Your cursor_ Ma&V Address do not two On Peabody MA 01960 return key,. Cilyrr"n State Zip Code 2. Properly Owner(if different): Name Mailing Address 1 Cityrrmn State rip Code B. Finding Information The Order of Conditions(or Extension Permit)issued to the applicant or property owner listed above on: December 12, 2002 Date for work at 116 Leach Street MAP 33 LOT 0546& Sbeet Address Assessoes Map/Plat Number 0547 Parcel/Lot Number recorded at the Registry of Deeds for. ESSEX 22238 350 County nook pap Certific t(if regWered lard) is hereby extended until: December 12,2008 Date This date can be no more than 3 years from the expiration date of the Order of Conditions or the latest extension. Only unexpired Orders of Conditions or Extension may be extended. Date the Order was last extended(if applicable): Date Issued by. ConservaWn Commission rpaaarmTdac•mr.rnaae Page r at 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection- Wetlands DEP File Number. WPA Form 7 — Extension Permit for Orders of Conditions Pmvkfed byoEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Finding Information (cont.) This Order of Conditions Extension must be signed by a majority of the Conservation Commission and a copy sent to applica9f and the appropriate DEP Regional Office. Signatures- No ry Acknowledgement Commonwealth of Massachusetts County of Essex On this 12 of January 2006 Day Month Year Before me,the undersigned Notary Public, personally appeared Kevin Comacchio, Kevin Carr, Keith Glidden,and Joe Fumed, Name of Signer proved to me through satisfactory evidence of identification,which was/were personally known Desm"on of evidence of idenwi ation 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 SSAR� Conservation Commission 5 � A FRANKTAORMINA NWotary Public " Commonwealth of Massachusetts sig re of►ote Public My Commission Expires Frank a April 27,2012 Printed Name of Notary Public Place rotary seal and/or any stamp above Ann I d�2. .20/L my C6mmissm (Date) vgem'm7.dw•w mace Paos2 of 3 Massachusetts Department of Environmental Protection DEP File Number. Bureau of Resource Protection -Wetlands WPA Form 7 — Extension Permit for Orders of Conditions DEP Wetlands Protection Act M.G.L. c. 131, §40 Provided by Ll C. Recording Confirmation The applicant shall record this document in accordance with General Condition 8 of the Order of Conditions(see below),complete the form attached to this Extension Permit, have it stamped by the Registry of Deeds,and return it to the Conservation Commission. Note:General Condition 8 of the Order of Conditions requires the applicant prior to commencement of work,to record the final Order(or in this case,the Extension Permit for the Order of Conditions)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, it shall be noted in the Registry's Granter Index under the name of the owner of the land upon which the proposed work is to be done. In the case of registered land, it shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done. Detach page 3 of Form 7 and submit it to the Conservation Commission prior to the expiration of the Order of Conditions subject to this Extension Permit To: SALEM conservation commission Please be advised that the Extension Permit to the Order of Conditions for the project at 116 Leach Street #64-342 Proied Location DEP File Number has been recorded at the Registry of Deeds of ESSEX County for. Robert DeNisco Properly Owner and has been noted in the chain of title of the affected property in accordance with General Condition 8 of the original Order of Conditions on: Date Book Page If recorded land the instrument number which identifies this transaction is: Instrument Number If registered land, the document number which identifies this transaction is: Document Number Signature of Applicant wpeform7.d=•rev.N1404 Papa 3 al3 A ' Leach Street LLC JA..r! i CIJ zoos 10 Bailey Terrace " Peabody, MA 01960 781-316-5535 Conservation Commission Salem, Ma 01970 Attention: Frank RE: 116-118 Leach Street Dear Frank, This letter is to request and extension of DEP#64-342. The work was started in August 2005, however, I was not able to complete it by December 2005. All other licenses and permits are in order. Thank you in advance for you consideration of this request. Sincer Robert DeNisco Ikc-c� Manager, Leach Street, LLC �fL1 Ott (lrnmmnnwralth of filassurhmsttts No. 9928 Whereas, Charles O'Connell of-- Salem --, in the County of-- Essex -- and Commonwealth aforesaid, has applied to the Department of Environmental Protection for license to—construct and maintain a pier, ramp and pile-held float ---------------------------------------------------------------------- and has submitted plans of the same; and whereas due notice of said application has been given, as required bylaw, to the --Mayor and City Council -- of the-- City-- of Salem; - --------------------------------------------------------------------------------------------------------- NOW, said Department, having heard all parties desiring to be heard, and having fully considered said application, hereby authorizes and licenses the said -- Charles O'Connell --, subject to the provisions of the ninety-first chapter of the General Laws, and of all laws which are or may be in force applicable thereto, to— construct and maintain a pier, ramp and pile-held float ----------------------------------------------------------- in and over the waters of Salem Harbor - in the - City, of-- Salem and in accordance with the locations shown and details indicated on the accompanying DEP License Plan No. 9928 (2 Sheets). I License No. 9928 Page 2 The structures hereby authorized shall be limited to the following use(s): to provide non- commercial docking and boating access to navigable waters. This license shall expire 10 (ten) years from the date of license issuance. By written request of the Licensee for an amendment, the Department may grant a renewal for a term of years not to exceed that authorized by the original license. All work authorized herein shall be completed within five (5) years of the date of license issuance. Said construction period may be extended by the Department for one or more one year periods without public notice, provided that the Applicant submits to the Department, thirty(30) days prior to the expiration of said construction period, a written request to extend the period and provides an adequate justification for said extension. Please see page 3 for additional conditions to this license. ------------------------------------- ----------------------------------------------------------------------------------------------------------- Duplicate of said plan, number 9928 is on file in the office of said Department, and original of said plan accompanies this License, and is to be referred to as a part hereof. License No. 9928 Page 3 STANDARD WATERWAYS LICENSE CONDITIONS 1. Acceptance of this Waterways License shall constitute an agreement by the Licensee to conform with all terms and conditions stated herein. 2. This License is granted upon the express condition that any and all other applicable authorizations necessitated due to the provisions hereof shall be secured by the Licensee Rdor to the commencement of any activity or use authorized pursuant to this License. 3. Any change in use of any substantial structural alteration of any structure of fill authorized herein shall require the issuance by the Department of a new Waterways License in accordance with the provisions and procedures established in Chapter 91 of the Massachusetts General Laws. Any unauthorized substantial change in use or unauthorized substantial-.structural alteration of any structure of fill authorized herein shall render.this Waterways License void. 4. This Waterways License shall be revocable by the Department for noncompliance with the temrs and conditions set forth herein. This license may be revoked after the Department has given written notice of the alleged noncompliance to the Licensee and those persons who have filed a written request for such notice with the Department and those persons who have filed a written request for such notice with the Department and afforded them a reasonable opportunity to correct said noncompliance. Failure to correct said noncompliance after the issuance of a written notice by the Department shall render this Waterways License void and the Commonwealth may proceed to remove or cause removal of any structure or fill authorized herein at the expense of the Licensee,its successors and assigns as an unauthorized and unlawful structure and/or fill.. 5. The structure(s)and/or fill authorized herein shall be maintained in good repair and in accordance with the terms and conditions stated herein and the details indicated on the accompanying license plans. 6. Nothing in this Waterways License shall be construed as authorizing encroachment in,on or over property not owned or controlled by the Licensee,except with the written consent of the owner or owners thereof. 7. This Waterways License is granted subject to all applicable Federal,State,County,and Municipal laws,ordinances and regulations including but not limited to a valid final Order of Conditions issued pursuant to the Wetlands Protection Act,G.L. Chapter 131,s.40. S. This Waterways License is granted upon the express condition that the use of the structure(s)and/or fill authorized herein shall be in strict conformance with all applicable requirements and authorizations of the DEP,Division of Water Pollution Control. 9. This License authorizes structure(s)and/or fill on: X Private Tidelands. In accordance with the public easement that exists by the law on private tidelands,the licensee - shall allow the public to use arr+.d to pass freely upon:the area of thesubject property lying between the high and low water marks,for the purposes of fishing,fowling,navigation,and the natural derivatives thereof. Commonwealth Tidelands. This Licensee shall not restrict the public's right to use and to pass freely,for any purpose,upon lands lying seaward of the low.water mark. Said lands are held in trust by the Commonwealth. .for the benefit of the public. A Great Pond of the Commonwealth. The Licensee shall not restrict the public's rights to-use and to pass freely upon lands lying seaward of the high water mark for any lawful purpose. _ Navigable River or Stream. The Licensee shall not restrict the public's right to use and to pass freely,for any lawful purpose, in the waterways. No restriction on the exercise of these public rights shall be imposed unless otherwise expressly provided in this license. 10. Unless otherwise expressly provided by this license,the licensee shall not limit the hours of availability of any areas of the subject property designated for public passage,nor place any gates,fences,or other structures on such areas in a manner that would impede or discourage the free flow of pedestrian movement thereon. License No.9928 Page 4 Department, and compensation thereof has been made — -- by paying into the treasury of the Commo o ars and zero cents ($2.00) -- for each cubic yard so Nothing in this License shall be so construed as to impair the legal rights of any person. This License shall be void unless the same and the accompanying plan are recorded within 60 days from the date hereof, in the Registry of Deeds for the County of-- Essex ----------------------- IN WITNESS WHEREAS, said Department of Environmental Protection have hereunto set their hands this twenty-third day of February in the year two thousand and four. Department of Section Chief Environmental Protection THE COMMONWEALTH OF MASSACHUSETTS by the said— -------------------------------------------------- ------ --------- the further sum of-- zero dollars and zero cents ($0.00) ---- the amount determined by the Governor as a just and equi e charge for rights and privileges hereby granted in the land of the Commonwealth BOSTON, Approved b Governor. f rK GULF OF MAINE RESEARCH CENTER INC. ENVIRONMENTAL CONSULTING SERVICES 204LAFAYETTE STREET SALEM, MA 01970 September 30, 2003 RECEIVED (978) 745-6618 FAX (978) 741-8648 OCT u a tow Jill E. ProvencalDEPI OF PLANNING Wetlands and Waterways Program COMMUNITY DEVELOPMENT 1 Winter Street Boston,MA 02108 RE: Chapter 91 Waterways Applications for 116 Leach Street, Salem,MA Transmittal Nos. W025950 and W0320369 Dear Ms. Provencal: This letter is in regard to Chapter 91 License applications filed by Charles O'Connell (the "applicant") for a pile supported pier and float at 116 Leach Street in Salem,MA(Transmittal Nos. W025950 and W0320369). As I had mentioned in previous correspondence to you, the applicant was in the process or revising the previously submitted pier and float plans to attain a 25-foot setback from the lot line, reduce the size of the float to 200 square feet, and keep the float off the substrate at low tide. The plan revisions have been completed, and copies are attached for your records. The applicant will submit the revised plans to the local Conservation Commission to incorporate into the Order of Conditions that was issued, and I will send you a copy of the public notice after it is published. If vou'have any questions on this matter,you can reach me at(978) 745-6618 or via e-mail at gmrcorzei@earthlink.net. Sin elyPsephH. / Jzel Senior Wetland Scientist attachments(3) cc: Charles O'Connell NORTH LICENSE NO. Approved by Department of Environmental Protection �jSA�C` N ter cM�w� Date: �o Mear�O� Sln \— rby Wharf ' 20 lo' � s �N PILES 00X) 20' LONG PRESSURE TREATED 12' DIA. AT TOPALEM6' WIDE DECK �� SDARBORSA16'-3' ter CMRBLEHEAl ��� MQPr• N1gl` Exlsting Seawall LElCUS MAP & Fill Licence See Note O 25' s'xls' Note: 31' Cabana MAP #0547 Existing Seawall & PROPOSED Fill Permit M,G.L c,91 8 xl5' 14'X16' ADDITION Licence No. 7129 Tool Shed Recorded 5/5/98 9 Reg. of Deeds LET #0533 46 g e T Bk14786 Pg129-133 MAP #05 e� 3 DEP file #64-268 F ,a 0 Approved 3/20/98 < Q DEP Application No, p rc " W97-8738 Q {� si ewa r`- ) 1 .4 so' -- •-I LEACH STREET PLAN VIEW (Scalei 1'=30') 0 7.5 15 30 60 PURPOSE, SIMPLIFIED LICENSING ADJACENT PROPERTY OWNERS, PLAN ACCOMPANYING Proposed 300 Sq. Ft. Pier 1. 106 Leach Street Karen Shepard Unit 1 PETITION OF: IN Salem Harbor - Mary Ungaro - Unit 2 AT Salem Randy M, Reid - Unit 3 Charles & Kathy O'Connell COUNTY OF, Essex STATES MA 2, Roger E, Marcorelte 116 Leach Street APPLICATION BY, Charles 171 Jersey St, Marblehead Salem, MA 01970 and Kathy O'Connell 3, John R. Gillespie Jr, SHEET 120 Leach Street 1 OF 2 DATE 28 Sep 2003 LICENSE NEI, Approved by Department of Environmental Protectio Date; GLENDALE COVE PROPOSED BEAM ACROSS TWO FREE-STANDING PILES FOR SEASONAL FLOAT AND GANGWAY TWO PILES FOR STABILIZATION OF PROPOSED SEASON L FLOAT AND GANGWAY 5'-7` 300 SO, FT. clearance DECK 11° 15'-3' XJ7ST]NG fIL� ANb I VA L (MHW=8,72') - - - - -- - - -- -- - - - - - (MLW=0,0') Salem CI y Base = Mean Low Water PROFILE VIEW (Scale 1'=20') 0 10 20 40 ADJACENT PROPERTY OWNERS 1, 106 Leach Street PLAN ACCOMPANYING Proposed 300 Sq. Ft. Pier Karen Shepard - Unit 1 PETITION OF: IN Salem Harbor Mary Ungaro - Unit 2 AT Salem Randy M, Reid - Unit 3 Charles & Kathy O'Connell COUNTY OFt Essex STATES MA 2, Roger E, Marcorelle 116 Leach Street APPLICATION BY, Charles 171 Jersey St, Marblehead Salem, MA 01970 3, John R. Gillespie Jr, and Kathy O'Connell 120 Leach Street SHEET 2 OF 2 DATE: 28 Sep 200 { d"11�13CiPl O1 � AT I Chart s a. 'Kethy,t C,ohriett COUNTY B' t_ser UP,{� �`• A T 1r311 B�T Ci'a] :]"Xl2 41( " C3I9 Q and Ka'ihy- O ( or7i.eCl t - - D( ,fID i Float is off substrate at low tide. � 1 1i COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION Wetlands and Waterways Program/NERD ONE WINTER STREET, 5ch Floor, BOSTON, MA 02108 617-292-5500 MITT ROMNEY 1N3WD01% M00 ELLEN ROY HERZFELDER Governor - '8 9Secretary KERRY HEALEY EO ROBERT W. GOLLEDGE,Jr. Lieutenant Governor Commissioner aMr. Charles O'Connell tember 23, 2003 c/o Gulf of Maine Research Center, Inc. 204 Lafayette Street Salem, MA. 01970 Re: PUBLIC NOTICE OF WATERWAYS LICENSE APPLICATION-No. W02-0480 (Pier) and W03-0872 (ramp and float),Palmer Cove, Salem, Essex County Dear Mr. O'Connell: The Waterways Regulation Program has received your application requesting authorization to perform certain activities in state waterways located in Salem pursuant to M.G.L. Chapter 91, the Public Waterfront Act and its regulations at 310 CMR 9.0 etc. The WRP has assigned these application filings with the above-referenced Waterways License application numbers. It is imperative that you refer to this application number whenever you submit or request information for this file. Upon review of this application, the WRP has made a determination that this project is a water-dependent use project. Attached is the WRP's Public Notice form for this application. The Applicant is required to publish this notice, at his/her expense,in one or more newspapers having circulation in the area affected by the proposed activity. This notice must be published in the local newspaper(s) for at least one day on or before the designated Notification Date. The required public Comment period shall beg';r on tr Lis designated Notification Date. The Applicant is required to submit proof of publication to the WRP by sending a copy of the newspaper notice showing the date of publication or a copy of the newspaper notice and a letter from the newspaper indicating the date the public notice was published. Lastly, the WRP cannot complete its review of this application until the following information/document(s) checked below have been submitted: roof of publication of the Public Notice Completion of the Public Comment Period Receipt of the Municipal Zoning Certification ❑ Receipt of the Municipal Planning Board Notification Form 0 Receipt of a valid Wetlands Order of Conditions This information is available in alternate format.Call Aprel McCabe,ADA Coordinator at 1-617-556-1171.TDD Service-1-800-298-2207. DEP on the World Wide Web: http://w .mass.gov/dep ►.yl Printed on Recycled Paper t Receipt of a valid DEP Water Quality Certification Completion of the MEPA review process El Plans ❑ Other: Should you have any questions, please contact me at (617) 654-6537. Thank you. Sincerely, .0 pA ill E. Prov ill Eencal Environmental Analyst Wetlands and Waterways Program cc: Salem Mayor and City Council, City Hall, Salem, MA 01970 Salem Conservation Commission, City Hall, Salem, MA 01970 Salem Harbormaster, Winter Island, Salem, MA 01970 Mark Tisa, c/o Division of Fish and Wildlife, Field Headquarters, 1 Rabbit Hill Road, -Westboro, MA 01581 Office of Coastal Zone Management, Suite 500, 251 Causeway Street, Boston, MA 02114 Division of Marine Fisheries, S.E. Marine Fisheries Station, 50A Portside Drive, Pocasset, MA 02559, Attn: Vin Malkowski Michael Gildesgame, c/o DEM/Ocean Sanctuaries, 251 Causeway Street, Boston, MA 02114 Mass. Historical Commission, 220 Morrisey Blvd. Columbia Pt., Boston, MA 02116 John R. Gillespie,Jr., 120 Leach Street, Salem, MA 01970 Roger E. Macorelle, 110 Leach Street, Salem, MA 01970 I_ DEPARTMENT OF ENVIRONMENTAL PROTECTION WATERWAYS REGULATION PROGRAM Notice of License Application pursuant to M. G. L. Chapter 91 Waterways License Application Number W02-0480 and W03-0872 NOTIFICATION DATE: October 15,2003 Public notice is hereby given of the Waterways application by Charles O'Connell to construct and maintain a pier, ramp and float at 116 Leach Street in the municipality of Salem in and over the waters of Palmer Cove. The proposed project has been determined to be water-dependent. The Department will consider all written comments on this Waterways application submitted 30 days subsequent to the "Notification Date". Failure of any aggrieved person or group of ten citizens or more to submit written comments to the Waterways Regulation Program by the Public Comments Deadline will result in the waiver of any right to an adjudicatory hearing in accordance with 310 CMR 9.13(4)(c). Additional information regarding this application may be obtained by contacting Jill Provencal of the Waterways Regulation Program at (978) 654-6537. Project plans and documents for this application are on file with the Waterways Regulation Program for public viewing, by appointment only, at the address below. Written comments must be addressed to: James A. Sprague, Section Chief, Wetlands and Waterways Program, One Winter Street, 5'Floor, Boston, MA 02108. I a PEE G�OR NORTH LICENSE NO, �N� B Approved by Departnent of Environmental Protection Gkj�l EM ~ Date: erCM�W 'F�Qan Low Sjr Derby Wharf 16 PILES (IOX) 20' LONG PRESSURE TREATED12' DIA. AT TOPSALEM6' WIDE DECK ^'`" SOHARBORSA 50' r CMN h /w` Mean H1gh Ovate MARBLEHEAD Existing Seawall LOCUS MAP & Fill Licence See Note 19' $'x15, 25' Cabana Note: MAP #0547 Existing Seawall &33 $'X15' PROPOSEDFill Permit M,G,L c,91 14'X16' ADDITION Too( Shed Licence No, 7129 9QG� Recorded 5/5/98 Reg, of Deeds LOT #05461 �e Bk14786 Pg129-133 MAP #33 LS��Q� ��e o DEP file #64-268 �Qyae Approved 3/20/98 i DEP Application No, E " W97-8738 Q i ewa 50' ---� LEACH STREET PLAN VIEW r`j (SCalet 1'=30') 0 7,5 15 30 60 PURPOSE, SIMPLIFIED LICENSING KM RRRZEK3�� ADJACENT PROPERTY OWNERS; PLAN ACCOMPANYING Pro osed 300 S Ft. Pler 1, 106 Leach Street P 9• Karen Shepard - Unit 1 PETITION OF: IN Salem Harbor Mary Ungaro - Unit 2 AT Salem Randy M. Reid - Unit 3 Charles & Kathy O'Connell COUNTY OF, Essex STATEi MA 2, Roger E. Marcorelle 116 Leach Street ION BYi Charles 171 Jersey St, Marblehead Salem, MA 01970 and APPLICATION 'Connell 3, John R. Gillespie Jr, KathyY 120 Leach Street SHEET 1 OF 2 DATE: 2 Nov 2002 L LICENSE NO, Approved by Department of Environmental Protectio Date: GLENDALE COVE PROPOSED BEAM ACROSS TWO FREE—STANDING PILES FOR SEASONAL FLOAT AND GANGWAY TWO PILES FOR STABILIZATION OF PROPOSED SEASONAL FLOAT AND GANGWAY 5'-7' 300 SO, FT. clearance DECK 11' JJ S 77NN 15'-3• AN b SEAVF L� (MHW=8.72') - - -- —— — ——— — — — (MLW=0,0') Salem CI y Base = Mean Low Water PROFILE VIEW (Scale: 1'=20') 0 10 20 40 ADJACENT PROPERTY tNERSi PLAN ACCOMPANYING Proposed 300 S Ft, Pier i, 106 Leach Street: P q, Karen Shepard - Unit 1 PETITION OF: IN Salem Harbor Mary Ungaro - Unit 2 AT Salem Randy M. Reid - Unit 3 Charles & Kathy O'Connell. COUNTY OF: Essex STATEi MA 2. Roger E, Marcorelle 116 Leach Street 171 Jersey St. Marblehead Salem, MA 01970 APPLICATION BY: Charles 3, John R. Gillespie Jr, and Kathy O'Connell 120 Leach Street SHEET 2 OF 2 DATE: 2 Nov 2002 (mental Protection DEP File Number: IS 64-342 and itions Provided by DEP M.G.L. c. 131, §40 ;try of Deeds and submit to the Conservation Commission. --------------------------------------------------- ------- - ---- or the Project at: 64-342 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: 1aIo� Date " If recorded land, the nstniment number identifying this transaction is: Instrument Number If registered land, the document number identifying this transaction is: Document Number Signature of Applicant boot NYr Farm 5 Re, " Page]of Rev.02100 F it . _ I ' imental Protection DEP File Number: IS 64-342 onditions Provided by DEP M.G.L. c. 131 , §40 ;try of Deeds and submit to the Conservation Commission. or the Project at: 64-342 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 in: property Book Page In accordance with the Order of Conditions issued on: Dale If recorded land, thein�ment number identifying this transaction is: Instrument Number If registered land, the document number identifying this transaction is: Document Number Signature of Applicant WPA Form 5 Rev,02100 Page 7 of r � Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands 64-342 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 advised that the Order of Conditions for the Project at: 116 Leach Street 64-342 Project Location DEP File Number Has been recorded at the Registry of Deeds of: County Book Page 9 for: Property Owner and has been noted in the chain of title of the affected property in: 'DZZ Book Page In accordance with the Order of Conditions issued on: IQ �9��� Date If recorded land, the nstaiment number identifying this transaction is: Instrument Number (�(, If registered land, the document number identifying this transaction is: Document Number Signature of Applicant WPA Form 5 Page 7 of 7 Rev.02100 i1 GULF OF MAINE RESEARCH CENTER INC. ENVIRONMENTAL CONSULTING SERVICES 204 LAFAYETTE STREET SALEM, MA 01970 December 2, 2003 (978) 745-6618 FAX (978)741-8648 Salem Conservation Commission 120 Washington Street Salem,MA 01970 RE: Request for Amended Order of Conditions Pier and Float at 116 Leach Street DEP File#64-342 Dear Commission Members: On behalf of the applicant, Mr. Charles O'Connell,Gulf of Maine Research Center requests the Salem Conservation Commission to amend the Order of Conditions issued for the above referenced project to include revised site plans(2 sheets attached). The Order of Conditions for this project was issued on December 12, 2002, and since that time the plans have be revised p been evlsed to reduce potential impacts to wetlands and abutters. Specifically,the revised plans(revision date 1 Dec. 2003)include the following changes from the plan referenced in the Order of Conditions(dated 2 Nova 2002). • The size of the float has been reduced from 384 square feet to 200 square feet. • A float stop has been incorporated into the design to prevent the float from resting on the mud flat at low tide. • The piles are no longer specified to be pressure treated lumber. • The pier setback from the property line has been increased from 19 feet to 25 feet. • The angle of the pier and float with respect to the seawall has been adjusted so the pier and float will be parallel to property lines with abutting properties. It is the opinion of Gulf of Maine Research Center that these changes are relatively minor in scope and serve to further protect the interests of the Wetlands GULF OF MAINE RESEARCH CENTER INC. Protection Act and Regulations. Therefore,we request that the Order of Conditions be amended to reference the revised plans without requiring the applicant to re-file a Notice of Intent for the project. If you have any questions on this matter or require further information, please contact me at(978)745-6618. Sinc ly, Joseph H. Orzel Senior Wetland Scientist c3 NORTH LICENSE NO, GS Approved by Departnent of Environmental Protectbn Date: MQ°ram ' gyp' SjQn Derby Wharf 2� s1�JPILES (lOX) 20' LONG12' DIA. AT TOP SALEM6' WIDE DECK �^" SOALEMEM rHARBOR l� 50' 16'-3' r CMKW� �^ Mean Nigri date MARBLEHEA Existing Seawall LOCUS MAP & Fill Licence See Note Q 25' 8'x15' 31' Cabana Note. `°� 3347 Existing Seawatt & pp Fitt Permit M.G,L c,9_ . 8'x15' 14''X16' ADDITION Tool Shed Licence No, 7129 Qat Recorded 5/5/98 Reg, of Deeds LOT 111546 Bk14786 Pg129-133 Q MAP #33 s`�QFece 3 DEP file #64-268 FQya ou ( Approved 3/20,1 98 i DEP Application No, Q Q W97-8738 } si ewa r LEACH STREET {-+--- 50' --}i PLAN VIEW (Scale, 1'=30') 0 7,5 15 30 60 PURPOSE, SIMPLIFIED LICENSING ADJACENT PROPERTY OWNERS, PLAN ACCOMPANYING Proposed 300 Sq. Ft. Pler L 106 teach Street.Karen Shepard Unit 1 PETITION ❑F1 IN Salem Harbor - Mary Ungaro - Unit 2 AT Salem Randy M, Reid - Unit 3 Charles & Kathy O'Connell COUNTY OF, Essex STATE: MA I 2, Roger E, Marcorelte 116 Leach Street APPLICATION BY Charles 171 Jersey St, Marblehead Salem, MA 01970 I 3, John R, Gillespie Jr, and Kathy O'Connell 120 Leach Street SHEET I OF 2 DATE: I Dec 2003 f LICENSE NO, Approved by Department of Environmental Protector Date+ GLENDALE COVE PROPOSED BEAM ACROSS TWO FREE-STANDING PILES FOR SEASONAL. FLOAT AND GANGWAY TWO PILES FOR STABILIZATION OF 5'-7' PROPOSED SEASONAL FLOAT AND GANGWAY Clearance 300 SO. FT. DECK Il' X] ] ANDS SEAVE (MHW=8.72", - - - - - - - -- - - -- -LF- (ML W 4 i Salem City Base = Mean Low Water . PROFILE VIEW (Scale: 1'=20') 0 10 20 40 ADJACENT PROPERTY OWNERS 1. 106 Leach Street: PLAN ACCOMPANYING Proposed 300 Sq, Ft. Pier Karen Shepard - Unit 1 PETITION OF: IN Salem Harbor Mary Ungaro - Unit 2 AT Salem Randy M, Reid - Unit 3 Charles & Kathy O'Connell COUNTY OFF Essex STATE, MA 2, Roger E• Marcoretle 116 Leach Street APPLICATION HY, Charles 171 Jersey St, Marblehead Salem, MA 01970 and Kathy O'Connell 3. John R, yh Street et SHEET 2 OF 2 DATE: I Dec 2003 120 Leach Street Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands 64-342 WPA Form 5 - Order of Conditions Provided by DEP 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 _Q To: Applicant: Property Owner(if different from applicant): ri Charles R. & Kathy O'Connell Same I(� Name Name 116 Leach Street Mailing Address Mailing Address Salem MA 01970 City/rown State Zip Code City/rown State Zip Code 1. Project Location: 116 Leach Street Salem Street Address City/rown Map 33 Lot 0546 &0547 Assessors Map/Plat Number Parcel/Lot Number 2. Property recorded at the Registry of Deeds for: Essex 9365 123 County Book Page NA Certificate(d registered land) 3. Dates: November 14, 2002 December 12, 2002 December 12, 2002 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): Chapter 91 Plans, 1 of 2 and 2 of 2—Charles & Kathy O'Connell, 116 Leach Street, Nov. 2, 2002 Salem, MA Date 5. Final Plans and Documents Signed and Stamped by: NA Name 6. Total Fee: $155.00 (from Appendix B:Wetland Fee Transmittal Form) WPA Form 5 Rev.02= Pege 7 of 7 Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands 64-342 WPA Form 5 - Order of Conditions Provided by DEP g Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 4 ye 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: Elthe proposed work cannot be conditioned to meett he r d 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. PP Y 9 WPA Form 5 Page 2 of 7 Rev.02100 Massachusetts Department of Environmental.Protection DEP File Number: " Bureau of Resource Protection - Wetlands64-342 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 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 64-342 " 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 Form 5 Rev.07N0 Page 3 of7 Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection -Wetlands 64-342 WPA Form 5 - Order of Conditions Provided by DEP 5 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. WPA Form 5 Page 4 of 7 Rev.02100 IL-- Massachusetts Department of Environmental Protection DEP File Number. • Bureau of Resource Protection -Wetlands 64-3y2 1 WPA Form 5 — Order of Conditions Provided by DEP 5 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. 12, 2,odZ 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 me to the appropriate Department of Environmental Protection Regional Office (see pendix d the property owner(if different from applioa ). Signatures: On VAv—�t\, Of teLe'.u..., 2,6sZ. Day Month and Year before me personally appeared to me known to be the person described in and who executed the foregoing instrument and ack wledged th the/s a exe Itted the sa Is/her free act and deed. Notary Public My Commission Expires This Order is issued to the applicant as follows: ❑ by hand delivery on IQ by certified mail, return receipt requested, on t MCA I Date Date WPA Farts 5 Page 5 of 7 Rev.02100 Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection -Wetlands 64-342 Y 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 VJPA Form 5 Page 6 of 7 Rev.02100 Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection -Wetlands 64-342 Y 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 advised that the Order of Conditions for the Project at: 116 Leach Street 64-342 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 Form 5 Page 7 of 7 Rev.O?/00 Salem Conservation Commission SPECIAL CONDITIONS—DEP FILE # 64-342 City of Salem, 116 Leach Street I. 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#64-342,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 Commission 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. 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 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 the 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 21A,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. L� 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 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. 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,trash 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 wetland. ADDITIONAL CONDITIONS 49. Before work can commence,the Applicant shall obtain all the necessary Federal,State and Local permits and or approvals needed to construct this project. r Notice of Intent Application Wetlands Protection Act and Salem Wetlands Protection By-Law Proposal for: ' Addition to Single Family Residence at 116 Leach Street and A Pile-Supported Pier at 118 Leach Street ' Submitted by Owner: ' Charles & Kathy O'Connell 116 Leach Street tSalem, MA 01970 ' November 14, 2002 1 I 1 1 f Charles R. O'Connell 116 Leach Street Salem, MA 01970 October 31, 2002 Mr. Donald Cefalo Senior Planner, Salem Conservation Commission ' 120 Washington Street Salem, MA 01970 ' RE: WPA Form 3 Notice of Intent Application -Property at 116/118 Leach Street Dear Mr. Cefalo and Conservation Commission Members: ' I hereby submit, for your consideration, this Notice of Intent, which proposes construction of a 14-foot by 16-foot addition to the house at 116 leach street and, a 6-foot 1 wide by 50-foot long pier(300 sq. ft.) at 118 Leach street. The Addition would be built on 1-foot diameter footings and therefore does not require ' the excavation of a cellar hole, or the pouring of concrete foundation walls. The Addition would rise 1-1/2 stories above what is currently a concrete slab and stairs to a cellar entrance. ' The Pier would be supported by two existing piles that are part of the wooden seawall ' and six (6) to eight (8) new piles to be driven into the mud flats as illustrated on the plans included with this N.O.I. The clearance under the pier would be the required five (5)feet at high tide. ' Included with this filing are: 8 copies of the Notice of Intent and attachments (see list). Application fee of$90.00 (chk#:5 ) for Wetlands Protection Act and local by-law fees ' Please schedule this matter for your November 14, 2002 meeting if possible. You may call me with any questions at 978-741-0359 (home). Sincerely, Charles R O'Co 1 1 1 Charles R. O'Connell 116 Leach Street Salem, MA 01970 List of Documents to Accompany the Notice of Intent File Number ' i. Site plans, 8-1/2" x 11" self-prepared. ' 2. Wetland Impact Assessment Narrative ' 3. Abutters List (properties within 100 feet) ' 4. Abutters Notification Form ' 5. Receipts for Certified Mail to Abutters and D.E.P. ' 6. Filing Fee Information & Payment ' 7. Copies of Checks to City and State ' Map List ' 1. USGS Salem Quad. 2. Assessors Map 3. Wetlands Map ' 4. Flood Zone Map ' S. Rare Wetlands Wildlife Habitat Map 1 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 So llem ' A. General Information ' Important: When filling out 1. Applicant: forms on the Charles R. and Kathy O'Connell ' computer, use Name E-Mail Address only the tab key to move 116 Leach Street your cursor- Mailing Address ' do not use the Salem MA 01970 return key. Cityrrown State Zip Code 978-741-0359 Phone Number Fax Number(if applicable) ' 2. Representative (if any): None ' Finn Note: Contact Name E-Mail Address Before ' completing this Mailing Address form consult your local Conservation Cityrrown State Zip Code ' Commission regarding any Phone Number Fax Number(if applicable) municipal bylaw or ordinance. 3. Property Owner(if different from applicant): ' -Same- Name ' Mailing Address Cityrrown State Zip Code ' 4. Total Fee: $65.00 (srAr&) i- 41o,00 (cr+r of .Sa jem) (from Appendix B:Wetland Fee Transmittal Form) 5. Project Location: 116 Leach Street Salem Street Address Cityrrown 033 0546 & 0547 Assessors Map/Plat Number Parcel/Lot Number ' 6. Registry of Deeds: Essex °P 3 S 12 3 ' County Book Page Certificate(if Registered Land) ' v aforrn4.tloc•rev.12/16/00 Page 1 of 8 Massachusetts Department of Environmental Protection DEP File Number: ' ILI 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 ' 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? ' 224 Square Feet ❑ No 1 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 Impact(e.g., sq. ft.) ' Mud Flats 6.3 sq. ft. B. Project Description 1. General Project Description: Addition of 224 sq. ft., built on footings (no cellar),to existing house within buffer zone. 4iWpiles to ' be driven into the mud flats to support a pier as shown on plan. t2. Plan and/or Map References: Plan to Accompany Petition of Charles R. & Kathy O'Connell Nov 2, 2-C3O 2 Title Date (plan view and profile view on 8-1/2" by 11"sheets) Nov 2 'Z yaZ Title Date ' vpaforniMm•rev.1 VI1 00 Page 2 0l 8 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 ' C. Activities Subject to Regulation Town ' 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 pkroposed activities located, in whole or in part, in Wetland Resource Area(s). tInland Resource Areas: ' Bordering Vegetated Wetlands: Bordering Land Subject to Flooding: 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: tLinear Feet altered ' Coastal Resource Areas: ' Coastal Dune: Land Under Salt Pond: Square Feet altered Square Feet altered ' Cubic Yards/Volume 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 I ' wpafornildoc•rev.12/15/00 Page 3 of 8 Massachusetts Department of Environmental Protection DEP File Number: 1 Bureau of Resource Protection - Wetlands WPA Form 3 — Notice of Intent Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 SOalleem C. Activities Subject to Regulations (cont.) Fish Run: Land Containing Shellfish: 6.3 sq. ft. ' Linear Feet altered Square Feet altered Land Subject to Coastal Storm Flowage: Beach: 224 Square Feet altered Square Feet altered Land Under Ocean: Square Feet altered Cubic Yards dredged II ' Riverfront Area: a. Name of Waterway (if available): N/A 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: 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: ' Square Feet ' f. Proposed alteration of the Riverfront Area: Total Square Feet Square Feet within 100 ft. Square Feet between 100 ft.and 200 ft. ' wpafortn3.tloo•rev.12/15/00 Page 4 of 8 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 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) t ❑ 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 NOI to ' Natural Heritage and Endangered Species Program Division of Fisheries and Wildlife Route 135, North Drive Westborough, MA 01581 ® No 1997 Date Date of Map b. Is any portion of the proposed project within an Area of Critical Environmental Concern (ACEC)? I ' ❑ Yes If yes, provide name of ACEC (see Appendix D for ACEC locations): ' ACEC ® 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 ' wpafamO.doc•rev.12/15/00 Page 5 of 8 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 ' D. Performance Standards Town ' 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: Limited 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: ' Exemption ® No 3 a. Is the project located in the Riverfront Area? ❑ Yes If yes, indicate the proposed project purpose: ' ❑ Single Family House ❑ Industrial Development 1 ❑ Residential Subdivision ❑ Commercial Development ❑ Transportation ❑ Other(describe) l 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:: Project is an addition to an existing dwelling. Pier is exempt because it is a pier. ❑ No If no, stormwater management measures are required. Applicants are encouraged to complete Appendix C: Stormwater Management Form and submit 't with this form. '. wpaform3.doc•rev.12/15/00 Page 6 of 8 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 Soalem 1 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 i payment: / 1 ' ` 52 i (City of Salem) &4SI8(Comm. of Mass) 1110VC1413Cl2 2 i 2002 Check Number Check date 1 Charles and Kathy O'Connell -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) 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 twpaform3.dx•rev.12/15/00 Page 7 of 8 r Massachusetts Department of Environmental Protection DEP File Number: r Bureau of Resource Protection - Wetlands i WPA Form 3 — Notice of Intent Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Salem rwn G. Signatures and Submittal Requirements (cont.) r 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 rCommission by certified mail or hand delivery. For DEP: r 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. r 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. r r 1 I' r 1 1 r r r wpaforn)3.dx•rev.12/15/00 Page 8 of 8 1 Massachusetts Department of Environmental Protection t Bureau of Resource Protection - Wetlands WPA Appendix A — DEP Regional Addresses ' Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Mail transmittal forms and DEP payments,payable to: Commonwealth of Massachusetts ' Department of Environmental Protection Box 4062 Boston, MA 02211 ' DEP Western ion Adams Colrain Hampden Monroe Pittafeld Tynngham 436 Dwight Get Agawam Conway Hancock Montague Plainfield Wales Alford Cummington Hatfield Monterey Richmond Were Suite 402 Amherst Dalton Hawley Montgomery Rowe Warwick Springf d,MA 01103 Ashfield Deerfield Heath Monson Russell Washington ' Pho :413-784-1100 Becket Easthampton Hinsdale Mount Washington Sandisfield Wendell Beichert. East Longmeadow Holland New Ashford Savoy Westfield F .413-784-1149 Bemardston Egremont Holyoke New Marlborough Sheffield Westhampton Bleadford Erving Huntington New Salem Shdbume West Springfield Bnmfeld Florida Lanesborough North Adams Shrewsbury West Stockbridge Buckland Gill Lee Northampton Southampton Whately Chademont Goshen Lenox Northfield South Hadley Wilbraham Cheshire Granby Leveretf Orange Southwick Williamsburg Chester Grenville Leyden Otis Springfield Williamstown Chesterfield Great Barrington Longmeadow Palmer Stockbridge Windsor Chicopee Greenfield Ludlow Pelham Sunderland Worthington Clarksburg Hadley Middlefield Peru Tolland DEP Central gion Anton Chariton Hopkinton Millbury Bullard Oxbridge 627 Main Bel Ashbumham Clinton Hubbartlstcn Miltville Shirley WarrenAshby Douglas Hudson New Braintree Shrewsbury Webster ' WDrDes MA O'608 Athol Dudley Holliston Nouhborough Southborough Westborough he .50$-792-7650 AuburnDunstable Lancater Northbridge Southbridge West Boylston F .508-792-76 Ayer East Brookfield Leicester North Brookfield Spencer West Brookfield Barre Fitchburg Leorninster Oakham Sterling Westford D:508-767-2788 Bellingham Gardner Littleton Oxford Stow Westminster t Berlin Grafton Lunenburg Paxton Sturbridge Winchendon Blackstone Groton Marlborough Pepperell Sutton Worcester Bolton Harvard Maynard Petersham Templeton Boxboough Hardwick Medway Phillipston Townsend Boylston Hold. Mention Princeton Tyngsborough Brookfield Hopedale Milford Royalston Upton DEP Southea egion Abington Dartmouth Freetown Mattapoisetl Provincetown Tisbury 20 RIversid rive Acushnet Dennis Gay Head Middleborough Raynham Truro Adleboro Dighton Gosnold Nantucket Rehoboth Wareham ' XFa8-9847-65!57 A 02347 Avon Duxbury Halifax NewBedford Rochester Wellfeet -946-2700 Barnstable Eastham Hanover North Anleborough RocklarM West Bridgewater Berkley East Bridgewater Hanson Norton Sandwich Westport Boume Easton Harwich Norwell Scituate West Tisbury 46-2795 Brewster Edgartown Kingston Oak Bluffs Seekonk Whitman Bridgewater Fairhaven Lakeville Orleans Sharon Wrentham ' Brockton Fall River Mansfield Pembroke Somerset Yarmouth Carver Falmouth Marion Plainville Stoughton Chatham Foxborough Marshfield Plymouth Swansea Chilmark Franklin Mashpee Plyrrpton Taunton ' DEP Northeast Region Amesbury Chelmsford Hingham Mani Quincy Wakefield 205 Lowell Street Andover Chelsea Holbrook Methuen Randolph Walpole Arlington Cohasset Hull Middleton Reading Waltham Wilmington,MA 01887 .Ashland Concord Ipswich Millis Revere Watertown Phone:978-661-7600 Bedford Danvers Lawrence Milton Rockport Wayland ' Belmont Dedham Lexington Nahant Rowley Fax: 978-661-7615 y Wellesley Beverly Dover Lincoln Natick —�j Salem We TDD:978-661-7679 Billerica Dracut Lowell Needham Salisbury Westst Newbury Boston Essex Lynn Newbury Saugus Weston Boxford Everett Lynnfield Newburyport Sherbom Westwood Braintree Framingham Malden Newdon Somerville Weymouth ' Brookline Georgetown Manchester-By-The-Sea Norfolk Stoneham Wilmington Budinglon Gloucester Marblehead North Andover Sudbury Winchester Cambridge Groveland Medfield North Reading Swampscott Winthrop Canton Hamilton Medford Norwood Tewksbury Woburn Carlisle Haverhill Melrose Peabody Topsfiefd 1 ' WpamrmS.doc•Appendix A•rev.1122100 Page 1 011 ' C, NORTH LICENSE NO. BQ� l Approved by Department of Environmental Protection Date: er 14,C Ae'a^ LoW Sh ttan Derby Wharf 16 PCY IN PILES (10X) 20' LONG ✓ e PRESSURE TREATED r _ 12' DIA. AT TOP P ^SALEM 6' WIDE DECK r"`�^ SOUTH Fore HARBOR . .r . ..� �� SALEM r i-w-. 1^ Par {� �1 ~¢ V 16'-31 �w ssc o 50' Water (MNW) �^ Mean High MARBLEHEAD Existing Seawall LOCUS MAP & Fill Licence See Note 0 19' 8'x15' Note. 25' Cabana t MAP #3347-71 Existing Seawatt & 8'x15' 14 PROPOSED DITION Fill Permit M.6•L c•91 Tool Shed Licence No. 7129 Qc� Recorded 5/5/98 Reg, of Deeds ' LOT #0546 Bk14786 Pg129-133 L3 MAP #33 Q� e�e DEP file #64-268 �4Qyd Approved 3/20/98 L DEP Application No. " W97-8738 tQ idewa I-f--50' LEACH STREET PLAN VIEW (Scalei 1'=30') 0 7,5 15 30 60 PURPOSE, SIMPLIFIED LICENSING Mw ' ADJACENT PROPERTYOWNERS PLAN ACCOMPANYING Proposed 300 S Ft. Pier 1. 106 Leach Street: p q• Karen Shepard - Unit 1 PETITION OF: IN Salem Harbor Mary Ungaro - Unit 2 AT Salem ' Rand M, Reid - Unit 3 Charles & Kathy ❑'Connell Y COUNTY 0F, Essex STATES MA 2. Roger E, Marcorelle 116 Leach Street 171 Jersey St, Marblehead Salem MA 01970 APPLICATION BY Charles 3. John R, Gillespie Jr, and Kathy O'Connell ' 120 each Street SHEET 1 OF 2 DATE: 2 Nov 2002 LICENSE NO, Approved by Department of Environmental Protectio Date 1 GLENDALE COVE PROPOSED BEAM ACROSS TWO FREE-STANDING PILES FOR SEASONAL FLOAT AND GANGWAY TWO PILES FOR STABILIZATION OF PROPOSED WNAFD GANGWAY 5'-7' 300 SO. FT. clearance DECK 77 ]] VF L� CMHW=8.72') (MLW=0,0') Salem CI y Base = Mean Low Water PROFILE VIEW ' (Scale 1'=20') 0 10 20 40 ADJACENT PROPERTY OWNERS; 1. 106 Leach Street; PLAN ACCOMPANYING Proposed 300 Sq. Ft, Pier Karen Shepard - Unit 1 PETITION OF; IN Salem Harbor Mary Ungaro - Unit 2 AT Satem Randy M. Reid - Unit 3 Charles & Kathy O'Connell COUNTY OR Essex STATE; MA 2. Roger E. Marcoretle 116 Leach Street 171 Jersey St, Marblehead Salem, MA 01970 APPLICATION BY; Charles 3, John R, Gillespie Jr, and Kathy O'Connell 120 Leach Street SHEET 2 OF 2 DATE; 2 Nov 2002 Wetland Impact Assessment ' Discussion of Proposed Work Conditions and Wetland Resource Areas Introduction ' The property is located at 118 Leach Street in Salem,MA(aka Map#33,Lot#0546). The subject parcel is a rectangular lot with 50' parallel to Leach Street, 50' frontage on ' Glendale Cove in Salem Harbor, and 105' along each side, which it shares with abutters. The abutter to one side is the O'Connell residence;to the other side is the residence of John R. Gillespie Jr. The lot is currently a vacant house lot, except for a small tool shed. tA deeded right of way to #120 Leach Street(Mr. Gillespie)runs across one end of the lot. The project proposes to build a 16' by 14' addition to the existing single family residence ' at 116 Leach Street. This addition,built as shown on the plans, would be supported by three new 6"x6"pressure treated posts on footings. The footings would be concrete of 12"diameter by 4' depth. No excavation will be required except fbithese footings. ' The project also proposes to build a 6' wide by 50' long pile-supported pier in flowed tidelands, which would extend out into Glendale Cove from the seawall. Two of the existing piles, which support the existing wooden bulkhead, would be utilized as the start point of the pier. Additional piles would be driven into the mud flats as shown on the plan. The property has deeded interest in the mud flats and a deeded ch.91 license to maintain a ' seawall and fill recorded in 1997. Hydrology and Wetland Resource Areas The Flawed Tidelands are awash with seaweed from time to time but I do not believe these constitute`Bordering Vegetated Wetlands". The topology is mostly rocks, sand, and mud which are all under water at high tide. I had a professional assessment done by Gulf of Maine Research Center in 1997 when I obtained a chapter 91 license to maintain the seawall. They did not find any`Bordering Vegetated Wetlands" at that time. ' Site vegetation, Topography and Soils 1 The Filled Tidelands(my back yard) are covered with grass,bushes, and other plantings. A gravel driveway is about the only feature on this level lot. Some of the soil adjacent to the seawall has been excavated to prevent erosion while ongoing repair work is performed ' on the seawall. ' Rare Species Gulf of Maine Research Center previously established that there are no"estimated habitats ' of rare wetlands wildlife"or"certified vernal pools"on or near the subject parcel. Rock crabs, hermit crabs,barnacles, muscles, clams, razor clams, oysters and snails (periwinkles) can be seen at low tide. I don't believe there will be any noticeable impact t upon the habitat of these creatures from the piles driven or the shade cast upon the beach by the proposed pier. ' Proposed Work Addition to house: ' Three 12"diameter sono-tubes will be buried 4' deep and filled with poured concrete. ' Pressure treated framing attached to the house would be supported by 6"x6"posts on the concrete footings. A 1-112 story wood-framed addition would be constructed. ' Pier Construction: Driving of 10 piles into the mud flats. Each pile would be approx. 12 inches Diameter by 20 feet long pressure treated as is typical at Palmer Cove Yacht Club or Hawthorne Cove Marina. I have spoken to North Shore Marine who operates a barge- mounted pile driver and they could install these piles. Other Lumber for the pier, such as pressure treated 4"x 12"x 16 ft would be delivered to the site and stored in the yard until needed. These pieces would be cut to size and pre- drilled for fasteners (bolts)while in the yard. Erosion Controls A siltration barrier and hay bales would seem unnecessary as the work in the buffer zone is merely the cutting and drilling of wooden beams and boards. I have no objection to such controls but am unsure how they could be used effectively. The proposed work would not cause or contribute to any erosion. The current seawall is a wooden bulkhead which ' already rises above the level of the yard and would contain any runoff of silt created by heavy rainfall. 1 " ,x�i'x i t .i ;I+Ym�d!;3i—v{i itC. 'rca i {r Jt r I'9` fi.1n A h r ti+SF r e 9 ,at 'fi w "�; e M, t -,:z a;7....,,t t i r, :i .'�,,e „y{flx` air r, ,< a ✓P Vic% `i a �, Yg.. a'3 '." ,, .:rt *>d,•r+a. 3a ai •�{, ry;FS ��m +9 . „y x ±.111""1" r 6 ti 3+ n b" 3. .W "j ':'a., 9hO T.=..e. - axe .r7:d Pa'v , C .per ta`.1.. �" ' ii y. .7ztrr.CJI rt1i yg # rm� _yv '.a a �N tk.. t 9 Zi `Az , ,* -i"'n. gg4 +, ,'n" %�+5'Y� ' :F ( " '_`3 "�':,'Su.r, r k r," X*a n•`. $ xvt _, <..` .. .. a .7. ., a M �i t :- " �. y�y ParcellD Location Owner Co-Owner Mailing Address City State Zip 33-0415-0 121 LEACH STREET GIBNEY PATRICK 2408 FERN CIRCLE CT RALEIGH NO 27613 33-0542.0 107 LEACH STREET POTHER REALTY TRUST OF 1997 POTHIER HOWARD TR 107 LEACH STREET SALEM MA 01970 33-0543-0 111 LEACH STREET MEDROS BRUCE R MARY ANNE 109 LEACH ST SALEM MA 01970 33-0544-0 117 LEACH STREET CLAVEAU GEORGE CONSTANCE 117 LEACH ST SALEM MA 01970 33-0545-0 120 LEACH STREET GILLESPIE JOHN R JR 120 LEACH STREET SALEM MA 01970 33-0546-0 118 LEACH STREET OCONNELL CHARLES R OCONNELL KATHY A 116 LEACH ST SALEM MA 01970 33-0547-0 116 LEACH STREET OCONNELL CHARLES R OCONNELL KATHY A 116 LEACH ST SALEM MA 01970 33-0548-0 110 LEACH STREET - MACKS REALTY TRUST MARCORELLE ROGER E TR 171 JERSEY STREET MARBLEHEAD MA 01945 33-0549-801 106 LEACH STREET SHEPARD KAREN A 106 LEACH ST U1 SALEM MA 01970 33-0549.802 106 LEACH STREET UNGARO MARY 106 LEACH ST U2 SALEM MA 01970 33-0549-803 106 LEACH STREET REID RANDY M 106 LEACH ST U3 SALEM MA 01970 33-0550-0 102 LEACH STREET JORDAN ADAM 102 LEACH ST SALEM MA 01970 33-0555-0 11 GLOVER STREET BOUDREAU JEAN C LINDA J 11 GLOVER ST SALEM MA 01970 33-0758.0 119 LEACH STREET CLAVEAU CONSTANCE LEBLANC MARIE L 117 LEACH STREET SALEM MA 01970 End of Report Notification to Abutters Under the Massachusetts Wetlands Protection Act II ' In accordance with the second paragraph of the Massachusetts General Laws Chapter 131, Section 40, you are hereby notified of the following: ' A. The name of the applicant is Charles R. O'Connell B. The applicant has filed a Notice of Intent with the Conservation Commission for ' the Municipality of Salem,MA seeking to alter an area subject to protection under the Wetlands Protection Act(Chapter 131, Section 40). ' Activities Proposed: 1. Build a 14-Foot by 16-foot addition at 116 Leach Street. 2. Construct a pile-supported 300 sq. ft. pier at 118 Leach Street. C. The address of the lot where the activity is proposed is: _Leach Street Map ' #33, Lot#0547 &0546, Property known as 116/118 Leach Street D. Copies of the Notice of Intent may be examined at : Salem Conservation Commission at 120 Washington Street ' between the hours of: 8:00 AM and 4:00 PM on the following days of the week: _ M-W also 8:OOAM to 7:OOPM on Thurs, 8:00 to 12:00 on Friday. E. Copies of the Notice of Intent may be obtained for a fee from the applicant at t 116 Leach Street by calling this telephone number 978-741-0359 F. Information regarding the date, time, and place of the public hearing may be obtained from: Salem Conservation Commission by calling the telephone ' number: 978-745-9595 between the hours of: 8:00 AM and 4:00 PM on the following days of the week: M-W also 8:OOAM to 7:OOPM on Thursday,8:00 to 12:00 on Friday. ' NOTE: Notice of the public hearing, including its date, time and place will be published at least five (5) days in advance in the_Salem Evening News ' NOTE: Notice of the public hearing, including its date, time and place will be posted in the City or Town Hall not less than forty-eight(48) hours in advance. ' NOTE: You also may contact your local Conservation Commission or the nearest Department of Environmental Protection Regional Office for more information about this ' application or the wetlands Protection Act. 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Coverage Provide d) ' 0 &oN& IA L USE N vostqa 4.60 UNIT ID: o974 o ti Carlin o Poshrimk a �"°' eQY"�'etum 1. "`� UNITED SP377ES o ad Cle : KKFJSY ' POSIM SERVICE TOM�° Pa. 4.65 D2 ***** WELCOME TO ***** Sent o SALEM POST OFFICE Er SALEM MA 01970-9998 ' rqe�O cAIVI/�Pa Q 11/64/02 08:28AM No.- or a"Na ' a ______ .—�/�.._.. ca.Y' Olo � Store USPS Trans 17 o city,smre,z�v.a Wkstn SYS5006 Cashier KKFJ5Y Cashier's Name ROSEANNE ' Stock Unit 00ASOhoumer 11-8KUSPS USPS # 2445930970 1. First Class 4.65 Destination: 02211 Weight: 1.10oz ' Postage Type: PVI Total Cost: 4.65 Base Rate: 0.60 SERVICES Certified Mail 2.30 ' F0011940000002025546 2. PVIuLabel(s)pt 1 44.20 Value: 4. 2 ' 3. PVInLabel(s) 8.84 Value: 4. 2 i Quantity: 2 Subtotal 57.59 Total 57.69 Personal/ Business Check 57.69 Number of Items Sold: 3 ' Thank You Window hours 8 AM-5 PM, Sat 8 AM- 1 PM t r Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Appendix B — 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 Charles R. and Kathy O'Connell key to move Name your cursor- 116 Leach Street do not use the Mailing Address ' return key. Salem MA 01970 Cityrrown State Zip Code "D 978-741-0359 Phone Number I ' 2. Property Owner(if different): -Same- II ' Name Mailing Address ' Cityrrown State Zip Code Phone Number ' 3. Project Location: 116/118 Leach Street Salem ' Street Address Citylrown B. Fees To calculate filing fees, refer Abbre •ated Notice of Resource Area Delineation (Form 4A): ' to the category fee list and The fee is ca ated as follows (check applicable project type): examples in Section D of ' this form. sing amity 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 sh of filling fee: (1/2 of total fee less$12.50) City/Town share of filling f ' (1 total fee plus$12.50) ' Wpaforaa.dw•ApwnGx B•rw.1=9/02 Pawl of 6 Massachusetts Department of Environmental Protection i ' 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 1rrype 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 5lrotal Project Fee: Determine the total project fee by adding the subtotal amounts from Step 4. ' Step Wee 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 1lrype of Activity Step 2/Number Step 3/Individual Step 4/Subtotal of Activities Activity Fee Activity Fee Category 5- Pier (50'x$2/l.f.) 1 $100.00 $100.00 Category 1 -Addition to house 1 $55.00 $55.00 1 Step 5/Total Project Fee:$155.00 ' Step 6/Fee Payments: Total Project Fee:$155.00 ' (Total fee from Step 5) State share of filing fee:$65.00 (1/2 total fee less$12.50) ' City/Town share of filling fee:$90.00 (1/2 total fee plus$12.50) ' W pafomaldw•Appench B•rev.1029/02 Page 2 of 6 LEIMassachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands WPA Appendix B — Wetland Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 C. Submittal Requirements I ' 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, a copy of pages 1 and 2 of this form; and the city/town fee payment. ' c.) To DEP Regional Office(see Appendix A): Send the Notice of Intent, ' I ; a copy of pages 1 and 2 of this form; and a copy of the state fee payment. ' D. Calculating Wetland Filing Fees The wetland filing fee should be calculated using the following steps. The examples listed for each step are based on a project that involves two driveway crossings through a Riverfront Area and Bordering Vegetated Wetland and six single family houses in Riverfront Area only. Step 1/Type of Activity: Review plans and narrative to identify each activity in wetland resource areas and Buffer Zones. Example: driveway crossing and construction of a single family house. Step 2/Number of Activities: Determine the number of each activity associated with the project. Example: driveway crossings and 6 single family homes Step 3/Individual Activity fee: List the fee amount for each category of activity (see Category Activities and Fee on page 4) Example: Driveway crossing is a Category 2(f.) activity and is$250 each. Construction of a single family house is a Category 2(a.) activity and is$250 each. ' Step 4/Subtotal Activity Fee: Determine the subtotal fee for each type of activity by multiplying the fee for the activity (Step 3) by the number of activities (Step 2). If the activity is within the Riverfront Area as well as another resource area or Buffer Zone, add 50%to total fee (e.g., multiply the fee by 1.5). If the activity is located in a Riverfront Area only, apply the fee amount for the category without the additional 50%. Example: 2 (driveway crossings in BVW) x$250 x 1.5 (for riverfront area) _ $750; 6 (single family homes) x$250=$1,500. Step 5/Total Project Fee: Add all the subtotals identified in Step 4 to determine the total fee. Example: $750 +$1,500=$2,250. Step 6/Fee Payments: The state share of the fee is 50% of any filing fee in excess of$25 (i.e., the state share can be determined by dividing the total fee in half and subtracting$12.50);the remaining portion of the fee shall be made to the city or town (i.e., the Cityfrown share can be ' determined by dividing the total fee in half and adding $12.50). Example: City/Town share: $1,137.50; state share: $1,112.50. ' W paforrnMoc•Appendix B•rev.10/29/02 Page 3 of 6 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands WPA Appendix B — Wetland Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 ' D. Calculating Wetland Filing Fees (cont.) i ' Category Activities and Fees Category 1 (Fee for each activity is $55): a.) work on single family lot; addition, pool, etc.; b.) site work without a house; c.) control vegetation; d.) resource improvement; ' e.) work on septic system separate from house; f.) monitoring well activities minus roadway; g.) new agricultural or aquaculture projects. ' Category 2 (Fee for each activity is$250) a.) construction of single family house; b.) parking lot; c.) beach nourishment; d.) electric generating facility activities; e.) inland limited projects minus road crossings and agriculture; t f.) each crossing for driveway to single family house; g.) each project source (storm drain) discharge; h.) control vegetation in development; i.) water level variations; ' j.) any other activity not in Category 1, 3, 4, 5 or 6; k.) water supply exploration. Category 3 (Fee for each activity is$525) a.) site preparation (for development) beyond Notice of Intent scope; d.) each building (for development) including site; c.) road construction not crossing or driveway; d.) hazardous cleanup; a.) water supply development. Category 4 (Fee for each activity is$725): a.) each crossing for development or commercial road; b.) dam, sluiceway, tidegate (safety) work; c.) landfills operation/closures; t d.) sand and gravel operations; a.) railroad line construction; f.) bridge; g.) hazardous waste alterations to resource areas; t h.) dredging; i.) package treatment plant and discharge; j.) airport tree clearing; tk.) oil and/or hazardous material release response actions. to. Category 5 (Fee is$2 per linear foot;total fee not less than $50 or more than $1,000): a.) work on docks, piers, revetments, dikes, etc. (coastal or inland). Category 6 (Fee is$1 perlinear near foot; but not to exceed$100 for activities associated with a single family house or$1,000 for all other activities) a.) boundary delineations for Bordering Vegetated Wetlands. ' Wpatonn1doc•Appendix B-rev.10129/02 Page 4 of 6 t• CHARLES R O CONNELL os as 53-179/1,3 °tx 4 5 2 4 570140392 ;d,C ' ^ ��k KATHY Al O)CONNELL 116_LEACH ST PH 97f8741-0359 SALEM MAc 01970BA � $ .RO'd ¢ � ill TO RH$k�ODEEOP 4°hVWM, '//�fi�eT .r.�/ --�lf3r✓ ' �u t t e 1 ¢. ''" '„ �� r� Oii30i798¢: 57 OL40392�� 452i ' CHARLES R. O'CONNELL 09-86 53-179/113 raj ° x 4`5'18 KATHY ++ 'v o v 57014039z Lr' A OCONNELLr s u� 116 LEACH ST PH 978 741-0359 r-+ 1.�.Y5 '"�u° 'k�}P@tiF 1` t SALEM MA 01970 R tt `'{ " t ) t.@?yN"•: .ka1;& y Rv Wj�4 f.Qr �s SPJ7�,Sf -b 5_ tAl TO THE C'JEYEROF 330 � - ���'r�}, 1:011300981: 57 014039211m 45i8 /tt CHARLES R. O'CONNELL os es 53-179/113 KATHY A O'CONNELL 570140392 xw 116 LEACH ST PH 978 741 0359 x� >m a �j ' . 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Fa_3 is i ♦ Lt '" cJ ga3,s Al -r ' r ,a ktf$'t-�� dntYt'dEa s3 r l F� ♦x'3 'a;� a � a}'�PT/ .+.: 4i2 cam. s i- }.r- 1 wa � We '� .. MR A` }� �s• ,{, /off vim''H' �fE FiS kR}� a-�tc. " a, Fy�]� b '� s rk T ; ��• ,'qrx. + "S - ,_ c ® • � Aft>�< �a w�� 3 .5 %>+?Y � � /. 9 IV Lei o1r. WETLANDS . P SITE: 116/118 Leach Street, Salem, MA BASE MAP: LISFWS NWI Map, Salem • .. 000 GULF OF MAME RESEARCH CENTER • \� �X'ay y2ly�y. Mils. � o a f^ •• '� T,C`"}Crs`"•�..e —tea' t'A� �' -{•i. C use I 1.���v'a.:', AN ®,p � -� arc\ .� �� •• •• • • 5 C a ^ s+ • c+3� � � i l � � f J -FLOODZONE AP FloodSITE: 116/118 Leach street, Salem, MA BASE MAP: insurance Rate Map,(FIRM) GULF OF MAWE RESEARCH CENTER - � `fT1 ♦ y' t 11 �1'. .4 N" � .: yr t° st^" a ..' y � _I— r {{• '. e'�"La u M , I 0, I, �a . •13}W�k�+1Y� 11 y �! '1.�� af+ l.. t ••� � 4 4 i� 1 i r t� 1 hr' Z 1 v �"� G i1'i1f 1 '. ♦ � .s W� a � T � ���zrfi I,rk, � i:��rr'P t 2� -- y� I s t �. ♦ � �� s f 011 FigI Y yyy PPP ` �(/g ! � +C f I / F .� �' r v d J �3x�✓ d+lt F h 1� Q L ��•�' 1 � g`l V i� ,� t� � '` e >�r t �`��JI �f� r l /` � }•' a�'y t' ij_(�I�y�t y��Mr1 W tD r $ IlJ �i4 k .�r \��� +�t,y� !f f .� ) ] li�"Pr+t3 ✓ � (n ',:5 ..l is r I` / 1 �'� rfi � ✓I v� } r'�Y r/ e ✓ { � r, ( / �I., ♦r°`�.' � O 1$ ^ t f� 4„�l�i��k f {, 1 �r / ✓tY P P F•J (Y*fi� �`!vm"(. ,� ._I a! m o W ¢ S � � .G � r co � N .� @� 4�q "t1 �it �. S�� sr Sf i :� f 1 %✓�'} i V Q J N J LU LL z m = V r � f _ r � v � ) � r�t� r� MIT to r. ✓ J1y� / +LNr 4 .` Y a �v 1 { w T ¢ "low \ q twir. M...� 3y �� ft r �_ I { '' �� 1n°`i O)( l �/1 . ' 2 Lu ELI ¢ �' .� `��'m'af �x���, u.r,�� '��• ��J/�lJ r; ,- l � i ,� � i* /Q�'i. �� ��. Q �u a 1'^ \� �3� -t 1 �yl UJ rA: ✓ \�: fity . Cr CL U ��o + i/' �� v � ,f ld �Y� I J/_IJ/ �� / ur /� 1y rn 4 rl� W3 ' 0 U, ter. e r .z y eavr,n a 9y�,w a .rw w��e.! r .-._' c',Y+-a�?R *[-... � ^.. c���•,._ar♦,'�n 'as y� J '',•,��,.�, - a _ i r� r dT.�rc "�4 .fix' • � y Jam'"_� _ ���41 1. �a _ ,� �• �w_ - Fes,. Massachusetts Department of Environmental Protection W025950 ' Bureau of Resource Protection - Waterways Regulation Program Transmittal No. Chapter 91 Waterways License Application -310 OMR 9.00 SIMPLIFIED,WATER-DEPENDENT,NONWATER-DEPENDENT,AMENDMENT ' A. Application Information (Check one) ' Name(Complete Application Sections) Check One Fee Application# SIMPLIFIED- ' For assistance Water-dependent and in completing Nonwater-dependent(A-E) ® Residential with <4 units $50.00 BRP W WO6a this application, see- The ❑ Other $50.00 BRP WW06b ' Waterways Application WATER-DEPENDENT- "How to Apply Guide" General (A-H) ❑ Residential with <4 units $100.00 BRP WW01a ❑Other $250.00 BRP WWOib ' ❑ Extended Term $2500.00 BRP WW01c _.._._----------- . ---------._.._.----------------._.._.----------------------- Amendment(A-H) ❑ Residential with <4 units $50.00 BRP WW03a ' ❑ Other $100.00 BRP WW03b NONWATER-DEPENDENT- ' , Full(A-H) ❑ Residential with <4 units $500.00 BRP WW15a ❑ Other $1500.00 BRP WW15b ❑ Extended Term $2500.00 BRP WW15c ............................................. ..__----................----------.._.._.._---_.._..------------- ' Partial(A-H) ❑ Residential with <4 units $500.00 BRP WW 14a ❑ Other $1500.00 BRP WW14b ' ❑ Extended Term $2500.00 BRP WW14c Municipal Harbor Plan (A-H) ❑ Residential with <4 units $500.00 BRP WW 16a ' ❑ Other $1500.00 BRP WW16b ' ❑ Extended Term $2500.00 BRP W W 16c _-------- - -----------------------------._.._.._..--------------------.._.._.._..------ Joint MEPA/EIR(A-H) ❑ Residential with <4 units $500.00 BRP WW 17a ' ❑ Other $1500.00 BRP WW17b ❑ Extended Term $2500.00 BRP W W 17c _._. ------- _.._..- Amendment(A-H) ❑ Residential with <4 units $250.00 BRP WW03c ' ❑ Other $750.00 BRP WW03d ❑ Extended Term $1000.00 BRP WW03e Rev. APpA01 Page 1 of 17 Massachusetts Department of Environmental Protection w025950 ' Bureau of Resource Protection - Waterways Regulation Program Transmittal No. Chapter 91 Waterways License Application -310 CMR 9.00 SIMPLIFIED,WATER-DEPENDENT,NONWATER-DEPENDENT,AMENDMENT ' B. Applicant Information Proposed Project/Use Information ' 1. Applicant: Note: Please VMRLw & THY - ='CONNE` refer to the Name E-mail Address ' WaterwaysLEG $TREE Application Mailing Address "How to SALEM Is M ' Apply"Guide Cdy/rown State Zip Code before (978)741-0359 (H) completing Telephone Number Fax Number sections A-H of ' this form. 2. Authorized Agent (if any): Name E-mail Address ' Mailing Address ' Cirylrown State Zip Code Telephone Number Fax Number IC. Proposed Project/Use Information 1. Property Information (all information must be provided): -SAME- ' Owner Name(if different from applicant) MAP 433 LOT#0546&0547 42 degrees 30'45" 70d 53' Tax Assessor's Map and Parcel Numbers Latitude Longitude 116/118 LEACH STREET l ' Street Address State Zip Code 2. Registered Land ❑ Yes ® No ' 3. Name of the water body where the project site is located: ' SALEM HARBOR 4. Description of the water body in which the project site is located (check all that apply): Type Nature Designation ❑ Nontidal river/stream ® Natural ❑Area of Critical Environmental Concern ' ® Flowed tidelands ❑ Enlarged/dammed ❑ Designated Port Area ❑ Filled tidelands ❑ Uncertain ❑ Ocean Sanctuary ' ❑ Great Pond ❑ Uncertain ❑ Uncertain ' Re9.OV Rev.APPA 1Aoc Page 2 of 17 Massachusetts Department of Environmental Protection W025950 ' Bureau of Resource Protection - Waterways Regulation Program Transmittal No. Chapter 91 Waterways License Application -310 CMR 9.00 SIMPLIFIED,WATER-DEPENDENT,NONWATER-DEPENDENT,AMENDMENT C. Proposed Project/Use Information (cont.) ' Select use(s)from pg.4 of the "HOW 5. Proposed Use/Activity description to Apply PILE SUPPORTED PIER FOR SWIMMING AND BOATING Guide" 6. Is the project a pre-1984 existing structure AND less than 600 square feet? ❑ Yes ® No ' 7. Is the project a post-1984 existing or new structure, less than 300 square feet AND water dependent? ® Yes ❑ No 8. What is the estimated total cost of proposed work (including materials&labor)? $5,000 ' 9. List the name&complete mailing address of each abutter(attach additional sheets, if necessary). An abutter is defined as the owner of land that shares a common boundary with the project site, as well 1 as the owner of land that lies within 50' across a waterbody from the project. JOHN R. GILLESPIE JR. 120 LEACH STREET Name Address ROGER E. MACORELLE 110 LEACH STREET Name Address -SEE ATTACHED- 106 & 108 LEACH STREET ' Name Address ' D. Project Plans 1. I have attached plans for my project in accordance with the instructions contained in (check one): ❑ Appendix A (License plan) ® Appendix B (Simplified License plan) ❑ Appendix C(Permit plan) 2. Other State and Local Approvals/Certifications ❑401 Water Quality Certificate Date of Issuance ®Wetlands File Number ❑Jurisdictional Determination JD- File Number ' ❑ MEPA File Number ❑ EOEA Secretary Certificate ' Date ❑21E Waste Site Cleanup RTN Number CH1Rev.AppAoc Rev.APPAg1 Page 3 o117 Abutters List for 116/Il8 Leach Street Sa lem, MA ' March 28, 2002 Name Address i. Karen A. Shepard 106 Leach Street Unit 1; Salem, MA 01970 2. Mary Ungaro 106 Leach Street Unit 2 3. Randy M. Reid 106 Leach Street Unit 3 4. Roger E. Marcorelle 171 Jersey Street, Marblehead, MA 01945 ' 5. John R. Gillespie Jr 120 Leach Street, Salem, MA 01970 I' � Massachusetts Department of Environmental Protection Wo25950 ' Bureau of Resource Protection - Waterways Regulation Program Transmittal No. Chapter 91 Waterways License Application -310 CMR 9.00 SIMPLIFIED,WATER-DEPENDENT,NONWATER-DEPENDENT,AMENDMENT E. Certification All applicants, property owners and authorized agents must sign this page. All future application correspondence may be signed by the authorized agent alone. "I hereby make application for a permit or license to authorize the activities I have described herein. Upon my signature, I agree to allow the duly authorized representatives of the Massachusetts Department of Environmental Protection and the Massachusetts Coastal Zone Management Program to enter upon the premises of the project site at reasonable times for the purpose of inspection." °I hereby certify that the information submitted in this application is true and accurate to the best of my knowledge." A Applicant's signature Date ' Property Owner's signature(if different than applicant) Date Agent's signature(if applicable) Date ' APPLICANTS FILING A SIMPLIFIED APPLICATION STOP HERE CH91App.dx Rev.022&Ol Page 4 of 1] Hand-enter Your Transmittal Number ► K07?595 t Your unique Transmittal Number can be accessed through DEP's web site or by calling the DEP Infol-ine as listed on the last page of this document Massachusetts Department of Environmental Protection Transmittal Form for Permit Application and Payment instruc orfA A Ircatron Information _PP e ;: x L Y :.� ' DEP Permit Code(the 7 or 8 character code from first page of permit application instructions). 1. Please type or BRPW W06a print.A separate Name of Permit Category: Transmittal Form must SIMPLIFIED LICENSE Ca+-e -O r S C,� ' be completed for each Type of Project or Activity: permit application. WATER DEPENDENT RESIDENTIAL WITH LESS THAN 4 UNITS P1 er ##BSA Iicant Informatwn Firm orx lftdivatl as --- 2. Your check should k,, ph... ' be made payable to Name of Firm: the Commonwealth of N/A Massachusetts. Or,i1 party needingthis approval is clearly an individual., Please mail your lad dual's Last Name: First Name MI ' check along with a O'CONNELL CHARLES R copy of this form to: DEP,P.O.Box 4062, Boston,MA 02211. Street Address 116 LEACH STREET 3. Three(3)copies of City/Town State Zip Code Telephone Number this form will be SALEM MA 01970 (978)741-0359 ext.HOME needed. Contact: e-mail address (optional) ' Copy 1 (the original) .r ..�� - , .�.~¢" ,. ,4.: must accompany yourC�Facihty, Site Or Individual,Requmng Approvalg .,.J --t permit application. "°- . ` Copy 2 must Name of Facility,Site or Individual DEP Facility Number(if Known) accompany your fee -SAME- ' payment. Street Address e-mail address: Copy 3 should be (optional) retained for your City/Town State Zip Code Telephone Number records ( ) ext. 4. Both fee-paying W. .''hP_"� Iicatron,Pre Pik if iffe're6"t from Sect1'on,8 and exempt applicants P -- y8� must mail a copy of Name of Individual or Firm: this transmittal form to -SAME- DEP,P.O.Box 4062, Address Boston,MA 02211 City/Town State Zip Code Telephone Number For DEP Use Only ( ) ext. Permit No. Contact: LSP Number(21 E only) Rec'd Date Reviewer - :,, � Perrrnt rojectGoo�diria#ion., :o- ` Is this project subject to MEPA review? ❑yes ® no If yes,indicate the project's EOEA file number(assigned when an Environmental Notification Form is submitted to the MEPA unit) ' EOEA# Is an Environmental Impact Report Required?❑yes® no Is application part of a l this arger project for which two or more DEP permits are being or will be sought? ®yes ❑ no List any other DEP permits that apy to thisproject: „ c Permit Cat"o• Date of Submission tentairye orac(dal�T.Transmittal_Numbed"apphcatwn:alieadysgllrrl ei! . ' BRPWW06a AJOV 1 7-007- W O 2 69 WPA 03 Notice of Intent N Ov i 2-0o Z. (Wetlands File#) F Amount#Due`` N. x x - Special Provisions: ❑ Fee Exempt (city,town or municipal housing authority)(state agency if fee is$100 or less) ❑ Hardship Request[payment extensions according to 310 CMR 4.04(3)(c)J ❑ Alternative Schedule Project(according to 310 CMR 4.05 and 4.10) ' 'There are no fee exemptions for 21 E,re ardless of applicant status Check#: 4 5- 19 Dollar Amount:$63.a6- 4 55-,00 Date: NOV -L ZL)OZ Please make check payable to the Commonwealth of Massachusetts and mail check and one copy of this form to DEP,P.O. Box 4062, Boston,MA 02211 rev:0&21= Hand-enter Your Transmittal Number -----y Your unique Transmittal Number can be accessed through DEP's web site or by calling the DEP InfoUne as fisted on the last page of this document ' Massachusetts Department of Environmental Protection Transmittal Form for Permit Application and Payment A. Appticatlon Infatw»atlon 1. Please type or print. DEP Permit Code(the 7 or a character code from first page of permit application insbuc ione): A separate Transmittal 13RP W W 0 6 Form must be Name of Permit Category: ' completed for each S , , L i e✓) S e— , r- los permit application. Type of Project or ActiNty:. r 'we Acid , t-ran +o S, )C.,LrjJy, ge at ns (Vtder 3LO SQJ.Ct, 2. Your check should be made Payable to $. App1L'8�t In#ol7tf�4tiotl (Fi►rte ol"lltlividudij Commonwealth of Name of Firm: Massachusetts. !VA Please mail your check On H peffy needing flits approval Is dearly an Individual: along with a copy of FInclividuals Last Name: First Name _ AI this form to;DEP,P.O. 10% (-ONNE L Box 4062,Boston.MA 02211. Street Address 3. Three(3)copies of ) 16 Lc C ST this form will be City/town State Zip Code Telephone Number needed. SA LcP-J t114 01970 (976) 741 a*- 0-S 5 9 0404E Copy 1(the original} Contact. a-mail address (optional) must accompany your permit application. Facplityy $Ite or Indivis#nal Reglu rin Approval Copy 2 must Name of Facility,Site or Individual DEP Facility Number(if Known) ' accompany your fee payment. — Copy 3 should be Street Address e-mad address: (optional) retained for your records CityRown State Zip Code Telephone Number 4. Both fee-paying and ( ) ext. exempt applicants must l). Application Prepairetd by (lf different ifORt 30cd9n 8) mail a copy of this transmittal form to Name of Individual or Firm: DEP,P.O.Box 4062, — S A M E — Boston,MA 02211 Address For DEP Use Only Cityfrown State Zip Code Telephone Number Permit No. ( ) ext. Reed Date Contact LSP Number(21 E only) Revmwer ' E Porrrtit� Project �t#'ot�cllna#ion . Is this project subject to MEPA review? ❑ yes ®no If yes, indicate the projects EOEA file number(assigned when an Environmental Notification Form is submitted to the MEPA unit) ' EOEA# Is an Environmental Impact Report Required?❑yes ® no Is this application part of a larger project for which two or more DEP permits are being or will be sought? Rr yes ❑ no List any other DEP that applyto thisproject Permit C4tegory Date of submisswn(tentative or actual) ; TrarnsmRtal Nrarthar(N apprxxtlon alb aubmittieC} , a wwO o` I w oZ —9 50 P ' ? r,ce OcX I nfY.ir I Nc>v20oz- wefl"Ods le # C Amount Due Special Provisions: ❑ Fee Exempt'(city,town or municipal housing authority rate agency if fee is$100 or less) ❑ Hardship Request(payment extenswn s according to 310 CMR 4.04(3)(c)) ❑ Alternative Schedule Project(according to 310 CMR 4.05 and 4.10) 'There are no fee exemptions for 21 E less of a icermt status Check# 'q ZZ Dollar Amount: V 00 1Date: IvoV "Z Zc3o2 Please make check payable to the Commonwealth of Massachusetts and mail check and one copy of this form to DEP, P.O. Box ' 4062, Boston, MA 02211 l