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HomeMy WebLinkAboutMiscellaneous - 100 SALEM STREET 4/30/20184 R Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands ' WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. rab A. General Information DEP File Number: 242-1297 North Andover From: 1. Conservation Commission 2. This issuance is for (check one): ❑ Order of Conditions ® Amended Order of Conditions 3. To: Applicant: Thomas Patenaude Lianne Cristaldi a. First Name b. Last Name c. Company 161 Massachusetts Avenue d. Mailing Address North Andover e. City/Town 4. Property Owner (if different from applicant): Kathy Campbell -Stevens a. First Name b. Last Name P. O Box 55865 d. Mailing Address Boston e. City/Town 5. Project Location: 100 Salem Street f. State 01845 g. Zip Code Mellon Trust of New England, North Andover c. Company MA. f. State North Andover 02205-5865 g. Zip Code a. Street Address b. Citylrown Map 96 Lot 57 c. Assessors Map/Plat Number d. Parcel/Lot Number Latitude and Longitude, if known (note: 42-41-03 71-06-23 electronic filers will click for GIS locator): e. Latitude f. Longitude 6. Property recorded at the Registry of Deeds for (attach additional information if more than one parcel): Essex North 8 9. a. County b. Certificate (if registered land) 1370 21 c. Book d Page Dates: 1113105 I l i f, /0,5 � /ssLc�e a. Da�%Not�ice f Intent Filed b. D e P blic Hearing Closed c. D e of Final Approved Plans an�Other Documents (attach additional plan or document references as needed): Proposed Site Plan a. Plan Title Andover Consultants, Inc. b. Prepared By 10/31/05 d. Final Revision Date Existina Conditions Plan f. Additional Plan or Document Title Total WPA Fee Paid: a. Total Fee Paid William S. MacLeod, P. E. c. Signed and Stamped by 1"=20' e. Scale b. State Fee Paid January 25, 2005 $100.00 c. City/Town Fee Paid wpaform5.doc • rev. 11/15/05 Page 1 of 9 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions J Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Findings 1. Findings pursuant to the Massachusetts Wetlands Protection Act: DEP File Number: 242-1297 Following the review of the above -referenced Notice of Intent and based on the information provided in this application and presented at the public hearing, this Commission finds that the areas in which work is proposed is significant to the following interests of the Wetlands Protection Act. Check all that apply: a. ® Public Water Supply b. ❑ Land Containing Shellfish c. ® Prevention of Pollution d. ® Private Water Supply e. ❑ Fisheries f. ® Protection of Wildlife Habitat g. ® Groundwater Supply n. ® Storm Damage Prevention i. ® Flood Control 2. This Commission hereby finds the project, as proposed, is: (check one of the following boxes) Approved subject to: ® the following conditions which are necessary in accordance with the performance standards set forth in the wetlands regulations. This Commission orders that all work shall be performed in accordance with the Notice of Intent referenced above, the following General Conditions, and any other special conditions attached to this Order. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, these conditions shall control. Denied because: ❑ the proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations. Therefore, work on this project may not go forward unless and until a new Notice of Intent is submitted which provides measures which are adequate to protect these interests, and a final Order of Conditions is issued. A description of the performance standards which the proposed work cannot meet is attached to this Order. ❑ the information submitted by the applicant is not sufficient to describe the site, the work, or the effect of the work on the interests identified in the Wetlands Protection Act. Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides sufficient information and includes measures which are adequate to protect the Act's interests, and a final Order of Conditions is issued. A description of the specific information which is lacking and why it is necessary is attached to this Order as per 310 CMR 10.05(6)(c). Inland Resource Area Impacts: Check all that apply below. (For Approvals Only) Permitted Proposed Permitted Alteration Replacement Replacement D. unear Leet c. unear reef a. nnear reec b. square feet c. square feet d. square feet b. square feet c. square feet d. square feet 1. %,u.yu uicuycu wpaform5.doc • rev. 11/15/05 Page 2 of 9 Proposed Resource Area Alteration 3. ❑ Bank a. linear feet 4. ❑ Bordering Vegetated Wetland a. square feet 5. ❑ Land Under a. square feet Waterbodies and Waterways e. cu.yd dredged Permitted Proposed Permitted Alteration Replacement Replacement D. unear Leet c. unear reef a. nnear reec b. square feet c. square feet d. square feet b. square feet c. square feet d. square feet 1. %,u.yu uicuycu wpaform5.doc • rev. 11/15/05 Page 2 of 9 L1Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands 1 WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Number: 242-1297 B. Findings (cont.) ❑ Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes below Resource Area Proposed Permitted Proposed Alteration Alteration Replacement 6. ❑ Bordering Land b. square feet c. c/y nourishmt. d. c/y nourishmt. 13. ❑ Subject to Flooding a. square feet b. square feet c. square feet Cubic Feet Flood a. square feet b. square feet c. c/y nourishmt. d. c/y nourishmt Storage e. cubic feet f. cubic feet g. cubic feet 7. ❑ Isolated Land Subject to Flooding a. square feet b. square feet ❑ Cubic Feet Flood Storage c. cubic feet d. cubic feet e. cubic feet S. ❑ Riverfront area ❑ Salt Marshes a. total sq. feet b. total sq. feet Sq ft within .100 ft b. square feet c. square feet d. square feet 17. ❑ Land Under Salt c. square feet d. square feet Sq ft between 100-200 ft Ponds a. square feet b. square feet e. square feet f. square feet Coastal Resource Area Impacts: Check all that apply below. (For Approvals Only) 9. ❑ Designated Port Indicate size under Land Under the Ocean, below Areas 1o. ❑ Land Under the Ocean a. square feet b. square feet Permitted Replacement h. cubic feet f. cubic feet 11. ❑ Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes below 12. ❑ Coastal Beaches a. square feet b. square feet c. c/y nourishmt. d. c/y nourishmt. 13. ❑ Coastal Dunes a. square feet b. square feet c. c/y nourishmt. d. c/y nourishmt 14. ❑ Coastal Banks a. linear feet b. linear feet 15. ❑ Rocky Intertidal Shores a. square feet b. square feet 16. ❑ Salt Marshes a. square feet b. square feet c. square feet d. square feet 17. ❑ Land Under Salt Ponds a. square feet b. square feet c. cu.yd dredged d. cu.yd dredged 18. ❑ Land Containing Shellfish a. square feet b. square feet c. square feet d. square feet 19. ❑ Fish Runs Indicate size under Coastal Banks, inland Bank, Land Under the Ocean, and/or inland Land Under Waterbodies and Waterways, above 20. ❑ Land Subject to Coastal Storm Flowage a. square feet b. square feet wpaform5.doc• rev. 11/15/05 Page 3 of 9 \ Massachusetts Department of Environmental Protection l� Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Number: 242-1297 C. General Conditions Under Massachusetts Wetlands Protection Act (only applicable to approved projects) 1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. 4. The work authorized hereunder shall be completed within three years from the date of this Order unless either of the following apply: a. the work is a maintenance dredging project as provided for in the Act; or b. the time for completion has been extended to a specified date more than three years, but less than five years, from the date of issuance. If this Order is intended to be valid for more than three years, the extension date and the special circumstances warranting the extended time period are set forth as a special condition in this Order. 5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. Any fill used in connection with this project shall be clean fill. Any fill shall contain no trash, refuse, rubbish, or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles, or parts of any of the foregoing. 7. This Order is not final until all administrative appeal periods from this Order have elapsed, or if such an appeal has been taken, until all proceedings before the Department have been completed. 8. No work shall be undertaken until the Order has become final and then has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done. In the case of the registered land, the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done. The recording information shall be submitted to this Conservation Commission on the form at the end of this Order, which form must be stamped by the Registry of Deeds, prior to the commencement of work. 9. A sign shall be displayed at the site not less then two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection" [or, "MA DEP"] "File Number 242-1297 vvpaform5.doc • rev. 11/15/05 Page 4 of 9 Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands Ll�)V WPA Form 5 - Order of Conditions 242-1297 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 C. General Conditions Under Massachusetts Wetlands Protection Act 10. Where the Department of Environmental Protection is requested to issue a Superseding Order, the Conservation Commission shall be a party to all agency proceedings and hearings before DEP. 11. Upon completion of the work described herein, the applicant shall submit a Request for Certificate of Compliance (WPA Form 8A) to the Conservation Commission. 12. The work shall conform to the plans and special conditions referenced in this order. 13. Any change to the plans identified in Condition #12 above shall require the applicant to inquire of the Conservation Commission in writing whether the change is significant enough to require the filing of a new Notice of Intent. 14. The Agent or members of the Conservation Commission and the Department of Environmental Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours to evaluate compliance with the conditions stated in this Order, and may require the submittal of any data deemed necessary by the Conservation Commission or Department for that evaluation. 15. This Order of Conditions shall apply to any successor in interest or successor in control of the property subject to this Order and to any contractor or other person performing work conditioned by this Order. 16. Prior to the start of work, and if the project involves work adjacent to a Bordering Vegetated Wetland, the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden stakes or flagging. Once in place, the wetland boundary markers shall be maintained until a Certificate of Compliance has been issued by the Conservation Commission. 17. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully stabilized with vegetation or other means. At no time shall sediments be deposited in a wetland or water body. During construction, the applicant or his/her designee shall inspect the erosion controls on a daily basis and shall remove accumulated sediments as needed: The applicant shall immediately control any erosion problems that occur at the site and shall also immediately notify the Conservation Commission, which reserves the right to require additional erosion and/or damage prevention controls it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of work line has been approved by this Order. If you need more space for additional conditions, select box to attach a text document Special Conditions: See attached wpaform5.doc • rev. 11/15/05 Page 5 of 9 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Number: 242-1297 D. Findings Under Municipal Wetlands Bylaw or Ordinance 1. Furthermore, the North Andover hereby finds (check one that applies): Conservation Commission 2. ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw specifically: wpaform5.doc • rev. 11/15/05 Page 6 of 9 a. Municipal Ordinance or Bylaw b. Citation Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides measures which are adequate to meet these standards, and a final Order of Conditions is issued. 3. ® that the following additional conditions are necessary to comply with a municipal ordinance or bylaw: North Andover Wetland Protection Bylaw Chapter 178 a. Municipal Ordinance or Bylaw b. Citation The Commission orders that all work shall be performed in accordance with the following conditions and with the Notice of Intent referenced above. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, the conditions shall control. If you need more space for C. The special conditions relating to municipal ordinance or law are as follows: p 9 P Y additional conditions, See Attached select box to attach a text document wpaform5.doc • rev. 11/15/05 Page 6 of 9 AMENDMENT -100 Salem Street - 242-1297 At their meeting of November 16, 2005, the North Andover Conservation Commission (NACC) voted unanimously to amend the Order of Conditions for the project located at 100 Salem Street (242-1297). With this amendment, the NACC hereby accepts the plan as referenced below showing the approved location of an in ground pool, concrete or paver deck, fence, and associated revised grading within the buffer zone to a Bordering Vegetated Wetland (BVW). Condition #29 of the Order of Conditions shall be amended to include the following revised record plan and associated additional documents: Site Plan Prepared by: Andover Consultants, Inc. 1 East River Place Methuen, MA 01844 Entitled: "Proposed Site Plan -100 Salem Street, North Andover, Mass." Dated: January 25, 2005, Last Revised 10-31-05. Stamped & Signed by William S. MacLeod, P.E. Other Record Documents: Andover Consultants Letter dated November 2, 2005. Condition #67 shall also include: Prohibition of pool/chemical discharges towards the wetland resource area (see condition #2 below). In addition, the following additional conditions shall also be incorporated as part of this amendment: 1. Prior to pool construction and associated pool work, the applicant shall submit to the Conservation Department for review and approval a detailed plan of the proposed waterfall and an accompanied letter, which shall clarify and describe waterfall flows. 2. The filter system used for the pool shall be a backwashing filter system. Prior to pool construction and associated pool work, the applicant shall submit the pool filter system description and specifications to the Conservation Department for review and approval. 3. Pool waters or other chemicals shall not be discharged towards the wetland resource area at any time. Pool waters shall be discharged greater than 50 feet away from the edge of the BVW and directed away from the wetland resource area in perpetuity to this Order.. If discharging is necessary, the applicant must install a drywell greater than 50 feet from the wetland resource area to handle the discharged waters. Massachusetts Department of Environmental Protection �-- Bureau of Resource Protection - Wetlands ' WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 E. Issuance DEP File Number: 242-1297 This Order is valid for three years, unless otherwise specified as a special II /11 &5 condition pursuant to General Conditions #4, from the date of issuance. 1. Date of Ishuan e Please indicate the number of members who will sign this form: 7 This Order must be signed by a majority of the Conservation Commission. 2. Number of signers The Order must be mailed by certified mail (return receipt requested) or hand delivered to the applicant. A copy also must be mailed or hand delivered at the same time to the appropriate Department of Environmental Protection Regional Office, if not filing electronically, and the prope ner, if different from applicant. Signatures: Notary Acknowledgement Commonwealth of Massachusetts County of Essex North On this Day, of Month Year Before me, the undersigned Notary Public, 'Sco'{f 5 personally appeared Name of Document Signer proved to me through satisfactory evidence of identification, which was/were Massachusetts License Description of evidence of identification to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he/she signed it voluntarily for its stated purpose. As member of North Andover Z_ DONNA M. WEDGE NOTARY PUBLIC ' COMMONWEALTH Of MASSACHUSETTS �(y\1 M tvly Comm. Expires Aug. 7, 2009 a'q Cityrrown Place notary seal and/or any stamp above This Order is issued to the applicant as follows: El by hand delivery on Date Conservation Commission Signature of Notary Public �D-K-1 � 2 6' X Printed Name of Notary Public G� ) % "260 My Commission Expifes (Date) O'by certified mail, eturn receipt requested, on Date wpaform5.doc • rev. 11/15/05 Page 7 of 9 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 F. Appeals DEP File Number: 242-1297 The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject to this Order, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate DEP Regional Office to issue a Superseding Order of Conditions. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and a completed Request of Departmental Action Fee Transmittal Form, as provided in 310 CMR 10.03(7) within ten business days from the date of issuance of this Order. A copy of the request shall. at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is not the appellant. The request shall state clearly and concisely the objections to the Order which is being appealed and how the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act, (M.G.L. c. 131, § 40) and is inconsistent with the wetlands regulations (310 CMR 10.00). To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. Section G, Recording Information is available on the following page. wpaform5.doc • rev. 11/15/05 Page 8 of 9 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 G. Recording Information DEP File Number: 242-1297 This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions. The recording information on Page 7 of this form shall be submitted to the Conservation Commission listed below. North Andover Conservation Commission Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission. --------------------------------------------------------------------------------------------------------------------------- To: North Andover Conservation Commission Please be advised that the Order of Conditions for the Project at: 242-1297 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 • rev. 11/15/05 Page 9 of 9 L7 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions 1 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. r- ninon DEP File Number: 242-1297 A. General Information From: North Andover 1. Conservation Commission 2. This issuance is for (check one): ® Order of Conditions ❑ Amended Order of Conditions 3. To: Applicant: Thomas Patenaude a. First Name b. Last Name 161 Massachusetts Avenue d. Mailing Address North Andover e. City/Town 4. Property Owner (if different from applicant): Kathy Campbell -Stevens a. First Name b. Last Name P. O Box 55865 Lianne Cristaldi c. Company MA. f. State 01845 g. Zip Code Mellon Trust of New England, North Andover c. Company d. Mailing Address Boston MA. 02205-5865 e. City/Town 'f. State g. Zip Code 5. Project Location: 100 Salem Street North Andover a. Street Address b. City/Town Map 96 Lot 57 c. Assessors Map/Plat Number d. Parcel/Lot Number Latitude and Longitude, if known (note: 42-41-03 71-06-23 electronic filers will click for GIS locator): e. Latitude f. Longitude 6. Property recorded at the Registry of Deeds for (attach additional information if more than one parcel): Essex North a. County b. Certificate (if registered land) 1370 21 c. Book d. Page 1/24/05 7. Dates: 3/9/05 3/15/05 a. Date Notice of Intent Filed b. Date Public Hearing Closed c. Date of Issuance 8. Final Approved Plans and Other Documents (attach additional plan or document references as needed): Proposed Site Plan a. Plan Title Andover Consultants, Inc. Joseph P. Burke, P. E. b. Prepared By 2/24/05 d. Final Revision Date Existing Conditions Plan f. Additional Plan or Document Title Tntal IA/PA Pima Pairi• $ 500.00 a. Total Fee Paid c. Signed and Stamped by 1"=20' e. Scale January 25, 2005 b. State Fee Paid c. City/Town Fee Paid wpaform5.doc • rev. 3/15/05 Page 1 of 9 i Massachusetts Department of Environmental Protection 1 Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Findings 1. Findings pursuant to the Massachusetts Wetlands Protection Act: DEP File Number: 242-1297 Following the review of the above -referenced Notice of Intent and based on the information provided in this application and presented at the public hearing, this Commission finds that the areas in which work is proposed is significant to the following interests of the Wetlands Protection Act. Check all that apply: a. ® Public Water Supply b. ❑ Land Containing Shellfish c. ® Prevention of Pollution d. ® Private Water Supply e. ❑ Fisheries f. ® Protection of Wildlife Habitat g. ® Groundwater Supply h. ® Storm Damage Prevention i. ® Flood Control 2. This Commission hereby finds the project, as proposed, is: (check one of the following boxes) Approved subject to: ® the following conditions which are necessary in accordance with the performance standards set forth in the wetlands regulations. This Commission orders that all work shall be performed in accordance with the Notice of Intent referenced above, the following General Conditions, and any other special conditions attached to this Order. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, these conditions shall control. Denied because: ❑ the proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations. Therefore, work on this project may not go forward unless and until a new Notice of Intent is submitted which provides measures which are adequate to protect these interests, and a final Order of Conditions is issued. A description of the performance standards which the proposed work cannot meet is attached to this Order. ❑ the information submitted by the applicant is not sufficient to describe the site, the work, or the effect of the work on the interests identified in the Wetlands Protection Act. Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides sufficient information and includes measures which are adequate to protect the Act's interests, and a final Order of Conditions is issued. A description of the specific information which is lacking and why it is necessary is attached to this Order as per 310 CMR 10.05(6)(c). Inland Resource Area Impacts: Check all that apply below. (For Approvals Only) Resource Area Proposed Permitted Alteration Alteration s. ❑ Bank c. linear feet d. linear feet b. square feet a. linear feet 4. ❑ Bordering Vegetated c. square feet d. square feet Wetland a. square feet 5. ❑ Land Under a. square feet Waterbodies and Waterways e. cu.yd dredged Permitted Proposed Permitted Alteration Replacement Replacement b. linear feet c. linear feet d. linear feet b. square feet c. square feet d. square feet b. square feet c. square feet d. square feet 1. uu.yu UICUIJCU wpaforrn5.doc - rev. 2/9/05 Page 2 of 9 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Findings (cont.) DEP File Number: 242-1297 11. ❑ Proposed Permitted Proposed Resource Area Alteration Alteration Replacement 6. ❑ Bordering Land Land Under Salt Ponds Subject to Flooding a. square feet b. square feet c. square feet Cubic Feet Flood Storage e. cubic feet f. cubic feet g. cubic feet 7. ❑ Isolated Land Subject to Flooding a. square feet b. square feet Cubic Feet Flood Storage c. cubic feet d. cubic feet e. cubic feet 8. ❑ Riverfront area b. total sq. feet a. total sq. feet Sq ft within 100 ft d. square feet c. square feet Sq ft between 100-200 ft f. square feet e. square feet Coastal Resource Area Impacts: Check all that apply below. (For Approvals Only) 9. ❑ Designated Port Indicate size under Land Under the Ocean, below Areas 1o. ❑ Land Under the Ocean a. square feet b. square feet 11. ❑ Barrier Beaches 12. ❑ Coastal Beaches 13. ❑ Coastal Dunes 14. ❑ Coastal Banks 15. ❑ Rocky Intertidal Shores 16. ❑ Salt Marshes 17. ❑ Land Under Salt Ponds 18. ❑ Land Containing Shellfish 19. ❑ Fish Runs 20. ❑ Land Subject to Coastal Storm Flowage Permitted Replacement h. cubic feet f. cubic feet Indicate size under Coastal Beaches and/or Coastal Dunes below a. linear feet b. linear feet a. square feet b. square feet a. square feet b. square feet Indicate size under Coastal Banks, inland Bank, Land Under the Ocean, and/or inland Land Under Waterbodies and Waterways, above a. cu.yd dredged a. square feet wpaform5.doc • rev. 2/9/05 Page 3 of 9 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Number: 242-1297 C. General Conditions Under Massachusetts Wetlands Protection Act (only applicable to approved projects) 1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. 4. The work authorized hereunder shall be completed within three years from the date of this Order unless either of the following apply: a. the work is a maintenance dredging project as provided for in the Act; or b. the time for completion has been extended to a specified date more than three years, but less than five years, from the date of issuance. If this Order is intended to be valid for more than three years, the extension date and the special circumstances warranting the extended time period are set forth as a special condition in this Order. 5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. Any fill used in connection with this project shall be clean fill. Any fill shall contain no trash, refuse, rubbish, or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles, or parts of any of the foregoing. 7. This Order is not final until all administrative appeal periods from this Order have elapsed, or if such an appeal has been taken, until all proceedings before the Department have been completed. 8. No work shall be undertaken until the Order has become final and then has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done. In the case of the registered land, the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done. The recording information shall be submitted to this Conservation Commission on the form at the end of this Order, which form must be stamped by the Registry of Deeds, prior to the commencement of work. 9. A sign shall be displayed at the site not less then two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection" [or, WA DEP"] "File Number 242-1297 wpaform5.doc • rev. 2/9/05 Page 4 of 9 L1Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands 1 WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Number: 242-1297 C. General Conditions Under Massachusetts Wetlands Protection Act 10. Where the Department of Environmental Protection is requested to issue a Superseding Order, the Conservation Commission shall be a party to all agency proceedings and hearings before DEP. 11. Upon completion of the work described herein, the applicant shall submit a Request for Certificate of Compliance (WPA Form 8A) to the Conservation Commission. 12. The work shall conform to the plans and special conditions referenced in this order. 13. Any change to the plans identified in Condition #12 above shall require the applicant to inquire of the Conservation Commission in writing whether the change is significant enough to require the filing of a new Notice of Intent. 14. The Agent or members of the Conservation Commission and the Department of Environmental Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours to evaluate compliance with the conditions stated in this Order, and may require the submittal of any data deemed necessary by the Conservation Commission or Department for that evaluation. 15. This Order of Conditions shall apply to any successor in interest or successor in control of the property subject to this Order and to any contractor or other person performing work conditioned by this Order. 16. Prior to the start of work, and if the project involves work adjacent to a Bordering Vegetated Wetland, the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden stakes or flagging. Once in place, the wetland boundary markers shall be maintained until a Certificate of Compliance has been issued by the Conservation Commission. 17. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully stabilized with vegetation or other means. At no time shall sediments be deposited in a wetland or water body. During construction, the applicant or his/her designee shall inspect the erosion controls on a daily basis and shall remove accumulated sediments as needed. The applicant shall immediately control any erosion problems that occur at the site and shall also immediately notify the Conservation Commission, which reserves the right to require additional erosion and/or damage prevention controls it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of work line has been approved by this Order. Special Conditions: If you need more See attached space for additional conditions, select box to attach a text document wpaform5.doc • rev. 2/9/05 Page 5 of 9 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Number: 242-1297 D. Findings Under Municipal Wetlands Bylaw or Ordinance 1. Furthermore, the North Andover hereby finds (check one that applies): Conservation Commission 2. ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw specifically: a. Municipal Ordinance or Bylaw b. Citation Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides measures which are adequate to meet these standards, and a final Order of Conditions is issued. 3. ® that the following additional conditions are necessary to comply with a municipal ordinance or bylaw: North Andover Wetland Protection Bylaw Chapter 178 a. Municipal Ordinance or Bylaw b. Citation The Commission orders that all work shall be performed in accordance with the following conditions and with the Notice of Intent referenced above. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, the conditions shall control. If you need more c. The special conditions relating to municipal ordinance or bylaw are as follows: space for additional See Attached conditions, select box to attach a text document wpaform5.doc • rev. 2/9/05 Page 6 of 9 DEP FILE # 242 -1297 Therefore, the North Andover Conservation Commission (hereafter the "NACU) hereby finds that the following conditions are necessary, in accordance with the Performance Standards set forth in the State Regulations, the local Bylaw and Regulations, to protect those interests noted above. The NACC orders that all work shall be performed in accordance with said conditions and with the Notice of Intent referenced below. 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. GENERAL CONDITIONS 18. 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. 19. This Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of property rights. However, the NACC, agent of the NACC or the Department of Environmental Protection (DEP) reserves the right to enter and inspect the property at all reasonable times until a Certificate of Compliance is issued, to evaluate compliance with this Order of Conditions, the Act (310 CMR 10.00), the North Andover Wetland Bylaw and Regulations, and may require any information, measurements, photographs, observations, and/or materials, or may require the submittal of any data or information deemed necessary by the NACC for that evaluation. Further, work shall be halted on the site if the NACC, agent or DEP determines that any of the work is not in compliance with this Order of Conditions. Work shall not resume until the NACC is satisfied that the work will comply and has so notified the applicant in writing. 20. 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, by-laws or regulations. 21. The work authorized hereunder shall be completed within three years from the date of this order. 22. This Order may be extended by the issuing authority for one or more periods of up to one year each upon application to the issuing authority at least thirty days (30) prior to the expiration date of the Order (Refer to Section 8.3 (p.37) of the North Andover Wetland Regulations). 23. The NACC reserves the right to amend this Order of Conditions after a legally advertised public hearing if plans or circumstances are changed or if new conditions or information so warrant. C:\Winword\OOC\100SalemSt.doc 1 NACC 3/15/05 DEP FILE # 242 - 1297 24. Where the Department of Environmental Protection (DEP) is requested to make a determination and to issue a Superseding Order, the Conservation Commission shall be a party to all agency proceedings and hearings before the Department. 25. This Order of Conditions is issued under File No. 242-1297. 26. The conditions of this decision shall apply to, and be binding upon, the applicant, owner, its employees and all successors and assigns in interest or control. These obligations shall be expressed in covenants in all deeds to succeeding owners of portions of the property. 27. 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 NACC shall be notified in writing within 30 days of all transfers of title of any portion of property that takes place prior to the issuance of a Certificate of Compliance. 28. The proposed work includes: The construction of a single-family dwelling with associated site work and grading in the buffer zone to a BVW. 29. The work shall conform to the following (except as noted in the remainder of this document where revisions may be required): Notice of Intent filed by: Thomas Patenaude (Applicant) 161 Mass Avenue North Andover, MA 01845 Kathy Campbell -Stevens (Owner) Melon Trust of New England, NA P.O. Box 55865 Boston, MA 02205-5865 Andover Consultants, Inc. (Representative) Joseph P. Burke, P.E. 1 East River Place Methuen, MA 01844 Site Plans prepared by: Andover Consultants, Inc. Entitled "Proposed Site Plan", dated January 25, 2005, Final Rev. February 24, 2005 and "Existing Conditions Plan", dated January 25, 2005. Signed & Stamped by Joseph P. Burke, P.E. Additional Record Documents: Letter from TEC dated February 3, 2005; Response Letter from Andover Consultants dated February 7, 2005. CAWinword\00C\100Salem&.doc 2 NACC 3/15/05 DEP FILE # 242 -1297 30. The following wetland resource areas are affected by the proposed work: Buffer Zone to Bordering Vegetated Wetland (BVW). These resource areas are significant to the interests of the Act and Town ByLaw as noted above and therein. The applicant has not attempted to overcome the presumption of significance of these resource areas to the identified interests. 31. The NACC agrees with the applicant's delineation of the wetland resource areas on the site as shown on the plans dated referenced herein. 32. The NACC finds that the intensive use of the upland areas and buffer zone proposed on this site will cause further alteration of the wetland resource areas. In order to prevent any alteration of wetland resource areas a twenty-five foot (25') No -Disturbance Zone and a fifty -foot (50') No -Construction Zone shall be established from the edge of the adjacent wetland resource area. The Conservation Administrator and/or other agents of the NACC do not have the authority to waive these setbacks as established under the local bylaw. No disturbance of existing grade, soils or vegetation is permitted in the No - Disturbance zone. (See Section 3.4 & Appendix F of the local Regulations). 33. This document shall be included in all construction contracts, subcontracts, and specifications dealing with the work proposed and shall supersede any conflicting contract requirements. The applicant shall assure that all contractors, subcontractors, and other personnel performing the permitting work are fully aware of the permits terms and conditions. Thereafter, the contractor will be held jointly liable for any violation of this Order resulting from failure to comply with its conditions. 34. The owners of the project and their successors in title, in the event they proceed to alter areas subject to the Commissions jurisdiction under the order, agree that the Order does not in itself impose upon the Town any responsibility to maintain the proposed drainage system and that said Town shall not be liable for any damage in the event of failure. By acceptance of this Order, the owners agree to indemnify and hold harmless to the Town and its residents for any damage attributable to alterations undertaken on this property pursuant to the Order. Issuance of these Conditions does not in any way imply or certify that the site or downstream areas will not be subject to flooding, storm damage or any other form of water damage. Maintenance of the drainage system, if accepted by the Town as part of a public way, becomes the responsibility of the Town. 35. Issuance of these Conditions does not in any way imply or certify that the site or downstream areas will not be subject to flooding, storm damage or any other form of water damage. CAWinword\00C\100SalemSt.doc 3 NACC 3/15/05 DEP FILE # 242 - 1297 11 PRIOR TO CONSTRUCTION 36. No work shall be undertaken until all administrative appeal periods from this Order have elapsed or, if such an appeal has been filed, until all proceedings before the Department or Court have been completed. 37. This Order shall be recorded by the applicant at the Registry of Deeds immediately after the expiration of all appeal periods. No work shall be undertaken until the Final Order 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 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 to be done. The recording information shall be submitted to the North Andover Conservation Commission on the form at the end of this Order prior to commencement of the work. Any Order not recorded by the applicant before work commences may be recorded by the NACC at the applicant's expense. 38. A sign shall be displayed at the site not less than two square feet or more than three square feet in size bearing the words "Massachusetts DEP, File Number 242-1297." 39. Any changes in the submitted plans caused by the applicant, another Board's decision or resulting from this Order of Conditions must be submitted to the NACC for approval prior to implementation. If the NACC finds said changes to be significant, the NACC will call for another public hearing (at the expense of the applicant). Within 21 days of the close of said public hearing the NACC will issue an amended or new Order of Conditions. Any errors found in the plans or information submitted by the applicant shall be considered as changes. The proposed project may be still under review by other local or state boards or agencies. This may result in changes to the project plans or wetland impacts. If any such changes occur a revised plan and an explanation of the revisions shall be submitted to the NACC for review and approval prior to the start of construction. No work shall begin on a project until written approval has been granted by the NACC. 40. It is the responsibility of the applicant, owner, and/or successor(s) to ensure that all conditions of this Order of Conditions are complied with. The project engineer and contractors are to be provided with a copy of this Order of Conditions and referenced documents before commencement of construction. 41. Prior to any work commencing on-site, the applicant shall submit to the NACC for approval, a detailed sequence of construction, including the construction of compensation and retention areas, installation of sedimentation/ erosion control devices and re - vegetation to be completed before other work begins on-site. C:\Winword\OOC\100SalemSt.doc 4 NACC 3/15/05 DEP FILE # 242 -1297 42. Wetland flagging shall be checked prior to start of construction and shall be re-established where missing. All wetland flagging shall remain visible and enumerated per the approved plan(s). throughout the life of the project and until a Certificate of Compliance is issued so that erosion control measures can be properly placed and wetland impacts can be monitored. The proposed limit of work shall be shall be clearly marked with stakes or flags and shall be confirmed by the NACC. Such markers shall be checked and replaced as necessary and shall be maintained until all construction is complete. Workers should 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 any time. All flags used for the above purposes shall be of a color different from other flagging used on the site. 43. A row of staked hay bales backed by trenched siltation fence shall be placed between all construction areas and wetlands. The erosion control barrier will be properly installed and placed as shown on the plans approved and referenced herein and shall be inspected and approved by the NACC prior to the start of construction and shall remain intact until all disturbed areas have been permanently stabilized to prevent erosion. All erosion prevention and sedimentation protection measures found necessary during construction shall be implemented at the direction of the NACC. The NACC reserves the right to impose additional conditions on portions of this project to mitigate any impacts which could result from site erosion, or any noticeable degradation of surface water quality discharging from the site. For example, installation of erosion control measures may be required in areas not shown on the plan(s) referenced in this Order of Conditions. Should such installation be required by the NACC, they shall be installed within 48 hours of the Commissions request. 44. The applicant shall have on hand at the start of any soil disturbance, removal or stockpiling, a minimum of 20 hay bales and sufficient stakes for staking these bales (or an equivalent amount of silt fence). Said bales shall be used only for the control of emergency erosion problems and shall not be used for the normal control of erosion. 45. A check payable to the Town of North Andover shall be provided in the amount of $3,000, which shall be in all respects satisfactory to Town Counsel, Town Treasurer, and the NACC, and shall be posted with the North Andover Town Treasurer through the NACC before commencement of work. Said deposit of money shall be conditioned on the completion of all conditions hereof, shall be signed by a party or parties satisfactory to the NACC, and Town Counsel, and shall be released after completion of the project, provided that provisions, satisfactory to the NACC, have been made for performance of any conditions which are of continuing nature. The applicant may propose a monetary release schedule keyed to completion of specific portions of the project for the NACC's review and approval. This condition is issued under the authority of the local Bylaw. 46. The applicant shall designate a Wetland Scientist as an "Erosion Control Monitor" to oversee any emergency placement of controls and regular inspection or replacement of sedimentation control devices. The name and phone number of the erosion control monitor must be provided to the NACC in the event that this person has to be contacted, C:\Winword\OOC\100SalemSt.doc 5 NACC 3/15/05 DEP FILE # 242 - 1297 due to an emergency at the site, during any 24-hour period, including weekends. Proof of the retained monitor must be submitted to the Conservation Department on letterhead by the retained consulting firm. This person shall be given the authority to stop construction for erosion control purposes. The erosion control monitor will be required to inspect all such devices and oversee cleaning and the proper disposal of waste products. Cleaning shall include removal of any entrapped silt. At least once during each week in which construction activities occurs on-site and for as long thereafter as ground remains unstabilized, the applicant shall submit a written report from the "Erosion Control Monitor" to the NACC certifying that, to the best of his/her knowledge and belief based on a careful site inspection, all work is being performed in compliance with this Order of Conditions and that approved setbacks are being adhered to. The erosion control monitor must visually inspect all sedimentation/erosion control measures and assume responsibility for their maintenance on a weekly basis and that they are functioning as intended. In addition, all wetland resource areas must be visually inspected for siltation, turbidity, and/or other water quality impacts. 47. Prior to construction, the applicant shall permanently mark the edge of the "25' No - Disturbance Zone" with thirteen (13) signs or markers spaced evenly every 25 feet incorporating the following text: "Protected Wetland Resource Area". This will designate their sensitivity and assure no further inadvertent encroachment into the wetland. These permanent markers are subject to review and approval by the NACC. The applicant shall instruct all agents to explain these markers to buyers/lessees/landscapers and all persons taking over the property from the applicant. 48. The applicant and/or the legal owner of that portion of land upon which these Orders of Conditions have been placed shall provide to the NACC prior to transferring, or assigning any portion of said land to another party, subject to said Orders of Conditions, the "Compliance Certification Form Affidavit" attached via "Appendix A" signed under the pains and penalties of perjury, stating that said applicant and/or owner has read these Orders of Conditions and is in compliance with each and every condition. This document shall apply to each of the conditions referenced herein and shall be provided to the Conservation Department at least five (5) business days after to the closing of said land transaction. 49. Once these above mentioned pre -construction requirements are complete, the applicant shall contact the Conservation Office prior to site preparation or construction and shall arrange an on-site conference with an NACC representative, the contractor, the engineer, wetland scientist and the applicant to ensure that all of the Conditions of this Order are understood. This Order shall be included in all construction contracts, subcontracts, and specifications dealing with the work proposed and shall supersede any conflicting contract requirements. The applicant shall assure that all contractors, subcontractors and other personnel performing the permitted work are fully aware of the permit's terms and conditions. Thereafter, the contractor will be held jointly liable for any violation of this Order of Conditions resulting from failure to comply with its conditions. The applicant or contractor shall notify the NACC in writing of the identity of the on-site construction supervisor hired to coordinate construction and to ensure compliance with CAWinword\00C\100SalemSt.doc 6 NACC 3/15/05 DEP FILE # 242 - 1297 this Order. A reasonable period of time shall be provided as notice of the pre - construction meeting (e.g. 72 hours). DURING CONSTRUCTION 50. IMPORTANT: Immediately upon completion of the dwelling foundation, and prior to further construction activities associated with the site, the applicant shall complete a plan prepared by a Registered Professional Land Surveyor of the Commonwealth (R.P.L.S.) which accurately depicts the foundation location and it's proximity to wetland resource areas as approved under this Order of Conditions. Said plan shall be submitted to the Conservation Administrator for approval. 51. Upon beginning work, the applicant shall submit written progress reports every month detailing what work has been done in or near resource areas, and what work is anticipated to be done over the next period. This will update the construction sequence. 52. A 34 foot high post and rail fence shall be installed just upslope of the regulated 25 - foot No Disturbance Zone from the driveway to the rear property boundary (opposite wetland flag 6A to opposite wetland flag 11A). The fence shall be installed in accordance with the approved plan referenced herein. 53.Approved de -watering activities anticipated shall be supervised and witnessed by the designated erosion control monitor. This designee must be on-site while work is occurring. De -watering activities shall be monitored daily by the erosion control monitor to ensure that sediment laden water is appropriately settled prior to discharge toward the wetland resource areas. No discharge of water is allowed directly into an area subject to jurisdiction of the Wetlands Protection Act and/or the North Andover. Wetland Bylaw. If emergency de- watering requirements arise, the applicant shall submit a contingency plan to the Commission for approval, which provides for the pumped water to be contained in a settling basin, to reduce turbidity prior to discharge into a resource area. 54.Any fill used in connection with this project shall be clean fill, containing 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 on any of the foregoing. 55.No exposed area shall remain unfinished for more than thirty (30) days, unless approved by the NACC. 56.No re -grading in the buffer zone shall have a slope steeper than 2:1 (horizontal: vertical). Slopes of steeper grade shall be rip -rapped to provide permanent stabilization. 57.There shall be no stockpiling of soil or other materials within twenty-five (25) feet of any resource area. CAWinword\00C\100SalemSt.doc 7 NACC 3/15/05 1 .7 DEP FILE # 242 - 1297 58.Washings from concrete trucks, or surplus concrete, shall not be directed to, any drainage system, or wetland resource area. 59.All waste generated by, or associated with, the construction activity shall be contained within the construction area, and away from any wetland resource area. There shall be no burying of spent construction materials or disposal of waste on the site by any other means. The applicant shall maintain dumpsters (or other suitable means) at the site for the storage and removal of such spent construction materials off-site. However, no trash dumpsters will be allowed within 50' of areas subject to protection under the Act or local Bylaw. 60. Accepted engineering and construction standards and procedures shall be followed in the completion of the project. 61. During and after work on this project, there shall be no discharge or spillage of fuel, or other pollutants into any wetland resource area. If there is a spill or discharge of any pollutant during any phase of construction the NACC shall be notified by the applicant within one (1) business day. No construction vehicles are to be stored within 100 feet of wetland resource areas, and no vehicle refueling, equipment lubrication, or maintenance is to be done within 100 feet of a resource area. AFTER CONSTRUCTION 62. No underground storage of fuel oils shall be allowed on any lot within one hundred (100) feet of any wetland resource area. This condition shall survive this Order of Conditions and shall run with the title of the property. This condition is issued under the authority of the Town's Wetland protection Bylaw. 63. Fertilizers utilized for landscaping and lawn care shall be slow release, low -nitrogen types (< 5%), and shall not be used within 25 feet of a resource area. Pesticides and herbicides shall not be used within 100 feet of a wetland resource area. This condition shall survive this Order of Conditions and shall run with the title of the property. This condition is issued under the authority of the Town's Wetland Protection Bylaw and shall remain in perpetuity. 64. Upon completion of construction and grading, all disturbed areas located outside resource areas shall be stabilized permanently against erosion. This shall be done either by loaming and seeding according to SCS standards. If the latter course is chosen, stabilization will be considered complete once vegetative cover has been achieved. 65. Upon approved site stabilization by Conservation staff, the erosion controls shall be removed and properly disposed of and all exposed unvegetated areas shall be seeded. C:\Winword\OOC\100Salem&.doc 8 NACC 3/15/05 DEP FILE # 242 -1297 66. Upon completion of the project the applicant shall submit the following to the Conservation Commission as part of a request for a Certificate of Compliance: a. WPA Form SA - "Request for a Certificate of Compliance." b. A letter from the applicant requesting a Certificate of Compliance. c. The name and address of the current landowner. d. Signed statements from the individual property owners shall be submitted with the request for a Certificate of Compliance indicating that they read and understood the recorded Order of Conditions prior to purchasing their property. e. The name and address of the individual/ trust or corporation to whom the compliance is to be granted. f. The street address and assessor's map/ parcel number for the project. g. The DEP file number. h. A written statement from a Registered Professional Civil Engineer (and/or Registered Professional Land Surveyor) of the Commonwealth certifying that the work has been conducted as shown on the plan(s) and documents referenced above, and as conditioned by the Commission. i. An "As -Built" plan prepared and signed and stamped by a Registered Professional Civil Engineer (and/or Registered Professional Land Surveyor) of the Commonwealth, for the public record. This plan will include: ➢ "As -Built" post -development elevations of all drainage & stormwater management structures constructed within 100 feet of any wetland resource area. NOTE: If portions of the stormwater systems exist partially within the Buffer Zone than the entire structure must be depicted to accurately verify compliance. ➢ "As -Built" post -development elevations and grades of all filled or altered wetland resource areas including the encompassing buffer zone, which is regulated as a resource area under the local Wetland Protection Bylaw. ➢ Distances from structures to wetland resource areas. Structures include (but are not limited to) septic systems, additions, fences, sheds, stone walls, pools, retaining walls, subsurface utilities and decks. ➢ A line showing the limit of work and the extent of existing erosion control devices. "Work" includes anv disturbance of soils or vegetation. ➢ Location of all subsurface utilities entering the property. C:\ W inword\OOC\ 1 OOSalem&.doc NACC 3/15/05 1 .t DEP FILE # 242 - 1297 67. The following special conditions shall survive the issuance of a Certificate of Compliance (COC) for this project: ➢ 25' No -Disturbance Zone and a 50' No -Construction Zone shall be established from the edge of adjacent wetland resource areas except in those locations approved under this filing. Future work within 100' of existing wetland resource areas will require a separate filing with the NACC. The Conservation Administrator and/or other agents of the NACC do not have the authority to waive these setbacks as established under the local Bylaw (Condition # 32); ➢ Discharge or spillage of pollutants (Condition # 61); ➢ Prohibition of underground fuels (Condition # 62); ➢ Limitations on the use of fertilizers, herbicides, and pesticides (Condition # 63). C:\Winword\OOC\IOOSalemSt.doc 10 NACC 3/15/05 DEP FILE # 242 - 1297 I, APPENDIX A — AFFIDAVIT (authorized agent of applicant and / or owner) 1) I am the on oath do hereby depose and state: (PLEASE CHECK AT LEAST ONE BLOCK) (position with applicant) of the applicant upon whom the Order of Conditions (applicant's name) have been (DEP or NACC File #) placed upon by the North Andover Conservation Commission (NACC). 2) I am the (position with owner) and / or of (owner) the owner upon whose land Order of Conditions have been (DEP or NACC File #) placed upon by the NACC. ♦ I hereby affirm and acknowledge that I have received said Order of Conditions and have read the same and understand each and every condition, which has been set forth in said Order of Conditions. ♦ I hereby affirm and acknowledge that on this day of 20---, I inspected said property together with any and all improvements, which have been made to the same and hereby certify that each and every condition set forth in the Order of Conditions are presently in compliance. ♦ I hereby affirm and acknowledge that this document will be relied upon by the NACC, as well as any potential buyers of said property, which is subject to the Order of Conditions. Signed under the pain and penalties of perjury this day of 20 (Authorized agent of applicant or owner) CAWinword\OOC\IOOSalemSt.doc 11 NACC 3/15/05 I Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 E. Issuance DEP File Number: 242-1297 This Order is valid for three years, unless otherwise specified as a special �3 115 p condition pursuant to General Conditions #4, from the date of issuance. 1. Date 6f Is uance Please indicate the number of members who will sign this form: S This Order must be signed by a majority of the Conservation Commission. 2. Number of signers The Order must be mailed by certified mail (return receipt requested) or hand delivered to the applicant. A copy also must be mailed or hand delivered at the same time to the appropriate De ent of Environmental Protection Regional Office, if not filing electronically, and the pr rty owner, if different from applicant. J Signatures: Notary Acknowledgement Commonwealth of Massachusetts County of Essex North A coos � h� On this Day of Month Year Before me, the undersigned Notary Public, 5 c'd y -f 1))4J3e personally appeared Name of Document Signer proved to me through satisfactory evidence of identification, which was/were Massachusetts License Description of evidence of identification to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he/she signed it voluntarily for its stated purpose. As member of North Andover Citylrown DONNA M. WEDGE I * NOTARY PUSUC COMMOUI AITH OF MASSACHUSETTS MY Comm. EM&W Aug. 7,20M Place notary seal and/or any stamp above This Order is issued to the applicant as follows: ❑ by hand delivery on Date Conservation Commission Signature of Notary Public /'v' 1leD6Z�--- Printed Name of Notary Public 'Fl 7/aoo 9 My CommidsionfExpires (Date) M/by certified mail, return receipt requested, on 3 k-Sos Date wpaform5.doc • rev. 2/9/05 Page 7 of 9 3` , At Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 F. Appeals DEP File Number: 242-1297 The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject to this Order, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate DEP Regional Office to issue a Superseding Order of Conditions. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and a completed Request of Departmental Action Fee Transmittal Form, as provided in 310 CMR 10.03(7) within ten business days from the date of issuance of this Order. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is not the appellant. The request shall state clearly and concisely the objections to the Order which is being appealed and how the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act, (M.G.L. c. 131, § 40) and is inconsistent with the wetlands regulations (310 CMR 10.00). To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. Section G, Recording Information is available on the following page. wpaform5.doc • rev. 219105 Page 8 of 9 T 0► ILIMassachusetts. Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 G. Recording Information DEP File Number: 242-1297 This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land Subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions. The recording information on Page 7 of this form shall be submitted to the Conservation Commission listed below. North Andover Conservation Commission Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission. --------------------------------------------------------------------------------------------------------------------------- To: North Andover Conservation Commission Please be advised that the Order of Conditions for the Project at: 242-1297 Project Location DEP File Number Has been recorded at the Registry of Deeds of: for: County Book Page 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 wpaform5.doc • rev. 2/9/05 Page 9 of 9