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Home My WebLink AboutMiscellaneous - 1094 SALEM STREET 4/30/2018 (3) I � I \. C� �J I � � X Date...... —/f—/.�.. ,�ORTI, TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,SgACIN This certifies that ....................................................D14u, S 4 u�- ......................................... has permission to perform 6'`'5 4e,-C C- 2 ...................................................,. ........... wiring in the building of............M. f.vu.1r1i1��ill:uLL�CLWL`AC1:L1-rl:alVUUCk1lllCnllmenrSJb/1.1V1M1L.uUgtcure2f: inaccoreance-wrtuttieprovisionsUM.U.L.c.143,§.31,,the permit application form to provide notice of installation o£wiring shall be uniform throughout the Commonwealth,and applications shall be filed' on the prescribed form.After a permit application has been accepted by an Inspector of Wiresappointed pursuant to M.01 c. 166,§32,an electrical permit shall be issued to the person,firm or corporation stated on the permit application.Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shallbe limited as to the time of ongoing construction zcavity,and maybe deemed_bythe,Inspectorof_Wares abandoned.and-invalid ithe_. or she has determined that the authorized worl�has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on thq permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections-74 and 75 o£Chapter 238 of the Acts of 2012.The purpose of this act is to promote job.'growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain-permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwis a applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008.and extending through August 15,2012. Rule 8—Permit/Date Closed: **Note:Reapply for new permi ❑Permit Extension Act—Permit;/ate losed: Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No.— BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07) (leave bank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 YY (PLEASE PRINT WINK OR TYPE ALL INFORMATION) Date: City or Town of: NORTH ANDOVER By this application the undersigned To.the Inspector of Wires: gn gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) -- -- Owner or Tenant Owner's Address " Telephone No.ZZ L_yj 53 Is this permit in conjunction with a building permit? Purpose of Building - Yes ❑ NO 0 (Check Appropriate Box) b,, Utility Authorization No. Existing.Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps ___/_Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and.Ampacity • Location and Nature of Proposed Electrical Work: Completion of the ollowin table-_Tay be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL-Sus o.of Total p.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of LuminairesAbove In- o.o mergency ig g Swimming Pool d• d. � Batte Units —, No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS Ne.of Zones No.of Switches No.of Gas Burners l No..of Detection and No.of No.of Air Cond. Ranges °tal Init'atin Devices Tons No.of Alerting Devices No,of Waste Disposers eat ump Number Tons KW No.of 5e -Contained Totals: �` ` ."` ---_ ___...._ .. No.of Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW LI Municipal Connection Other No.of Dryers Heating Appliances KW Security IIIIIIIIIIIIIIIIISystems:* o.of Water ° of No.of Devices or E uivalent Heaters KW No.of Data Wiring; Signs Ballasts No.of Devices or r. ..:valent No.Hydromassage Bathtubs No. of Motors Total Hp Telecommunications Wiring: No .� OTHER: .of Devices or E ..:valent Attach additional detail if desired,or required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start (When required by municipal policy.) S�//"/e) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee.provides proof of liability insurance including "completed operation"coverage or its substantial equivalent. The undersigned certifies that such cove els in force,and has exhibited proof of s to permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER � I certify,under the pains andpenalties o er'u that the�o(Specify:) < T`G'4 p p fP 1 rY� information on this applicatzo�f rs true and co7hplete.'` FIRM NAME: Licensee: LIC.NO.: I aPP hcable, enter"exempt,,in the license num er line.) Signature (.1� LIC.NO.: Address: Ice Bus.Tel.No.: *Per M.G.L c. 147,s.57-61,security work requires D o / Alt.Tel.No. 4 Department -_ ep t of Pu Iic Safety S License: Lic.No. y OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the Iiability insurance coverage normally required by taw. By my signature below,I herebywaive g Y this requirement. Owner/Agent q I am the(check one) ❑owner ❑owner's agent. Signature Telephone No. rPERMIT FEE. S The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 ky www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leaibl Name(Business/Organization/individual): Address: v City/State/Zip: Phone Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with 4. E] I am a general contractor and I ployees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.L2 I am a sole proprietor or partner- listed on the attached sheet 1 7• ❑Remodeling " ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. workers' comp.insurance. [No workers' comp. insurance 5. 9. Building addition p 0 We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.0 I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers'comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.] t employees. [No workers' comp:insurance required.] 13.0 Other "`n3'aPPtieant that check--box 1 must alsv Cell riot the section halo..,sho.,.jye^ workers'com ....sation ric•in t Homeowners who submit this affidavit indicating they are doing all wort;and then hire outside contractors must submit new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: 17, Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: r City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded Investigations of th DIA for insurance coverage verification. y dad to the Office of I do hereby ce nde�t the sins an anal ' s of e 'u at the information provided above is true and correct Si afore: ` Date.: Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." s Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,.are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be return.ed to the city or town that the application for the pewit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the , applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investivations 600 Washington Street Boston,MA 02111 Tel. # 617-72.7-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 wvvi%mass..gov/dia pORTp .9e?4t•11 "• 6 OL . OA J 00- 1 A , a 7q pDA1TeD 0" '(5 SSACNus�� CONSERVATION DEPARTMENT Community Development Division NEGATIVE DETERMINATION OF APPLICABILITY SPECIAL CONDITIONS 1094 Salem Street, North Andover At the July 13, 2011 public hearing,the North Andover Conservation Commission (NACC) voted to issue a Negative Determination of Applicability for the removal of an existing deck and replacement with a new slightly smaller deck within the g y buffer zone to Bordering Vegetated Wetland (BVW). The new deck is 4- feet farther away from BVW. The BVW delineation is not confirmed due to the presence of fill material in the yard. Applicant: NCS Inc. 314 Clark Street North Andover,MA 01845 Owner: Richard Miller 1094 Salem Street North Andover,MA 01845 Record Documents: Request for Determination of Applicability and Associated Maps and Plans Submitted June 30,2011 Plan Titled: 1094 Salem,Street,Assessors map 106A,Parcel 57 SPECIAL CONDITIONS: ❖ Prior to the resumption of work, the applicant shall provide the Conservation Department with a detail of the proposed permanent barrier to be placed 5-feet upgradient of the existing wetland line deleting flag A5.Wetland markers shall be spaced evenly every 25-feet on the permanent barrier. During Construction Excess material and construction debris shall be properly disposed of off site and stockpiled material shall be stored within the erosion controls. Post Construction ❖ Immediately following completion of the work, any disturbed areas shall be permanently stabilized against erosion (loam and seed or other stabilization as approved by Conservation Department). 1600 Osgood Street,Building 20,Suite 2-36,North Andover,Massachusetts 01845 Phone 978.688.9530 Fax 978.688.9542 Web:http://www.townofnorthandover.com/Pages/NAndoverMA_Conservation/index ':• Upon completion of all requirements,the Conservation Department shall be contacted to conduct a final site inspection. t 1600 Osgood Street,Building 20,Suite 2-36,-,North-Andover,Massachusetts 01845 Phone 978.688.9530 Fax 978.688.9542 Svr_1-.1-1-.//------- Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131 §40 A. General Information Important: When filling out From: forms on the North Andover computer, use Conservation Commission only the tab key to move To: Applicant Property Owner If your cursor- p y (' different from applicant): do not use the NCS, Inc. Richard & Susan Miller return key. Name Name 314 Clark Street 1094 Salem Street Mailing Address Mailing Address North Andover MA 01845 North Andover MA 01845 City/Town State Zip Code City/Town State Zip Code anon 1. Title and Date(or Revised Date if applicable) of Final Plans and Other Documents: 1094 Salem Street Assessors map 106A, Parcel 57 June 30, 2011 Title (Received) Title Date Title Date 2. Date Request Filed: 6/30/11 B. Determination Pursuant to the authority of M.G.L. c. 131, §40, the Conservation Commission considered your Request for Determination of Applicability, with its supporting documentation, and made the following Determination. Project Description (if applicable): Removal and replacement of an exisitng deck within the Buffer Zone to Bordering Vegetated Wetland (BVW). New deck to be 4'farther from BVW Project Location: 1094 Salem Street North Andover Street Address City/Town Map 106A Parcel 57 Assessors Map/Plat Number Parcel/Lot Number wpaform2.doc•Determination of Applicability-rev.10/6/04 Page 1 of 5 ILIMassachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands WPA Form 2 - Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Determination (cont.) The following Determination(s)is/are applicable to the proposed site and/or project relative to the Wetlands Protection Act and regulations: Positive Determination Note: No work within the jurisdiction of the Wetlands Protection Act may proceed until a final Order of Conditions(issued following submittal of a Notice of Intent or Abbreviated Notice of Intent)or Order of Resource Area Delineation (issued following submittal of Simplified Review ANRAD) has been received from the issuing authority(i.e. Conservation Commission or the Department of Environmental Protection). ❑ 1.. The area described on the referenced plan(s) is an area subject to protection under the Act. Removing,filling,dredging,or altering of the area requires the filing of a Notice of Intent. ❑ 2a.The boundary delineations of the following resource areas described on the referenced plan(s)are confirmed as accurate.Therefore, the resource area boundaries confirmed in this Determination are binding as to all decisions rendered pursuant to the Wetlands Protection Act and its regulations regarding such boundaries for as long as this Determination is valid.. ❑ 2b. The boundaries of resource areas listed below are not confirmed by this Determination, regardless of whether such boundaries are contained on the plans attached to this Determination or to the Request for Determination. ❑ 3. The work described on referenced plan(s) and document(s) is within an area subject to protection under the Act and will remove, fill, dredge, or alter that area. Therefore, said work requires the filing of a Notice of Intent. ❑ 4. The work described on referenced plan(s) and document(s) is within the Buffer Zone and will alter an Area subject to protection under the Act. Therefore, said work requires the filing of a Notice of Intent or ANRAD Simplified Review(if work is limited to the Buffer Zone). ❑ 5. The area and/or work described on referenced plan(s)and document(s) is subject to review and approval by: Name of Municipality Pursuant to the following municipal wetland ordinance or bylaw: Name Ordinance or Bylaw Citation wpaform2.doc•Determination of Applicability•rev.10/6/04 Page 2 of 5 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Determination (cont.) ❑ 6. The.following area and/or work, if any, is subject to a municipal ordinance or bylaw but not subject to the Massachusetts Wetlands Protection Act: ❑ 7. If a Notice of Intent is filed for the work in the Riverfront Area described on referenced plan(s) and document(s), which includes all or part of the work described in the Request, the applicant must consider the following alternatives. (Refer to the wetland regulations at 10.58(4)c. for more information about the scope of alternatives requirements): ❑ Alternatives limited to the lot on which the project is located. ❑ Alternatives limited to the lot on which the project is located, the subdivided lots, and any adjacent lots formerly or presently owned by the same owner. ❑ Alternatives limited to the original parcel on which the project is located, the subdivided parcels, any adjacent parcels, and any other land which can reasonably be obtained within the municipality. i ❑ Alternatives extend to any sites which can reasonably be obtained within the appropriate region of the state. Negative Determination Note: No further action under the Wetlands Protection Act is required by the applicant. However, if the Department is requested to issue a Superseding Determination of Applicability, work may not proceed on this project unless the Department fails to act on such request within 35 days of the date the request is post-marked for certified mail or hand delivered to the Department. Work may then proceed- at roceedat the owner's risk only upon notice to the Department and to the Conservation Commission. Requirements for requests for Superseding Determinations are listed at the end of this document. ❑ 1. The area described in the Request is not an area subject to protection under the Act or the Buffer Zone. ❑ 2. The work described in the Request is within an area subject to protection under the Act, but will not remove, fill, dredge, or alter that area. Therefore, said work does not require the filing of a Notice of Intent. ® 3. The work described in the Request is within the Buffer Zone, as defined in the regulations, but will not alter an Area subject to protection under the Act. Therefore, said work does not require the filing of a Notice of Intent, subject to the following conditions(if any). See attached conditions ❑ 4. The work described in the Request is not within an Area subject to protection under the Act (including the Buffer Zone). Therefore, said work does not require the filing of a Notice of Intent, unless and until said work alters an Area subject to protection under the Act. wpaform2.doc•Determination of Applicability•rev.10/6/04 Page 3 of 5 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Determination (cont.) ❑ 5. The area described in the Request is subject to protection under the Act. Since the work described therein meets the requirements for the following exemption, as specified in the Act and the regulations, no Notice of Intent is required: Exempt Activity(site applicable statuatory/regulatory provisions) ❑ 6. The area and/or work described in the Request is not subject to review and approval by: I Name of Municipality Pursuant to a municipal wetlands ordinance or bylaw. North Andover Wetlands Protection Bylaw Chapter 178 Name Ordinance or Bylaw Citation C. Authorization This Determination is issued to the applicant and delivered as follows: ❑ by hand delivery on by certified mail, return receipt requested on Date Date This Determination is valid for three years from the date of issuance(except Determinations for Vegetation Management Plans which are valid for the duration of the Plan). This Determination does not relieve the applicant from complying with,all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. This Determination must be signed by a majority of the Conservation Commission. A copy must be sent to the appropriate DEP Regional Office(see http://www.mass.gov/dep/about/region.findvour.htm) and the property owner(if different from the applicant). Signatures: LXY � 7//rid Date wpaform2.doc•Determination of Applicability•rev.10/6/04 Page 4 of 5 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands WPA Form 2 — Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 D. Appeals The applicant, owner, any person aggrieved by this Determination, any owner of land abutting the land upon which the proposed work is to be done, 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 Department of Environmental Protection Regional Office(see http://www.mass.gov/dep/about/region.findyour.htm)to issue a Superseding Determination of Applicability. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and Fee Transmittal Form (see Request for Departmental Action Fee Transmittal Form)) as provided in 310 CMR 10.03(7)within ten business days from the date of issuance of this Determination. 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 Determination which is being appealed. To the extent that the Determination is based on a municipal ordinance or bylaw and not on the Massachusetts Wetlands Protection Act or regulations, the Department of Environmental Protection has no appellate jurisdiction. wpaform2.doc•Determination of Applicability•rev.10/6/04 Page 5 of 5 • a LlMassachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands Request for Departmental Action Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. Request Information Important: When filling out 1. Person or party making request(if appropriate, name the citizen group's representative): forms on the computer, use Name only the tab key to move your cursor- Mailing Address do not use the return key. City/Town State Zip Code Phone Number Fax Number(if applicable) Project Location mann Mailing Address City/Town State Zip Code 2. Applicant(as shown on Notice of Intent(Form 3), Abbreviated Notice of Resource Area Delineation (Form 4A); or Request for Determination of Applicability(Form 1)): Name Mailing Address City/Town State Zip Code Phone Number Fax Number(if applicable) 3. DEP File Number: B. Instructions 1. When the Departmental action request is for(check one): ❑ Superseding Order of Conditions($100 for individual single family homes with associated structures; $200 for all other projects) ❑ Superseding Determination of Applicability($100) ❑ Superseding Order of Resource Area Delineation ($100) Send this form and check or money order for the appropriate amount, payable to the Commonwealth of Massachusetts to: Department of Environmental Protection Box 4062 Boston, MA 02211 wpaform2.doc•Request for Departmental Action Fee Transmittal Form•rev.1016/04 Page 1 of 2 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands Request for Departmental Action Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Instructions (cont.) 2. On a separate sheet attached to this form, state clearly and concisely the objections to the Determination or Order which is being appealed. To the extent that the Determination or Order is based on a municipal bylaw, and not on the Massachusetts.Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. 3. Send a copy of this form and a copy of the check or money order with the Request for a Superseding Determination or Order by certified mail or hand delivery to the appropriate DEP Regional Office (see http://www.mass.gov/dep/ab6ut/region/findyour.htm). 4. 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 isnot the appellant. i wpaform2.doc-Request for Departmental Action Fee Transmittal Form•rev.10/6/04 Page 2 of 2 i Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance 242-1266 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 Joseph Stringer computer, use Name only the tab 57 Lawrence Road key to move your cursor- Mailing Address do not use the Salem N. H. 03079 return key. City/Town State Zip Code r� 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: Joseph Stringer Name 8/5/04 242-1266 Dated DEP File Number 3. The project site is located at: 1094 Salem Street North Andover Street Address City/Town Map 106A Parcel 57 Assessors Map/Plat Number Parcel/Lot Number the final Order of Condition was recorded at the Registry of Deeds for: Property Owner(if different) Essex North Instrument#39886 County Book Page Certificate 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: 6/24/05 Date B. Certification Check all that apply: ® Complete Certification: It is hereby certified that the work regulated by the above-referenced Order of Conditions has been satisfactorily completed. ❑ Partial Certification: It is hereby certified that only the following portions of work regulated by the above-referenced Order of Conditions have been satisfactorily completed.The project areas or work subject to this partial certification that have been completed and are released from this Order are: wpaform 8b.doc•rev.7113/04 Page 1 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: L11 WPA Form 8B — Certificate of Compliance 242-1266 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP B. Certification (cont.) ❑ Invalid Order of Conditions: It is hereby certified that the work regulated by the above-referenced" Order of Conditions never commenced. The Order of Conditions has lapsed and is therefore no longer valid. No future work subject to regulation under the Wetlands Protection Act may commence without filing a new Notice of Intent and receiving a new Order of Conditions. ® Ongoing Conditions: The following conditions of the Order shall continue: (Include any conditions contained in the Final Order, such as maintenance or monitoring, that should continue for a longer period). Condition Numbers: 66 C. Authorization Issued by: North Andover 7h&los Conservation Commission Date df Issu nce This Certificate must be signed by ajority of the Conservation Commission and a copy sent to the applicant and appropriate DE eg' nal Office (See Attachment). Signatures: WTA wpaform 8b.doc•rev.7/13/04 Page 2 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: Ll WPA Form 8B — Certificate of Compliance 242-1266 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP t C. Authorization (cont.) Notary Acknowledgement Commonwealth of Massachusetts County of Essex North aoo � On this Day Of Month Year before me, the undersigned Notary Public, personally appeared Sc'off— MCk'-sS'?— 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 Conservation Commission CityfTown Signature of Notary Public DONNA M.WEDGE D0019A NOTARY PUBLIC Printed Name of Nota Public COMMONWEALTH OF WSSACHUMM Notary My Comm E*u Aug.7,2009 My Co. issio Expires(Date) Place notary seal and/or any stamp above Sig ature of Notary Public wpaform 8b.doc•rev.7/13/04 Page 3 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP File Number: Ll WPA Form 8B — Certificate of Compliance 242-1266 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: North Andover Conservation Commission Please be advised that the Certificate of Compliance for the project at: 242-1266 Project Location DEP File Number Has been recorded at the Registry of Deeds of: County for: Property Owner and has been noted in the chain of title of the affected property on: Date Book Page If recorded land, the instrument number which identifies this transaction is: If registered land, the document number which identifies this transaction is: Document Number Signature of Applicant wpaform 8b.doc•rev.7/13/04 Page 4 of 4 i LlMassachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands 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 Region Adams Colrain Hampden Monroe Pittsfield Tyringham 436 Dwight Street Agawam Conway Hancock Montague Plainfield Wales 9 Alford Cummington Hatfield Monterey Richmond Ware Suite 402 Amherst Dalton Hawley Montgomery Rowe Warwick Springfield,MA 01103 Ashfield Deerfield Heath Monson Russell Washington Phone:413-784-1100 Becket Easthampton Hinsdale Mount Washington Sandisfield Wendell Belchertown East Longmeadow Holland New Ashford Savoy Westfield Fax:413-784-1149 Bernardston Egremont Holyoke New Marlborough Sheffield Westhampton Blandford Erving Huntington New Salem Shelburne West Springfield Brimfield Florida Lanesborough North Adams Shutesbury West Stockbridge Buckland Gill Lee Northampton Southampton Whately Charlemont Goshen Lenox Northfield South Hadley Wilbraham Cheshire Granby Leverett Orange Southwick Williamsburg Chester Granville Leyden Otis - Springfield Williamstown Chesterfield Great Barrington Longmeadow Palmer Stockbridge Windsor Chicopee Greenfield Ludlow Pelham Sunderland Worthington Clarksburg Hadley Middlefield Peru Tolland DEP Central Region Acton Charlton Hopkinton Millbury Rutland Uxbridge 627 Main Street Ashlb mham Clinton Hubbardston Millvllle Shirley Warren Ashby Douglas Hudson New Braintree Shrewsbury Webster Worcester,MA 01608 Athol Dudley Holliston Northborough Southborough Westborough Phone:508-792-7650 Auburn Dunstable Lancaster Northbridge Southbridge West Boylston h Brookfield Spencer West Brookfield Fax:508-792-7621 Ayer East Brookfield Leicester North p Barre Fitchburg Leominster Oakham Sterling Westford TDD:508-767-2788 Bellingham Gardner Littleton Oxford Stow Westminster Berlin Grafton Lunenburg Paxton Sturbridge Winchendon Blackstone Groton Marlborough Pepperell Sutton Worcester Bolton Harvard Maynard Petersham Templeton Boxborough Hardwick Medway Phillipston Townsend Boylston Holden Mendon Princeton Tyngsborough Brookfield Hopedale Milford Royalston Upton DEP Southeast Region Abington Dartmouth Freetown Mattapoisett Provincetown Tisbury 20 Riverside Drive Acushnel Dennis Gay Head Middleborough Raynham Truro Attleboro Dighton Gosnold Nantucket Rehoboth Wareham Lakeville,MA 02347 Avon Duxbury Halifax New Bedford Rochester Wellfleet Phone:508-946-2700 Barnstable Eastham Hanover North Attleborough Rockland West Bridgewater Fax:508 947-6557 Berkley East Bridgewater Hanson Norton Sandwich Westport Bourne Easton Harwich Norwell Scituate West Tisbury TDD:508-946-2795 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 Plympton Taunton DEP Northeast Region Amesbury Chelmsford Hingham Merrimac Quincy Wakefield 1 Winter Street Andover Chelsea Holbrook Methuen Randolph Walpole Arlington Cohasset Hull Middleton Reading Waltham Boston,MA 02108 Ashland Concord Ipswich Millis Revere Watertown Phone:617-654-6500 Bedford Danvers Lawrence Milton Rockport Wayland Fax: 617 556-1049 Belmont Dedham Lexington Nahant Rowley Wellesley Beverly Dover Lincoln Natick Salem Wenham TDD:617-574-6868 Billerica Dracut Lowell Needham Salisbury West Newbury Boston Essex Lynn Newbury Saugus Weston Boxford Everett Lynnfield Newburyport Sherborn Westwood Braintree Framingham Malden Newton Somerville Weymouth Brookline Georgetown Manchester-By-The-Sea Norfolk Stoneham Wilmington Burlington Gloucester Marblehead North Andover Sudbury Winchester Cambridge Groveland Medfield North Reading Swampscott Winthrop Canton Hamilton Medford Norwood Tewksbury Woburn Carlisle Haverhill Melrose Peabody Topsfield wpeform8b.doc•DEP Addresses-rev.6/27/05 Page 1 of 1 Massachusetts Department of Environmental Protection f Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions 242-1266 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. General Information Important: North Andover When filling From: 1.Conservation Commission out forms on the computer, 2. This issuance is for(check one): ® Order of Conditions ❑ Amended Order of Conditions use only the tab key to 3. To: Applicant: move your cursor-do not Joseph Stringer use the return a. First Name b. Last Name c.Company key. 1094 Salem Street d. Mailing Address North Andover MA. 01845 e.City/Town f.State g.Zip Code B 4. Property Owner(if different from applicant): a. First Name b. Last Name c.Company d. Mailing Address e.City/Town f.State g.Zip Code 5. Project Location: 1094 Salem Street North Andover a.Street Address b.City/Town Map 106A Parcel 57 c.Assessors Map/Plat Number d.Parcel/Lot Number Latitude and Longitude, if known (note: 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) 1955 262 c.Book d.Page 7/16/04 7. Dates: a. Date Notice of Intent Filed b. Date Public Hearing Closed c. Date of Issuance s. Final Approved Plans and Other Documents (attach additional plan or document references as needed): Proposed Subsurface Sewage Disposal System a. Plan Title New England Engineering Services, Inc. Benjamin C. Osgood, Jr. b. Prepared By c.Signed and Stamped by 7/1' /04 1" = 20' d. Final Revision Date e.Scale f.Additional Plan or Document Title g. Date 9. Total WPA Fee Paid: $ 55.00 a.Total Fee Paid b.State Fee Paid c.City/Town Fee Paid i wpaform5.doc• rev.8/3/04 Page 1 of 8 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions 242-1266 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Findings 1. Findings pursuant to the Massachusetts Wetlands Protection Act: Following the review of the above-referenced Notice of Intent and based on the information provided in this application and presented at the public hearing, this Commission finds that the areas in which work is proposed is significant to the following interests of the Wetlands Protection Act. 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 Proposed Permitted Alteration Alteration Replacement Replacement 3. ❑ Bank a.linear feet b. linear feet c.linear feet d. linear feet 4. ❑ Bordering Vegetated Wetland a.square feet b.square feet c.square feet d.square feet 5. ❑ Land Under a.square feet b.square feet c.square feet d.square feet Waterbodies and Waterways e.cu.yd dredged f.cu.yd dredged wpaform5.doc• rev.8/3/04 Page 2 of 8 I L1Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: 1 WPA Form 5 - Order of Conditions 242-1266 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Findings (cont.) Resource Area Proposed Permitted Proposed Permitted Alteration Alteration. Replacement Replacement 6. ❑ Bordering Land Subject to Flooding a.square feet b.square feet c. square feet d.square feet Cubic Feet Flood Storage e.cubic feet f.cubic feet g.cubic feet h.cubic feet 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 f.cubic feet 8. ❑ Riverfront area a.total sq.feet b.total sq.feet Sq ft within 100 ft c.square feet d.square feet Sq ft between 100-200 ft 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 c.cu.yd dredged d.cu.yd dredged 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 a.cu.yd dredged b.cu.yd dredged 20. ❑ Land Subject to Coastal Storm Flowage a.square feet b.square feet wpaform5.doc- rev.8/3/04 Page 3 of 8 Massachusetts Department of Environmental Protection 1 Bureau of Resource Protection -Wetlands DEP File Number: WPA Form 5 - Order of Conditions 242-1266 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 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 242-1266 " wpaform5.doc• rev.8/3/04 Page 4 of 8 Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions 242-1266 1 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. I 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.8/3/04 Page 5 of 8 DEP FILE#242 - 1266 Therefore, the North Andover Conservation Commission(hereafter the "NACC") 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). C:\Winword\1094SalemSt.doc 1 NACC 8/12/04 DEP FILE #242 - 1266 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. 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. 242-1266. 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 a within 30 days of all transfers of title of an portion of Y Y property that takes place prior to the issuance of a Certificate of Compliance. 28. The proposed work includes: The installation of a replacement subsurface sewage disposal system and associated grading in the buffer zone to a bordering vegetated wetland. 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: Joseph Stringer (Applicant) 1094 Salem Street North Andover MA 01845 Received date 7/16/04 Prepared by: New England Engineering Services, Inc. 60 Beachwood Drive North Andover, MA 01845 Site Plans prepared by: New England Engineering Services, Inc. 60 Beachwood Drive North Andover, MA 01845 Entitled "Proposed Subsurface Sewage Disposal System" - Sheets 1 &2 Dated July 14,2004 Stamped & Signed by Benjamin C. Osgood,Jr., P.E. C:\Winword\1094SalemSt.doc 2 NACC 8/12/04 DEP FILE #242 - 1266 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 does not agree with the applicant's delineation of the wetland resource areas on the site as shown on the plans dated referenced herein. Hydric soils were found upgradient to wetland flags A-3 & A4 in the historically maintained lawn area where the existing shed is located. It appears that the area (limits unknown) was filled (date unknown). For the purposes of improving site conditions with a replacement septic system,the NACC has approved such work as proposed without approving the actual resource area limits. 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 except in those locations as shown for existing conditions (excluding the shed- see condition #45, which mandates removal).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. There shall be no increase in the post development discharges from the storm drainage system or any other changes in post development conditions that alter the post development watershed boundaries as currently depicted in the Notice of Intent and approved by this Order of Conditions, unless specifically approved in writing by the Commission. 34. 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. 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\1094SalemSt.doc 3 NACC 8/12/04 DEP FILE#242 - 1266 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 242-1266." 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. C:\Winword\1094SalemSt.doc 4 NACC 8/12/04 I DEP FILE #242 - 1266 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. 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 10 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. The existing shed shall be removed from its current location, as it is in violation to the 25-foot No-disturbance and 50-foot No-Build Zones. The shed shall be removed with minimal disturbance to the surrounding area,which includes the lawn. Specifically, no trucks/equipment shall be allowed on the lawn within 25- feet of the shed for removal. Specifics to removal shall be discussed and approved by the Conservation Administrator prior to removal. C:\Winword\1094Salemkdoc 5 NACC 8/12/04 DEP FILE #242 - 1266 46. A check payable to the Town of North Andover shall be provided in the amount of $2000,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. 47. 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 writing by the hired professional in the event that this person has to be contacted, due to an emergency at the site, during any 24-hour period, including weekends. 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. 48. Prior to construction, the applicant shall permanently mark the edge of disturbance with 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 available at the Conservation Office for$2 apiece and 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. CAWinword\1094SalemSt.doc 6 NACC 8/12/04 DEP FILE#242 - 1266 49. 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 prior to the closing of said land transaction. 50. 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 this Order. A reasonable period of time shall be provided as notice of the pre- construction meeting (e.g. 72 hours). DURING CONSTRUCTION 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. i j 52. Approved de-watering activities anticipated shall be supervised and witnessed by the designated erosion control monitor. De-watering activities shall be conducted as shown on the approved plans and 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, C:\Winword\I094SalemSt.doc 7 NACC 8/12/04 DEP FILE#242 - 1266 which provides for the pumped water to be contained in a settling basin, to reduce turbidity prior to discharge into a resource area. 53. 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. 54. No exposed area shall remain unfinished for more than thirty (30) days,unless approved by the NACC. 55. No g re-g radin 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. 56. There shall be no stockpiling of soil or other materials within twenty-five (25) feet of any resource area. 57. P Washings from concrete trucks, or surplus concrete, shall not be directed to, any drainage system, or wetland resource area. 58. 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 dumP sters will be allowed within 50' of areas,subject to protection under the Act or local ByLaw. standards and procedures shall be followed 59. Accepted engineering and construction in the completion of the project. 60. During and after work on this project, there shall be no discharge or spillage of fuel, or other pollutants into an wetland resource area. If there is a spill or discharge of P Y p an construction the NACC shall be notified b the pollutant during phase of co y YP g an Y n within�one 1 business day. No construction vehicles are to be stored applicant O y 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. C:\Winword\1094SalemSt.doc 8 NACC 8/12/04 DEP FILE #242 - 1266 AFTER CONSTRUCTION 61. 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. 62. 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. 63. 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. 64. 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. 65. 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:liance: a. WPA Form 8A- "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 liance indicatin 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. CAWinword\1094SalemSt.doc 9 NACC 8/12/04 i I DEP FILE#242 - 1266 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 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 a—X disturbance of soils or vegetation.- Location of all subsurface utilities entering the property. 66. 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 DEP# 242-1094. Future work within 100' of existing wetland resource areas will require a separate filing d a with the NACC. The Conservation Administrator and/or other gents of the NACC do not have the authority to waive these setbacks as established under the local ByLaw; ➢ Discharge or spillage of pollutants (Condition# 60); ➢ Prohibition of underground fuels (Condition#61); ➢ Limitations on the use of fertilizers, herbicides, and pesticides (Conditions #62). CAWinword\1094SalemSt.doc 10 NACC 8/12/04 DEP FILE#242 - 1266 APPENDIX A- AFFIDAVIT 1 on oath do hereby depose and state: (authorized agent applicant and/or current owner) (PLEASE CHECK AT LEAST ONE BLOCK) 1. I am the of (position with applicant) (applicant name or company name) the applicant upon whom Order of Conditions have been placed upon by (DEP or NACC number) the North Andover Conservation Commission. &/or 2. I am the of (position with owner) (owner name) the owner upon whose land Order of Conditions have been placed up by (DEP or NACC number) the North Andover Conservation Commission. & 3. I hereby affirm and acknowledge that I have received said Order of Conditions and have read the same and understand each (DEP File#) and every condition which has been set forth in said Order of Conditions. & 4. 1 hereby affirm and acknowledge that on this day of 19 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 Order of Conditions are presently in compliance. (DEP File#) & 5. I hereby affirm and acknowledge that this document will be relied upon by the North Andover Conservation Commission as well as any potential buyers of . said property which is subject to said Order of Conditions (DEP File#) Signed under the pains and penalties of perjury this day of 19 (Signature-authorized agent of applicant or owner) C:\Winword\1094Sa1emSt.doc 11 NACC 8/12/04 Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection -Wetlands WPA Form 5 - Order of Conditions 242-1266 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 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 b.Citation a.Municipal Ordinance or Bylaw 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 E. Issuance This Order is valid for three years, unless otherwise specified as a special condition pursuant to General Conditions#4, from the date of issuance. 1. Date bf iss ance 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 (see Appen ' and the property owner, if different from applicant. Signat es: G Page 6 of 8 wpaform5.doc• rev.8/3/04 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: 7L'�, : WPA Form 5 - Order of Conditions 242-1266 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 E. Issuance (cont.) Notary Acknowledgement Commonwealth of Massachusetts County of Essex North �I IN� Usf a®oy On this Day °f Month J Year Before me, the undersigned Notary Public, personally appeared ScX,rt 44SSC, &.4, Name of Document Signer proved to me through satisfactory evidence of identification, which was/were 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 Conservation Commission City/Town 4. i Si nature of Notary Pubic Prin ed Name of Notary Public Place notary seal and/or any stamp above DONNA M.WEDGE My Commis s� ��AMM This Order is issued to the applicant as follows: *GOQ""' �'7'� ❑ Igloo by hand delivery on [t/j/by certified mail, return receipt requested, on Date Date F. Appeals The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject to this Order, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate 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. wpaform5.doc• rev.8/3/04 Page 7 of 8 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 - Order of Conditions 242-1266 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 G. Recording Information This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions. The recording information on 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: 242-1266 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 wpaform5.doc• rev.8/3/04 Page 8 of 8