Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Miscellaneous - 900 Alder Way
.AA 9 O o v m A .o ❑®❑❑ K w A _. ^ c �^ C C 2 N ° C N .. 3 � El ❑® m N 3 a .°7, m o °' � io m o- m o. v c o . _? S m 3 avi a W t w w 0 o G n � N N� , o m 9 0 v a,m 0n �i•..., C" cWO . �-m y'o' o n'm 0 m mi O)c y3 o. I'D �° � `< c Ge c v9 g m p _ � m W c vi" a a• aD� _• w o.m ° � o W 'gy p m 0 a m El a c Na 'm a o o v c ma F m m Q mo 'Tm'�.az`swots'• ® 3 R 2 m r�o� `�v a 3»" 9 m g A A m a Q 3 3 '.M1, 0c_ 3 mww'� R a'' m �� 8a��T3,mv n T E; y 1:1 pO n El j r o,c 2y 33 my t??o a8 nj O» g iF G 3< n0, S9 �•"•wa•'° o °a8 o m of ^ ., 520n�mo S3 a 'd. :4 n [t c• o 2�g• n R �• E m 9 m m 0. o a c�co'o 0"FaD# Dm d m m c c m m e �°,• W o a n c N K < R a u R 0 m m 9 3 a o A J m o.� w � � .. m �. � � ❑ s»� a ,�°., ^' 3 c� F :, a„ rt�c•� c' a=go go v Ei, v ❑ ,R o' 01m=�o H m msO 3 v°o a3 � 3 wo. �'m 33o.N p°° O am a cg�mw0 C j O H A C T N ° ac N > m r > N o x N 2 c1 G c 3 F w nc_.nm O A �O C F+ n o O s m a VI a C n A W n v Q m cD r'.i m m m �. m 0_ w w c a 7 3w.h• o m �a o ma mw m. D Nbb o DF °' pn N a a p9 m N r .i J O H .ui O R 2 S A IOL N` p .di O D - .[ n m m �. n'. N w Q» ` w n r a H� C h a 9 a u ,� m y C S fD ,7 ° 4 7 l .t^~ 9 T N •C `� 4 �• m '. cD W o mn F+ c` m a m ��•- m m �m�m oa m 8 m c m k o 3m n• vt o 3 0� a N 3 °' 6xi ry o A 3 > f. > F a o 00 n 8 oam �m °o � m• m y � 9. n o m z•" m� A c@@ o v� m 'm m , 4 o' m $ •moo m -R =� N- =' ad t o a o `h- "on n Qo. m9 l° 0., Q,1 3 c Z o m p Q rmc m 0° c a+ m 5 o- m m �v '^ .o•w' 9�cw'•m chi °. 3 o` o A� A3 •O 3'�O n a ° vc n m C 9� �': m N 4� m aa I p o, a iN 09 tN O A g A MOo $ N 5 m 2 9 0° i m o Im m a 0 nci o ' c o R o c an a am9or mma`m»°� M O 'O im �G Z Q D 1 O z O m 3 �a o 3 DR o Z m as D N N D z A 3. ®❑ El El Llm m 3 C° o m a m o m o A o ' v v" S o 0 o O c P O o o o A N f^c C 7 m ^°. F n °• e a R o C. • o .o a 3 C o 0 o Nn m �- n 3 '$ e' o ^• d N n n a_ ,� m 3 3 3 c c "2 '" =0 N d — aziz = ® < D m w 0 9,3 c mm m m 3' 'd^ = o- 3 f_ 3 a s n m n 5 a a 3 0 n o v a ono N Q irCD C d O A A D T C m m .fir ]• O d 76 •_ri O O O uu in C y O ry Ip V :° ° N G T 0 f7 0 C V 3 �• �' �' ° d O C n P O �; ° 3 L LX •°p a O S `-''� p n 3 »» <c n o R d � » "' ° gq °•., n V S F N. As ¢� o•Z= a tr x o 6 ry On .., a ur 3 w� Vm= 5. i PCo n O3 d C d O I9 " tue r 9 ra £ A ¢ d m SL m 9 (D z c m v m .gym maa awn is vg wn awn g $ n o \ a � A jS ~ Q oT A 3 m N � a° � � n � R � � L�• g g ao �.o mo o n d o q. ^ V G V J9 0 m 01 m n L 3mc� c '_•+,n� 3 'o 3 ry o m 3 �.D � � D a a ��e G ,� N m � � a TGn mo°as a :o ^o ac m mE zlmO m �-3 �� m c �o»'<m3 em Qw,5m0p Z N O w� i+'o 3 m w i0 2 .z ^ E d n m m a :2 y o Oq mn� o a o n w c c O j < p s o [`o XX 9.9 c m o 2 c 2 �_ a 4p c c �c00• f F� c umi w N ma o<°— m o- °'a° �3� a= 'o 8 omca3 is 5' a m n ® Fr tea❑ m n 0 v °J qz 310 v- 0 �v t n� a 2 p M' m o m �m. - a -•�•^'mo Limn: �RO0� m v ., Da'°'-°. c o e, m a o o ro ° n w o • 6 c c m c 0 s o ° ❑a ❑O �• vc L' » D a n m B �. m r2 o „ o• m x _ c m m Q Z O o: < o m z v p 2 DZD Elw DO w O w �+ o a0 11 n g: 3 y ❑m 4 °> G' ul ° 2 Z° x m K Ra_soda_ zm ' A O N V m E � S? m n �_ � rr C O � '�•" � a 'c � Oct O T N 3 f�= N o 2 O OAC a s s n fy0 Cp A V C1 tttrrrCppp��� o cry RI Q � ��� !c1 C. ? 3 C Z 'v33W a� mo •i 'm'.mn 1 � .o'"... � � � s�w � n �r m ''3 O a D C. d� o a ¢. �� NmCL O T Nw �� c¢ v o m n m � c o� � °• n g o f o C •S119S z 3 3 a g m 3 n C;33T a o mEr v c? o^ a S En12. n c •• .. a o� �° o � w °' t \■;! ^ �}\ - 4 \■ R}k� { (}t k 7 »#_ | k � §( : !- !■ 2 $| \\ N i 3 3 3 %T v °3 m3 3 3d'o T�Q mm IoW m�P D 3 a oP m e oam°ac 3 > 3 > 3 s d a m z c f D o ^ G g D c 2 3 G' c a 0 o v T n �+ y s o `._�, n. ry - o M G; o o B n A o o E z O �3 0 3 o�og W ?. ^ m N a a w O C osn; I 0 w3 En^ o a 3 a 3 °3� v3 m w a a��c�Oo o 'O o n e Of� m w O o° a D a<°o m n 3 v o a9 0 3-aw'o ? Z a' 3 F. m Wd vQ z Z p m T- rt 3 a�� < v a? v io o. 9 °• m `' ` o .arty 'm 3 O- 61 v n n N ° n m n°'^ h:[ mH = d d = o g "a a inn' 3 °emu rt N .2..{{ .�. con XF o omi o"0"3 N .v.� u_=moo �^ °" = C U �n ? ,n , -Ow O N 9 b °. pip 0 yv {@o ID ? p Q. a v inO 0 5 rO o a s a T 3 o A o a N n m 0 °, T C c o a o onoo s. v,p, oz� ° N m 3 o. ? ;^• d m 3N oma'» nv 9 a » a D .n v M ID a' z N m °, j o 3 a B o 3 D o 3 3 p y S A y o m �. c ? ° c^ -, nN a3 m co z'o a s o ��I- ,nab o c c_° o � 7 d '^• m ° o-ic Y! m o �. O 'o F . M•3 c m a h Er 3 c3 m N Nrt nZ�3 wv�°�"$ pm °n OIL m 3 3 m D w -.7, r' ��mm O �a M, a° o n N. ?o 3 w m A F S a _ 3 S n m z m c m a o ay S•. ? '° v m ° �_Q3 m O d�wmD�Pa: �9 5„ m° 'm °ti 3 a; o m n N n =y T O 3 m w vo n w n A nro m s a w m f°• v` ° o c m S^' = n FF 10 N 7 d �. n m a /g7 z 3 m 0. To A° na m 3 a O«ma 6'c (71 o n ° �-p 0 -.0 N �Oo ? 0 3 "0 $ ��� a.o07c Qavm 3c 'ow3c�' caa x-,10, F• 0`�3,1D o 3LL. 3 } \ } ag/§ ©z E § " O ® & ;� } \�}«ƒ §K ° �\ ` . k © \( '� / | )\ \! , — }\ §\ ) ■ 2 ;§ - . ;& m § /f O |'. e� ) Z I \ k% 0 2 o E 4 /¥ I» \ A « { ! EIZ > a k j \ � � , = f / z 90§ § § ( & § § $ ° m !w ;_ __ £ ( 2 I� z to § § � ( ■ 7 k \ IQ� k{X-4 7(R� \ m ® co\ ., F � � ; 2 2\R■ §A\Q k } � ���/ o » \2/■ 0 / \m § § Ln ` 9 ( ). 0 § § 0 3H ; $ loo* o ) � / ( .� . ( H .. . z 2 m WWW W�W� �m m o a m w a pt m 3 �• 'ri C CA OD " w W " 3 w 3 w a o0 °° w 00 d N in N 13CD 1 3 3 � a f�D y t -N 3 U n � O 3 O7 3 Ln ALL I 3 N {a O � 30 r Page.1 of 2 : Date;. January 22, 2013 Case No.: 13-01-0874A LOMR-F �m Emergency Federal Agency g Y Mana ement g Y Washington, D.C. 20472 LETTER OF MAP REVISION BASED ON FILL DETERMINATION DOCUMENT (REMOVAL) COMMUNITY AND MAP PANEL INFORMATION LEG/{L PROPERTY DESCRIPTION TOWN OF NORTH ANDOVER, A portion of Oakridge Village/Maplewood Reserve, Phases IV and V, ESSEX COUNTY, as shown on the 'P.lan, recorded as Plan No. 16278, in -the Office of COMMUNITY MASSACHUSETTS the Registry of Deeds; Essex County, Massachusetts :250098 :-. AFFECTED NUMBER:25009CO381F MAP PANEL DATE: 7/312012 FLOODING SOURCE: LOCAL FLOODING APPROXIMATE LATITUDE & LONGITUDE OF PROPERTY: 42.623, -71.661 SOURCE.OF LAT & LONG: ARMS 10 DATUM: NAD 83 DETERMINATION OUTCOME 1%oANNUA'L LOWEST LOWEST BLOCK/ WHAT IS CHANCE ADJACENT LOT' LOT SUBDIVISION STREET REMOVED FROM. FLOOD, FLOOD GRADE ELEVATION SECTION THE SFHA ZONE ELEVATION I ELEVATION (NAVD 88) Oakridge 901-gblS Alder Way Structure X - 116.7 feet Village/- (Building 9) (unshaded) Maplewood Special Flood Hazard Area (SFHA) - The SFHA is an area that would be inundated by the flood having a 1 -percent chance of being equaled or exceeded in any.given Veer (base flood). ADDITIONAL CONSIDERATIONS (Please refer to the appropriate section on Attachment 1 for the additional considerations listed below,) . DETERMINATION TABLE (CONTINUED) PORTIONS REMAIN IN THE SFHA ZONE A This document provides :the Federal Emergency Management Agency's determination regardjrg.: a request for a Letter of Map Revision based on Fill for the property described above. Using .the information submitted and the effective National Flood Insurance Program (NFIP) map, we have determined that the structure(s) on. the property(ies) is/are not located in the SFHA; an area inundated by the flood having a 1 -percent chance of being equaled or exceeded in any given year (base flood). This document revises the effective NFIP map to remove the subject property from the .SFHA located on the effective NFIP map; therefore, : the Federal mandatory , flood in requirement does not ,apply. However, the lender has the option to continue the flood insurance requirement to protect Its financial 'risk on the loan. A Preferred 'Risk Policy (PRP) is available for buildings located, outside the SFHA. Informatn in.about the.P.RP and how:one can applyis enclosed. This determination is based on the flood data presently available. The enclosed documents provide additional information regarding. this determination. If you have any questions about this document, please: contact the FEMA Map Assistance Center toll free at (877) 336-2627' (877 -FEMA MAP) or by letter addressed to the Federal Emergency Management Agency, Engineering Library, 647 South Pickett Street,. Alexandria, VA 22304-4605. Luis Redrigue-, RE., Chlef Engineering Managomeht Branch Federal Insurance and Mitigation Administration f Page 2 of 2 bate: Janaary 23, 201:3 Case No,: 13-01-0874A. Federal Emergency Management Agency Washington, D.C. 20472 LOMR-F LETTER OF MAP REVISION BASED ON FILL - DETERMINATION DOCUMENT (REMOVAL) ATTACHMENT 1 (ADDITIONAL CONSIDERATIONS) DETERMINATION, (CONTINUED) OUTCOME 1%ANNUAL LOWEST LOWEST BLOCK/ WHAT IS CHANCE LOT SUBDIVISION STREET. FLOOD ADJACENT LOT SECTION REMOVED FROM : FLOOD GRADE ELEVATION THE SFHA ZONE ELEVATIONELEVATION (NAND 88) vu oo- NAVU 613) Oakridge 1401-1405 Basswood Structure X 113.5 feet Village/ Circle {Building 14) (unshaded).,. Maplewood PORTIONS OF THE PROPERTY REMAIN IN THE SFHA (This Add itionaLConsideratton applies to the preceding 2 Properties.) Portions of this property, but not the stlijec# of the Determination/Comment document, may remain in the Special Flood Hazard Area. Therefore, any future construction or substantial improvement on the property remains subject to Federal, State/Commonwealth, and local regulations for floodpla. in: management. ZONE A (This Additional Consideration applies to the preceding '2 Properties.) The National Flood Insurance Program map affecting. this property depicts. a Special Flood Hazard Area that was determined using the best flood hazard data available to FEMA, but without performing a: detailed engineering. analysis. The flood elevation used to make this determination is based on approximate methods and has not been formalized through the standard process for .establishing base flood elevations published in the Flood Insurance Study. This flood elevation is subject to change. This attachment provides additional information regarding thirequest. If .you have any questions about this attachment, please :contact the FEMA Map Assistance Center toll free at (877) 336-2627( . 877 -FEMA MAP)or by letter addressed to the Federal Emergency Management Agency, Engineering Library, B47 South Pickett Street, Alexandria, VA.22304-4605.. Luis Rodrtguez, P.E Chief E"91nee7irtg Management Btancn Federal Insurance;and Mitigation Administration O.M.B. NO.1650-0015 DEPARTMENT OF HOMELAND SECURITY- FEDERAL EMERGENCY MANAGEMENT AGENCY FmpfrpsFebruory28, 2014 PROPERTY INFORMATION FORM PAPERWORK BURDEN DISCLOSURE NOTICE Public reporting burden for this data collection is estimated to average 1.63 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing and subir ing the form. This collection is required to obtain or retain benefits. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing this burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, Ism South Bell Street, Arlington, VA 20598-3005, Paperwork Reduction Project (1660-0015). NOTE: Do not send your completed form to this address. This form maybe completed by the property owner, property owner's agent, licensed land surveyor, or registered professional engineer to support a request for a Letter of Map Amendment (LOMA), Conditional Letter of Map Amendment (CLOMA), Letterof Mop Revision Based on Fill (CONK -F), or Conditional Letter of Map Revision Based on Fill (CLOMR-F) for existing or proposed, single or multiple lots/structures. In order to process your request, all information on this form must be submissions will result in processing delays. Please check the item below that describes your request. completed in its entirety, unless stated as optional. Incomplete ❑ LOMA A letter from DHS -FEMA stating that an existing structure or parcel of land that has not been elevated by fill (natural grade) would not be inundated by the base flood, ❑ CLOMA A letterfrom DHS -FEMA stating that a proposed structure that is not to be elevated by fill (natural grade) would not be inundated by the base flood if built as proposed. LOMR F A letter from DHS -FEMA stating that an existing structure or parcel of land that has been elevated by fill would not be inundated by the base flood. A letter from DHS -FEMA stating that a parcel of land or proposed structure that will be elevated by fill ❑ CLOMR-F . would not be inundated by the base flood if fill is placed on the parcel as proposed or the structure is built as proposed. Fill is defined as material from any source (including the subject property) placed that raises the ground to or abovethe Base Flood Elevation (BFE). The common construction practice of removing unsuitable existing material (topsoil) and backfilling with select structural material is not considered the placement of fill if the practice does not alter the existing (natural grade) elevation, which is at or above the BFE. Fill that is placed before the date of the first National Flood Insurance Program (NFIP) map showing the area in a Special Flood Hazard Area (SFHA) is considered natural grade. Has fill been placed on your property to raise + ground that was previously below the BFE? ® Yes F1 No If yes, when was fill placed? April/2005 month/year Will fill be placed on your property to raise ground that is below the BFE? ❑Yes* [I No If yes, when will fill be placed? J month/year * If yes, Endangered Species Act (ESA) compliance must be documented to FEMA prior to issuance of the CLOMR-F determination (please refer page 4 to the MT -1 instructions). 1. Street Address of the Property (if request is for multiple structures or units, please attach additional sheet referencing each address and enter street names below): 901-906 Alder Way & 1401-1405 Basswood Circle 2. Legal description of Property (Lot, Block, Subdivision or abbreviated description from the Deed): Assessors Map 1080 Block 39 Lots 901-006 & 1401-1405 (Oakridge Village - Maplewood Reserve 3, Are you requesting that a flood zone determination be completed for (check one): ® Structures on the property? What are the dates of construction? June 2005 (MM/YYYY) JV (9 ®® A portion of land within the bounds of the property? (A certified metes and bounds description and map of the area to be removed, certified by a licensed land surveyor or registered professional engineer, are required. For the preferred format of metes and bounds descriptions, please refer to the MT -1 Form 1 Instructions.) _ ❑ The entire legally recorded property? 4. Is this request for a (check one): Single structure ❑ Single lot ® Multiple structures (How many structures are involved in your request? List the number: 2) ❑ Multiple lots (How many lots are involved in your request? List the number: _J In addition to this form (MT -1 Form 1), please complete the checklist below. ALL requests must include one copy of the following: ...r. �c nn r .... rtue1L7R FGR 77 pr operty information For NT -1 Form 1 Page 1 of 2 ® Copy of the effective FIRM panel on which the structure and/or property location has been accurately plotted (property inadvertently located in the NFIP regulatory floodway will require Section B of MT -1 Form 3) ® Copy of the Subdivision Plat Map for the property (with recordation data and stamp of the Recorder's Office) OR ® Copy of the Property Deed (with recordation data and stamp of the Recorder's Office), accompanied by a tax assessor's map or other certified map showing the surveyed location of the property relative to local streets and watercourses. The map should include at least one street intersection that is shown on the FIRM panel. ® Form 2 — Elevation Form. If the request is to remove the structure, and an Elevation Certificate has already been completed for this property, it may be submitted in lieu of Form 2. If the request is to remove the entire legally recorded property, or a portion thereof, the lowest lot elevation must be provided on Form 2. ® Please include a map scale and North arrow on all maps submitted. For LOMR-Fs and CLOMR-Fs, the following -must be submitted in addition to the items listed above: ® Form 3— Community Acknowledgment Form For CLOMR-Fs, the following must be submitted in addition to the items listed above: p Documented ESA compliance, which may include a copy of an Incidental Take Permit, an Incidental Take Statement, a "not likely to adversely affect" determination from the National Marine Fisheries Service (NMFS) or the U.S. Fish and Wildlife Service (USFWS), or an official letter from NMFS or USFWS concurring that the project has "No Effect" on proposed or listed species or designated critical habitat. Please refer to the MT -1 instructions for additional information. Please do not submit original documents. Please retain a copy of all submitted documents for your records. DHS -FEMA encourages the submission of all required data in a digital format (e.g. scanned documents and images on Compact Disc (CD)). Digital submissions help to further DHS-FEMA's Digital Vision and also may facilitate the processing of your request. Incomplete submissions will result in processing delays. For additional information regarding this form, including where to obtain the supporting documents listed above, please refer to the MT -1 Form instructions located at http:/Iwww.fema.gov/plan/prevent/fhm/dl mt-1.shtm. Processing Fee (see instructions for appropriate mailing address; or visit http://www.ferna.gov/fhm/frm fees.shtm for the most current fee schedule) Revised fee schedules are published periodically, but no more than once annually, as noted in the Federal Register. Please note: single/multiple lots)/structure(s) LOMAs are fee exempt. The current review and processing fees are listed below: Check the fee that applies to your request: $325 (single lot/structure LOMR-F following a CLOMR-F) $425 (single lot/structure LOMR-F) ❑ $500 (single lot/structure CLOMA or CLOMR-F) ❑ $700 (multiple lot/structure LOMR-F following a CLOMR-F, or multiple lot/structure CLOMA) ® $800 (multiple lot/structure LOMB -F &CLOMR-F) Please submit the Payment Information Form for remittance of applicable fees. Please make your check or money order payable to: National Flood Insurance Program. All documents submitted in support of this request are correct to the best of my knowledge. I understand that any false statement may be punishable by fine or imprisonment under Title 18 of the United States Code, Section 1001. Applicant's Name (required): Oakridge Village - Maplewood Reserve Company (if applicable): Affinity Realty & Property Management Mailing Address (required): 63 Atlantic Avenue Daytime Telephone No. (required): 978-686-4800 Boston, MA 02110 C�O doe SOL�eMI Fax No. (optional): 97$-685-0527 josep l a►�'fy e.otyi E -Mail Address (optional): ® By checking here you may receive correspondence electronically at the email address provided): Signature of Applicant (required) Date (required) 0 --hr Infnrmatinn Farm !'dT -1 Form 9 Page 2 of 2 DEPARTMENT OF HOMELAND SECURITY - FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. NO. 1660-0015 ELEVATION FORM I Expires February 28, 2014 PAPERWORK BURDEN DISCLOSURE NOTICE Public reporting burden for this data collection is estimated to average 1.25 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing and submittingthe form. This collection is required toobtain or retain benefits. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing this burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency,1800 South Bell Street, Arlington, VA 20598-3005, Paperwork Reduction Project (1660-0015)..N.OTE: Do not send your completed form to this address. This form must be completed for requests and must be completed and signed by a registered professional engineer or licensed land surveyor. A DHS - FEMA National Flood Insurance Program (NFIP) Elevation Certificate may be submitted in lieu of this form for single structure requests. For requests to remove a structure on natural grade OR on engineered fill from the Special Flood Hazard Area (SFHA), submit the lowest adjacent grade (the lowest ground touching the structure), Including an attacheddeckorgarage. For requests to remove an entire parcel of land from the SFHA, provide the lowest lot elevation; or, if the request involves an area described by metes and bounds, provide the lowest elevation within the metes and bounds description. All measurements are to be rounded to nearest tenth of afoot. In order to process your request, all information on this form must be completed in its entirety. incomplete submissions will result in processing delays. 1. NAP Community Number: 250098 Property Name or Address: 901-906 Alder Way & 1401-1405 Basswood Circle 2. Are the elevations listed below based on ® existing or ❑ proposed conditions? (Check one) 3. For the existing or proposed structures listed below, what are the types of construction? (check all that apply) ❑ crawl space O slab on grade 0 basement/enclosure ❑ other (explain) 4. Has DHS- FEMA identified this area as subject to land subsidence or uplift? (see instructions) [:]Yes O No If yes, what is the date of the current re -leveling? / (month/year) 5. What is the elevation datum? O NGVD 29 ❑NAVD 88 ❑ Other (explain) If any of the elevations listed below were computed using a datum different than the datum used for the effective Flood Insurance Rate Map (FIRM) (e.g., NGVD 29 or NAVD 88), what was the conversion factor? 6d 1 r15 ')Local Elevation +/- ft. = FIRM Datum 6. Please provide the Latitude and Longitude of the most upstream edge of the structure (in decimal degrees to the nearest fifth decimal place): Indicate Datum: O WGS84 ❑ NAD83 ❑ NAD27 Laa,t. 42.6228 Long. -71.0506 Ll d r Please provide the Latitude and Longitude of the most upstream edge of th fin decimal degrees to the nearest fifth decimal place): Indicate Datum: O WGS84 ❑ NAD83 ❑ NA 7 Lat. 42.6217 Long. -71.0603 Address I Lot Number 901-906 Alder way I Building 1401-1405 Basswood Circle I Building 14 Lowest Block Lowest Lot Adjacent Base Flood Number Elevation* Grade To Elevation Structure 117.5' 114.14' 114.9' 112.50' BFE Source FEMA Simplified Method FEMA Simolified Method This certification is to be signed and sealed by a licensed land surveyor, registered professional engineer, or architect authorized by law to certify elevation Information. All documents submitted in support of this request are correct to the best of my knowledge. I understand that any false statement maybe punishable by fine or imprisonment underTitle 18 of the United States Code, Section 10D1, License No.: 39836 Expiration Date: June 30, 2014 Certifier's Name: John M. Morin Company Name: The Neve -Morin Group, Inc. Telephone No.: 978-887-8586 Email: john@nevemorin.com I Fax No. 978-887-3480 I Signature: Date: December 14, 2012 No. ' For requests involving a portion of property, includethe lowestground elevation within the metes and bounds description. Please note: If the Lowest Adjacent Grade to Structure is the only elevation provided, a determination will be issued for the structure only. M. DHS - FEMA Form 086-0-26A, FEB 11 Elevation Form MT -1 Form 2 Page 1 of 2 DHS - FEMA Form 086-0-26A, FEB 11 Elevation Form MT -1 Form 2 Page 2 of 2 DEPARTMENT OF HOMELAND SECURIITY - FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. NO. 1660-0015 Expires February 28, 2014 COMMUNITY ACKNOWLEDGMENT FORM PAPERWORK BURDEN DISCLOSURE NOTICE Public reporting burden for this data collection Is estimated to average 1.38 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing and submitting the form. This collection is required to obtain or retain benefits. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing this burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 1800 South Bell Street, Arlington, VA 20598-3005, Paperwork Reduction Project (1660-0015). NOTE: Do notsend your completed form to this address. This form must be completed for requests Involving the existing or proposed placement of fill (complete Section A) OR to provide acknowledgment ofthis request to remove a property from the SFHA which was previously located within the regulatory floodway (complete Section B). This form must be completed and signed by the official responsible for floodplain management in the community. The six digit NFIP community number and the subject property address must -appear in thespaces provided. below. Incomplete submissionswill result in processing delays. Please refertothe MT -1 instructions for additional information about this form. Community Number: _250098 Property Name or Address: 901-906 Alder Way & 1401-1405 Basswood Circle A REQUESTS INVOLVING THE PLACEMENT OF FILL As the community official responsible for floodplain management, I hereby acknowledge that we have received and reviewed this Letter of Map Revision Based on Fill (LOMR-F) or Conditional LOMR-F request. Based upon the community's review, we find the completed or proposed project meets or is designed to meet all of the community floodplain management requirements, including the requirement that no fill be placed in the regulatory floodway, and that all necessary Federal, State, and local permits have been, or in the case of Conditional LOMR-F, will be obtained. For Conditional LOMR-F requests, the applicant has or will document Endangered Species Act (ESA) compliance to FEMA prior to issuance of the Conditional LOMR-F determination. For LOMR-F requests, I acknowledge that compliance with Sections 9 and 10 of the ESA has been achieved independently of FEMA's process. Section 9 of the ESA prohibits anyone from "taking" orharming an endangered species. If an action might harm an endangered species, a permit is required from U.S. Fish and Wildlife Service or National Marine Fisheries Service under Section 10 of the ESA. For actions authorized, funded, or being carried out by Federal or State agencies, documentation from the agency showing its compliance with Section 7(a)(2) of the ESA will be submitted. In addition, we have determined that the land and any existing or proposed structures to be removed from the SFHA are or will be reasonably safe from flooding as defined in 44CFR 65.2(c), and that we have available upon request by DHS -FEMA, all analyses and documentation used to make this determination. For LOMR-F requests, we understand that this request is being forwarded to DHS - FEMA for a possible map revision. Community Comments: Community Official's Name and Title: (Please Print or Type) Telephone No.: Gerald Brown, BuildingDate: Inspector Date: -9545 Community Name: Commu 'ty fficial's Signature: (required) North Andover B. PROPERTY LOCATED WITHIN THE REGULATORY FLOODWAY As the community official responsible for floodplain management, I hereby acknowledge that we have received and reviewed this request for a LOMA. We understand that this request is being forwarded to DNS-FEMAto determine if this property has been inadvertently included in the regulatory floodway. We acknowledge that.no fill on this property has been or will be placed within the designated regulatory floodway. We find that the completed or proposed project meets or is designed to meet all of the community floodplain management requirements. Community Comments: Community Official's Name and Title: (Please Print or Type) Telephone No.: Community Name: Community Official's Signature (required): Date: DHS = FEMA Form 086-0-26B, FEB 11 Community Acknowledgment Form MT -1 Form 3 Page 1 of 1 a FEDERAL EMERGENCY MANAGEMENT AGENCY PAYMENT INFORMATION FORM Community Name: North Andover Project Identifier: 91-906 Alder Way & 1401-1405 Basswood Circle THIS FORM MUST BE MAILED, ALONG WITH THE APPROPRIATE FEE, TO THE ADDRESS BELOW OR FAXED TO THE FAX NUMBER BELOW. Please make check or money order payable to the National Flood Insurance Program. Type of Request: LOMC Clearinghouse MT -1 application 847 South Pickett Street ❑ MT -2 application} Alexandria, VA 22304-4605 Attn.: LOMC Manager FEMA Project Library ❑ EDR application 847 South Pickett Street Alexandria, VA 22304-4605 FAX (703) 212-4090 Request No. (if known): Check No.: Amount: 800.00 ❑ INITIAL FEE* ❑ FINAL FEE [] FEE BALANCE** ❑ MASTER CARD ❑ VISA ® CHECK ❑ MONEY ORDER *Note: Check only for EDR and/or Alluvial Fan requests.(as appropriate). **Note: Check only if submitting a corrected fee for an ongoing request. COMPLETE THIS SECTION ONLY IF PAYING BY CREDIT CARD CARD NUMBER EXP. DATE — — IT, — 1 ❑ m 1 2 3 4 5 6 7 8 9 10 11-12 13 14 15 16 Month Year Date Signature NAME (AS IT APPEARS ON CARD): (please print or type) ADDRESS: (for your credit card receipt -please print or type) DAYTIME PHONE: FEIVIA Form 81-107 Payment Information Form • DEPARTMENT OF HOMELAND SECURITY- FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. NO.1660-0015 PROPERTY INFORMATION FORM Expires February 28,2014 PAPERWORK BURDEN DISCLOSURE NOTICE Public reporting burden for this data collection is estimated to average 1.63 hours per response. The burden estimate includes -the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing and submitting the form. This collection is required to obtain or retain benefits. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send comments regarding the burden Information Collections Management, Department of Homeland Security, Federal accuracy of the burden estimate and any suggestions for reducing this to: Emergency Management Agency,1800South Bell Street, Arlington, VA 20598-3005, Paperwork Reduction Project (1660-0015). NOTE: Do not send your completed form to this address. This form may be completed by the property owner, property owner's agent, licensed land surveyor, or registered professional engineer to support a request for a Amendment (CLOMA), Letter of Map Revision Based on Fill (LOMB -F), or Conditional Letter of Map Letter of Map Amendment (LOMA), Conditional Letter of Map Revision Based on Fill (CLOMR-F) for existing or proposed, single or multiple lots/structures. In order to process your request, all information on this form must be completed in its entirety, unless stated as optional. Incomplete submissions will result in processing delays. Please check the item below that describes your request: A letter from DHS -FEMA stating that an existing structure or parcel of land that has not been elevated ❑ LOMA by fill (natural grade) would not be inundated by the base flood, ❑ CLOMA A letter from DHS -FEMA stating that a proposed structure that is not (natural Eelevatedill grade) would not be inundated by the base flood if built as proposed. LOMR-F A letter from DHS -FEMA stating that an existing structure or parcel ofn elevated by fill would not be inundated by the base flood. A letter from DHS -FEMA stating that a parcel of land or proposed structure that will be elevated by fill ❑ CLOMR-F would not be inundated by the base flood if fill is placed on the parcel as proposed or the structure is built as proposed. Fill is defined as material from any source (including the subject property) placed that raises the ground to or above the Base Flood Elevation (BFE). The common backfilling with select structural material is not considered the placement of fill if the construction practice of removing unsuitable existing material (topsoil) and practice does not alter the existing (natural grade) elevation, which is at or above the BFE. Fill that is placed before the date of the first National Flood Insurance Program (NFIP) map showing the area in a Special Flood Hazard Area (SFHA) is considered natural grade. Has fill been placed on your property to raise + ground that was previously below the BFE? ® Yes ❑ No If yes, when was fill placed? April/ 2005 monthh/ye/ye ar Will fill be placed on your property to raise ground that is below the BFE? ❑ Yes* ❑ No If yes, when will fill be placed? / month/year * If yes, Endangered Species Act (ESA) compliance must be documented to FEMA prior to issuance of the CLOMR-F determination (please refer page 4 to the MT -1 instructions). 1. Street Address of the Property (if request is for multiple structures or units, please attach additional sheet referencing each address and enter street names below): 901-906 Alder Way & 1401-1405 Basswood Circle 2. Legal description of Property (Lot, Block, Subdivision or abbreviated description from the Deed): Assessors Map 108C Block 39 Lots 901-906 & 1401-1405 (Oakridge Village - Maplewood Reserve 3. Are you requesting that a flood zone determination be completed for (check one): ® Structures on the property? What are the dates of construction? June 2005 (MM/YYYY) e July Z ®®Q'e ❑ A portion of land within the bounds of the property? (A certified metes and bounds description and map of the area to be removed, certified by a licensed land surveyor or registered professional engineer, are required. For the preferred format of metes and bounds descriptions, please refer to the MT -1 Form 1 Instructions.) ❑' The entire legally recorded property? 4. Is this request for a (check one): ❑ Single structure ❑ Single lot ® Multiple structures (How many structures are involved in your request? list the number: 2) ❑ Multiple lots (How many lots are involved in your request? List the number: In addition to this form (MT -1 Form 1), please complete the checklist below. ALL requests must include one copy of the following: DHS - FEMA Form 086-0-26, FEB 11 Property Information Form MT -.1 Form 1 Page 1 of 2 ® Copy of the effective FIRM panel on which the structure and/or property location has been accurately plotted (property inadvertently located in the NFIP regulatory floodway will require Section B of MT -1 Form 3) ® Copy of the Subdivision Plat Map for the property (with recordation data and stamp of the Recorder's Office) OR ® Copy of the Property Deed (with recordation data and stamp of the Recorder's Office), accompanied by a tax assessor's map or other certified map showing the surveyed location of the property relative to local streets and watercourses. The map should include at least one street intersection that is shown on the FIRM panel. ® Form 2 — Elevation Form. If the request is to remove the structure, and an Elevation Certificate has already been completed for this property, it may be submitted in lieu of Form 2. If the request is to remove the entire legally recorded property, or a portion thereof, the lowest lot elevation must be provided on Form 2. ® Please include a map scale and North arrow on all maps submitted. For LOMR-Fs and CLOMR-Fs, thefollowing•must be submitted in addition to the items listed above: ® Form 3 —Community Acknowledgment Form For CLOMR-Fs, the following must be submitted in addition to the items listed above: ❑ Documented ESA compliance, which may include a copy of an Incidental Take Permit, an Incidental Take Statement, a "not likely to adversely affect" determination from the National Marine Fisheries Service (NMFS) or the U.S. Fish and Wildlife Service (USFWS), or an official letter from NMFS or USFWS concurring that the project has "No Effect" on proposed or listed species or designated critical habitat. Please refer to the MT -1 instructions for additional information. Please do not submit original documents. Please retain a copy of all submitted documents for your records. DHS -FEMA encourages the submission of all required data in a digital format (e.g. scanned documents and images on Compact Disc ICD]). Digital submissions help to further DHS-FEMA's Digital Vision and also may facilitate the processing of your request. Incomplete submissions will result in processing delays. For additional information regarding this form, including where to obtain the supporting documents listed above, please refer to the MT -1 Form Instructions located at http://www.fema.gov/plan/prevent/fhm/dl mt-1.shtm. Processing Fee (see instructions for appropriate mailing address; or visit http://www,fema.gov/fhm/frm fees.shtm for the most current fee schedule) Revised fee schedules are published periodically, but no more than once annually, as noted in the Federal Register. Please note: single/multiple lot(s)/structure(s) LOMAs are fee exempt. The current review and processing fees are listed below: Check the fee that applies to your request: ❑ $325 (single lot/structure LOMR-F following a CLOMR-F) ❑ $425 (single lot/structure LOMR-F) ❑ $500 (single lot/structure CLOW or CLOMR-F) ❑ $700 (multiple lot/structure LOMR-F following a CLOMR-F, or multiple lot/structure CLOMA) ® $800 (multiple lot/structure LOMB -F or CLOMR-F) Please submit the Payment Information Form for remittance of applicable fees. Please make your check or money order payable to: National Flood Insurance Program. All documents submitted in support of this request are correct to the best of my knowledge. I understand that any false statement may be punishable by fine or imprisonment under Title 18 of the United States Code, Section 1001. Applicant's Name (required): Oakridge Village - Maplewood Reserve Mailing Address (required): 63 Atlantic Avenue Boston, MA 02110 Joseph@ aRir,i fy r-eod+Y. Cof1r1 E -Mail Address (optional): ® By checking here you may receive correspondence electronically at the email address provided): Date (required) Company (if applicable): Affinity Realty & Property Management Daytime Telephone No. (required): 978-686-4800 C/O ,,los✓ SodeMl Fax No. (optional): 978-085-0521 Signature of Applicant (required) DHS - FEMA Form 086-0-26, FEB 11 Property Information Form MT -1 Form 1 Page 2 of 2 DEPARTMENT OF HOMELAND SECURITY - FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. NO. 1660-0015 ELEVATION FORM Expires February 28,2014 PAPERWORK BURDEN DISCLOSURE NOTICE Public reporting burden for this data collection is estimated to average 1.25 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing and submitting the form. This collection is required to obtain or retain benefits. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing this burden to: Information Collections Management Department of Homeland Security, Federal Emergency Management Agency, 1800 South Bell Street, Arlington, VA 20598-3005, Paperwork Reduction Project (1660-0015). NOTE: Do not send your completed form to this address. This form must be completed for requests and must be completed and signed by a registered professional engineer or licensed land surveyor. A DHS - FEMA National Flood Insurance Program (NFIP) Elevation Certificate may be submitted in lieu of this form for single structure requests. For requests to remove a structure on natural grade OR on engineered fill from the Special Flood Hazard Area (SFHA), submit the lowest adjacent grade (the lowest ground touching the structure), including an attached deck or garage. For requests to remove an entire parcel of land from the SFHA, provide the lowest lot elevation, or, if the request involves an area described by metes and bounds, provide the lowest elevation within the metes and bounds description. All measurements are to be rounded to nearest tenth of afoot. In order to process your request, all information on this form must be completed in its entirety. Incomplete submissions will result in processing delays. 1. NFIP Community Number: 250098 Property Name or Address: 901-906 Alder Way & 1401-1405 Basswood Circle 2. Are the elevations listed below based on ® existing or ❑ proposed conditions? (Check one) 3. For the existing or proposed structures listed below, what are the types of construction? (check all that apply) ❑ crawl space ® slab on grade ❑ basement/enclosure ❑ other (explain) 4. Has DHS - FEMA identified this area as subject to land subsidence or uplift? (see instructions) ❑ Yes ® No If yes, what is the date of the current re -leveling? / (month/year) 5. What is the elevation datum? ® NGVD 29 ❑ NAVD 88 ❑ Other (explain) If any of the elevations listed below were computed usinga datum different than the datum used for the effective Flood Insurance Rate Map (FIRM) (e.g., NGVD 29 or NAVD 88), what was the conversion factor? ,� Local Elevation +/- ft. = FIRM Datum �Jt « 5 6. Please provide the Latitude and Longitude of the most upstream edge of the structure (in decimal degrees' to�the nearest fifth decimal place): Indicate Datum: ® WG584 ❑ NAD83 ❑ NAD t7o 6 .4r 2.6228 Long. -71.0606 Please provide the Latitude and Longitude of the most upstream edge of fin decimal degrees to the nearest fifth decimal place): A Indicate Datum: E WGS84 ❑ NAD83 ❑ NA 7 Lat.42.6217 Long. -71.0603 Lowest Address Lot Number Block Number Lowest Lot Elevation* Adjacent Grade To Base Flood Elevation BFE Source Structure 901-906 Alder way Building 9 117.5' 114.14' FEMA Simplified Method 1401-1405 Basswood Circle Building 14 114.3' 112.50' FEMA Simplified Method This certification is to be signed and sealed by a licensed land surveyor, registered professional engineer, or architect authorized by law to certify elevation information. All documents submitted in support of this request are carred to the best of my knowledge. I understand that any false statement maybe punishable by fine or imprisonment under Title 18 of the United States Code, Section 1001, Certifier's Name: John M. Morin License No.: 39836 Expiration Date: June 30, 2014 Company Name: The Neve -Morin Group, Inc. Telephone No.: 978-887-8586 Email: john@nevemorin.com Fax No. 978-887-3480 tH OF •. �sd4 Signature:i q Date: December 14, 2012 Vo YIA JOHN. M. MORIN CIVIL No. 39836 ' For requests involving a portion of property, include the lowest ground elevation within the metes and bounds description. Please note: If the Lowest Adjacent Grade to Structure is the only elevation provided, a determination will be Issued for the structure only. DHS - FEMA Form 086-0-26A, FEB 11 Elevation Form MT -1 Form 2 Page 1 of 2 ' Continued from Page 1. Address Lot Number Block Number Lowest Lot Elevation* Lowest Adjacent Grade To Structure Base Flood Elevation BFE Source This certification is to be signed and sealed by a licensed land surveyor, registered professional engineer, or architect authorized by law to certify elevation information. All documents submitted in support of this request are correct to the best of my knowledge. I understand that any false statement may be punishable byfine or imprisonment underTrtle 18 of the United States Code, Section 1001. Certifier's Name: License No.: Expiration Date: Company Name: Telephone No.: Email: Fax No. Signature: Date: * For requests involving a portion of property, include the lowest ground elevation within Seal (optional) the metes and bounds description. Please note: If the Lowest Adjacent Grade to Structure is the only elevation provided, a determination will be issued for the structure only. DHS - FEMA Form 086-0-26A, FEB 11 Elevation Form MT -1 Form 2 Page 2 of 2 DEPARTMENT OF HOMELAND SECURITY - FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. NO.1660-0015 COMMUNITY ACKNOWLEDGMENT FORM Expires February 18, 1014 PAPERWORK BURDEN DISCLOSURE NOTICE Public reporting burden for this data collection is estimated to average 1.38 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing and submitting the form. This collection is required to obtain or retain benefits. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing this burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 1800 South Bell Street, Arlington, VA 20598-3005, Paperwork Reduction Project (1660-0015). NOTE: Do notsend your completed form to this address. This form must be completed for requests involving the existing or proposed placement of fill (complete Section A) OR to provide acknowledgment of this request to remove a property from the SFHA which was previously located within the regulatory floodway (complete Section B). This form must be completed and signed by the official responsible for floodplain management in the community. The six digit NFIP community number and the subject property address mustappear in thespaces provided below. Incomplete submissions will result in processing delays. Please refer to the MT -1 instructions for additional information about this form. Community Number: _250098 Property Name or Address: 901-906 Alder Way & 1401-1405 Basswood Circle A. REQUESTS INVOLVING THE PLACEMENT OF FILL As the community official responsible for floodplain management, I hereby acknowledge that we have received and reviewed this Letter of Map Revision Based on Fill (LOMR-F) or Conditional LOMR-F request. Based upon the community's review, we find the completed or proposed project meets or is designed to meet all of the community floodplain management requirements, including the requirement that no fill be placed in the regulatory floodway, and that all necessary Federal, State, and local permits have been, or in the case of a Conditional LOMR-F, will be obtained. For Conditional LOMR-F requests, the applicant has or will document Endangered Species Act (ESA) compliance to FEMA prior to issuance of the Conditional LOMR-F determination. For LOMB -F requests, I acknowledge that compliance with Sections 9 and 10 of the ESA has been achieved independently of FEMA's process. Section 9 of the ESA prohibits anyone from "taking" or harming an endangered species. If an action might harm an endangered species, a permit is required from U.S. Fish and Wildlife Service or National Marine Fisheries Service under Section 10 of the ESA. For actions authorized, funded, or being carried out by federal or State agencies, documentation from the agency showing its compliance with Section 7(a)(2) of the ESA will be submitted. In addition, we have determined that the land and any existing or proposed structures to be removed from the SFHA are or will be reasonably safe from flooding as defined in 44CFR 65.2(c), and that we have available upon request by DHS -FEMA, all analyses and documentation used to make this determination. For LOMR-F requests, we understand that this request is being forwarded to DHS - FEMA for a possible map revision. Community Comments: Community Official's Name and Title: (Please Print or Type) Telephone No.: Gerald Brown, Building. Inspector 978-688-9545 Community Name: Commu ' fficial'sSignature: (required) Date: North Andover /-a Z/ B. PROPERTY LOCATED WITHIN THE REGULATORY FLOODWAY As the community official responsible for floodplain management, I hereby acknowledge that we have received and reviewed this request for a LOMA. We understand that this request is being forwarded to DHS -FEMA to determine if this property has been inadvertently included in the regulatory floodway. We acknowledge that no fill on this property has been or will be placed within the designated regulatory floodway. We find that the completed or proposed project meets or is designed to meet all of the community floodplain management requirements. Community Comments: Community Official's Name and Title: (Please Print or Type) Telephone No.: Community Name: Community Official's Signature (required): Date: DHS = FEMA Form 086-0-26B, FEB 11 Community Acknowledgment Form MT -1 Form 3 Page 1 of 1 FEDERAL EMERGENCY MANAGEMENT AGENCY PAYMENT INFORMATION FORM Community Name: North Andover Project Identifier: 91-906 Alder Way & 1401-1405 Basswood Circle THIS FORM MUST BE MAILED, ALONG WITH THE APPROPRIATE FEE, TO THE ADDRESS BELOW OR FAXED TO THE FAX NUMBER BELOW. Please make check or money order payable to the National Flood Insurance Program. Type of Request: LOMC Clearinghouse ® MT -1 application 847 South Pickett Street ❑ MT -2 application} Alexandria, VA 22304-4605 Attn.: LOMC Manager ❑ EDR application I Request No. (if known): Check No.: FEMA Project Library 847 South Pickett Street Alexandria, VA 22304-4605 FAX (703) 212-4090 Amount: 800.00 ❑ INITIAL FEE* ❑ FINAL FEE [] FEE BALANCE** ❑ MASTER CARD ❑ VISA ® CHECK ❑ MONEY ORDER *Note: Check only for EDR and/or Alluvial Fan requests.(as appropriate). **Note: Check only if submitting a corrected fee for an ongoing request. I COMPLETE THIS SECTION ONLY IF PAYING BY CREDIT CARD CARD NUMBER EXP. DATE FTI m 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Month Year Date Signature NAME (AS ITAPPEARS ON CARD): (please print or type) ADDRESS: (for your credit card receipt -please print or type) DAYTIME PHONE: FEMA Form 81-107 Payment Information Foran THE NEVE-MORIN GROUP, INC. F ' Engineers • Surveyors . Environmental Consultants • Land Use Planners 447 Boston Street US Route 1 Topsfield, MA 01983 www.nevemorin.com 978- 887-8586 FAX 978-887-3480 LETTER OF TRANSMITTAL Date: December 21, 2012 To: Gerald Brown Inspector of Buildings 1600 Osgood Street — Bldg 20 - Suite 2-36 North Andover, MA Re: LOMA Application 901-906.Aider--NU4 &-.14-01-1405--Circle We are sending you the following: Copies Date No. Description 1 LOMA application These are transmitted as checked below: For Review / Approval x For Your Use As Requested For Review / Comment For Your Information For Quote For execution For Completion Remarks: Hi Gerry, Please find attached a copy of the LOMA application that was submitted for the above referenced addresses for your file. The only thing I did not give you is the Master Deed. Any questions please give me a call. Thanks, Signed: Copy to: DEPARTMENT OF HOMELAND SECURITY - FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. NO. 16M-0015 PROPERTY INFORMATION FORM Expires February 28, 2014 PAPERWORK BURDEN DISCLOSURE NOTICE Public reporting burden for this data collection is estimated to average 1.63 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing and submitting the form. This collection is required to obtain or retain benefits. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing this burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 1800 South Bell Street, Arlington, VA 20598-3005, Paperwork Reduction Project (1660-0015). NOTE: Do not send your completed form to this address. This form may be completed by the property owner, property owner's agent, licensed land surveyor, or registered professional engineer to support a request for a Letter of Map Amendment (LOMA), Conditional Letter of Map Amendment (CLOMA), Letter of Map Revision Based on Fill (LOMR-F), or Conditional Letter of Map Revision Based on Fill (CLOMR-F) for existing or proposed, single or multiple lots/structures. In order to process your request, all information on this form must be completed in its entirety, unless stated as optional. Incomplete submissions will result in processing delays. Please check the item below that describes your request: ❑ LOMA A letter from DHS -FEMA stating that an existing structure or parcel of land that has not been elevated by fill (natural grade) would not be inundated by the base flood. ❑ CLOMA A letter from DHS -FEMA stating that a proposed structure that is not to be elevated by fill (natural grade) would not be inundated by the base flood if built as proposed. ® LOMR-F A letter from DHS -FEMA stating that an existing structure or parcel of land that has been elevated by fill would not be inundated by the base flood. ❑ CLOMR-F A letter from DHS -FEMA stating that a parcel of land or proposed structure that will be elevated by fill would not be inundated by the base flood if fill is placed on the parcel as proposed or the structure is built as proposed. Fill is defined as material from any source (including the subject property) placed that raises the ground to or above the Base Flood Elevation (BFE). The common construction practice of removing unsuitable existing material (topsoil) and backfilling with select structural material is not considered the placement of fill ifthe practice does not alter the existing (natural grade) elevation, which is at or above the RIFE. Fill that is placed before the date of the first National Flood Insurance Program (NFIP) map showing the area in a Special Flood Hazard Area (SFHA) is considered natural grade. Has fill been placed on your property to raise ground that was previously below the BFE? ® Yes ❑ No If yes, when was fill placed? April/2005 ± month/year Will fill be placed on your property to raise ground that is below the BFE? ❑ Yes* ❑ No If yes, when will fill be placed? / month/year ' If yes, Endangered Species Act (ESA) compliance must be documented to FEMA prior to issuance of the CLOMR-F determination (please refer page 4 to the MT -1 instructions). 1. Street Address of the Property (if request is for multiple structures or units, please attach additional sheet referencing each address and enter street names below): 901-906 Alder Way & 1401-1405 Basswood Circle 2. Legal description of Property (Lot, Block, Subdivision or abbreviated description from the Deed): Assessors Map 108C Block 39 Lots 901-906 & 1401-1405 (Oakridge Village - Maplewood Reserve 3. Are you requesting that a flood zone determination be completed for (check one): ® Structures on the property? What are the dates of construction? June 2005 (MM/YYYY) _ J„ I y t OD 6 ❑ A portion of land within the bounds of the property? (A certified metes and bounds description and map of the area to be removed, certified by a licensed land surveyor or registered professional engineer, are required. For the preferred format of metes and bounds descriptions, please refer to the MT -1 Form 1 Instructions.) ❑ The entire legally recorded property? 4. Is this request for a (check one): ❑ Single structure ❑ Single lot ® Multiple structures (How many structures are involved in your request? List the number: 2) ❑ Multiple lots (How many lots are involved in your request? List the number: ) In addition to this form (MT -1 Form 1), please complete the checklist below. ALL requests must include one copy of the following: DMS - FEMA Form 066-0-26, FEB 11 Property Information Form MT -1 Foran 1 Page 1 of 2 ® Copy of the effective FIRM panel on which the structure and/or property location has been accurately plotted (property inadvertently located in the NFIP regulatory floodway will require Section B of MT -1 Form 3) ® Copy of the Subdivision Plat Map for the property (with recordation data and stamp of the Recorder's Office) OR ® Copy of the Property Deed (with recordation data and stamp of the Recorder's Office), accompanied by a tax assessor's map or other certified map showing the surveyed location of the property relative to local streets and watercourses. The map should include at least one street intersection that is shown on the FIRM panel. ® Form 2 — Elevation Fon). If the request is to remove the structure, and an Elevation Certificate has already been completed for this property, it may be submitted in lieu of Form 2. If the request is to remove the entire legally recorded property, or a portion thereof, the lowest lot elevation must be provided on Form 2. ® Please include a map scale and North arrow on all maps submitted. For LOMR-Fs and CLOMR-Fs, the following must be submitted in addition to the items listed above: ® Form 3 —Community Acknowledgment Form For CLOMR-Fs, the following must be submitted in addition to the items listed above: ❑ Documented ESA compliance, which may include a copy of an Incidental Take Permit, an Incidental Take Statement, a "not likely to adversely affect" determination from the National Marine Fisheries Service (NMFS) or the U.S. Fish and Wildlife Service (USFWS), or an official letter from NMFS or USFWS concurring that the project has "No Effect" on proposed or listed species or designated critical habitat. Please refer to the MT -1 instructions for additional information. Please do not submit original documents. Please retain a copy of all submitted documents for your records. DHS -FEMA encourages the submission of all required data in a digital format (e.g. scanned documents and images on Compact Disc [CD)). Digital submissions help to further DHS-FEMA's Digital Vision and also may facilitate the processing of your request. Incomplete submissions will result in processing delays. For additional information regarding this form, including where to obtain the supporting documents listed above, please refer to the MT -1 Form Instructions located at http://www.fema.gov/plan/prevent/fhm/dl mt-l.shtm. Processing Fee (see instructions for appropriate mailing address; or visit http://www.fema.gov/fhm/frm fees.shtm for the most current fee schedule) Revised fee schedules are published periodically, but no more than once annually, as noted in the Federal Register. Please note: single/multiple lot(s)/structure(s) LOMAs are fee exempt. The current review and processing fees are listed below: Check the fee that applies to your request: ❑ $325 (single lot/structure LOMR-F following a CLOMR-F) ❑ $425 (single lot/structure LOMR-F) ❑ $500 (single lot/structure CLOMA or CLOMR-F) ❑ $700 (multiple lot/structure LOMB -F following a CLOMR-F, or multiple lot/Structure CLOMA) ® $800 (multiple lot/structure LOMR-F or CLOMR-F) Please submit the Payment Information Form for remittance of applicable fees. Please make your check or money order payable to: National Flood Insurance Program. All documents submitted in support of this request are correct to the best of my knowledge. I understand that any false statement maybe punishable by fine or imprisonment under Title 18 of the United States Code, Section 1001. Applicant's Name (required): Oakridge Village - Maplewood Reserve Mailing Address (required): 63 Atlantic Avenue Boston, MA 02110 30sePti@ OLMnI fy r-ea)}Y. conA E -Mail Address (optional): ® By checking here you may receive correspondence electronically at the email address provided): Date (required) Company (if applicable): Affinity Realty & Property Management Daytime Telephone No. (required): 978-686-4800 C.lO }-1 Oe S 0.I 2 M 1 Fax No. Sigm re of plica) required) V ry- DHS - FEMA Form 086-0-26, FEB 11 Property Information Form MT -1 Form 1 Page 2 of 2 DEPARTMENT OF HOMELAND SECURITY - FEDERAL EMERGENCY MANAGEMENT AGENCY' O.M.e. NO. 1660-0015 ELEVATION FORM Expires February 28, 2014 PAPERWORK BURDEN DISCLOSURE NOTICE Public reporting burden for this data collection is estimated to average 1.25 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing and submitting the form. This collection is required to obtain or retain benefits. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing this burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 1800 South Bell Street, Arlington, VA 20598-3005, Paperwork Reduction Project (1660-0015). NOTE: Do not send your completed rm to this address. 7formmust be completed for requests and must be completed and signed by a registered professional engineer or licensed land surveyor. A DHS - FEMA National [Flood urance Program (NFIP) Elevation Certificate may be submitted in lieu of this form for single structure requests. or requests to remove a structure on natural grade OR on engineered fill from the Special Flood Hazard Area (SFHA), submit the lowest adjacent grade (the lowest ground touching the structure), including an attached deck or garage_ For requests to remove an entire parcel of land from the SFHA, provide the lowest lot elevation; or, if the request involves an area described by metes and bounds, provide the lowest elevation within the metes and bounds description. All measurements are to be rounded to nearest tenth of a foot. in order to process your request, all information on this form must be completed in its entirety. Incomplete submissions will result in processing delays. 1. NFIP Community Number: 250098 Property Name or Address: 901-906 Alder Way & 1401-1405 Basswood Circle 2. Are the elevations listed below based on ® existing or ❑ proposed conditions? (Check one) 3. For the existing or proposed structures listed below, what are the types of construction? (check all that apply) ❑ crawl space ® slab on grade ❑ basement/enclosure ❑ other (explain) 4. Has DHS- FEMA identified this area as subject to land subsidence or uplift? (see instructions) []Yes ®No If yes, what is the date of the current re -leveling? J (month/year) 5. What is the elevation datum? ® NGVD 29 ❑ NAVD 88 ❑ Other (explain) If any of the elevations listed below were computed using a datum different than the datum used for the effective Flood Insurance Rate Map (FIRM) (e.g., NGVD 29 or NAVD 88), what was the conversion factor? BJi) ao ng Local Elevation +/- ft. = FIRM Datum r 6. Please provide the Latitude and Longitude of the most upstream edge of the structure (in decimal degrees to the nearest fifth decimal place): Indicate Datum: ® WGS84 ❑ NAD83 ❑ NAD2 . 42.6228 Long. -71.0606 ��L Please provide the Latitude and Longitude of the most upstream edge of A fin decimal degrees to the nearest fifth decimal place): Indicate Datum: ® WGS84 ❑ NAD83 ❑ NA 7 Lat. 42. 6217 Long. -71.0603 �ul'�d'+n9 4 14 - Lowest Lowest Address Lot Number Block Lowest Lot Adjacent Base Flood BFE Source Number Elevation* Grade To Elevation Structure 901-906 Alder way Building 9 117.5' 114.14' FEMA Simplified Method 1401-1405 Basswood Circle Building 14 114.3' 112.50' FEMA Simplified Method This certification is to be signed and sealed by a licensed land surveyor, registered professional engineer, or architect authorized by law to certify elevation information. All documents submitted in support of this request are correct to the best of my knowledge. I understand that any false statement maybe punishable by fine or imprisonment under Title 18 of the United States Code, Section 1001. Certifier's Name: John M. Morin License No.: 39836 Expiration Date: June 30, 2014 Company Name: The Neve -Morin Group, Inc. Telephone No.: 978-867-8586 Email: john@nevemorin.com Fax No_ 978-887-3480 OF Signature: „ Date: December 14, 2012 JOHN M. r, MORIN ., civil NO. 39836' * For requests involving a portion of property, include the lowest ground elevation within \ . the metes and bounds description. Please note: If the Lowest Adjacent Grade to Structure is the only elevation provided, a determination will be issued for the structure only. DHS - FEMA Form 086-0-26A, FEB 11 Elevation Form MT -1 Form 2 Page 1 of 2 Continued from Page 1. Address Lot Number Block Number Lowest Lot Elevation* Lowest Adjacent Grade To Structure Base Flood Elevation BFE Source This certification is to be signed and sealed by a licensed land surveyor, registered professional engineer, or.architect authorized by law to certify elevation information. All documents submitted in support of this request are correct to the best of my knowledge. 1 understand that any false statement may be punishable by fine or imprisonment under Title 18 of the United States Code, Section 1001. Certifier's Name: License No.: Expiration Date: Company Name: Telephone No.: Email: Fax No. Signature: Date: * For requests involving a portion of property, include the lowest ground elevation within the metes and bounds description. Seal (optional) Please note: If the Lowest Adjacent Grade to Structure is the only elevation provided, a determination will be issued for the structure only. DHS - FEMA Form 086-0-26A, FEB 11 Elevation Form MT -1 Form 2 Page 2 of 2 DEPARTMENT OF HOMELAND SECURITY - FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. NO.1660-0015 COMMUNITY ACKNOWLEDGMENT FORM Expires February 28, 2014 PAPERWORK BURDEN DISCLOSURE NOTICE Public reporting burden for this data collection is estimated to average 1.38 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the needed data, and completing and submitting the form. This collection is required to obtain or retain benefits. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing this burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 1800 South Bell Street, Arlington, VA 20598-3005, Paperwork Reduction Project (1660-0015). NOTE: Do not send your completed form to this address. This form must be completed for requests involving the existing or proposed placement of fill (complete Section A) OR to provide acknowledgment of this request to remove a property from the SFHA which was previously located within the regulatory floodway (complete Section B). This form must be completed and signed by the official responsible for floodplain management in the community. The six digit NFIP community number and the subject property address must appear in the spaces provided below. Incomplete submissions will result in processing delays. Please refer to the MT -1 instructions for additional information about this form. Community Number: _250098 Property Name or Address: 901-906 Alder Way & 1401-1405 Basswood Circle A. REQUESTS INVOLVING THE PLACEMENT OF FILL As the community official responsible for floodplain management, I hereby acknowledge that we have received and reviewed this Letter of Map Revision Based on Fill (LOMR-F) or Conditional LOMR-F request. Based upon the community's review, we find the completed or proposed project meets or is designed to meet all of the community floodplain management requirements, including the requirement that no fill be placed in the regulatory floodway, and that all necessary Federal, State, and local permits have been, or in the case of a Conditional LOMR-F, will be obtained. For Conditional LOMR-F requests, the applicant has or will document Endangered Species Act (ESA) compliance to FEMA prior to issuance of the Conditional LOMR-F determination. For LOMR-F requests, I acknowledge that compliance with Sections 9 and 10 of the ESA has been achieved independently of FEMA's process. Section 9 of the ESA prohibits anyone from "taking" or harming an endangered species. If an action might harm an endangered species, a permit is required from U.S. Fish and Wildlife Service or National Marine Fisheries Service under Section 10 of the ESA. For actions authorized, funded, or being carried out by Federal or State agencies, documentation from the agency showing its compliance with Section 7(a)(2) of the ESA will be submitted. In addition, we have determined that the land and any existing or proposed structures to be removed from the SFHA are or will be reasonably safe from flooding as defined in 44CFR 65.2(c), and that we have available upon request by DHS -FEMA, all analyses and documentation used to make this determination. For LOMR-F requests, we understand that this request is being forwarded to DHS - FEMA for a possible map revision. Community Comments: Community Official's Name and Title: (Please Print or Type) Telephone No.: Gerald Brown, BuildingInspector 978-688-9545 Community Name: Commu 'ty icial's Signature: (required) Date: North Andover B. PROPERTY LOCATED WITHIN THE REGULATORY FLOODWAY As the community official responsible for floodplain management, I hereby acknowledge that we have received and reviewed this request for a LOMA. We understand that this request is being forwarded to DHS -FEMA to determine if this property has been inadvertently included in the regulatory floodway. We acknowledge that no fill on this property has been or will be placed within the designated regulatory floodway. We find that the completed or proposed project meets or is designed to meet all of the community floodplain management requirements. Community Comments: Community Official's Name and Title: (Please Print or Type) Telephone No.: Community Name: Community Official's Signature (required): Date: DHS - FEMA Form 086-0-26B, FEB 11 Community Acknowledgment Form MT -1 Form 3 Page 1 of 1 FEDERAL EMERGENCY MANAGEMENT AGENCY PAYMENT INFORMATION FORM Community Name: North Andover Project Identifier: 91-906 Alder Way & 1401-1405 Basswood Circle ITHIS FORM MUST BE MAILED, ALONG WITH THE APPROPRIATE FEE, TO THE ADDRESS BELOW OR FAXED TO THE FAX NUMBER BELOW. Please make check or money order payable to the National Flood Insurance Program. Type of Request: LOMC Clearinghouse ® MT -1 application 847 South Pickett Street ❑ MT -2 application} Alexandria, VA 22304-4605 Attn.: LOMC Manager Request No. (if known): ❑ EDR application }. FEMA Project library 847 South Pickett Street Alexandria, VA 22304-4605 FAX (703) 212-4090 CheckNo.: zLiGZ- Amount: 800.00 ' ❑ INITIAL FEE* ❑ FINAL FEE ❑ FEE BALANCE** ❑ MASTERCARD ❑ VISA ® CHECK ❑ MONEY ORDER *Note: Check only for EDR and/or Alluvial. Fan requests.(as appropriate). **Note: Check only if submitting a corrected fee for an ongoing request. COMPLETE THIS SECTION ONLY IF PAYING BY CREDIT CARD CARD NUMBER EXP. DATE m m 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Month Year 1 Date INAME (AS IT APPEARS ON CARD): (please print or type) ADDRESS: (for your credit card receipt -please print or type) I DAYTIME PHONE: Signature FEMA Form 81-107 Payment Information Form .. .S'aa*�."�'$,�r bv r+'w' ��`_a7`s*�.« t-'tater' �4 �+e z TO 'fy' ,_ w t •r ° tr s�K� f,w+ a, .,n -:L r yr, y x a ''` 1 +25�` t` i$,'� s .?'�' r" a„7 � THE NATTONALrFLOOD}INS PROGRAM ORDER OF AUTHO ZED`SDGNATURE' NOT VALID AFTER 90 DAYS i 1 ii■002452u' i:0iL30L3�C]l: 2L4'24'845u• z 1 W W cow c C�� D o n bo a �. u 3 u 3 to b (ZL4 m L4 N Oo a W W W CD• a o O 3N oo 3 i,w O N 0 ± 3 ± d �-C 0, II Ln II ,7 fD fD �+ 3 3 a 0 4 ^ �v Un II 3 II 3 N L -j L4 0 O W — bn 00 — in 0 1+ 3 3 p II � II 3 O. N P L O P