HomeMy WebLinkAbout242-1852, 7 Fuller Meadow Road OOC - Permits #242-1852 - 7 FULLER MEADOW ROAD 10/5/2022 4
Maggachusetts Departunent of Environmental Protection 11'rovided by MassDEP:
Bureau of Resource �Protection - Wetlands 42-185
22
WSSDEIF He
WPA Form 5 — Order� f Conditina ons,
MassalchUSettS Wetlands Protection Act M.G.L. c. 131, §40 elDEP'Trans,ad-iun#
!j North Andovei
Gilyffown
.......................
A. General Inforination
Pleaso North Andover
U iis fori i i I i, From, ,- ...........
been,Modified Connervation C(inunKslori
with addPA 2. Th[s iSSUzllI0e is for,,
struck.10 a. Order of Conditions b. Fl,An-tended Order of Conditioi-ts
arcorlunodale (checkone)�:
Via Rugislipy
&DeEds 3. To,: Applicant,
Raquire,manla
Matthew Zal-toruft
..
I'll—Na-01 67EiifRame ..... ...............
lnlplcortaf)t��
Whon fitling
............................ ...........
out fo,nns on c:.Organiz@tion
the 7 FLtH,09' Ml(-,,!adow Road
complyter, ..........................
ul.e only the (d. MadingAd"Allre,,os,
t,alti,kray to Norlh Andover MA 01845
11novo your e.Gityffown f State g. Zip Cf2dn
cursofr-do
not use the 4, P roperty Owner (if different f'romi a pplicant).
re'tUrn key
v QW a.Finil Name b. Last N2ino
...............
..... ........
d. Mailing.Addiress
11... ............................ ... ........
ie. Cilyffown f,state g,Zip Code
r Project Location:
7 Fuller Meadow Road, North Andover
a.�tr'ee't Address ............... b. Gityffown
Map 104D Lot '129
A ....... ......
c. s s-,a P16 se ors P—Wt Njumbef d, Farcetk.ot Number
Latitude and Lon gitirde, if known. 42d6ft9l7s 71d07m427s
,d. Lablude a:. Long'tudia
�Nym�npnv'Mr, rpv"A,"OP.0 P;lg,.I elf I'l,
4
Marsachus,etts Department of Environmental Protection Provided by MassDEP�
Bureau of Resource Protection - We;tla nod s 242-11852
WPA Form 5, �- Order of Conditions 'M4ISSIJEP File-9
M #
assachusetts Wetlands Protecfion� Act M.G. 1 L. 31 §4 0 DEP ansaction
North-Andover
.............- ................
....... ........
X General Information (,cont.)
6. Property rec.,orded at the Registry of Deeds for(attach additional inforimation it more than
one parcel)i,
N arth erni Essex 18595
a. County b-Coilifirale Number(iif registered nand
.......................
C' Book d-Page
7 Dates. August 5, 20,22 Septernber 28, 2022 5, 2022
a.Date Nobue of lInte-int Hed b-Data Public Hbairinq closed c. Date of Ilssuance
a Final Approved Plans and Other Documerils, (attich additilomal plan or document references
as needed):
131an toAcconipany a Notice of Intent 7 FUller Meadow Road
--.—Pllan Tiii
willi-arns & SYl ages Richard L. Williams, PE
b 10'f'oparod"'Y c.Signed and StarnIped by
Septembeir 21, 2022
d.Final Revision Date c. Scale
See Attached
.... .......
f,A(JdRR)inqI Plain or Document Tiffe Win:
B. Findings
1. Findings pursuant to Ote Massachusetts Wetlands Protection Act:
Following the ireview of the above-referenced Notice of Intent and based on the information
provided in this 3ppliC2tiorl, and presented at the, public hearing, this Conimissi,on finds that
the areas in which work is piropo8eid iis isngnifiicant to the foflowfi-tg interests of the Wetlands
Protection Act (the Act). Check all that apply:
0 0 Pl-evention of
a. Public Water Suipply b. E] Land Containing Shelffish " Polkifion
d. Private Water supply P. E Fisheries f. M Protection of
Wildlife Habitat
Ciroundwateir Supply h. � Storm IDarnage Prevention i, Flood Contro,[
2. This Grarn;rnission hereby finds the project, as,proposed, is- (check erne of the following boxes),
Approved subject to::
a. MI the followinig conditions wh0i are irleice,5sairy in accordance with the perforrnance
standards set forth in, the wetlandt reigulatians- This Commission ordems tltait alll work shall
be Performed in accordance with the Noflice of iIntent referenced above, th�e following
General Condifiotis, and any otherspieoial conditions,attached to,thJis Orde r. To the extent
that the following conditi,ons modify or differ from the plains, specificatiiorl% or other
proplasals SUbirnifted with the Notice of Intent, these condili,ons shall control.
vvpsfimr,r5 doc-rey 5XI&TC29 1115"19 2 0 1:1"q
4
Massachusetts Depairttnent of Environmental Prutection Provided by NtassDEP:
Bureau of Resource Protection - 242-185
Wetlands 2
WPA Firm 5 — Order o�f Conditions
Massachusetts Wetlands ProtecUon Act M.G.L., c. 131, §40 eDEP Tfarlsactioni 0,
Nor9i Andaver
..................
CityTF,uwa
...............
B. Findings (cont.),
Denied becaUse::
b. 0 the proposed work.cannot be conditioned to, meet the perfofmance starldards set,forth
in the wet'land regUlations. Therefore, work on this project may not go forward unless and
until a new,Notice of Intent is submitted which provides measures wfijc are adequate to
protect the interests, of the,Art, and a final Order of Conditions is, issuoid. A diescription of
this performance standards which the Ipropose.dl work cannot meet is attached to this
Order.
r_ F1 the inforniation SUbimitted by the applicant ns not siufftcierit to describe the site, the work,
or Vie effect of the work inn the interests, [denifified in the Wetlands Protection Act.
Therefore, work or) this, project may not go forward unless and tintil a revised Notice of
Intent is subrnitted which, provides sufficient Information arld includes measures which are
adequate to protect the Act's, interests, and a final, Order of Condit[ons is issued. A
desc�ription o f the spLt-cific informatJon which is, lacking and why it is necessary is
attached to this Order as per 310 CMR,10.05(6)(c).
3. Buffer Zone lnipacts,1-11 Shortest:distal-tce between fin-lit of project 61
disturbance and the wetland resource area specified in 310 CMR 10.02(1)(a) plantings,1111
Inland Resource Area Impacts:: Check all that apply bel'Ow, fFor Approvak,3, Only)
Resource Area Proposed Permitted Proposed Permitted
Alteration Alteration Replacernerrt Replacement
4. [I dank
a. linear feet b. fiflearfeer o. linow foat d. Finear fact
5. El Bordering
Vegetated Wetland a,square feed b. & uafe fact C. Square fe'et d.square feet
ri, E] Land Under
Waterbo6es and a.square feet b. L)quarp feat C'. Square foot d.squares feet
Waterways,
e. ciy dredged f. cJy dredged
7, �1 Bordering Land ...............
Subject to Filoodinig a.square feel is Squafe foot c.squaro,fact d.squa,re feet
CuUc Feet Flood Storage T-cubic-feel. i. cubic feet g cubic feet K cob.1,1 c Net
B. El Isolated Land
&Jbject to Floodiag .11d square feel t). square feat
Cubic Feet 11ood Stor-ago ..................
c.cubic Feet d.cublc feet e cubir;feet cub6c fdot
9. D Rive rff ont Area
.q,total sq. fool b.total sq. feed
Sq ft w4hin '100,ft
C. SqUaFe feet '-'s(iu'a'Fie feet o, aquaro fool f.squwe feet
Sq It between 100-
200 ft Tsquare f ee h.s 11 q-u I I are feet i.square feel J�square foot
W171WOMN NK FEW fllgn 3 af
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Massa cniu s,etts, Depantinent of Environvoental Protection Provided by rdassDEP:
BUreau if ReSOUrce Protectiorl, - Wetlands 242-18 52
Massl)Efl Hile#
WPA Forin 5 — Order of Conditions
Massachusetts Wetlands Protection Act M,G.L,, c. 131, §,40 eDEPTTInsact�Dn ft
North And'over
Gity[Tawn
B., Findings (cont-)
Coastal Resource Area Impacts, heck all that apply below. (For Approvals Ortly)
Proposed Perr'nitted Proposed, Permitted
Alteration Alterafloti Replacernien't Replacement
to,, El Designated lPort Indicate size under Land Ul nd er th e Ocean, bellow
Areas,
11. E] Land Under the
Ocean q.square feet b.square feet
..............-
r,. rly Wedged d. Oy dradpel
12. E] Barrier Beaohes Indicate size Under Coast.,fl Beaches and/Lor Coastal Dunes
bclow
Ulf,Yd CAR Y'd
EJ Coa.,Aal Beacheg Fi..sqi,iar(�friel b. square feet c naurishniond d. nourishnmnr
14. Coastw �Djunes clu yd f uyl
a�. Sqliare feet b. SqUaFe feet Q C101IFiShMent d. nougishn,e r
v- El Coastal Banks a. I'iinoar feat b. linear feet
16. Rocky Intertidal
Shores a,:Square feet tLSKJLIIRre fret
17 El Salt Mairshes ............................. .......
a.square feet b. square feet c.square feet d.square feet
16, Land Under Salt
Ronds a.squalo feet K,s(Itlaro W-1
e. dy dredged d.c,fy dredged
la, El Land Containing
Shellfish a,Squaso feel b.squaw,fool c.square feet Cil. %qUaffl fOL11
20. E] Fish RLMS Indicate size under Coastal Banks, Inland Bank, Land Under
the Ocean, andfor inland Land Under Waterbod[es and
Waterways, above
a.,cly dredged b. cs'y dredged
21 11.and SubjeGt to
Coastal Storm a-square foot b.siquare feet
Flowage
22. E] R[Vorftont Area
aj.toted sq.feet b. total sq. feet
Sq ft wAhin 100 ft
ir,squam feel, d.Square feet, a-square feat f.square,faer
Sq ft between 100-
200,ft g.SqUare feet. h.square feet K:squ,are feet Square ferret
I IRQ,0-1 of la
4
Mars-sacillusetts Department of Environmental Protection, Provided by M8S,,-fl)PR
Bureau of Re,source Protedi'011 - Wetlands 2412-11852
-K1m"-5q 13FP File#
WRA Form 5 1- Order of Conditions
Massachusetts Wetland's Protection Act I. ,IL, c. 1131, §40
North(And over
B,., Findings (cont.)
#23 if tke 23. F-1 �Restoii,@tionlEiiliaiicemen,t
p(oJ,P.,r;t if.fix
the purposa of
restoring air
enhancing a q,square fact of B ki.square feet of salt marsh
wetiand
FeSGUrue are 24. �F-1 Strearn Crossing(s):
hi midWork to
Via square . ......... ............ .... ......
faiata.90 twiibe r of new streann crossings, b. number of repfacemenn&trearri cxfi
has been G. General Conditions Un�der Mas,sachUsetts Wetlands Protection AGt
entered in
Section H,5,
(RM)of The following conditions, are only applicable to Approved projects.
B.-1'1.c(,asap
Mafsh)abovei, I. Failuirle to cornply with all conditions stated herein, i wabi all related statutes and other
p�ease eteir
the:additnional regulatqry measiures, .shall be deen-ted cause to revoke of, niodify this Order.
amount here, 2. The Order does net grant 8ny property rights,or any exclusive privileges, it does hot
authorize any injury to private property or invasion of private rights,
This Order does, not relieve the pleanittee or any other person of the necessity of complying
with all other applicable federal, state, or local stah,ites, ordinances, bylaws,, or regulations.
4. The wark aulborized hereunder shafl be,completed within three years from the date of this
Order Unless either of the following app,[Y
a The work is a, maintenance dredging project as provided for in the Act, or
b The fime for completion hais been extionded to a specified date more than three years,
but less than live years, from the date,Of iSSLfance, Ilf this Cirder is intended to be valid
for,more, than three,years, the extension date,and the special circumstances wai-iranfing
the extended firrie per[od are set forth, as ,a spec al condition in this Order.
c. If the work is for a"'rest Project:,, this Ori of Conditions shall be,valid for no, ri than
one year.
5. This Order niay be extended by the iSSUinq authority for one or more periods Of Lip to three
years eacli upon application to tho issuing authority at least 30 days prior to the expiration
date Of the Order, An Order of Canditions for a Test Project i-nay be extended for One
additional year only upon wiritter,application by the applicant, Subject to,the provisions of 310,
CMR 10.0,5(11)(f),
6. If this Order consfitutes an Amended Order of Conditions, this Amended Order of
Cond itionis does neat exte rid the issuance date of the orig i aal F i nal Order of Conditions,and
the:Order will expire or) unless extended iin writirig, bythie Departniient.
7. Any fill) used in, conniectib n with this project s hall be clean,frill, Any fill shall contain, no trash,
refuse, rubbish, or debris, including but not firriJited to Wniber, brliGks, plaster, wire, Illath,
paper, cardboard, pipe, fires, ashes, refrigerators, rinotor vehibl:es, or parts of any of the
foregoing.
I,vpatormlui.*Dc rev bMWOM, 5 Ur 13
4
Massachusetts Department of Environmental Protection Picjvidad by MassDEP�
1 urea u of Res ouroe Pmtection etlands 242-1852
MassDEP He#
WPA Form 5 — Order of Conditions
MassachUsetts Wetlands Protection Act KG1. c. 13,11, §40 Dr-- transactian,#
North.Andovei-
Ulyff Owl
C General Conditions Under Massachusetts Wetlands Protection Act
8.. This Order is riot finaI until all adii,,iinistrafive!appeal periods from this Order have 1011apsed,
or iif such an appeal has, been taken, until all proceedings before the Department have boer"i
completed.
9- No work shall be Undertaken until the Order has bc,mnie final and then has been recorded
in the Registry of Deeds or the Land Court for the district iin which,the land is locat�ed, within
the chain of title of the affected property. In the cause of recorded land, the Final Order shall
also be noted in the .eg i stry's Granitor Index winder t[te name of the owner of the land L,l Poirl
which the proposed work is to be (Jone, IIn the case of the registered land, the Final Order
shall also be noted on the [,.,,and Court Certificate of Title of the owner of the land upon
which the, proposed work is done, T'he recording information shall be�,submjtted to the
Conservation Commission on the topil at the enct of this Order:, which form must be
stamped by the Reqistryof Deeds, prior to the coinimefluervierit of wark.
10. A.sign shall be dlspl�ayed 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" jor, "MassDEP"]
"File! Number 242-1852 _"
11. Where. the (Department of Erwhonirnentali Protection is requested to, iSSUe a SUpersedIng
Order, the Cori se rvatibin Corarnissioin, shall be a party to,all agency proceedings and
he dings before MassDEP.
12. Upon completion of the work described herein, the applicant shall s,kibmit a Request for
Certificate of Compliance (WPA Form aA) to the Co,r,)se,,i,vat.ioii( Comillission.
13, The work shall conforrri to the plans and special conditions referenced in this order.
14� Aiiiy ohmage to the plans identified in Condition#13 above shall requVe,the q plicant,to
p
inquire of the Conservati,on Conimission in wrifing whether the change is signifibant enough
to require the fi'141g of a new Notice of'lntent.
15. The Agent or mernbers of the Conservation Carnmission and the! Department olf
Envirotirniental Protectflon shall have the right to enter and inspect the,area siuh ject to,this
Order at reasonable hokins to evaluate compliance with the conditions stated in this Order:,
and may reqUife,the subini,ittal0f any data deemed necessary by the Conservaflon�
Cornmission or Deparlment for that evalu8tion,.
16,. This Order of Conditions shall apply to any stjoressor in interest or successoir in control of
the properly subject to this Order and to,any contractor or other,person perform work
conditioned) by this Order..
4
MassaGhusetts Department of Environmentall, Protection F'rovided by W�s[)Ep.l
Bureau of Reu sorce Protettion Wetlands 242-1852
WPA Form 5 �— Order of Conditions MassDEP He#
Massachusetts 'Wetlands Protection Act M,G,L. c., 131, §40 —oDJEP Transaction
North An[dover
C. General Conditions, Wider Massachusetts Wetlands Protection Act (c,ont.)
IT Prior to the start of work., and if the project invoWes work adjacent to a. Bardering Vegetated
Wetland, the boundary of the wetiand M the vicinity of the proposed work area shall, be
marked by wooden stakes or flagging. Once in place, the vvetl'iand boundary markers shall
be ni�ai,ntaineid until a CertifilGate of Comphance has been issued by the Coflservation
C
,ommiss0n,
18. Ail sedimentation barriers shaEl be:maintaineid irl good repair Until all disturbed gees have
been fully stabilized with vegetation or othor,mieans. At no Urne shallsedfi-nents be!
deposited in a wefiand' or water body. luring construct oq, the applicant or hWher des,ignee
shall iinspect the eirosion fiontfols on a daily basis and shall'i rernove accurnulated sediments
843 needed. The applicantsball fi-nniefflately control any erosion problems that occur at the
site and shiall ,.Aso hn,niediately aotify the Conservation Comm i�Ssiiori, which reserves the
rigtit to reqlLfire additional erosion andlor damage prevention aofltrols it may deem
necessary. Sedimentation healers serve as the limit of work unless another 11irnit of
work Ilene has, been approved by this Order.
19. The work associated:with this Order(the "Project")
(1) its SUbjett to time Massachusetts Stormwater Standard8
(2) is, NOT subject to the Massachusetts; Stormwater Standards
If the work I's subject to the Stortinwater Standards, f1han the Iproject is Subject to the
following condifions*
a) AH work, irlClUding site preparation, gland disturbance, construction and redevelopment,
shiall be implerrieritecl in accordanoe wilth the construction period pollution pire veintion and
erosion and sedimentation control plan and, if applicable, the Storni(water Pollution
Prevention Ran reqUirrad by the National Pollution Mscharge Efirniflafiofl Systorn
Coinstruction Genera,[ Permit is required by Sform water Condition 8. Construction, period
erosion, seldimentatio,ri and Pollution control measures and best managernent practices
(BMPs) shall remain in P18[Co, U111il the site is fullystabilized-
b) No stormwater runoff may be discharged to the pest-construction stormwatieT HM NS
Uritess and UrIfil a Registered P,rofessionat Engineer provides a Certification that:
11 all constructilon, period BMPs have been romoved or wil[ be remicived by a date certain
specified in the Certificatimi,. For any construction period BMPs ir.A.ended to be converted
to post construction 0 pleratio'lli for stornTwa ter atte n w,.ifion, recharge:, and/or tf eaftil e nt, the
conversion is allowed by the MassDEP Stormwator Handbook BMID specilficatiatiis and that
the BMP has been property cleansed or prepared for post construction operation, including
removall of aH construction period sediment traapped in inlet an,cl outlet COnItT01 structures;
fl. as-bLfflt final construction HMP plans are included, signed and stamped by a, Registered
Professibnall Engineer, certifying, the site is fully stabilized;
fli. any illicit discharges to the stormwater irrua,nagernent ystern have been removed, as per
the req u i rernarl is of Stor niwater Standard 10,-,,
wpalormili Wc ram 1�,flHOY21) P2��7 ijr T3
4
Massachtisetts Dapartiment of Environirrental Protection Provided by MasM)FI1,
242-
Buau re of Res0l.irce Protection - 1852
Wetland s
Ma5miDl.P Rio#
WPA. Foirm 5 - Order of Conditions
Massachusetts Wo.flarids Protection Act M. .G L c. 131, §410
forth And'Dver
..... .........
C, General Conditions Under, Massachusetts Wietfaiids Protection Act (oont-)
iv, all post-construction stormwater BMPs are in%talled in accordance with the plans
(including all planfling plarls) approved by the issuing authority, and have been i4ispected to
ensure that they are not darnaged and that they are in proper working condition;
v, any vegetation asso6ated wift'i post-construction del' Ps is,suitably established to
withistand erosion,
c) The larildowner is responsible for BMP maintenafl,G8 Uflfil the iSSLIjIlg authority is notitied
that another party has legally assurned responsibility for BMIP rnaiintenance. F-Irior to
requesting a.Certificate of Gom,phance, or Partial Certificate of ConipHa rice, the responsible:
party (defined in General Condition 1 Ne)) shall execute Land submit to the i1s,suing authority
an Operation and Maintenance Conipfianre Statement ("'O&M Statement) to],the,
Stormwater BMPs iderfflfyiing the party responsible for implementing the stormwater BMP
Operation and Maintenarice Plan ("O&M Plan"') and certifying the following:
i.), the O&M Plan is complete and will be irfl,pliernented Upon receipt of'the Cartifilcato of
Cornpliance, and
ii.) the future respol)6[b,ler parties shall be notified iri[ wifiting of their ongoing legal
responsibility to operate and maintain the stormwater trNanagement EIMPsand
implernent,the Stormwater Plo,11bfion Prevention, Plan.
d), P0St-CGnStrL1Ct1011 PdRUtiOn prevention and source control shall be implemented in
accordance with the long-term pollution prevention plan; section of the approved
Stormwater IReport and, it applicable, the Stormwater Pollution Prevention Plan required by
the national Pollution Disf harge Elimination SyStCM MUlti-S"ector G'eneral Permit.
e) Unless,and until another,party accepts responsibility, the landowner, or ownei-of any
drainage easement, assuri)es responsibility for main.taining each BMP. To overcome. this
pre,gumption, the larrdowner of the property jjioustsubmjt to the issuing authority a legafly
binding agreement of record, acceptable to,the issuing authority, evidencing that another
entity has, accepted responsibility for maintah*g the BMP, and that the 1proposed
responsible party shall be treated as,a permittele,for purposes of implornentirig the
requirementg of Conditions '18(f) through 18(k) with respect to that BMP. Any,fiflure of the
proposed responsible party to implernent the requirements,of Conditions 18(f) through
18(k)with respect to that BMP sh,611 be a vidation of the Order of Conditions or Certificate
of Compliance. In the case of stormwater-113NIPs that are serving more than one lot, the
Regally binding agreement shall also identify the lots that will be serviced by the stortl,iwater
MID& A plan and easement deed that grants the responsible party access to perform the
required operation and maintenance mUSt he submAted allong with the llegally binding
agreement
f) The responsible party shall operate and maintain, all storm water BMPs in accordance
with, the desi rnl plans, the OW Plan, and the reqUirernents of the Massachusetts
Storrnwiter Handbook
wPMnrMr'd'nr. rry SYMN020 Pap 8 ur M
4
Massachilusetts, Department of Environinental Protection P(civided by MassDEP:
242-1852
Bureau of ReSOUrce Protection - Wetlands massiGEP Fle ff
WPA IForm 5 - Order of Canditions
Massachusetts Wetlands Protection Act: M. -L. c.. 131, §40 TITE-P t
North Andover
C. General Conditions Under Massachusetts Wetlands P,roteGtion Act (cont.),
19) The responsible party' shaW
1. MA.iri an opecrallion and maintenance log; for the last three( ) Corls,oCUUVe
calendar years of inspections, repairs, riniaintenance andlor replacement of the
storm ester managernerd systern or any part thereof, and disposal (for disposal the
log shall indicate the type of material andl the disposal locafion),
2�, Make the,1112intenance log available to Mass,DEP and the Conservation
Commission ("C0q1rnjSSi0t,)") UP041 request; and
�3, Allow members and agents of the iMassDEP and the Cornmission to enter and
inspeict the site to evaiIuate and ensure that the responislb[e party is in conipk2flGO
with the reqjuiremients for each BUIP, established in the O&M Plain approved by the,
Issuing authority.
h) ,ill sediiiiiento,r other contaminants rtaf'rijavced froin[ stortnw titer HMIP,5 shall bledisposed
of in accordance with all appl[cable federal, state, and local laws and regulations.
i) Illicit dischw,ges to the stormwater rnianagernent system as defined in 10 CMR 10.04
are prohibited.
j), "T he storniwater manageni system approved in the Order of Condii shall) not be
chaniged without the prior written approval of the issuing authority,
k) Afeas designated as q112fifying pervious areas for the purpose of the Low Impact Site,
[)esignj Credit (as defined in the MassDEP Stormweder Handbook, Volurne. 3, Chapter 1,
Low Impact Development Site Desigin Credits) shalt not be altered wilithaut the prior written
approval of the issuing authority.
1) Access for mainten21nce, repair, andlor rep[aiceinient of BIVIN,shall not be withheld.
Any fencing constructed 31FOUnd stormwater BUIPs shall include accesq,gates,and shall) be
at le,99t six inches,above grade to allaw for wildlile passage,
Special Conditions (if you need ni space for additional conditions, p[ease attach a text
docunient)��
......... ......
20- IFor Test Projects, subject to 310 CM R 10 05(11), the applicant shall also, irnplernent,the
moriftoring plan and the restoration plan SUbiniitted with the Notice of Intent. If the
conservation commissibn Or Department deternijines that the Test Project thronrten s 'the
public health, safety or the environment, the applicant shall implement the removal pla,11
subimitted with the Noi of Intent or modify the project as directed by the conseirvation,
comrniissio,n or the Dcpartrnent,
%Vpararms dar. rry IW180020 I leas 11101 13
4
Massachusetts Department of Environmental Protection, Provided by Mass,DER
BlLjlr atj of Resource PrateGfion - VVetlands 2,42-1852
MassIDEP File,
WPA Form 5 — Orider of Conditions,
Massachusetts Wetlands Protection Act M.G.L. c� 131, §40 eDEP Transadion
LI North An,diover
....................
............
D. Findings Under IVILMICIPal Wetlands Bylaw or Ordinance
I. Is,a municipal wetlands bylaw or ordinance applicable? M Yas, El fie
2. The N rth Andover hereby finds (check one that applies)!
i Onsorv'Orjn Golnnl'rssion --
a. F-1 t4at the proposed work cannot be conditioned to meet the 9talid2rds set forth in a
rrlUnicipW ordinartce or bylaw, specifically:
1, Munidpa�0,Tdinance ox Byllaw
Therefore,work on this Iproject may not go,forward uMess amid until a revised Notice of
Intent inS,SUbmitted which provides measures which are adequate to me these,
standards, and a finaJ Order of Conditions is iSSILie,d.
ib
o. Ej that the fol[ �wing additional candit[ons are necessary to cornply with a municipal
ordin8nce or' lav
North,Andover Wetlands Protection Bylaw & RegM Ch ations ap, 190
I-Munidpal Ordinance or Bylaw et, seg.
the CnimmissiOn orders that adll work shall bo performed in atcordance with the following
conditions and with,the Notice of Intent referenced above. To the extent that the fbIllowing
conditions :nic,d4 or differ from the plans, specificatioris, or other proposals submitted with
the, Notice of Intent, the conditions,shall control.
The special coindillon,5 relating to municipal ordinance,or bylaw are as fol[aws (f Y'O,U need
more space for additional conditilloms, attachi a text document)::
No rth Aniclove r C onseirvation C,o nliniJssion F inding s & Special Con d i tio ns (see attacfted
4
Massachusetts Depa,rtment of Environmental, Protection llliovklod by IMassDERu
iuitttl of Resource, Protection - Wetlands 242-1852
MassIDEP File#:
WPA Form, 5 ®- Order, of Conditions
Massachusetts Wetlands Protection Act M,G.L. c. 131, §40 oIDEP Transaction,#
�North Andover
..........
Cilyf Town
...........................
E. Signatures,
This, Order is valid for three years, Unliaas other so spc,oJfiied as a special
condifion PUTSU'ant to Gonerat CondiliatILSr 114, frorn the date Of iSSLI,ance. 'I. Date f I
Ptease lindicato ft nurnberf)f fl"Rep'n'bers who will sigin this form,
This Order onusl be signed by a majority of t4e Conservation C01ruir7nission. 2. Number of Signers
"II ho 0Tdpr mki.q be rnaHedl by ceflified mail (retUrn receipt requested)or hand defiveted 6a the applicant. A
,copy also,must be mailed or horid deliveted rat tine same tirne to the appropriate Department of
Fnvironmantal Protedion Regional Office,, if not fiIing electron[cally,j need the property owner', lf different
from applicant.
.... .............
ry
114 ......
i garPFin:tTd Nome
Si. re Priated Nanie i
Printed Naar II
Ell
�"e
Printed Naime
Is,i, na;ure,
PInted INailte
..........
7,igmTture Printed Name
Signature PrinI100 Name
i-g,inature Printed Name
Ej by hand delivery on by certified niail, return receipt
reqUested, on
ri
-dale— , DaIe
wplftrm5A rry 141012WO Page 11 of 13
4
iassaohvs,etts Department of Environmental Protection r r(wided by MassDEn:
iim�i Wetlands
..
r52
Resource, Protection
MassDEP Frre
WPA m ry` r l s i Form
5- OrderConditions of
Protection Act M. ,.L. c. 131, 4 oDEP Transa rio
Norttm.Andoy r'
.... ._............
.. .... ........
F. Appeal
The applicant, the owner„ rar y person aggrieved by this Order, any owner of Ltr7d abutting the
land subject to this,Order, or any,ten re Rdents,of the city or town in whictu such sand is located,
are hereby notified of their,right to rerlrnes,t the appropriate MassIDEP Regiorial office to issue a
Superseding Order of Cofiditions. The request must be made by certified mail or hand delivery
to the Department, with the appropriate filing fee and a completed Request for departmental
Action Fee Transrmmittal Form, as provided in 310 GMR 10,03(7) withiin ten business days from
time date of issuaim e of this Order. A copy, of the request shalll at the .sane time be seat by
certified r naih or haind d.elliivery to the Conservation Corn�misghonr end,to the appiiic grit„ if helshe is,
riot time appellant.
Any appellants seeking to appeal the Department's Superseding Order associated with this
appeal will be rerlr,rired to demonstrate prior participation in the review of this project. Previous
parti,cipatiom 1n, the perniit proceedliing nmearms th,e subrnis ion of written infrarroatio n to the
Conservation Conn mmiss'ion prior to the cRos,e of the pw`nblro hearing, requesting a Superseding
Order; or Providing written inforniatioon,to the Department prior to issuance of a Superseding
Order.
The request shall state clearly and concisely the objections to the Order whiitah is being
appealed and how the Order does, not contribute to the protection of the interests, identified in
the MassachUsetts Wetlands protection Act(M. .L c. 131, §40), and is inconsistent with the
wetlands re Ulation ( 10 Clip 10.00)a To the extent that the Order its based on a rmiaunicipaI
ordinarnce or bylaw, and not on the Massachusetts Woflands Protection Act or regulations, the
Department has rmo appellate jurisdiction,
4
Massachusetts Departm ent of Envlronrn ental Protection I'iovidecl byM4,88
Bureau of Resource Protection, --Wetlands 242-1852
MaqsIDIEP File#
WPA IForm 5 — Order ofCond'itions
Massaditisetts Wetlands Protection Act M,G,.L, a 131, §40 ti 114
North Andover
ityTr�ovin
..............
G. Recording Information
Prior to cornatencement of work, thiis Order of Cortdifions must be recorded in the Registry of
Deeds or the Lwid COILIrt for the cilistOlct in which the land ins, located:, wi4hin the chain of title of
the affected properly. In type case of recorded land, the Fhiall Order shall also be noted iirl the
Registry's Grafllor Index und,er the name of the owner of the lend subject to the Order. In the
,case of registered land, this Order shall also be noted on the Land Couift Certifibate of Tifle of
the owner of the land subject tio the Oirderof Conditions, 'The recording information on tttis page
shall be submitted to the Cortservation Commission 11sted below,
North Andovor
. ........... ...
Conserwation Cornrtl,h;sion
Detach on dotted fine, have sta,rnpecl by the Registry of Deeds and submit to the Conservation
-C-ommi.qsioni------------------- ----------------------------------------------------
To,:
North,Andover
Conservation Ccmmisstnn
Please be advised that the, Order of Conditions for thie Project at:
7 Fuller Meadow Road 242-1�852
Ii5 : - I'll,
roject Locatibn MassDEP Filip,Number
Has been recorded'at the Registry of Deeds of�
Northern Essex
........... ................
County Book P'age
Matthew Zahorui�ko,
fo,r,, 01opp'tty owner
and Nas belen noted in the chain of title-of the affected property in:
Ba,ak Page
In accordance wffl,) the Order of Gon,dilions issued on:
October 5, 2022, .............
Date
If reco�rdeld land, the ingtrti;mient nurnber identifying this transaction is.
18596 ................. . .................. ...........
instr'drieni Number
If registered land, the document riumber identifying this transaction is-,
..... ... ...... .... ....
Document Numbw
&gnature of Ap fica-n't
13 of to
7 Fulter Meadow Road - DEP FILE 4 242 - 18,52
North Anduver Conservation Cummission Findings of Fact:
C I u rrent I"roject Site Conditions: Tfie '1,55-acro project SitQ CUrrently consists, of an exi�fiiig,
single-fanii ly hou", (:(:)Yv tv u c,ted i n 19,84, as ssoci a Le d sep t ic sy s ten-T, d ri v %V ay, I awn,
lan,(:Iscaping, and utilities.
114% lot ml,; part of a ,subdivision constructed under OOC #'242-22:2 iSSUed in 1984 - this 0,01C
pre-dated the establishment of tfi(,� N(�)vfli A riclover Wetlands 17rotection By and
Bose(] on '1985 correspondence in the file, said 00C %vas iievier recorded.
130CLIUSe this was land court/registered laurucl, the Registry of Deeds would not accept t1w
OOC farm record i n g js i n c:t,,' the i n1c]i v�i di u a.] Iota t�s were alra ed 3, curiv ey ed to i i t m w (-)w inner s- N 0
furth,(.,.r action oil this was taken.
The NACCagrees, ,Mith the delineation oftlie h,-)II(-)wjIng we.tkind re,�,-ource areas as confiri-ned
iti the field Iny the, Consenratiuri Adn,-rinistvator and reflected on the approved pJam J,"he
applicartt ha,; not aittlefflPted true overcome the presunipd oin,
off,,;igInificance of these resource areas, to, ffie identified hiterests, in.the Act and
Bylaw.,
Vegetated Wetland (13VW) - W(JI'and FlagsAl, - A9
b. 100-Foot Buffer Zunt'' to 13VW
"1110 Property does not contain 200-Foot RivoTfnl),rit Arca
d. The property (toes not Ji:(�e MtFiin o,r adjacent to NHES'r Prion ty Habitat
e. "J"fie prop urty CIO(-,,s not lie,within the '100-year floodploin
E "'I"he on- ite resource area,s, d(..) not contain certified or potential vernall, p,(..)(:)Is
based c-m. N I I FS P ma pp,i n g,
To. rq try cI or includes: after the fact permitting f(W floc! COIAStIAICtiOn of an wood deck
and wood stairs off of the west sidt, of an exis,fing 3-season porch, an(i renovation of the
pord'i, 'I'h(,:,, dock and stairs received 3 new foutings, 01(� pi:)rdi roceived 5 new foolings,, all
within the laNvii or previously disturbod airea. 'Flie new deck and stairs are 3,9,8 Fv('t frcmnrr
the B W at tl-i,(, closost point, A c(-m-ner of the, existing liouse an(I portkmi of the existing porch
is within the 5,0,'NBZ. 95 si. of the new deck is wiffiin the 50' NB.Z to the BVW. As TI,144,afiorl
for this encroadirnei-il,, 945 0, of buffoi, zone p,lanLinge,!i-il-iaii.ceiiient,, ,vvitfiiii. lawn area that is
about 5 feet frcm,n the edge of the wetland, that vvill vosiflt in, a '101.1 ratio of enhancement to
encroaclun,ent. (Native shrubs are 1.�)roposed to be planted in the enhariceniont avea, a.md the
area is In,oposed to be scarified and seeded wifl-i New Fn,g,tancl Seed.
I'n ix.),
Waiver R ind i p gS-
Tlie NACCfind.sthat I ouse iv�ir porch and associated-slairs were cq;msb'uC*,.d
he h attaclivc �
prior to establislu-no-A („)f tine local wetland Bylaw and.regulafic)ms, OVICI therefore were not
stibject to thie,2F NDZ and 50" NB�Z, resulfiiig iri, lik(,Iy placine, the 11OUse cluser to the
wetland. thari, what wuuld be pernlitted tioday. The NACC reviewe(i On, T,(,quest for waiver
arld find", 0111ar applicant: has dernonstraled. thal dwro arle no viable alternatives to relucating
the deck. 0 LE Iside tine 50" N o Bu i I(I Zo tic d u e to the ex is ting rear porch I oca ti oi i, ']'lie N ACC
7 FUllel Meadow Road DLP FiR,#742-IIS5? N ACC F i mfings&'i Ptuilul;Coudili.Dns
hl"t t of 13
7 Fuller M eadow Road - DEP FILE - 1852
ackriovvledges that, clue to curre.nt- building c0du reqUircilie its, a prope�rly sized la�nding IS
required. TI-le NACCfinds tbat elevated decks/landings result in less irlfenie 11'se than
gm,unct lee elstruct ures. The N. finds f fia f flu,1.),roposed 10:1 buffer zone planting wit[lb,'I
lawn area. will rcstlft iul sijrtlfficmlt en Ila ncenlent of the buffer zone cou,sisting n of ative shrubs
J
alld -.eed i lie,,, that will increase plard diversity ai-lid wil(A lift, fa iietio,ris. Based on its findings as
-ie opposed) to grant the waiver Lis
diSCLIs,sed above, Hie NA(I.C votvd4--] �(4 4). favor', ot,
)V(p,l,cstod stlbject to compliance iArith [lie, approved plan mid col,ldifit-ms lierein.
ThereffaTe, tfie ,NACC 1ierehy finds that the following condifiuns arc, rue,,,cusaryl hl accordance
w itli the Perfor2nance Standards set fort[i fi:i dw, tiute Regu latitmis, the local. Bylaw and
Regulations, to protect t]losc- irftercsts t-loted above. 'The NAC-C orders fl:lat;cull woi k shall be
r1'e.rfolirled in accordance with said conditions and witFN tho No-,tice. of I 11terit/approved plans
referenced below. To the extept tivt flu'- following conditions modify or differ fronl...the
.......
other proposals submitted with the qtjc.,(. f)ptc, t� the conditions
silall control.
RAL CONDITIONS
21- Thy-- woi k shall conform to, the followft g (except as uoted in tho rcmainder of this
docun-tent where revisions n-lay bf,,
Notice of Intent filed by: Matthew Za,h,(.:)rui1ko
7 Fuller Meadow Road
North AndoverMA 0-1845
Wcltkii-ld Dcfirieation By: Greg H.0cl-u-nuth, PWS,
project Richard Williams, PE
Williams &sparagc's
-189 N ort li Ma in Street
Middleton, MA 01949
Site Plan,:
F'lan to Accompany as Notice of Iritent 7 Fu I Ier Meadmv Road",
prepared by Wflfianls &:Sparages, signed and stamped by Ricflirrd
W i I I i a ms, PE, scal e 1. =:20" re v isi on a.laatw9cl SoPtc,ri,i be r 21, 2022;
0 J.e[k-I! Ely G rT`81 I I OCII 11l U.1-1-1, Williams & Spragets,da to(I Septem be r
21, 2022.
2
owner, an ,2, 11vc, tm,rri "Applicant" as used in this Order of refer to the
successor in interest or succcsm~)r incc iitrol of the property referenced intho Notice of
clocurnents and this Order of Conditiorls. Tlie NACC shall be
i'lotified. in writing within 30 days of all ti"Lmsfers of title of any partion of property t1lat
takes Place 1,-nior tca t11C.' iSSU.-Mce of a Certificate
7FcOlcr Nlmdow R4,1141 01�-,P Rt 4242-H52 NACC F i ndin?s&Spccial Cand i I ifym
llagc'2 of 13 ......
7 Fullcr Meadow Road - DEP FILE - IN52
23., The cone di t i ons, of this i f(,ii�,j si c,m i s Fia I I a pl)I y to, a i-i d be bind i ng upon, Lhe ap pl ica.n LY
o"Int'r, its, eniployees and all successors and as's,ign.'s" in illtercst or cori,troL These
i ri a I I c�l eed s, to,s Licceed ing owners of
call igatiorts shall be expxessed in c(mvi lklints
1'.),ur'fions of [I'le property.
24. Faiture to witl'i k.fll condititmis stated herein, and with all related stablltes and
(AII01- r0gUlatory measures, shall be deemedcaal.ac to 1,cvokcov inocli(y this Order.
25, 11iis Order do,es, not grant any property rights or any exclusivc privilogts. ; it dines not
authorize any iniury to private prorw.,,t_Y or irneasion, on prcpperty rights., flo- weever, the
NNACC agent (-if th(, NA CC or the DepartinenLof EnvironMejjtZj.j. (DF'T
'O argent PT
rc,,,serves the right to, enter and insped the property at al I veas,onable tisanes until as
CertificaW oft oTTq)l41m,(' ilS' iSiISUCCIII tO eValUate compliance with this Order of
C`ora d itilons, the Act (310 (--'.MR 10.1010), the North And,cn,cr Wothind Bylaw sand
RegUlations, and may require a,riy inforn'l;affi-m., n-teasuren-tents, photographs,
arld/or materials, or in,ay require [lie submittal uf any data or
inforniation deenied necessary by ffi,e NACC for ttiat evaluation,. Further, work shall.
be hafted. on thc. site iF tFic., NA,(,-'(-, agent or DEI' determines that any of the W(Wk iS T)Ot
in cotmpliance with this Order ofConditions., Work, sh�ffl not resunic until the NAC-C
is satisfied that the wg.ok will coniply and has sio,notified the! applicant in,writing,
26. This Order does not relieve tho perillitt(x- or any other person of the necessity of
coull"Aying Wifli all oflier applicable federal, o stale r local stahiles, ord,',inanc.es, L�y-lams.
I
lor regUlations.
27. The work authorized hereunder shall be con-ij-411cNxJ wit[dri from the date of
this order.
28. This Order may be extendcd by flit, authority for one but not more than t-"ru
Pew riodsof up to One year each upon application to the issuiTi,g autlu)rit at lea,"',t t1lirt
3 y mgiy
days (30) prior to the expiration dak' of tflic"-Order (Refer to Section 8.3) t�f fbe North
An.daver Wellatid Regulafiot?s),.
29, '174 1 e N A C(I a servies the ri?.,ht to, amend this Order ofCondAi1(.ai,s aftor a lc,gally
D
advertised public hearing if plans, axe chatigged, or if new conditions
Or 41"forl-nati(m so WOITLWA
301. Where the Depa:1,t1-714;nt of Enviromnental Protection (DEIP) is requested to u-wko as
deterinination and to,issue a Supersedilng Or(k,,T,", t[ie onservation Coil 111-Lission shall
be a party to all, asgoicy procee-dings and hearings,before the Departnient.
31. The NACC finds that the b-itknisive tvcles of flee upland areas and buffer zone proposed,
011 this site W ill Ca LISe further al tera tion of [:he we tl a n.(.I resou ru a reiu;, I ti order to,
71.7uller Meadow Road 0,1711 Fflc:02,12-1852 NACC Nndirig & Special Condifions
7 Fuller Meadow Road - DEPFILE H 242 - 18:52
pTevent arq7 alteration of weHand rc��ioijrcu al'(101ml a five foot (25') Nom
Dish] � ,a t)C:
;eZone, I a fifty foot (50] No-Cbnstruction Zuni shW1 be whbhshed Wail
the edge of the adjacent weManua. resmurc area. The Adn-dnisLrator
and/m UtIK"OFCntS of thc!, N AC.C, do not have the authoril[y to waive these Wbacks
e.,:Aablished Under the. local bylaw. No, disti,:u.1),aiwe of existing gyadq soils or
vegetation is penydRed in the Nc)-Disturbance zone., (.See Sedion 3.4 &Apperulix .F qf fhe
local Regi.dalby).
32. This document shall be in in A consductiori (:()ntraets, subcontracts, and
specificatio-ris (kating wAth the work proposed and shall sup sede any cunflictIg
contract ine,irenients. The applicant shall assure U.iat aH StAbc.:ontractors,
and other personnel performing dra permitti ng work are full aware of the permits
teirlys and cuidibons. Iliereafter, the conUador *01 be held.johady liab[c fi�);r atly
violation. of this Order resulting frorn faailuar,c, to con'llfly with its corlditions.
31- The owners of the projeo anti their successors in tUhn agree that die (Wer does not W-1
itself im,pose upon the To,wn any responsibility to niaintain the proposed drain.age
syshni and thatsaid 'l`owarm shall not be HaMe for any darnap,, irl the twcn,t of Eaduve.
By acce p tance of this Order, Ogle 0 willcrs a g rot�. t(�i, i rid ei i:i n i fy ran d hold ha ri-ril es,s t 0 [lie
Towii ai-id it-, rcsiclents for any, dainage altribLI.Lable to alterations undertakcn on this
property- pursuant to, the (Didex. Issuance of We dcbe,,.; not in any wa3T
imply or cerfify that the ME! or downstreani areas will not be subjed to flooding, storm
damage oT an), Mher hmna of water, damage. of die dr&nage ymen; if
accepted by the Town p irt o,f a public way, becomes, the resportsibility of the Town.
34. In uaric(-.! of these Chnid itions does not in any way unply or cerlify that tl-wsitc (:,)r
downstream areas will not be subjecl to f100diT1j-T,, �401111 darnage (-)r at'ly other form of
water damage.,
PRIOR TO CONSTRUCTION
35. No work shall be undertaken until aill adininistrative appeal periods from this OT(IeJ.'
ho Vt.. (Jap'secl or, if SILICh an appeal has been filed, W1 A ynocmilings behme the
Department or Court have been conipIcte(J,
316. 1,"his Order shall be recorded, in its entirgky, by the applicant at the Registry of Deeds,
inunediaMy a fkT Hot emphWan of all appeal periodT No work shall be undortakon
until the Final 0rder has been recorded in the Regish,l ' cif Deeds or the Land Court for
the district in which Hun Wrid in located, within the chain of title of theaffectc!d
propert)T. fri the case of recorded land, ffie Final ()rdcn hallalsn be noted in the
Registry's Grantor Index under the name of the owner of the land upon which th.e
propos,ed work is ba be dons In the case of reoshered land, the Final Oridc r shall ahsc)
be .noted on the Land CARW WHOM! of Ade of the owner of the, land upon which
7 hdu MmAw Rml DEP M AMS52 NACC Fjndiag5&Spice,i oil Condhhns
l"Ing 4 0"J
I F'Wicri Mcaooaii, R:(�)ad -DEP FILE 9 242 - 18512
011C PV`T'O,%(°d work is tc) 1),e, clone.. The recording information shall be sublalift-ted to the
North Andover Conservatiun, Cun-uaiission on ttic foriii at tli(, erid of this Order prior
Any Order not recorded by [hie appi befure u,d�
coinn-terices may be recorded by the NACCat fli.e applicant's expen,sei.
37. A ch.eck PaYable to the Town of North Andover shall be pruivided iii fl i,o. a'Irrmu lit of
two thousand dollars, $2,00101 VVI-lic],-,i sliall 11t, in' 'all to To-viiiim
Counst"I Tio-mvi-11 reasureri d theN , andshallbpusLedwi th U ieNurfli
Andover "Tow Treasurer llixougfii the, N ad"(.` befurc. of work. Said
cichrcr it of rnulle.yi bc!conditioned on the conipletion of all conditions hkuecif, shall
besig ne by a Party or parLiesatisfctory to the AC, aniw , mriso1, a11 S1la 11
be released after complotion of the projoct, PrOVideid that provisionis, satisfactory to the
NACC..', hi be,enn, made for performance of any conditions which are of col-itinilling
J
nai.U re. The a p plicant ma Y per a T,n on(I tary re I ease �c Ii ec!u I e keyed to com piletion
of Flortionsi of flie project for the NA.C.C's review and. approval. Tfaiiscondititm,
iS iSSUed Linder'the authority of the local Bylaw.
3K Asign, visible fton-t the street. shall be displayed at the siite not less tfiian two sqiam,e
I
feet or more than three squar(:.^ fco, t insnzc boc .iring the words, "Massachusetts DEP,1
File Number 24Z-1852."
39. No changes to,the approved plan shall be inaplemented in the field until.writte.n.
qj pl,ovcll has been gtj A n.y changes in the su bmi t ted pita i is cau,s,(:,d
by the applicara, another Board's dechqiiul-i (.n,1"vsu ting frorri. this Ordor of Conditions
1'1-ixist be �u,,bmittod to the NACC for approval prior to implementation. If the N.M.7-C.
finds, said changes to be significant, (he NACC will call for allut.1"Im, public. Ilearing., (at
the expense of flae applicant), Wilffiin 21 days o,f the close of said public I-Learing the
Na CCI wi H issue an aniended or new Order of Condition,,., Any crrorsi Fi in t1le,
plans or inforrnatioi-.i.submi tted by ttilio, appliciiint sl,ia 11 be cotisidered Lis chang,,es.
4D. It is the responsibility of the applicant, owiaer, to e-illsttre that all
()f t1iiis ()rd(!V I Of C-o n cl i tions a re,cmonied i with,, The projec t en.ghaeei, and
conitra ct(-,i i's are to be provided with an copy of this Ordor c)f Clo;ri,ditioiliis and refe,rienced
documents before coTauTiell ccl n orit of c�onstrttc:tionii,
41. WeLlandi flagging on site shalt be cliecked in tht, field prior tositart of constrUdion and
sluill bc whc'i,re niissing. All welland flagging shall remain vii5ible m-icl
enumerated per the approved plan(s) th"ro'll"J."h(Jut t[w lift, o,f flic project and until as
cortific.aito caf Cc,rnplia nce is issued so that erosion control rneasures,caxi be priup,erly
placed and wetland impacts can be nionffi.)rcd, ckicFi barriers-sha H be checked and
relflaced as nc(',(s sary and shall be maintained Until all constrUiClion is complete.
42. At as rnhainiainii, as row of staked -12" niL31ch sock (Fiftrexx SiltSoxx or equivalent) i
be properly installed betnveen all, construction and resitc)ratio.N,,i a.Htd wetlands as',
7 Fuller Meadlomi Road DE11,17,He t242-1852 NACC Findings&r Npiccial Cundilions
............. ......
7 FuHer Meadow Road -DEP JULF # Z42 - 1852
shomm on the plans appvoved and wh2renced herein and shall be inspected o,,ud
approved by the NACU; or its agent prior to the shut of cons tru.(A j oin and shall remain.
intachnAll all dist-urkwd asms have becn pernianently stabilized. to prevent crosion,
AlJadditional lerosion Imovendon and sedim ask atiun JIMMI&I InVOSCUTS Wind
necessary during ccins[ructic)nshall be at the direction of theMACC. or
its The NAC_'C rieserves,the righL to impose adiditional cou'(fitions orr portions of
dais; projNct to niiLigate any impacN YON[i. coifld re tflt frotn site erosion, ,or any
noticeable degradation of surface waterLjUalfty discharging frona dw sftc For,
exwnplq ins,tallation of erosion cordrol measures way be required in area not shoWn
on the plan(s) referenced in this (girder of Co,nditions. Should. such.installation be
re.qnrirud by thee. NACC, they shall be installed within 48, of the Connnission's
req Uet.
Wrhe applicant/coTdraacLor sliall have on hand at the S411t Of curry S,Oil diStUrbance,
removal or stockpiHng, addRinnal 25 feet ofniukh sock a.1-id sufficierft stakes for
staid ne convered from die elenank, and shA be used ouly fear Hin ccmitrol of
emergency erosion probleii-i,s anc[ sharp not be used for the normal contral of
44, The erosion controls shall serve as the Wit of work. WoTkers should be informed that
no u.se of of inaclihiery or materials, slockpiling of sofl, (:)r
consuuction activity is to occur beyond this, fin(,! at ony tin,te.
MTN appleamt shall designate as WeLland ScWnHst or oth{�,.r crivironinental professional
as approved by tine MACC or its agmit) as an "Idosion, Clontrol Monitor" to ovanw.!
auy =wgemry p I Lice nient of clontrols and regular inspecR(Hi or n1dacernent of
setkmentadOn control devices. Proof (,.)f tho ret'lined n1o'nitor naust be subrnitted. to, Hie
Con,servatiou Departnient cKletterheald by the retained consulting firin° The nan"to
and phone nurnber of the erosion control Tnuvdb)r niust 1),e provided to the NACC in
[lie event that this 1wison has to be cotuacted, due to an ernergency at thesitc:v, duritir,
oil; 24-hnur periloct including weekends. niis persm, shall be given the authority to
stop construction for the purposes of conneting problems with erosion control. The
Environrnental Fluffssional will inirnediately notify the Conservation agenk of any
matter that requires attention by the Coniniission or Oie agcrit., The erosion control
monton: &H be requked to inywt all such devkes and oversee cleaning and the
prupei: disposa I of waste products. Cleaning shall include remawl of any enhnppecl
Silt.
46, At least err eye during each week in which conshvction artivifie; OCCUrs, on-site and for
as long thereafter as ground wnwins unstabilized, Elie applicant o Written
report with photosxaphs from the "Erosioui Cuntroll M(�)nitor" to the- NA CC certifying
that to the best of his/her knovoledge and belief ba&ed on an.careful site all
work is being perfornied in compliance wiCh this Ord or,c:)F 0:3;nJitierrns r-arnd that
approved selfback's are heing, adho.ro(i to, The erlosion control monitor must visually
inspect all control measures and assurno respon.s.,ibility for flieir
7 au I ler Meddim Rokid DEP6"mat,42411852
7 Fuller Meadmi, Road - IAiT FILE 0 242 - 18,52
maintenan(�'e on a w(,t-kl I I h.c.), are f Unctioning as, intended. In a(.1,'ditiol 1,
. . y b i�is is a r c t hat t
all. ,tvetland resource areas,niusl be, visually inspected for tm-bidity, and/or
-o onitor shall be on site " �?
othe�r water qu.abty Erosion Conti .1 m uring
following a major storm event of I`A" ind-L,af rabi (.,)r grealor (24 hour event) to
el-ISLIffe, that soils remabi sfabN:-, onderosioii corr&ols are adequate and sec Lire.
47. F'rior to recon-u-nencing any work oi,-1, the (,kck, tho Propo,sed enharicement planting
P'tan SI-tall, Crcn cn cna artuwcl i'm kae.r than May 30, 2023, and the following sliall
be adhered to-
o, Plaoitine, installation shall be overseen/supervise(I by a qua od wefland
scientist;
I),, Any sofl imported to the site shall be obtained .6"myli a rospon.,;iblc.-'
source, to avoid h-itrodircing Oile invasivc Asiafic j tA inpi q Worni to the resource
be visually inspected. for warms and if found ren.ioved'
area�� Pla n ts S I i ij, a 1,;(
m)d terniiiiated, and the mulch sl-tal.1 be all nal-ural & Frico of mi)7 dYes, If worn-Is
are encountered the shall inforn-i the Conservation
c. The piantings shall.be conservation gradv flee greatest extent possible;
d. Once cornpleted, the Conservation Departi-nent shall be contacte(l, to, schedu Ie a
site it ispection. to review the, area;
e., The enhainceu-icnt j.')Ioiifings, and sec,.,.ding shall receive proper watering to msurc
gernilmition arid SUrvival as weather coinditioris, dictat('-f'
L The seeding, and plantiri,gs, sfiall be rrimitored by a.qualified wetland scientist
for a p,eriod of 2 full gr'owing seasions post installath.)n aud s1lioll ocfiieve an
o-verall survival rate of 75'Yo"
g A yearly ITI('.)I'dtoring rep ortshall be submitted to (he Conservafi(.�):Ti, Dlqxa.Irhnent
do,cumeming restoration planting areas �,iind status of slope stability;
h. Prior to, ffic issuo�ncv of a Cerfificatc'.' of Compliance, [lie final. nionitoring plan
shall beSUbInitted. to the Conservation Deparhi,'i,(,nt for review atict scheduling a
site inspedion. to fi,,,is�cct
i, 'I'he plantitig, enhancement area shall be left W,naWraltv"(" witFlout being SLIbject
to rOLI[ine residential Iandscal,-)(:- condition shall survive
beymrd fflo. i nnarrncc Of as Certific.-:tte of Compliance.
li-m-nediately after
nnent planting completion, the edge of the pLanted ark!as
NDZ: aid along the. edge of woods, shall be munumei-lted witi'l 6, (six) wedand marl ers
to be placed on healthy mature t-rct'.s or Weather resist a.nt MOI-ILLments (Le. 4A pxes i:uxe
treated Post'.$) a.s a ppropriate based on field conditiomi, as ag' [?y 11C,
'
Conservation eparhnerI!, Slid, tnafl�lers -A)all be C,1,7enly spaced rougl-dy every 30 feet
OTKI [)al I it c or'pncuraate the following text on their uj.-Aand. sidc. ""Pr otoCted Wetland
Res.OUrce Area"., This will designah tFic i, st,nsitivity a iid as,.sure no further inadvertent
into Hie wetland. 'anid markers are available for purchasc in the
Conservation Department at Town, Hall, 'T'I-ie aplflicant .shill instruct all agents to
IRIII&MzadowBaud DEPRIc#242-1852
Pa.yx 7 of'13 ............... . ...... .....
7 Fuller Meatlow Rinal - DEP F I LIC :14242 - 1852
explain these tnaekets to buyers,/lessees/landscapers arml all per arns taking over thc-
property from the applicai-ijt Ifuse markma shall renuin posted and be replaced as
in perpetuity.
49, Priam to any, wo,t,k on-site, the applicant shall sulornit to We NACC or it's
Administrator for reviemw and corn.ment, as detai(c(I work of
constrtzctio,ri,
50. Prior to an,),, vvork conut.1clicing, on site." it isi the. resplortsibility of the applicant to
procure all other appikaWe federal, state and local perri-ifts and approva.ls required for
HUs project, and no work witbiii, the Coniniission's jurisdiction shall commence,
urail all other state or local permits,, appruvalh, and variances have been Obtained.
This is to ensure that h-iipact to jurisdictional areas are avoided in the case that any
such pernit is denied or withheld for any period of tisane, thereby i-nain%hng the
integrHy of the resource area ur Offer zc ne. vnti[ st.ich firnc..�. all approvals are
grante& Note: The AM% Permit shall have been applied for at the of as 1n).re-
ccuistruction nieeting with the Conservation Departm.ent, and (,'c:)ns,e,rvation
Department sign (A MH not be gar a.ntc!d until pre-construction conditions are say tived.
51. Runapplicant andjor the legal uvvncr of that jxmtkmi of land upon which these Orders
of Unditions have been placed shall provide to [he I ACC priur totranshouing, or
assigrning any pohimi af said larKI to ankher party, SuNuct to said Orders, of
('011dit4litt", thin " oniprliaunce Cortificatimi Fonn Affidavit" attached via "Apperufix
A" signed tan der the pabs and pendties of perjury, stiitin ,; fluttsaid applicant and/or
owner lias read these Orclerg of C.:ond.itions, and is in compliance with each an(I every
co n d,i ti o n. Th i s d01C LI men t hall a -apply to each of' the cond i H on's re fcrc.l tc-..('!�d II ere.i 11 a n cl
shall be pgovided to the Ca�i-iiservation 111mrtment Lit least five (5) bLtSiness days prior
twa the ig c.4 said land transaction.
52. Once these above mentioned prevonsduction reqWremcnts are anvpl(ate, thc
applicarit shall contact the Coiis( rvation Office prior to site preparation or
(nnshuction and sliall arrange art on-Ate corderence vddh an MACC. - q — I (,
..:: �ep!KP
contractor, erosion control n-ionitur aij(]j.!)q qq t*ppt to en.sure that all of the
QuAtions of Hds (Nder are understood. This Order shall be included in all
construction contracts, subcontracts, arul specific.afiw�.,�, wifli the work
proposed ancl, shall supmede any conMeting contract reqUirernents, The applicant
s,liall assure that all contractors, subcondaMrs and otii!er the,
permitted. work are hily avmre of the pennit!,; tern is and clonditions, Thereafter, the
ea-nwa= will be held jointly liable fox any violation of this Onler of Conditians
rare sul Ung froun f ai lure tv) cum p4 y vv i th its c.(-)n d iti ons, Th e a p pl ican t or,con Lrac,Lor shall
ri(A4 the NACC in writing of the identity of the on-sile hired
to coordinate construction and to ensun;comphanc vvith this Order. A reasoriable
period of firnt,!! shall be prodded as notice of the pre-construdion.meetii.i[g �e.g. 72
hours).
7 Fuller Mcadmv R Gad 134P We 424DE AS Z N At T bndbgs&Sphd CAWAns
0101f 13
7 Fuller Meadow Road - Ii«T+P FILE # 242 - 185
_._ . .. ............_....
53. 11 a°r°eM dA aa,lI Le rain) increase in the beret clevelcaprnent fru.araa the urtc rni drainage
system or any other changes iu-a past d.uN (°dc)lra°nu nt conditions that alter the lest
cicaw7(A al:ro-nont wauto_°ushc.d boundaries as currently depicted in tlac Notia:u of Daatcyrut and
al ,l roved by .this Order of car-aclitac ns, sli c`ificaally approved writ
ing ritin bythe
` aa:araaiSSi:c as-.
54. Water quality in down d,r•aaciiu aat BVV s enroll n t differ significantly following
(:011111uletio ru of tFie project frorn the pre- evelop nee tcaan.c.:lwlticaaas� d)'c' no
sedimentation into wetlands or vvartcr l:ruacdiu„s fu°crrn disclarar°'ge pipes or surf aace rou:n.o f`
leaving the sitt,:
I I ING CONSTRUCTION
5, . Upon beginning work, the aapplic-aaa-at shall suularaait ritte-,ra progress reports every
month detaritiral w fiat work.has been ozone in or near resource aaa.cryau�� as a�ajarc.d drat work is
anticipated to be done overthe next puar:dcrct. This will update tlaeY cearr ta•uctiOn
equerace a act can be as lraur't t;af tdav wee y e ros ion contrcal re pox t s.
56. All exposed. soil finish laralt be irnniediaately landscaped and. stabilized,
aar° Io'aauaa(,m;:1, u.u�u. e- d and unulclaed, with as layer of mulch h,ary, All tdistu:uu°d'ed aareaas :eiu st
be graded, l arnecd and seet;lecat pa,k),r to Nuaver°uuber 'P4 rrf each year. Outside of the
growing "ukaa,scrn, u.xlro;se d ;oil firii.sh grade surfaces shall be staabilized witlr o layer of
raarudcla lavay euuwtil climate conditions allow fcn, 'scacLdiru , Du:ur°irag ceau7Struction, any area of
expos,ecl sails that will; be left idle for ua'iore than.3 days shall .e autaabilia�ed with au Iaayol�
Of uuauada,da d-aaay or o the r° ineans a`appr ved by the NA(."(.
57. Msoc it',J :°cd lrauw enieoat and roadways shall be swept at least wcokly or as d iu{ecteroo_i ley
the Ero ierr-r Control monitor the Site uup-orvisor, i�'roje ct ' laanaa er, car Conservationstaff for as,;toaru aa^i tl'ie site^ aen)aauun exposed and un-stabilized., If raaaatugaiaal is tracked
Lcyouad tlae construction entrance onto thl e aatljiaac Cuut roadway, it will be swept Up daily.
58, Tfie construction access for the project sha'ill ble swept doily to r{ea^raove sedirnent
deposited by ccarash,uac:°tion w,el'ik'lus accic-':;Lsing the site aarar_Pd avoid tracking on tca public
ril'd.ut of Way,
519. 1"T'I ° ceruastu"uuction access and all materials stockpiling aar-cYa is lrr9cul,rursc.d outside., the .1 0 -
laacreat Buffer ,Zone, At no th e s aa:ll 1-)est("),ckpfline, of soil or any other materials occur.
can tat w flaan d sides of the erosion controls'.
7 Fusaarn''Meadow Rnd DEP File f,1242,B52
Page()u'r B
7 Fidler Meadow Road - DEP FF LE 4 242 - 1852,
60, Sforage (�-)f con.,Aruction velikle and any associated fuels, aricl re-ffic�Jing activifie -sball
be 011111.Side of the 'R110-foof Hiffei zone-
61. All ivaste generated by, or associated witli, Hic construction activity shall be contained
Withill, flIC HT11it Of work, arid away from any wedand resource area. Tfherctilrrall bc,, no
burying of spent construction materia1s or disposal of waste 0['I the site by any other
naeans. The app,ficm-it' Sliall 1'naintain dullipsters, (or other suitable rneans) at the sik-,
for the storip,e and reini-wal of such spent construction nlak"3"iak off-site. I lowrveverwI tic)
trash dumpsters, will. be a lk.')wed wifliirii 50 fuet of the edge of BVW.
62. Accepted engineerh-tg arid Stmxhi'rds and proced'ures shall be followed in
thecoi�xiq)lcfion of tfie project.
63., During ai-ul after work o�1-1 t1iiq project, ffiere shall be riodischarge or spillage of RIO, 01,
OtFic,'T p'C'.411:1tants i tito,any vvefland reSOUrcearea. If t.hei,:e,is a pull or cliscl,large, of a:aany
pollutant during any ph,-use tFic NACCdiall be notified by the
applk'�lut vvit[lin' (13-rilt, (1), busiries�,-, day. No coiistrUcLion vehicles axe to t)e wifliirN
'100 feet of wetland resource areas, and no vellick, ecjuipnient lubrication, or
maintenance is to, be dollic wifffln '1010 feet of a resource area.
[AFTER .-ONSTRUCTION
64. No underground storage of fuel ofl.s shall bo allowed on any lot within one-hundred
(100) fe,!t of a 1 ly W('t I'n)n(I re,�;(i u rce a rea. This cond it ion shall survive this,Oni cr of
Conditions and shall run with the, tiffeof the pl-Operty, Tbis, cinndifi(.-j,�n is, i.sSUed. under
the authority of H.-te Tuwn's Wvfla�rid protectio'rl Bylalv.
65. FertilizefS Utilized for Iandscapii-i�g aiid' [awn care stiall be slow release, low-nit.1, ogen.
3
typc:,, (< 5%), and skdtnot be, used within 25 feet of a resource area, Pe tkidie arld herbicides shall not be used within 1100 fcct of as vvetiand rescmt-ce area. This,condition
sl-l'al I L
" iyviw" this, Order of Coriditiorls and shall run with the title of the property. '11-iis-
COI)Cfiti011 is iSSUed Linder the authority of the Town's Wvtl�,.md Protectic)n H,ylaw and
shall remain in perp(-.Nftiity.
66., No,sodiUrn-basied prodiacts shatl be usod for cx)ntrol of ice t-),r srlow within 1010 feet of
the wc'-flarld'
167. TheresIN111 [W.,TIO dtA1)1j)ir1g,, Of leaves, grass clippings, brush, or other debriks info a
wetlandreSOUI'Ce areas or the 50-foot No-llufld Zone, - &s called OUt by the applicant
the lo,cad'on for Yard w,Aste c-c)ii'i posti rig shall be Outside the 5' NB Z at the westerly
side of the properly. TMs condition shall ren-lain,it-a, P(,,T'p("t1.1ftY-
7 R111EN Nkadmv.RoA DF11 hic ft742-3 k 52, NACC Finding &�*Ziid CUIRECkils
7 Falter .Mea(low Road - DEP FIL E ,4 242 - 1852
68, Upou corriptetion of construction and gradirg, all dishirbed arcas 10(.'aIted OLELSiide
Y'e,SOUrce areas shall be shOM7,cd perrnr ineritly against erosion. This shall be doi,-ze I-)y
foanling and, sc!e-dit,ig I according to NROS standards. Stabflization will 1)e cloiisidered
CoMplete once full vegetative covcr lion bee t'i a('J'Jv%Ped-.
69, Thc, use of coal tar-based. pavement sealai'lits is prol"iibited anti the property, as theY
have been dete.i.,D-iincd to co ntribute high levels of polyclyclic arornatic liydix carbons
(P.A1 is to storniwater,runoff. This condition shall stiu,vivc. tfi,u Order of Conditions
and. sh I f tho propert T
all run with the title o )A
70., -Upon al-.)proved site staliflization by Conservation staff, [lie erosiori conh.,ols be
Vell)(Wed and properly disposed of and all expc�sed unw-goti.,itcd areas, shall be seeded.
71 . Upon cornpletion of [lie project the apyAk'ail'iI slui I[ su bn)it the following to the
Conservation.Commissi on as pa rt of as reqUest for'as Certificate of Complial,-u,t-
oi, WPA Form A - "ReqUest for as Certificate of Comp,114a1i(,(,,"
b. A letter from the applicai,�it roc:Uesting a Cei,fificate of Compliance.
c. l lrc narnic ond address of the current landowner.
d, S'i tuned statenients from the indhdd'ilal 1,-)roperty ow iiers shall be submitted with.
the requ(-�st fc),-r a Cei tificate of Conipliance indicating that tfi.ey T--ead ai Id
uniderstood the recorded Order of Conclitious Prior to purchasing their property.
e. Tlne narr.ie arkd add1,1-('!ss (13,f fl'Et, individual/41"USt Orcorponation. to whom tfiv
)rrill1liatilce is to,be granted.
f. The street address and assc,.Ssor's trial'.),/parccl nurnber for the project.
gm TI-ic DEP file nuniber.,
h. A written siaLement froni, as lac Professional Civil Engineer (and/or
Re,giSt(-.-!r(!d 1'rof(!Ssio,11,111 L'.111d SUrvey or), of the Conu-nonwealtti,certifyirig t[lat the
work has, been conducted as shown cni fl-le phin�(s) and CIOC'Unlents, referenced
above, an a co d s uditioned by the Conitniss.ion.
i, (.Fieck, payable to the Tawi-.i of'North for Certificate of Conipliance,filing
fee (inquire with Conscrvotion Departine-l'it f( r current fee rate).
1. An "As-Bu i It" plat prepared and signed and stanil-)icd [)y a Registered Professional
Civil Engineer (and/or RegisftJ`C(J 1--rOf(`NHi0T1,!1l La Ill SUrveyor), of the
Coriinionwk',zwltl,i, for ffie public recoi-d. This plan will inchide:
"'As-Built" elevations of all drainage & sk)rniwat(,,-r
31W,Ti.agetnent strUdltres constructed within -.100 feet of any wetland, resource
area.
�O "As-Built" post-development elevations aannc.l of all filled or altered
wetland reso-umv aru,,is in,cl Lid ine, the e n com pass ing,buffer zone whidi is
regulated Lis as resource area Linder the lu,cal Wetizu'uJ Pr otec.tiot) Bylaw.
Distances from struchu.vs to wofland resource areas. StrUCtures. include (bu.t
ar(.! iivot linlfite-,cl to) septic systems, additions, fences, wa H's,
pools, retainin,g walls, subsiulac ,.!i,ifififies and decks.
- I Speuial C
7 Fullei Meadow Road DLP Filc#7112-1852. N'A CC P i i idingN&S :ondifiuns
pugc I I af 13
............... ..... .. .................. .. .....
7 Fuller Meii&i%v Road - DEP FILE H 242 - 18-52
A line showing the limit, of work and the exont of exiody eroqon conhol
"'Work" Ynducles, an cliqurbance of soils, or vegetation.
72. The condRions shall survive the issivance of a Certificate of
conipliarice (c'cq fcn- tiis projecL:
2,5" No-Disturf)onc(- Zou�it-, ;nid a 50' Zone. IN work
within '10,0' of existing wedand resource areas will requne a separatefififi-ig
pith the NACC of I fie Reg u la H on s fcnr forTTi a n ce s to ii L-1 a rd.s' w i th i n these
MUM) Vie Chnse�rvation Adniinistratm and/or other agentsof the NACC
do not have the authority to waive these sebacl<s ase"'toblished 111.1cfel, the,
local Byl.aw (C'ondftion # 31);
)h A A nee m en t Ed a nting to be left (0 nat Ural i ze (Condi tion, 047. i 1;
Resource Area Markers �Cundifit,)T] #48);
K I Ise hair ge or{ so H age Of p 0,11 U tarits (Co nd itiori #63),;
Prohibition of underground fu.els (Corulifi.on #64);
K I imitatHis on the use of Fertilizer,,-,, her'bicides, sodiUm.based de-icing
co ni pc�rand a nd pesticides ((--.'ondi[ions #65 & 66);
A Tfoldbi%n afthe -,use of tar, based produc:N-- for paving (Condition #69).
7 Fullu Rcwd I 1F.11 Ffle 9 24 2-18 52 NACC Findimg &Spiecial Canditions
Page 12 of L3 .............
7 Fuller Me-admi- Road - DF13 IFILL # 242 - 1852
APPENDIX A. - AFFIDAVIT
1, on omh do hc,.rc,.by dej)a.wand slatc-.
(authorized agent applicant and/or current owner)
(PITASE ATLEAST ONE
I a ril,t'he of
(pusition wiflk applicant) (it p P I ican I name or C0,111 pa ny nanie)
[lie.ap.plicatit upon "rhom Order of Cond.itiotis.
have beejt placed upon by w�D.EP or NA CC nu mbet),
the Morfli Ai Omer Corisetvatimi Cumiidss�ioli.
&1or
2. 1 am the of
(posItion with owner) (owner nanie)
the owner upon whose land Obi-der of Conditions,
have beery plaC&I LIP by (DEP or NACC nuniber)
Lire Nurtti.Ariduver Cotiservatim CocamisSICY11-
..............
alld IMVe Veiid ffide.Sallle.iUlld LECIdef-SitikIld eitch
(DEV Fi I e #) and everycondifion wilk..'11 ha's beettset forth
ors aid Orthm-of Coin]ffions.
day of
1.insjxdcd said property logether witil. anyaud all. bave
been made to [he,same a,.ri.d hereby cerfify thal each and every coMilJon spurt
forth in Order of Conditions are,presently in Compliance.
(T)FIF F110#)
5- 1 hereby affirai iuid acknowledge thak diis docurnentwill be relied upon by (lie
Norfli .Ar.-Nd(sver,Conserva(iorl Cc)In I'll iss ioll,its well as atty potential bUyers of
.,,,.aid property "'Itict'll i,.L,subject to said Order 4Yf Coriflitiotts;
�DEP rue #)
Sigfled Lff der the pains imid peindfies of perjury flals day of 19
........... .................
(Signature-authorized agent of applIcant. or owner.)
7 Fullcr Miudf,5w RGO'd DFA"H Ic 42.4 2-li 952 NACCJ-'indinrgs&Spccial Congfifirrms
jlag,c 13 of 13