HomeMy WebLinkAbout83-1875CAPE COD ENGINEERING, INC.
Robert M. Perry, P.E.
P.O. Box 1517
East Dennis, MA 02641
Tel./Fax 508-385-1445 / Fax 508-385-1446
bobperry(k�capecod.net
November 20, 2015
Yarmouth Conservation Department
1146 Route 28
South Yarmouth, MA 02664
RE: Recording Information: SE83-1875, SE83-2027 & SE83-2032
Enclosed please find recording confirmation sheets for the following 3 projects:
SE83-1875 - Certificate of Compliance for Jeff Chizmas at 66A River Street
SE83 2027 - Order of Conditions for Robert Greene at 15 Ship Shops Way
SE83-2032 — Order of Conditions for Robert Childs at 154 South Street
Please contact our office should you have any questions.
Sincerely,
Capes -Cod Engineering, Inc.
Nanc Kepi Eh
Y
Yarmouth Conservation
Commission
NOV 3 0 2015
RECEIVED
C-4��2 Mt�j
Massachusetts Department of Environmental Protection
LI
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance SE83-1875
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
Town of Yarmouth Wetland By -Law, Chapter 143
D. Recording Confirmation
The applicant is responsible for ensuring that this Certificate of Compliance is recorded in
the Registry of Deeds or the Land Court for the district in which the land is located.
Detach on dotted line and submit to the Conservation Commission.
t-6: ----------------------------------------------------------------------------------------------------
Yarmouth
Conservation Commission
Please be advised that the Certificate of Compliance for the project at:
66A River Street SE83-1875
Project Location DEP File Number
Has been recorded at the Registry of Deeds of:
Barnstable
County
for:
Property Owner
and has been noted in the chain of title of the affected property on:
E'k 29285 Ps129 JD57324
Date , .._ p C!
If recorded land, the instrument number which identifies this transaction is:
If registered land, the document number which identifies this transaction is:
Document Number
Signature of Applicant
wpafrm8b.doc • rev. 12/23/09 WPA Form 8B, Certificate of Compliance • Page 3 of 3
CG�e Cocl
TOWN OF YARMOUTH
CONSERVATION COMMISSION
Acknowledgment of Receipt
DEPARTMENT
OF
CONSERVATION
I, of e
(Print ame) (Business/Company
have received the following permit(s) via hand delivery on this
Day of em 20 15 at
♦ Original Plan to be Copied and Returned SE83 -
♦ Order of Conditions SE83 -
♦ Extension Permits SE83-
♦ Certificate of Compliance SE83- 6a rR11OZ . 64.
♦ ORAD SE83-
* Determination of Applicability
(Street Address, Owners Name)
ignature
pm/am.
Yarmouth Conservation Commission * 1146 Route 28 • South Yarmouth, MA 02664-4492
Tel. (508)-398-2231 Ext. 1288 • Fax (508)-398-0836 • TTD# (508) 398-2231
04
1
\ Massachusetts Department of Environmental Protection
i`— Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance SE83-1875
Massachusetts Wetlands Protection Act M.G.L. c. 131, S40 Provided by DEP
Town of Yarmouth Wetland By -Law, Chapter 143
A. Project Information
Important:
When filling out 1. This Certificate of Compliance is issued to:
forms on the
computer, use Cape Cod Engineering, Inc
only the tab key Name
to move your PO Box 1517
cursor - do not
use the return Mailing Address
key. East Dennis MA ^'r^'
City/Town State Zip Code
2. This Certificate of Compliance is issued for work regulated by a final Order of
Conditions issued to:
Jeffery Chizmas
Name
4/16/2010 SE83-1875
Dated
3. The project site is located at:
66A River Street
Street Address
Map 43
Assessors Map/Plat Number
South Yarmouth
City/Town
Lot 37
Parcel/Lot Number
DEP File Number
the final Order of Condition was recorded at the Registry of Deeds for:
Property Owner (if different)
Barnstable
County
24499 179
Book Page
Certificate
4. A site inspection was made in the presence of the applicant, or the applicant's agent,
on:
9/15/2015
Date
wpafrm8b.doc - rev. 12/23/09
WPA Form 8B, Certificate of Compliance - Page 1 of 3
0
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance
SE83-1875
Massachusetts Wetlands. Protection Act M.G.L. c. 131, §40 Provided by DEP
Town of Yarmouth Wetland By -Law, Chapter 143
B. Certification
Check all that apply:
® Complete Certification: It is hereby certified that the work regulated by the
above -referenced Order of Conditions has been satisfactorily completed.
❑ Partial Certification: It is hereby certified that only the following portions of work
regulated by the above -referenced Order of Conditions have been satisfactorily
completed. The project areas or work subject to this partial certification that have
been completed and are released from this Order are:
❑ Invalid Order of Conditions: It is hereby certified that the work regulated by the
above -referenced Order of Conditions never commenced. The Order of
Conditions has lapsed and is therefore no longer valid. No future work subject to
regulation under the Wetlands Protection Act may commence without filing a new
Notice of Intent and receiving a new Order of Conditions.
❑ Ongoing Conditions: The following conditions of the Order shall continue:
(Include any conditions contained in the Final Order, such as maintenance or
monitoring, that should continue for a longer period).
Condition Numbers:
C. Authorization
Issued by:
Yarmouth
Conservation Commission
9-as-ts
Date of Issuance
This Certificate must be signed by a majority of the Conservation Commission and a
copy sent to the applicant and appropriate DEP Regional Office (See
http://www.mass.gov/dep/about/region/findyour.htm).
wpafrm8b.doc - rev. 12/23/09
WPA Form 813, Certificate of Compliance - Page 2 of 3
;.
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance SE83-1875
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
Town of Yarmouth Wetland By -Law, Chapter 143
D. Recording Confirmation
The applicant is responsible for ensuring that this Certificate of Compliance is recorded in
the Registry of Deeds or the Land Court for the district in which the land is located.
Detach on dotted line and submit to the Conservation Commission.
f-6: ----------------------------------------------------------------------------------------------------
Yarmouth
Conservation Commission
Please be advised that the Certificate of Compliance for the project at:
66A River Street SE83-1875
Project Location DEP File Number
Has been recorded at the Registry of Deeds of:
Barnstable
County
for:
Property Owner
and has been noted in the chain of title of the affected property on:
Date Book Page
If recorded land, the instrument number which identifies this transaction is:
If registered land, the document number which identifies this transaction is:
Document Number
Signature of Applicant
wpafrm8b.doc • rev. 12/23/09
WPA Form 813, Certificate of Compliance • Page 3 of 3
CAPE COD ENGINEERING, INC.
Robert M. Perry, P.E.
P.O. sox 1517
East Dennis, MA 02641
Tel./Fax 508-385-1445 / Fax 508-385-1446
bobperryAcapecod.net
August 31, 2015
Town of Yarmouth
Conservation Commission
1146 Route 28
South Yarmouth, MA 02664
RE: 66A River Street, S. Yarmouth; SE 83-1875
To the Conservation Commission,
Attached please find Form 8A for the Request for Certificate of Compliance for SE 83-
1875 and a check in the amount of $75.00
The proposed work to remove invasive growth and the re -planting has been completed.
A very ample term has ensued where in the re -planted growth has prospered very well.
The applicant is seeking a Certificate of Compliance for the project at this time.
Please contact me directly should you have any questions
Sincerely,
Cape Cod n eering, Inc.
obert . Perry
w
Massachusetts Department of Environmental Protection
DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 8A — Request for Certificate of Compliance SE 83-1875
1 Massachusetts Wetlands Protection Act M.G. L. c. 131, §40 Provided by DEP
Town of Yarmouth Wetland By -Law, Chapter 143
A. Project Information
Important:
When filling out 1. This request is being made by: ($55 dollar filing fee required with submittal)
forms on the Cape Cod Engineering, Inc.
computer, use Name
only the tab p
key to move 0 BOX 1517
your cursor - Mailing Address
do not use the East Dennis MA 02641
return key. City/Town State Zip Code
508-385-1445
VILA Phone Number
2. This request is in reference to work regulated by a final Order of Conditions issued to:
Jeffrey Chizmas
Applicant
April 1, 2010 SE 83-1875
Dated DEP File Number
Upon completion
of the work 3•
authorized in
an Order of
Conditions, the
property owner
must request a
Certificate of 4
Compliance
from the issuing
authority stating
that the work or
portion of the
work has been
satisfactorily
completed.
The project site is located at:
66A River Street
South Yarmouth
Street Address City/Town
43 37
Assessors Map/Plat Number Parcel/Lot Number
The final Order of Conditions was recorded at the Registry of Deeds for:
Property Owner (if different)
Barnstable
County
Certificate (if registered land)
5. This request is for certification that (check one):
24499
Book
179
Page
the work regulated by the above -referenced Order of Conditions has been satisfactorily completed.
❑ the following portions of the work regulated by the above -referenced Order of Conditions have
been satisfactorily completed (use additional paper if necessary).
❑ the above -referenced Order of Conditions has lapsed and is therefore no longer valid, and the
work regulated by it was never started.
wpaform8a.doc -- rev. 7/13104 Page 1 of 2
Al
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
DEP File Number:
WPA Form 8A — Request for Certificate of Compliance SE 83-1875
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
Town of Yarmouth Wetland By -Law, Chapter 143
A. Project Information (cont.)
6. Did the Order of Conditions for this project, or the portion of the project subject to this request, contain
an approval of any plans stamped by a registered professional engineer, architect, landscape
architect, or land surveyor?
❑ Yes If yes, attach a written statement by such a professional certifying substantial
compliance with the plans and describing what deviation, if any, exists from the plans
approved in the Order.
❑ No
B. Submittal Requirements
Requests for Certificates of Compliance should be directed to the issuing authority that issued the final
Order of Conditions (OOC). If the project received an OOC from the Conservation Commission, submit
this request to that Commission. If the project was issued a Superseding Order of Conditions or was the
subject of an Adjudicatory Hearing Final Decision, submit this request to the appropriate DEP Regional
Office (see http://www.mass.clov/dep/about/region/fiindvour.htm).
wpoform8a.doc -- rev. 7/13/04 Page 2 of 2
CAPE COD ENGIIVEERING, INC.
Robert M. Perry, P.E.
P.O. Box 1517
East Dennis, MA 02641
Tel./Fax 508-385-1445 / Fax 508-385-1446
bob perrvna,capecod.net
August 31, 2015
Town of Yarmouth
Conservation Commission
1146 Route 28
South Yarmouth, MA 02664
RE: 66A River Street, S. Yarmouth; SE 83-1875
To the Conservation Commission,
Attached please find Form 8A for the Request for Certificate of Compliance for SE 83-
1875 and a check in the amount of $75.00
The proposed work to remove invasive growth and the re -planting has been completed.
A very ample term has ensued where in the re -planted growth has prospered very well.
The applicant is seeking a Certificate of Compliance for the project at this time.
Please contact me directly should you have any questions
Sincerely,
Cape Cod ni Bering, Inc.
obert . Perry
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
DEP File Number:
WPA Form 8A — Request for Certificate of Compliance SE 83-1875
Massachusetts Wetlands Protection Act M.G. L. c. 131, §40 Provided by DEP
Town of Yarmouth Wetland By -Law, Chapter 143
A. Project Information
Important:
When filling out 1
forms on the
computer, use
only the tab
key to move
your cursor -
do not use the
return key.
VQ
ICI 2
Upon completion
of the work 3.
authorized in
an Order of
Conditions, the
property owner
must request a
Certificate of 4
Compliance
from the issuing
authority stating
that the work or
portion of the
work has been
satisfactorily
completed.
This request is being made by: ($55 dollar filing fee required with submittal)
Cape Cod Engineering, Inc.
Name
PO BOX 1517
Mailing Address
East Dennis
City/Town
508-385-1445
Phone Number
MA
State
This request is in reference to work regulated by a final Order of Conditions issued to:
Jeffrey Chizmas
Applicant
April 1, 2010
Dated
The project site is located at:
66A River Street
Street Address
43
Assessors Map/Plat Number
SE 83-1875
DEP File Number
South Yarmouth
City/Town
37
Parcel/Lot Number
The final Order of Conditions was recorded at the Registry of Deeds for:
Property Owner (if different)
Bamstable
County
Certificate (if registered land)
5. This request is for certification that (check one):
02641
Zip Code
24499 179
Book Page
the work regulated by the above -referenced Order of Conditions has been satisfactorily completed.
❑ the following portions of the work regulated by the above -referenced Order of Conditions have
been satisfactorily completed (use additional paper if necessary).
❑ the above -referenced Order of Conditions has lapsed and is therefore no longer valid, and the
work regulated by it was never started.
wpaform8a.doc -- rev. 7/13104 Page 1 of 2
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
DEP File Number:
WPA Form 8A — Request for Certificate of Compliance SE 83-1875
Massachusetts Wetlands Protection Act M.G. L. c. 131, §40 Provided by DEP
Town of Yarmouth Wetland By -Law, Chapter 143
A. Project Information (cont.)
6. Did the Order of Conditions for this project, or the portion of the project subject to this request, contain
an approval of any plans stamped by a registered professional engineer, architect, landscape
architect, or land surveyor?
❑ Yes If yes, attach a written statement by such a professional certifying substantial
compliance with the plans and describing what deviation, if any, exists from the plans
approved in the Order.
❑ No
B. Submittal Requirements
Requests for Certificates of Compliance should be directed to the issuing authority that issued the final
Order of Conditions (OOC). If the project received an OOC from the Conservation Commission, submit
this request to that Commission. If the project was issued a Superseding Order of Conditions or was the
subject of an Adjudicatory Hearing Final Decision, submit this request to the appropriate DEP Regional
Office (see http://www.mass.gov/dep/about/reaion/findyour.htm).
wpaform8a.doc -- rev. 7113/04 Page 2 of 2
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 5 — Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Town of Yarmouth Wetland By -Law, Chapter 143
G. Recording Information
Provided by MassDEP:
SE-83-1875
MassDEP File #
eDEP Transaction #
Yarmouth
City/Town
Prior to commencement of work, this Order of Conditions must be recorded in the Registry of
Deeds or the Land Court for the district in which the land is located, within the chain of title of
the affected property. In the case of recorded land, the Final Order shall also be noted in the
Registry's Grantor Index under the name of the owner of the land subject to the Order. In the
case of registered land, this Order shall also be noted on the Land Court Certificate of Title of
the owner of the land subject to the Order of Conditions. The recording information on this page
shall be submitted to the Conservation Commission listed below.
Yarmouth
Conservation Commission
Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation
Commission.
---------------------------------------------------------------------------------------------------------------
To:
Yarmouth
conservation commission
Please be advised that the Order of Conditions for the Project at:
66-A River Street, South Yarmouth, MA
Project Location
Has been recorded at the Registry of Deeds of:
Barnstable
County
for: Jeffrey Chizmas
Property Owner
SE-83-1875
MassDEP File Number
2-gl4gq qq
Book Page
and has been noted in the chain of title of the affected property in:
Z`f3q0 106
Book Page
In accordance with the Order of Conditions issued on:
q
Date
If recorded land, the instrument number identifying t i traryatipr F.:, 1
1 9393
Instrument Number
If registered land, the document number identifying this transaction is:
Document Number
Signature of Applicant
wpaform5.doc • rev. 03/2/2010 Page 12 of 12
Massachusetts Department of Environmental Protection
LlBureau of Resource Protection - Wetlands
WPA Form 5 — Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Town of Yarmouth Wetland By -Law, Chapter 143
Provided by MassDEP:
SE-83-1875
MassDEP File #
eDEP Transaction #
Yarmouth
Citylrown
A. General Information
Important:
Yarmouth
When filling
1. From: Conservation Commission
out forms
on the
2. This issuance is for a. ®Order of Conditions b. ❑ Amended
Order of Conditions
computer,
(check one):
use only the
tab key to
3. To: Applicant:
move your
cursor - do
Jeffrey
Chizmas
not use the
a. First Name
b. Last Name
return key.
c. Organization
VQ
2401 Lewis O'Gray Drive
Mailing Address
Saugus
S
MA
01906
e. City/Town
f. State
g. Zip Code
4. Property Owner (if different from applicant):
a. First Name
b. Last Name
c. Organization
d. Mailing Address
e. CitylTown
f. State
g. Zip Code
5. Project Location:
66-A River Street
South Yarmouth
a. Street Address
b. City/Town
43
37
c. Assessors Map/Plat Number
d. Parcel/Lot Number
41d39m21s
70d11m49s
Latitude and Longitude, if known:
d. Latitude
e. Longitude
Page 1 of 12
wpaform5.doc • rev. 0312/2010
Massachusetts Department of Environmental Protection
LlBureau of Resource Protection - Wetlands
WPA Form 5 — Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Town of Yarmouth Wetland By -Law, Chapter 143
Provided by MassDEP:
SE-83-1875
MassDEP File #
eDEP Transaction #
Yarmouth
City/Town
A. General Information (cont.)
6. Property recorded at the Registry of Deeds for (attach additional information if more than
one parcel):
Barnstable
a. County
b. Certificate Number (if registered land)
24340
106
c. Book
d. Page
March 18, 2010
7. Dates:
April 15, 2010 April 16, 2010
a. Date Notice of Intent Filed
b. Date Public Hearing Closed c. Date of Issuance
8. Final Approved Plans and Other Documents (attach additional plan or document references
as needed):
Vegetation Management & Restorative Landscape Sketch Plan
a. Plan Title
Cape Cod Engineering
Robert M. Perry
b. Prepared By
c. Signed and Stamped by
April 1, 2010
1 inch = 20 feet
d. Final Revision Date
e. Scale
f. Additional Plan or Document Title
g. Date
B. Findings
1. Findings pursuant to the Massachusetts Wetlands Protection Act:
Following the review of the above -referenced Notice of Intent and based on the information
provided in this application and presented at the public hearing, this Commission finds that
the areas in which work is proposed is significant to the following interests of the Wetlands
Protection Act (the Act). Check all that apply:
a. ❑ Public Water Supply b. ❑ Land Containing Shellfish c. ❑ Prevention of
Pollution
d. ❑ Private Water Supply e. ❑ Fisheries f. ❑ Protection of
Wildlife Habitat
g. ❑ Groundwater Supply h. ® Storm Damage Prevention I. ® Flood Control
2. This Commission hereby finds the project, as proposed, is: (check one of the following boxes)
Approved subject to:
a. ® the following conditions which are necessary in accordance with the performance
standards set forth in the wetlands regulations. This Commission orders that all work shall
be performed in accordance with the Notice of Intent referenced above, the following
General Conditions, and any other special conditions attached to this Order. To the extent
that the following conditions modify or differ from the plans, specifications, or other
proposals submitted with the Notice of Intent, these conditions shall control.
wpaform5.doc • rev. 03/2/2010 Page 2 of 12
Massachusetts Department of Environmental Protection
Provided by MassDEP:
Bureau of Resource Protection - Wetlands
SE-83-1875
WPA Form 5 - Order of Conditions
Ll
MassDEPFile #
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
eDEP Transaction #
Town of Yarmouth Wetland By -Law, Chapter 143
Yarmouth
City/Town
B. Findings (cont.)
Denied because:
b. ❑ the proposed work cannot be conditioned to meet the performance standards set forth
in the wetland regulations. Therefore, work on this project may not go forward unless and
until a new Notice of Intent is submitted which provides measures which are adequate to
protect the interests of the Act, and a final Order of Conditions is issued. A description of
the performance standards which the proposed work cannot meet is attached to this
Order.
c. ❑ the information submitted by the applicant is not sufficient to describe the site, the
work, or the effect of the work on the interests identified in the Wetlands Protection Act.
Therefore, work on this project may not go forward unless and until a revised Notice of
Intent is submitted which provides sufficient information and includes measures which are
adequate to protect the Act's interests, and a final Order of Conditions is issued. A
description of the specific information which is lacking and why it is necessary is
attached to this Order as per 310 CMR 10.05(6)(c).
3. ❑ Buffer Zone Impacts: Shortest distance between limit of project
disturbance and the wetland resource area specified in 310 CMR 10.02(1)(a) a. linear feet
Inland Resource Area Impacts: Check all that apply below. (For Approvals Only)
Resource Area Proposed Permitted Proposed Permitted
Alteration Alteration Replacement Replacement
a. ❑
Bank
5. ❑
Bordering
Vegetated Wetland
6. ❑
Land Under
Waterbodies and
Waterways
7. ❑ Bordering Land
Subject to Flooding
Cubic Feet Flood Storage
8. ❑ Isolated Land
Subject to Flooding
Cubic Feet Flood Storage
s. ❑ Riverfront Area
Sq ft within 100 ft
Sq ft between 100-
200 ft
a. linear feet b. linear feet c. linear feet d. linear feet
a. square feet b. square feet c. square feet d. square feet
a. square feet b. square feet c. square feet d. square feet
e. c/y dredged f. Gy dredged
a. square feet b. square feet c. square feet d. square feet
V. uuuw Iccl 1. a.uvla. 1- V.
......
c. cubic feet d. cubic feet e. cubic feet f. cubic feet
a fntci an fact
U. WWI b4. 1VUL
r and mra foci
d. square feet a and,nra foci
f. square feet
n an/Zara fact
h. square feet i and lara fact
j. square feet
wpaform5.doc • rev. 03/2/2010 Page 3 of 12
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 5 — Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Town of Yarmouth Wetland By -Law, Chapter 143
Provided by MassDEP:
SE-83-1875
MassDEP File #
eDEP Transaction #
Yarmouth
Cityrrown
B. Findings (cont.)
Coastal Resource Area Impacts: Check all that apply below. (For Approvals Only)
Proposed Permitted Proposed Permitted
Alteration Alteration Replacement Replacement
10. El Designated Port Areas Indicate size under Land Under the Ocean, below
11. ❑ Land Under the
Ocean
12.
❑
Barrier Beaches
13.
❑
Coastal Beaches
14.
❑
Coastal Dunes
15.
®
Coastal Banks
16.
❑
Rocky Intertidal
Shores
17.
❑
Salt Marshes
18.
❑
Land Under Salt
Ponds
19. ❑ Land Containing
Shellfish
20. ❑ Fish Runs
21. ❑ Land Subject to
Coastal Storm
Flowage
a. square feet
Indicate size under Coastal Beaches and/or Coastal Dunes
below
cu yd
cu yd
a. square feet
b. square feet
c. nourishment
d. nourishment
cu yd
cu yd
a. square feet
b. square feet
c. nourishment
d. nourishment
120
120
a. linear feet
b. linear feet
a. square feet b. square feet
c. c/y dredged d. c/y dredged
Indicate size under Coastal Banks, Inland Bank, Land Under
the Ocean, and/or inland Land Under Waterbodies and
Waterways, above
a. c/y dredged b. c/y dredged
a. square feet b. square feet
wpaform5.doc • rev. 0312/2010 Page 4 of 12
Massachusetts Department of Environmental Protection
LlBureau of Resource Protection - Wetlands
WPA Form 5 — Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Town of Yarmouth Wetland By -Law, Chapter 143
B. Findings (cont.)
project is for 2. If the 22. ElRestoration/Enhancement ":
the purpose of
restoring or
enhancing a
wetl d
a. square feet of BVW
an
resource area 23. ❑ Stream Crossing(s):
b. square feet of salt marsh
Provided by MassDEP:
SE-83-1875
MassDEP File #
eDEP Transaction #
Yarmouth
Cityrrown
in addition to
the square
footage that a. number of new stream crossings b. number of replacement stream crossings
has been C. General Conditions Under Massachusetts Wetlands Protection Act
entered in
Section B.5.c
(BVW) or The following conditions are only applicable to Approved projects.
B.17.c (Salt
Marsh) above, 1. Failure to comply with all conditions stated herein, and with all related statutes and other
please enter regulatory measures, shall be deemed cause to revoke or modify this Order.
the additional 9 rY Y
amount here. 2. The Order does not grant any property rights or any exclusive privileges; it does not
authorize any injury to private property or invasion of private rights.
3. This Order does not relieve the permittee or any other person of the necessity of complying
with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations.
4. The work authorized hereunder shall be completed within three years from the date of this
Order unless either of the following apply:
a. the work is a maintenance dredging project as provided for in the Act; or
b. the time for completion has been extended to a specified date more than three years,
but less than five years, from the date of issuance. If this Order is intended to be valid
for more than three years, the extension date and the special circumstances warranting
the extended time period are set forth as a special condition in this Order.
5. This Order may be extended by the issuing authority for one or more periods of up to three
years each upon application to the issuing authority at least 30 days prior to the expiration
date of the Order.
6. If this Order constitutes an Amended Order of Conditions, this Amended Order of
Conditions does not extend the issuance date of the original Final Order of Conditions and
the Order will expire on unless extended in writing by the Department.
7. Any fill used in connection with this project shall be clean fill. Any fill shall contain no trash,
refuse, rubbish, or debris, including but not limited to lumber, bricks, plaster, wire, lath,
paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles, or parts of any of the
foregoing.
8. This Order is not final until all administrative appeal periods from this Order have elapsed,
or if such an appeal has been taken, until all proceedings before the Department have
been completed.
wpaform5.doc • rev. 03/2/2010 Page 5 of 12
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands SE-83-1875
WPA Form 5 -Order %P ConditiMassDEP File #
ons
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction #
Town of Yarmouth Wetland By -Law, Chapter 143 Yarmouth
City/Town
C. General Conditions Under Massachusetts Wetlands Protection Act (cont.)
9. No work shall be undertaken until the Order has become final and then has been recorded
in the Registry of Deeds or the Land Court for the district in which the land is located, within
the chain of title of the affected property. In the case of recorded land, the Final Order shall
also be noted in the Registry's Grantor Index under the name of the owner of the land upon
which the proposed work is to be done. In the case of the registered land, the Final Order
shall also be noted on the Land Court Certificate of Title of the owner of the land upon
which the proposed work is done. The recording information shall be submitted to the
Conservation Commission on the form at the end of this Order, which form must be
stamped by the Registry of Deeds, prior to the commencement of work.
10. A sign shall be displayed at the site not less then two square feet or more than three
square feet in size bearing the words,
"Massachusetts Department of Environmental Protection" [or, "MassDEP")
"File Number SE-83-1875 "
11. Where the Department of Environmental Protection is requested to issue a Superseding
Order, the Conservation Commission shall be a party to all agency proceedings and
hearings before MassDEP.
12. Upon completion of the work described herein, the applicant shall submit a Request for
Certificate of Compliance (WPA Form 8A) to the Conservation Commission.
13. The work shall conform to the plans and special conditions referenced in this order.
14. Any change to the plans identified in Condition #13 above shall require the applicant to
inquire of the Conservation Commission in writing whether the change is significant enough
to require the filing of a new Notice of Intent.
15. The Agent or members of the Conservation Commission and the Department of
Environmental Protection shall have the right to enter and inspect the area subject to this
Order at reasonable hours to evaluate compliance with the conditions stated in this Order,
and may require the submittal of any data deemed necessary by the Conservation
Commission or Department for that evaluation.
16. This Order of Conditions shall apply to any successor in interest or successor in control of
the property subject to this Order and to any contractor or other person performing work
conditioned by this Order.
17. Prior to the start of work, and if the project involves work adjacent to a Bordering Vegetated
Wetland, the boundary of the wetland in the vicinity of the proposed work area shall be
marked by wooden stakes or flagging. Once in place, the wetland boundary markers shall
be maintained until a Certificate of Compliance has been issued by the Conservation
Commission.
wpaform5.doc • rev. 03/2/2010 Page 6 of 12
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands SE-83-1875
WPA Form 5 — Order of Conditions MassDEP File #
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction #
Town of Yarmouth Wetland By -Law, Chapter 143 Yarmouth
Cityrrown
C. General Conditions Under Massachusetts Wetlands Protection Act (cont.)
18. All sedimentation barriers shall be maintained in good repair until all disturbed areas have
been fully stabilized with vegetation or other means. At no time shall sediments be
deposited in a wetland or water body. During construction, the applicant or his/her
designee shall inspect the erosion controls on a daily basis and shall remove accumulated
sediments as needed. The applicant shall immediately control any erosion problems that
occur at the site and shall also immediately notify the Conservation Commission, which
reserves the right to require additional erosion and/or damage prevention controls it may
deem necessary. Sedimentation barriers shall serve as the limit of work unless another
limit of work line has been approved by this Order.
NOTICE OF STORMWATER CONTROL AND MAINTENANCE REQUIREMENTS
19. The work associated with this Order (the "Project") is (1) ❑ is not (2) ® subject to the
Massachusetts Stormwater Standards. If the work is subject to the Stormwater
Standards, then the project is subject to the following conditions:
a) All work, including site preparation, land disturbance, construction and redevelopment,
shall be implemented in accordance with the construction period pollution prevention and
erosion and sedimentation control plan and, if applicable, the Stormwater Pollution
Prevention Plan required by the National Pollution Discharge Elimination System
Construction General Permit as required by Stormwater Condition 8. Construction period
erosion, sedimentation and pollution control measures and best management practices
(BMPs) shall remain in place until the site is fully stabilized.
b) No stormwater runoff may be discharged to the post -construction stormwater BMPs
unless and until a Registered Professional Engineer provides a Certification that:
i. all construction period BMPs have been removed or will be removed by a date certain
specified in the Certification. For any construction period BMPs intended to be converted
to post construction operation for stormwater attenuation, recharge, and/or treatment, the
conversion is allowed by the MassDEP Stormwater Handbook BMP specifications and that
the BMP has been properly cleaned or prepared for post construction operation, including
removal of all construction period sediment trapped in inlet and outlet control structures;
ii. as -built final construction BMP plans are included, signed and stamped by a Registered
Professional Engineer, certifying the site is fully stabilized;
iii. any illicit discharges to the stormwater management system have been removed, as per
the requirements of Stormwater Standard 10;
iv. all post -construction stormwater BMPs are installed in accordance with the plans
(including all planting plans) approved by the issuing authority, and have been inspected to
ensure that they are not damaged and that they are in proper working condition;
v. any vegetation associated with post -construction BMPs is suitably established to
withstand erosion.
wpaform5.doc • rev. 03/2/2010 Page 7 of 12
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 5 — Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Town of Yarmouth Wetland By -Law, Chapter 143
Provided by MassDEP:
SE-83-1875
MassDEP File #
eDEP Transaction #
Yarmouth
City/Town
G. General Conditions Under Massachusetts Wetlands Protection Act (cont.)
c) The landowner is responsible for BMP maintenance until the issuing authority is
notified that another party has legally assumed responsibility for BMP maintenance. Prior
to requesting a Certificate of Compliance, or Partial Certificate of Compliance, the
responsible party (defined in General Condition 18(e)) shall execute and submit to the
issuing authority an Operation and Maintenance Compliance Statement ("O&M Statement)
for the Stormwater BMPs identifying the party responsible for implementing the stormwater
BMP Operation and Maintenance Plan ("O&M Plan") and certifying the following: i.) the
O&M Plan is complete and will be implemented upon receipt of the Certificate of
Compliance, and ii.) the future responsible parties shall be notified in writing of their
ongoing legal responsibility to operate and maintain the stormwater management BMPs
and implement the Stormwater Pollution Prevention Plan.
d) Post -construction pollution prevention and source control shall be implemented in
accordance with the long-term pollution prevention plan section of the approved
Stormwater Report and, if applicable, the Stormwater Pollution Prevention Plan required by
the National Pollution Discharge Elimination System Multi -Sector General Permit.
e) Unless and until another party accepts responsibility, the landowner, or owner of any
drainage easement, assumes responsibility for maintaining each BMP. To overcome this
presumption, the landowner of the property must submit to the issuing authority a legally
binding agreement of record, acceptable to the issuing authority, evidencing that another
entity has accepted responsibility for maintaining the BMP, and that the proposed
responsible party shall be treated as a permittee for purposes of implementing the
requirements of Conditions 18(f) through 18(k) with respect to that BMP. Any failure of the
proposed responsible party to implement the requirements of Conditions 18(f) through
18(k) with respect to that BMP shall be a violation of the Order of Conditions or Certificate
of Compliance. In the case of stormwater BMPs that are serving more than one lot, the
legally binding agreement shall also identify the lots that will be serviced by the stormwater
BMPs. A plan and easement deed that grants the responsible party access to perform the
required operation and maintenance must be submitted along with the legally binding
agreement.
f) The responsible party shall operate and maintain all stormwater BMPs in accordance
with the design plans, the O&M Plan, and the requirements of the Massachusetts
Stormwater Handbook.
wpaform5.doc • rev. 03/2/2010
Page 8 of 12
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands SE-83-1875
WPA Form 5 — Order of Conditions MassDEP File #
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction #
Town of Yarmouth Wetland By -Law, Chapter 143 Yarmouth
City/Town
C. General Conditions Under Massachusetts Wetlands Protection Act (cont.)
g) The responsible party shall: .
1. Maintain an operation and maintenance log for the last three (3) consecutive
calendar years of inspections, repairs, maintenance and/or replacement of the
stormwater management system or any part thereof, and disposal (for disposal the
log shall indicate the type of material and the disposal location);
2. Make the maintenance log available to MassDEP and the Conservation
Commission ("Commission") upon request; and
3. Allow members and agents of the MassDEP and the Commission to enter and
inspect the site to evaluate and ensure that the responsible party is in compliance
with the requirements for each BMP established in the O&M Plan approved by the
issuing authority.
h) All sediment or other contaminants removed from stormwater BMPs shall be disposed
of in accordance with all applicable federal, state, and local laws and regulations.
i) Illicit discharges to the stormwater management system as defined in 310 CMR 10.04
are prohibited.
j) The stormwater management system approved in the Order of Conditions shall not be
changed without the prior written approval of the issuing authority.
k) Areas designated as qualifying pervious areas for the purpose of the Low Impact Site
Design Credit (as defined in the MassDEP Stormwater Handbook, Volume 3, Chapter 1,
Low Impact Development Site Design Credits) shall not be altered without the prior written
approval of the issuing authority.
1) Access for maintenance, repair, and/or replacement of BMPs shall not be withheld.
Any fencing constructed around stormwater BMPs shall include access gates and shall be
at least six inches above grade to allow for wildlife passage.
Special Conditions (if you need more space for additional conditions, please attach a text
document):
wpaform5.doc - rev. 0312/2010 Page 9 of 12
Massachusetts Department of Environmental Protection
LlBureau of Resource Protection - Wetlands
WPA Form 5 — Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Town of Yarmouth Wetland By -Law, Chapter 143
Provided by MassDEP:
SE-83-1875
MassDEP File #
eDEP Transaction #
Yarmouth
City/Town
D. Findings Under Municipal Wetlands Bylaw or Ordinance
1. Is a municipal wetlands bylaw or ordinance applicable? ® Yes ❑ No
2. The Yarmouth
hereby finds (check one that applies):
Conservation Commission
a. ❑ that the proposed work cannot be conditioned to meet the standards set forth in a
municipal ordinance or bylaw, specifically:
1. Municipal Ordinance or Bylaw
2. citation
Therefore, work on this project may not go forward unless and until a revised Notice of
Intent is submitted which provides measures which are adequate to meet these
standards, and a final Order of Conditions is issued.
b. ® that the following additional conditions are necessary to comply with a municipal
ordinance or bylaw:
Yarmouth Wetland By -Law, Chapter 143
1. Municipal Ordinance or Bylaw 2. Citation
3. The Commission orders that all work shall be performed in accordance with the following
conditions and with the Notice of Intent referenced above. To the extent that the following
conditions modify or differ from the plans, specifications, or other proposals submitted with
the Notice of Intent, the conditions shall control.
The special conditions relating to municipal ordinance or bylaw are as follows (if you need
more space for additional conditions, attach a text document):
See attached text page(s)
wpaform5.doc - rev. 03/2/2010 Page 10 of 12
WPA FORM 5-ORDER OF CONDITIONS
SPECIAL CONDITIONS -PAGE 10A OF 12
SE-83-1875-Jeffrey Chizmas
66-A River Street, South Yarmouth, MA
The applicant shall be responsible for having a copy of the "Orders of
Conditions" on the job site at all times. Failure to do so may result in the
revocation of these "Orders", a fine or both.
2. The Conservation Commission, it's agents or assigns, shall have the express
right of entry upon the job site at all reasonable times for the purposes of
establishing "compliance" with the conditions stated herein.
3. Upon completion of the project, a "Certificate of Compliance" shall be
requested in writing. This "Order of Conditions" shall be considered
incomplete until the "Certificate of Compliance" is issued and recorded at the
Registry of Deeds.
4. Any plan changes whatsoever must be brought to the attention of the
Conservation Administrator prior to implementation of such change. Failure
to do so may result in the revocation of these "Orders, a fine or both.
5. A pre -construction review shall be arranged by the contractor with the
Conservation Administrator. This review shall occur prior to any work.
6. Applicants are reminded that these "Orders" are only valid for 3 years from
their date of issue, unless otherwise specifically noted within the "Orders".
Extension Permit requests must be applied for at least 30 calendar days prior
to the expiration of the original "Orders". Failure to do so will result in a
new "Notice of Intent" filing.
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 5 — Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Town of Yarmouth Wetland By -Law, Chapter 143
Provided by MassDEP:
SE-5r3--1S7S_
MassDEP File #
eDEP Transaction #
Yarmouth
City/Town
E. Signatures
This Order is valid for three years, unless otherwise specified as a special - 16�
condition pursuant to General Conditions #4, from the date of issuance. 1. Date of Issuance
Please indicate the number of members who will sign this form. 1
This Order must be signed by a majority of the Conservation Commission. 2. Number of Signers
The Order must be mailed by certified mail (return receipt requested) or hand delivered to the applicant. A
copy also must be mailed or hand delivered at the same time to the appropriate Department of
Environmental Protection Regional Office, if not filing electronically, and the property owner, if different
from applicant. / /
Signatures:
Xby hand delivery on
F. Appeals
i
❑ by certified mail, return receipt
requested, on
Date
The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the
land subject to this Order, or any ten residents of the city or town in which such land is located,
are hereby notified of their right to request the appropriate MassDEP Regional Office to issue a
Superseding Order of Conditions. The request must be made by certified mail or hand delivery
to the Department, with the appropriate filing fee and a completed Request of Departmental
Action Fee Transmittal Form, as provided in 310 CMR 10.03(7) within ten business days from
the date of issuance of this Order. A copy of the request shall at the same time be sent by
certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is
not the appellant.
Any appellants seeking to appeal the Department's Superseding Order associated with this appeal
will be required to demonstrate prior participation in the review of this project. Previous participation
in the permit proceeding means the submission of written information to the Conservation
Commission prior to the close of the public hearing, requesting a Superseding Order, or
providing written information to the Department prior to issuance of a Superseding Order.
The request shall state clearly and concisely the objections to the Order which is being
appealed and how the Order does not contribute to the protection of the interests identified in
the Massachusetts Wetlands Protection Act (M.G.L. c. 131, § 40), and is inconsistent with the
wetlands regulations (310 CMR 10.00). To the extent that the Order is based on a municipal
ordinance or bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the
Department has no appellate jurisdiction.
wpaform5.doc • rev. 03/2/2010 Page 11 of 12
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 5 — Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Town of Yarmouth Wetland By -Law, Chapter 143
G. Recording Information
Provided by MassDEP:
SE-83-1875
MassDEP File #
eDEP Transaction #
Yarmouth
Cityrrown
Prior to commencement of work, this Order of Conditions must be recorded in the Registry of
Deeds or the Land Court for the district in which the land is located, within the chain of title of
the affected property. In the case of recorded land, the Final Order shall also be noted in the
Registry's Grantor Index under the name of the owner of the land subject to the Order. In the
case of registered land, this Order shall also be noted on the Land Court Certificate of Title of
the owner of the land subject to the Order of Conditions. The recording information on this page
shall be submitted to the Conservation Commission listed below.
Yarmouth
Conservation Commission
Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation
Commission.
---------------------------------------------------------------------------------------------------------------
To:
Yarmouth
Conservation Commission
Please be advised that the Order of Conditions for the Project at:
66-A River Street, South Yarmouth, MA SE-83-1875
Project Location MassDEP File Number
Has been recorded at the Registry of Deeds of:
Barnstable
County Book Page
for: Jeffrey Chizmas
Property Owner
and has been noted in the chain of title of the affected property in:
Book Page
In accordance with the Order of Conditions issued on:
Date
If recorded land, the instrument number identifying this transaction is:
Instrument Number
If registered land, the document number identifying this transaction is:
Document Number
Signature of Applicant
wpaform5.doc - rev. 03/2/2010 Page 12 of 12
DEVAL L. PATRICK
Governor
TIMOTHY P. MURRAY
Lieutenant Governor
DATE: April 06, 2010
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENERGY & ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
SOUTHEAST REGIONAL OFFICE
20 RIVERSIDE DRIVE, LAKEVILLE, MA 02347
Yd(Mbuth Conservation
Commission
APR 0 9 2010
RECEIVED
Municipality YARMOUTH
(city/town)
RE: NOTIFICATION OF WETLANDS PROTECTION ACT FILE NUMBER
IAN A. BOWLES
Secretary
LAURIE BURT
Commissioner
The Department of Environmental Protection has received a Notice of Intent filed in accordance with the
Wetlands Protection Act (M.G.L. c. 131, §40):
Applicant: JEFFREY CHIZMAS Owner:
Address: 2401 LEWIS O'GRAY DRIVE Address:
SAUGUS, MA 01906
LOCUS: 66A RIVER ST.
This project has been assigned the following file # : SE 083-1875
ISSUANCE OF A FILE NUMBER INDICATES ONLY COMPLETENESS OF SUBMITTAL,
NOT APPROVAL OF APPLICATION
Although a file # is being issued, please note the following:
If you have any questions regarding this letter, please contact: CHRISTINE ODIAGA @ (508)-946-2836
Cc: Yarmouth Conservation Commission, 1146 Route 28 South Yarmouth, Yarmouth, MA, 02664
Representative: CAPE COD ENGINEERING, PO BOX 1517, EAST DENNIS, MA, 02641
This information is available in alternate format. Call Donald M. Gomes, ADA Coordinator at 617-556-1057. TDD# 1-866-539-7622 or 1-617-574-6868.
htti)://www.mass.gov/dei)
0 Printed on Recycled Paper
YARMOUTH Conservation Commission
1146 Route 28
South Yarmouth
YARMOUTH, MA 02664
r
Massachusetts Department of Environmental Protection
ILIBureau of Resource Protection - Wetlands
WPA Form 3 — Notice of Intent
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Important:
When filling out
forms on the
computer, use
only the tab key
to move your
cursor - do not
use the return
key.
ILA
_ Iml
Note:
Before
completing this
form consult
your local
Conservation
Commission
regarding any
municipal bylaw
or ordinance.
A. General Information
1
Provided by MassDEP:
MassDEP File Number
Document Transaction Number
Yarmouth
Cityrrown
Project Location (Note: electronic filers will click on button to locate project site):
66A River Street South Yarmouth
a. Street Address b. Citylrown
Latitude and Longitude: 41 39' 21"
d. Latitude
43 37
f. Assessors Map/Plat Number g. Parcel /Lot Number
2. Applicant:
Jeffrev Chizmas
a. First Name b. Last Name
nn@c A
c. Zip Code
70 11' 49"
e. Longitude
c. Organization
2401 Lewis O'Gray Drive
d. Street Address
Saugus MA 01906
e. Citylrown f. State g. Zip Code
617-285-1246
h. Phone Number i. Fax Number j. Email Address
3. Property owner (required if different from applicant): ❑ Check if more than one owner
4
5
a. First Name b. Last Name
c. Organization
d. Street Address
e. Citylrown
f. State
h. Phone Number i. Fax Number j. Email address
Representative (if any):
g. Zip Code
Robert
Perry
a. First Name
b. Last Name
Cape Cod Engineering,
Inc.
c. Company
P.O. Box 1517
d. Street Address
East Dennis
MA 02641
e. Cityfrown
f. State g. Zip Code
508-385-1445
508-385-1446 bobperry@capecod.net
h. Phone Number
i. Fax Number j. Email address
Total WPA Fee Paid (from NOI Wetland Fee Transmittal Form):
$165.00
$70.00 $95.00
a. Total Fee Paid
b. State Fee Paid c. City/Town Fee Paid
wpaform3.doc • rev. 11/16/09 Page 1 of 8
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 3 — Notice of Intent
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. General Information (continued)
Provided by MassDEP:
MassDEP File Number
Document Transaction Number
Yarmouth
Cityrrown
6. General Project Description:
Vegetation management and restorative plantings of native species within 100 ft. of the top of the
coastal bank and coastal beach
7a. Project Type Checklist:
1 _ ® Single Family Home
3. ❑ Limited Project Driveway Crossing
5. ❑ Dock/Pier
7. ❑ Coastal Engineering Structure
2. ❑
Residential Subdivision
4. ❑
Commercial/Industrial
6. ❑
Utilities
8. ❑
Agriculture (e.g., cranberries, forestry)
9. ❑ Transportation 10. ❑ Other
7b. Is any portion of the proposed activity eligible to be treated as a limited project subject to 310 CMR
10.24 (coastal) or 310 CMR 10.53 (inland)?
1. ❑ Yes ® No If yes, describe which limited project applies to this project:
2. Limited Project
8. Property recorded at the Registry of Deeds for:
Barnstable
a. County
24340
b. Certificate # (if registered land)
106
c. Book d. Page Number
B. Buffer Zone & Resource Area Impacts (temporary & permanent)
1. ® Buffer Zone Only — Check if the project is located only in the Buffer Zone of a Bordering
Vegetated Wetland, Inland Bank, or Coastal Resource Area.
2. ❑ Inland Resource Areas (see 310 CMR 10.54-10.58; if not applicable, go to Section B.3,
Coastal Resource Areas).
Check all that apply below. Attach narrative and any supporting documentation describing how the
project will meet all performance standards for each of the resource areas altered, including standards
requiring consideration of alternative project design or location.
For all projects
affecting other
Resource Area
Resource Areas,
please attach a
a. ❑
Bank
narrative
explaining how
b. ❑
Bordering Vegetated
the resource
Wetland
area was
delineated.
c. ❑
Land Under
Waterbodies and
Waterways
wpaform3.doc • rev.
11/16/09
Size of Proposed Alteration Proposed Replacement (if any)
1. linear feet
1. square feet
1. square feet
3. cubic yards dredged
2. linear feet
2. square feet
2. square feet
Page 2 of 8
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 3 — Notice of Intent
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Provided by MassDEP:
MassDEP File Number
Document Transaction Number
Yarmouth
Cityfrown
B. Buffer Zone & Resource Area Impacts (temporary & permanent) (cont'd)
Resource Area
d. ❑ Bordering Land
Subject to Flooding
e. ❑ Isolated Land
Subject to Flooding
® R' rf 4-A
Size of Proposed Alteration Proposed Replacement (if any)
1. square feet
3. cubic feet of flood storage lost
1. square feet
2. cubic feet of flood storage lost
Bass River
f. IVe rOn rea 1. Name of Waterway (if available)
2. Width of Riverfront Area (check one):
❑ 25 ft. - Designated Densely Developed Areas only
❑ 100 ft. -New agricultural projects only
® 200 ft. - All other projects
2. square feet
4. cubic feet replaced
3. cubic feet replaced
3. Total area of Riverfront Area on the site of the proposed project: 24,000
square feet
4. Proposed alteration of the Riverfront Area:
5,400 5,400 0
a. total square feet b. square feet within 100 ft. c. square feet between 100 ft. and 200 ft.
5. Has an alternatives analysis been done and is it attached to this NOI? ® Yes ❑ No
6. Was the lot where the activity is proposed created prior to August 1, 1996? ® Yes ❑ No
3. ❑ Coastal Resource Areas: (See 310 CMR 10.25-10.35)
Check all that apply below. Attach narrative and supporting documentation describing how the project
will meet all performance standards for each of the resource areas altered, including standards
requiring consideration of alternative project design or location.
Online Users:
Include your
Resource Area
Size of Proposed Alteration Proposed Replacement (if any)
document
transaction
number
a. ❑ Designated Port Areas
Indicate size under Land Under the Ocean, below
(provided on
your receipt
b. ❑ Land Under the Ocean
1. square feet
page) with all
supplementary
information you
2. cubic yards dredged
submit to the
Department.
c. ❑ Barrier Beach
Indicate size under Coastal Beaches and/or Coastal Dunes below
d. ❑ Coastal Beaches
1. square feet 2. cubic yards beach nourishment
e. ❑ Coastal Dunes
1. square feet 2. cubic yards dune nourishment
wpaform3.doc • rev. 11/16/09 Page 3 of 8
Massachusetts Department of Environmental Protection Provided by MassDEP:
Bureau of Resource Protection - Wetlands
MassDEP File Number
WPA Form 3 — Notice of Intent
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Yarmouth
City/Town
B. Buffer Zone & Resource Area Impacts (temporary & permanent) (cont'd)
Size of Proposed Alteration Proposed Replacement (if any)
f. ®
Coastal Banks
120
1. linear feet
g. ❑
Rocky Intertidal
Shores
1. square feet
h. ❑
Salt Marshes
1. square feet 2. sq ft restoration, rehab., creation
i. ❑
Land Under Salt
Ponds
1. square feet
2. cubic yards dredged
j. ❑
Land Containing
Shellfish
1. square feet
k. ❑
Fish Runs
Indicate size under Coastal Banks, inland Bank, Land Under the
Ocean, and/or inland Land Under Waterbodies and Waterways,
above
1. cubic yards dredged
I. ❑ Land Subject to
Coastal Storm Flowage 1. square feet
4. ❑ Restoration/Enhancement
If the project is for the purpose of restoring or enhancing a wetland resource area in addition to the
square footage that has been entered in Section B.2.b or B.3.h above, please enter the additional
amount here.
a. square feet of BVW b. square feet of Salt Marsh
5. ❑ Project Involves Stream Crossings
a. number of new stream crossings
b. number of replacement stream crossings
C. Other Applicable Standards and Requirements
Streamlined Massachusetts Endangered Species Act/Wetlands Protection Act Review
1. Is any portion of the proposed project located in Estimated Habitat of Rare Wildlife as indicated on
the most recent Estimated Habitat Map of State -Listed Rare Wetland Wildlife published by the Natural
Heritage and Endangered Species Program (NHESP)? To view habitat maps, see the Massachusetts
Natural Heritage Atlas or go to
http://www.mass.gov/dfwele/dfw/nhesp/regulatory review/priority habitatlonline viewer.htm.
a. ❑ Yes ® No
10/08
b. Date of map
If yes, include proof of mailing or hand delivery of NOI to:
Natural Heritage and Endangered Species Program
Division of Fisheries and Wildlife
Route 135, North Drive
Westborough, MA 01581
wpaform3.doc • rev. 11/16/09 Page 4 of 8
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 3 — Notice of Intent
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Provided by MassDEP:
MassDEP File Number
Document Transaction Number
Yarmouth
City/Town
C. Other Applicable Standards and Requirements (cont'd)
If yes, the project is also subject to Massachusetts Endangered Species Act (MESA) review (321
CMR 10.18). To qualify for a streamlined, 30-day, MESANVetlands Protection Act review, please
complete Section CA.C, and include requested materials with this Notice of Intent (NOI); OR
complete Section C.1.d, if applicable. If MESA supplemental information is not included with the NOI,
by completing Section 1 of this form, the NHESP will require a separate MESA filing which may take
up to 90 days to review (unless noted exceptions in Section 2 apply, see below).
1. c. Submit Supplemental Information for Endangered Species Review'
1. ❑ Percentage/acreage of property to be altered:
(a) within wetland Resource Area
(b) outside Resource Area
percentage/acreage
percentage/acreage
2. ❑ Assessor's Map or right-of-way plan of site
3. ❑ Project plans for entire project site, including wetland resource areas and areas outside of
wetlands jurisdiction, showing existing and proposed conditions, existing and proposed
tree/vegetation clearing line, and clearly demarcated limits of work **"
(a) ❑ Project description (including description of impacts outside of wetland resource area &
buffer zone)
(b) ❑ Photographs representative of the site
(c) ❑ MESA filing fee (fee information available at:
http://www.mass.gov/dfwele/dfw/nhesp/regulatory review/mesa/mesa fee schedule.htm).
Make check payable to "Commonwealth of Massachusetts - NHESP" and mail to
NHESP at above address
Projects altering 10 or more acres of land, also submit:
(d) ❑ Vegetation cover type map of site
(a) ❑ Project plans showing Priority & Estimated Habitat boundaries
d. OR Check One of the Following
1. ❑ Project is exempt from MESA review.
Attach applicant letter indicating which MESA exemption applies. (See 321 CMR 10.14,
htto://www.mass.ciov/dfwele/dfw/nhesp/requlatory review/mesa/mesa exemptions.htm;
the NOI must still be sent to NHESP if the project is within estimated habitat pursuant to
310 CMR 10.37 and 10.59.)
2. ❑ Separate MESA review ongoing.
a. NHESP Tracking # b. Date submitted to NHESP
' Some projects not in Estimated Habitat may be located in Priority Habitat, and require NHESP review (see
http://www.mass.gov/dfwele/dfw/nhesa/nhesi).htm, regulatory review tab). Priority Habitat includes habitat for state -listed plants and
strictly upland species not protected by the Wetlands Protection Act.
** MESA projects may not be segmented (321 CMR 10.16). The applicant must disclose full development plans even if such plans are
not required as part of the Notice of Intent process.
wpaform3.doc • rev. 11/16/09 Page 5 of 8
Massachusetts Department of Environmental Protection Provided by MassDEP:
I i Bureau of Resource Protection - Wetlands
MassDEP File Number
WPA Form 3 — Notice of Intent
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Yarmouth
City/Town
C. Other Applicable Standards and Requirements (cont'd)
3. ❑ Separate MESA review completed.
Include copy of NHESP "no Take" determination or valid Conservation & Management
Permit with approved plan.
2. For coastal projects only, is any portion of the proposed project located below the mean high water
line or in a fish run?
a. ❑ Not applicable — project is in inland resource area only
b. ❑ Yes ® No If yes, include proof of mailing or hand delivery of NOI to either:
South Shore - Cohasset to Rhode
Island, and the Cape & Islands:
Division of Marine Fisheries -
Southeast Marine Fisheries Station
Attn: Environmental Reviewer
1213 Purchase Street — 3rd Floor
New Bedford, MA 02740-6694
North Shore - Hull to New Hampshire:
Division of Marine Fisheries -
North Shore Office
Attn: Environmental Reviewer
30 Emerson Avenue
Gloucester, MA 01930
Also if yes, the project may require a Chapter 91 license. For coastal towns in the Northeast Region,
please contact MassDEP's Boston Office. For coastal towns in the Southeast Region, please contact
MassDEP's Southeast Regional Office.
3. Is any portion of the proposed project within an Area of Critical Environmental Concern (ACEC)?
Online Users: a. [:1 Yes ® No If yes, provide name of ACEC (see instructions to WPA Form 3 or MassDEP
Include your Website for ACEC locations). Note: electronic filers click on Website.
document
transaction b. ACEC
number
(provided on 4. Is any portion of the proposed project within an area designated as an Outstanding Resource Water
your receipt (ORW) as designated in the Massachusetts Surface Water Quality Standards, 314 CMR 4.00?
page) with all
supplementary a. ❑ Yes ® No
information you
submit to the 5. Is any portion of the site subject to a Wetlands Restriction Order under the Inland Wetlands
Department. Restriction Act (M.G.L. c. 131, § 40A) or the Coastal Wetlands Restriction Act (M.G.L. c. 130, § 105)?
a. ❑ Yes ® No
6. Is this project subject to provisions of the MassDEP Stormwater Management Standards?
a. ❑ Yes. Attach a copy of the Stormwater Report as required by the Stormwater Management
Standards per 310 CM 10.05(6)(k)-(q) and check if:
1. ❑ Applying for Low Impact Development (LID) site design credits (as described in
Stormwater Management Handbook Vol. 2, Chapter 3)
2. ❑ A portion of the site constitutes redevelopment
3. ❑ Proprietary BMPs are included in the Stormwater Management System.
b. ® No. Check why the project is exempt:
1. ® Single-family house
wpaform3.doc • rev. 11/16/09 Page 6 of 8
L11Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 3 — Notice of Intent
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Provided by MassDEP:
MassDEP File Number
Document Transaction Number
Yarmouth
Cityrrown
C. Other Applicable Standards and Requirements (cont'd)
2. ❑ Emergency road repair
3. ❑ Small Residential Subdivision (less than or equal to 4 single-family houses or less than or
equal to 4 units in multi -family housing project) with no discharge to Critical Areas.
D. Additional Information
Applicants must include the following with this Notice of Intent (NOI). See instructions for details.
Online Users: Attach the document transaction number (provided on your receipt page) for any of the
following information you submit to the Department.
1. ® USGS or other map of the area (along with a narrative description, if necessary) containing
sufficient information for the Conservation Commission and the Department to locate the site.
(Electronic filers may omit this item.)
2. ® Plans identifying the location of proposed activities (including activities proposed to serve as a
Bordering Vegetated Wetland [BVW) replication area or other mitigating measure) relative to
the boundaries of each affected resource area.
3. ❑ Identify the method for BVW and other resource area boundary delineations (MassDEP BVW
Field Data Form(s), Determination of Applicability, Order of Resource Area Delineation, etc.),
and attach documentation of the methodology.
4. ® List the titles and dates for all plans and other materials submitted with this NOI.
Vegetative Management & Restorative Landscape Sketch Plan 66A River Street, South Yarmouth
a. Plan Title
Cape Cod Engineering, Inc.
b. Prepared By
3/10/10
d. Final Revision Date
f. Additional Plan or Document Title
Robert M. Perry, P.E.
c. Signed and Stamped by
1" = 20'
e. Scale
g. Date
5. ❑ If there is more than one property owner, please attach a list of these property owners not
listed on this form.
6. ❑ Attach proof of mailing for Natural Heritage and Endangered Species Program, if needed.
7. ❑ Attach proof of mailing for Massachusetts Division of Marine Fisheries, if needed.
8.0 Attach NOI Wetland Fee Transmittal Form
9. ❑ Attach Stormwater Report, if needed.
wpaform3.doc • rev. 11/16/09 Page 7 of 8
Massachusetts Department of Environmental Protection Provided byMassDEP:
Bureau of Resource Protection - Wetlands
MassQEP File Number
WPA Form 3 — Notice of Intent
Document Transaction Number
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Yarmouth
Citylrown
E. Fees
1. ❑ Fee Exempt: No filing fee shall be assessed for projects of any city, town, county, or district of
the Commonwealth, federally recognized Indian tribe housing authority, municipal housing
authority, or the Massachusetts Bay Transportation Authority.
Applicants must submit the following information (in addition to pages 1 and 2 of the NOI Wetland Fee
Transmittal Form) to confirm fee payment:
5176 3/17/10
2. Municipal Check Number 3. Check date
5175 3/17/10
4. State Check Number 5. Check date
Cape Cod Engineering, Inc.
6., Payor name on check: First Name 7. Payor name on check: Last Name
F. Signatures and Submittal Requirements
I hereby certify under the penalties of perjury that the foregoing Notice of Intent and accompanying plans,
documents, and supporting data are true and complete to the best of my knowledge. I understand that
the Conservation Commission will place notification of this Notice in a local newspaper at the expense of
the applicant in accordance with the wetlands regulations, 310 CMR 10.05(5)(a).
I further certify under penalties of perjury that all abutters were notified of this application, pursuant to the
requirements of M.G.L. c. 131, § 40. Notice must be made by Certificate of Mailing or in writing by hand
delivery or certified mail (return receipt requested) to all abutters within 100 feet of the property line of the
project location.
1. Signature of Applicant
3. Signature of Property Owner (if different)
5. Signature of Representative (if any)
2. Date
4. Date
6. Da
For Conservation Commission:
Two copies of the completed Notice of Intent (Form 3), including supporting plans and documents, two
copies of the NOI Wetland Fee Transmittal Form, and the city/town fee payment, to the Conservation
Commission by certified mail or hand delivery.
For MassDEP:
One copy of the completed Notice of Intent (Form 3), including supporting plans and documents, one
copy of the NOI Wetland Fee Transmittal Form, and a copy of the state fee payment to the MassDEP
Regional Office (see Instructions) by certified mail or hand delivery.
Other:
If the applicant has checked the "yes" box in any part of Section C, Item 3, above, refer to that section
and the Instructions for additional submittal requirements.
The original and copies must be sent simultaneously. Failure by the applicant to send copies in a
timely manner may result in dismissal of the Notice of Intent.
wpaform3.doc • rev. 11/16/09 Page 8 of 8
Notice of Intent — Narrative
66A River Street, South Yarmouth
The area subject to this Notice of Intent is land in South Yarmouth off of River Street.
Please see the locus maps for the exact location. The site is a residential property
partially within the buffer zone of the coastal resources associated with Bass River. The
property at this site also lies within the Riverfront Area associated with the Bass River
tidal water body.
The site contains a residential dwelling with informal landscaping and open lawn areas.
Portions of the existing site contain invasive vegetation predominantly bittersweet and
bush honeysuckle. The applicant wishes to implement a program of vegetative
management by culling out the invasive plants and planting coastal hardy varieties in
their place. The primary location for this work is on the river -side land slope that is a
form of coastal bank. The bank is gently sloping and interacts with the coastal flood
zone. The bank is not eroding. No increase in cleared area or open lawn is proposed in
the buffer. The areas slated for removal of invasive shrubs and vines species shall be
thickly planted with native coastal hardy shrubs from the list provided. The plan shows
locations of proposed work with general landscaping specifications and guidelines.
Alternatives to the project are few but we offer a short discussion because the project is
within the Riverfront Area associated with Bass River.
1. One alternate is to leave the area as is. Doing so perpetuates the proliferation of
the less valuable types of thick vegetation that would become an improved food
source and cover for wildlife.
2. Landscaping the bank with traditional yard landscape varieties is an alternate but
is improper for consideration for many well accepted reasons.
3. The proposed project is the selected alternate because it addresses the problem of
long term neglect after the introduction of the invasive vines and shrubs. The
objective is to retain the thicket which has very beneficial effects for the coastal
bank and flood zone, but with the native varieties that amplify those benefits.
The proper management of the project work activity and the consequential effect to the
land area will improve the stability and habitat value of the coastal bank, related buffer
zone and the riverfront area.
j,- _,JL 51
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Locus Map
Portion of USGS Dennis Quadrangle
------ 66A River Street, South Yarmouth -I T T -7--
39L 9 12'30" 10, '03
0 1 MILE
tAS 1000 0 1000 2000 3000 4000 5000 6000 7000 FEET
1 5 0 1 KILOMETRE
Iii:Y E_
MILS�0'47' CONTOUR INTERVAL 10 FEET
la Mils NATIONAL GEODETIC VERTICAL DATUM OF 1929
DEPTH CURVES AND SOUNDINGS IN FEET —DATUM IS MEAN LOW WATER MASS
SHORELINE S I IOWN R LPRES ENTS THE APPROXIMATE LINE OF MEAN HIGH WATER
I I IF MEAN RANGE OF TIDE IS APPROXIMATELY 9.5 FEET
AND 1974 MAGNETIC NORTH IN CAPE CM, RAY AND 2.8 FEET IN NANTUCKET SOUND
INFORMATION SHOWN HEREON IS FOR ASSESSING
PURPOSES ONLY. NO LIABILITY FOR ERROR IS
ASSUMED BY THE TOWN OF YARMDUfH
DATE OF LATEST MAP REVISION: 9116M
100 50 0 ' 100 ZOOF
eet
Locus Map
Assessors Map 43, Parcel 37
66A River Street, South Yarmouth
TAX MAP
TOWN OF YARMOUTH
'ABLE COUNTY, MASSACHUSETTS
Tol
woe
Portion of Flood Insurance Rate Map
Panel #4 - Yarmouth
66A Rivier Street, South Yarmouth
Abutter List -66A River Street, South Yarmouth -Map 43, Parcel 37
Man 43, Parcels 30 & 32:
Kenneth & Nancy Rodgers
20 Brookline Road
Scarsdale, NY 10583-6004
Man 43, Parcel 31
614 Realty LLC
C/o Beacon Capital Partners LLC
200 State St FL 5
Boston, MA 02109-2605
Man 43, Parcel 33:
Michael Shay
25 Goodings End
Yarmouth, ME 04096-6102
Man 43, Parcel 34:
Richard McCarthy
R.P. McCarthy Rev Living Trust
256A Pleasant Street
South Yarmouth, MA 026644557
Man 43, Parcel 36:
Jonathan & Deborah Wood
82A River Street
South Yarmouth, MA 02664
May 43, Parcel 38:
Howard W. Cowee
C/o Jonathan Wood
82A River Street
South Yarmouth, MA 02664
May 43, Parcel 39•
John D. Clark
C/o Rebecca B. Clark
1163 East Shore Drive
Ithaca, NY 14850
May 43, Parcel 40:
Robert & Elizabeth MacBeth
11 Grant Lane
Cumberland, RI 02864-4244
May 43, Parcel 41:
Martha P. Gilmore TR
C/o Blum, Clark, Churchill, Winslow
44 River Street
South Yarmouth, MA 02664
CAPE COD ENGINEERING, INC.
Robert M. Perry, P.E.
P.O. Box 1517
East Dennis, MA 02641
Tel 508-385-1445 / Fax 508-385-1446
bobperry@capecod.net
NOTIFICATION TO ABUTTERS UNDER THE
MASSACHUSETTS WETLAND PROTECTION ACT
In accordance with the second paragraph of the Massachusetts General Laws
Chapter 131, Section 40 and the Yarmouth Wetland Protection By -Law, you are
Hereby notified of the following:
Jeff Chizmas has filed a Notice of Intent with the Yarmouth Conservation
Commission for vegetation management and restorative plantings of native species
within 100 ft of ;the top of the coastal bank and coastal beach.
The project location is 66A River Street, South Yarmouth; Assessors Map 43, Parcel
37.
A Conservation Commission public hearing is scheduled for Thursday, April 1,
2010 at Yarmouth Town Hall, 1146 Rte. 28, South Yarmouth. The meetings start at
7 PM. For more information or to review the Notice of Intent and plans contact the
Yarmouth Conservation Dept. office @ 508-398-2231 x 283 between the hours of
8:30 AM and 4:30 PM, Monday thru Friday or contact this office.
YARMOUTH CONSERVATION COMMISSION
APPLICANT:
DATE:
REPRESENTATIVE (if any): 2 ,
ri
GREEN RECEIPTS (circle one) ,.COMPLETE i"INCOMPLETE
(explain]
LEGAL AD $$ (circle one): PAID--�
NOT PAID (explain.
TYPE OF HEARING
,_,. -_— CIRCLE ONE:
Notice of Intent (NOI)
opening enin 7 Request for Determination (RFD)
_
opening
Notice of Intent (NOI) Request for Determination (RFD)
continuation continuation
DECISION
circle one:
/ NOI r
\Approved
Denied"'
Continued
RFD
g• #
Pos. #
Continued
For:
VOTE (list last names)
Against:
DISCUSSION
(Example: Approval conditions, Denial Reasons, Continuance
reasons.)
LEGAL NOTICE
TOWN OF YARMOUTH CONSERVATION COMMISSION
The Yarmouth Conservation Commission will conduct public hearings pursuant to the
Massachusetts Wetland Act, M.G.L. Chapter 131, Section 40 and the Town of Yarmouth
Wetland By-law, Chapter 143, on April 1, 2010 at the Yarmouth Town Offices, 1146
Route 28, South Yarmouth, MA beginning at 7:00 p.m. for the following matters:
REQUEST FOR DETERMINATION: Theodore & Susan Wojnar, 10 Whale Road,
West Yarmouth, MA. To construct a wooden deck and upgrade septic system to include
retaining wall and fill.
NOTICE OF INTENT: Thomas & Dorothy Woods, 212 Blue Rock Road, South
Yarmouth, MA. To construct wooden pier, ramp and float(s).
NOTICE OF INTENT: Robert McPhee, 91 Crowell Road, West Yarmouth, MA. To
raze and replace single family dwelling.
NOTICE OF INTENT: Jeffery Chizmas, 66-A River Street, South Yarmouth, MA. To
perform various landscape activities.
AMMENDED ORDER OF CONDITIONS: Dewey & Margaret Awad, 911 Great
Island Road, West Yarmouth, MA. To install beach and bank erosion devices.
Plans and applications for the above may be examined in the Yarmouth Conservation
Commission Office, 1146 Route 28, South Yarmouth, MA. Monday thru Friday,
between the hours of 8:30 a.m. and 4:00 p.m.
David D. Flaherty, Jr., Chairman
Yarmouth Conservation Commission
-
H
Important:
When filling out
forms on the
computer, use
only the tab key
to move your
cursor - do not
use the return
key
IL�I
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
NOI Wetland Fee Transmittal Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. Applicant Information
1. Applicant:
a. First Name
c. Organization
2401 Lewis O'Grady Drive
d. Mailing Address
Saugus
e. Cityrrown
617-285-1246
Chizmas
b. Last Name
MA
f. State
h. Phone Number i. Fax Number j. Email Address
2. Property Owner (if different):
01906
g. Zip Code
a. First Name b. Last Name
c. Organization
d. Mailing Address
e. Cityrrown f. State g. Zip Code
h. Phone Number i. Fax Number j. Email Address
3. Project Location:
66A River Street South Yarmouth
a. Street Address b. Cityrrown
To calculate B. Fees
filing fees, refer
to the category The fee should be calculated using the following six -step process and worksheet. Please see
fee list and 9 9 P
examples in the Instructions before filling out worksheet.
instructions for
filling out WPA Step 1/Type of Activity: Describe each type of activity that will occur in wetland resource area and
Form 3 (Notice of Intent). buffer zone.
Step 2/Number of Activities: Identify the number of each type of activity.
Step 3/Individual Activity Fee: Identify each activity fee from the six project categories listed in the
instructions.
Step 4/Subtotal Activity Fee: Multiply the number of activities (identified in Step 2) times the fee per
category (identified in Step 3) to reach a subtotal fee amount. Note: If any of these activities are in a
Riverfront Area in addition to another Resource Area or the Buffer Zone, the fee per activity should be
multiplied by 1.5 and then added to the subtotal amount.
Step 5/Total Project Fee: Determine the total project fee by adding the subtotal amounts from Step 4.
Step 6/Fee Payments: To calculate the state share of the fee, divide the total fee in half and subtract
$12.50. To calculate the city/town share of the fee, divide the total fee in half and add $12.50.
Wpaform&doc • Wetland Fee Transmittal Form • rev. MUM Page 1 of 2
t
L1Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
1 NOI Wetland Fee Transmittal Form
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Fees (continued)
Step 1/Type of Activity
Cat 1 in Riverfront Area
C. Submittal Requirements
Step 2/Number
of Activities
1
Step
3/Individual
Activity Fee
$110 x 1.5
(R.A.)
Step 5/Total Project Fee:
Step 6/Fee Payments:
Total Project Fee:
State share of filing Fee:
City/Town share of filling Fee:
Step 4/Subtotal Activity
Fee
165.00
$165.00
$165.00
a. Total Fee from Step 5
$70.00
b. 1/2 Total Fee less $12.50
$95.00
c. 1/2 Total Fee plus $12.50
a.) Complete pages 1 and 2 and send with a check or money order for the state share of the fee, payable to
the Commonwealth of Massachusetts.
Department of Environmental Protection
Box 4062
Boston, MA 02211
b.) To the Conservation Commission: Send the Notice of Intent or Abbreviated Notice of Intent; a copy of
this form; and the city/town fee payment.
To MassDEP Regional Office (see Instructions): Send a copy of the Notice of Intent or Abbreviated Notice of
Intent; a copy of this form; and a copy of the state fee payment. (E-filers of Notices of Intent may submit these
electronically.)
Wpaforrn1doc • Wetland Fee Transmittal Form • rev. 2/21/08 Page 2 of 2
CAPE COD ENGINEERING, INC.
ROBERT M. PERRY, P.E.
PO.BOX 1517
EAST DENNIS, MA 02641
PH. 608-385-1445
p Pay to the
< Order of
5175
~! 53-716412113
10 Date 01
Dollars
as
ArCAPEVCOD' r;
i COOPERATIVE BANK
Yarmouth Port, MA 02675 (C-L O 2 4
For Oyf,-(*A-y v&v 5r
1:2113716411: 902000376in■ SL7S
CAPE COD ENGINEERING, INC.
ROBERT M. PERRY, P.E.
PO BOX 1617
EAST DENNIS, MA 02641
PH. 508-385-1445
Pay to the
Order of
U�
5176
53-7164/7113
Date 01
$ qs
Dollars a �
Fa:.'B8• _ �•; : •
'CAP COD'�i'€
2 cooPERaT�vE
Yarmouth Port, MA 02675
For " f.,b/� 'yzy
1:2113716411: 902000376LII■ SL76
CAPE'COD ENGINEERING, INC. 5177
ROBERT M. PERRY, P.E.
PO BOX 1617 53.7164/2113
EAST DENNIS, MA 02641 Date 01
PH. 508-385-1445
®Pay to the DOT $ <
yOrder of
UO Dollars ••
�•..
CAPE COD&
COOPERATIVE BANK
Yarmouth Port, M�t� tQ0
A02676
For
f�-/r�JFtG� /l- P ram.'Sts air
1:21137L6411: 902000376LII■ SL77