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All filings must be made on Town of Yarmouth forms.
CONSERVATION
DIVISION
All applications must be submitted two weeks prior to the next scheduled Conservation
Commission meeting. Refer to Meeting Schedule.
Failure to follow the Administrative Checklist shall result in an Administrative Incomplete
Application and will not be scheduled for a Public Hearing.
Contact the Conservation Office if you need assistance.
✓1 complete original application, plan/sketch, and other supporting information
to the Conservation Division - mailed to/dropped off at Town Hall.
1 complete pdf of application, plan/sketch, and other supporting information
emailed to kgrant(cDVarmouth.ma.us.
Statement from Engineer and/or stamped As -Built plan if required under the
Order of Conditions to be included with both original and pdf application.
Refer to 310 CMR 10.05(9)(d).
`/ Local filing fee. Refer to Fee Schedule. Make check payable to "Town of Yarmouth"
and include property address in memo.
All forms, Fee Schedule and Meeting schedule can be found at
https://www.yarmouth.ma.usl696/Filing-Forms.
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 • kgrant(a,yarmouth.ma.us
Rev 8/2021
939 main street rte. 6a
yarmouth port
mass 02675
land court
surveys
structural design
site planning
sewage system
designs
inspections
permits
down cape engineering, inc
civil engineers & land surveyors
January 7, 2022
Kelly Grant, Conservation Administrator
Conservation Commission
Town of Yarmouth
1146 Route 28
South Yarmouth, MA 02664
tel. (508) 362-4541
fax(508)362-9880
Daniel A. Ojala, P.E., P.L.S.
4rne H. Ojala, P.E., P.L.S.
Daniel E. Gonsalves, P.E., S.E.
Craig J. Ferrari, E.I.T., S.E.
Regards: Request for Certificate of Compliance Mass DEP file #SE83-1414
Cape Cod Hospital / Cape Cod Healthcare
Site: 4 Bayview St, West Yarmouth
Dear Commission Members and Administrator Kelly Grant:
On August 12, 1997, the Commission issued an Order of Conditions for the Cape Cod
Hospital proposed parking lot off 4 Bayview Street, West Yarmouth.
This letter is to certify, to the best of my knowledge and belief, the work was
performed in substantial compliance with the approved plans and Order of Conditions.
We respectfully request the issuance of the Certificate of Compliance at this time.
Thank you for your consideration.
Sincerely,
1
Daniel A. Ojala, PE, PLS
Down Cape Engineering, Inc.
cc: Michael Bachstein, CCH
Important:
When filling out
forms on the
computer, use
only the tab
key to move
your cursor -
do not use the
return key.
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IG�I
Upon completion
of the work
authorized in
an Order of
Conditions, the
property owner
must request a
Certificate of
Compliance
from the issuing
authority stating
that the work or
portion of the
work has been
satisfactorily
completed.
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 8A — Request for Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Town of Yarmouth Wetland By-law, Chapter 143
A. Project Information
1. This request is being made by:
DEP File Number:
SE 83-1414
Provided by DEP
Cape Cod Hospital /Cape Cod Healthcare c/o Daniel A. Ojala, PE, PLS, Down Cape Engineering, Inc
Name
27 Park St
Mailing Address
Hyannis
City/Town
MA
State
Phone Number
2. This request is in reference to work regulated by a final Order of Conditions issued to:
Cape Cod Hospital
Applicant
8-12-1997 SE 83-1414
Dated DEP File Number
0
The project site is located at:
4 Bayview St
Street Address
36
Assessors Map/Plat Number
Yarmouth
City/Town
93
Parcel/Lot Number
The final Order of Conditions was recorded at the Registry of Deeds for:
Property Owner (if different)
Barnstable
County
(if registered land)
5. This request is for certification that (check one):
10906
Book
02601
Zip Code
216
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. 5/29/14 Page 1 of 2
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 8A — Request for Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Town of Yarmouth Wetland By-law, Chapter 143
A. Project Information (cont.)
DEP He Number:
se83-11414
Provided by DEP
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/eea/agencies/massdep/about/contacts/find-the-massdep-regional-office-
for-your-city-or-town. html).
wpaformBa.doc ••rev. 5/29/14 Page 2 of 2
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