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Home My WebLink AboutCOC request;e83-«90 P Y V I W e'�T Cm�s farce) CONSERVATION DIVISION _•.r.•�a.l _r. J1,rr_S.__c_r All filings must be made on Town of Yarmouth forms. 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 kgrantCWyarmouth.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). V 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.us/696/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 • kerant e,,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 11, 2022 Kelly Grant, Conservation Administrator Conservation Commission Town of Yarmouth 1146 Route 28 South Yarmouth, MA 02664 tel. (508) 3624541 fax (508) 36M880 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 #SE83-1690 Cape Cod Hospital / Cape Cod Healthcare Site: Bayview St, West Yarmouth Dear Commission Members and Administrator Kelly Grant: On November 2, 2004, the Commission issued an Order of Conditions for the Cape Cod Hospital proposed patient bed addition & materials management on 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 Conons. We respectfully request the issuance of the Certificate of Compliance. Thank you for your consideration. Sincerely, 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. tab Upon completion Or 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 I A. Project Information DEP File Number: SE 83-1690 Provided by DEP 1. This request is being made by: Cape Cod Hospital / Cape Cod Healthcare c/o Daniel A. Ojala, PE, PLS, Down Cape Engineering, Inc Name 27 Park St Mailing Address Hyannis MA 02601 Cityrrown State Zip Code Number 2. This request is in reference to work regulated by a final Order of Conditions issued to: Cape Cod Hos Applicant 11-02-04 Dated 3. The project site is located at: Bayview St Street Address 28 Assessors Map/Plat Number SE 83-1690 DEP File Number Yarmouth CityfTown 52.1 Parcel/Lot Number 4. 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): 19216 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 DEP File Number: Bureau of Resource Protection - Wetlands WPA Form 8A — Request for Certificate of Compliance SE 83-1690 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/eea/agencies/massdep/about/contacts/find-the-massdep-regional-office- for-your-city-or-town.html). wpaform8a.doc ••rev. 5/29/14 Page 2 of 2 AR�lE H 00/+LA CIVIL No. 3D79; down cape engineering, Inc. Vj C/t?L ENC/NEERS LAND SURVEYORS 939 Main Steel — YARMOUTHPORT, MASS / \ CAPE COD HOSPITAL \ ZONE C fl�� ZbTIE -� - -. r BOG EL. 9' WATER E . 7.9 / x / 3 19-' EKiSTING CONTOUR DEgWWS TREE i 19.11 DUSTING SPOT EIEYADON 'S •;< CONIFER unutY POLE BENCHMARK GAS CATE ^�"l1 VEGETATION O MANHOLE r 3 /UPOLE HYDRANT 19 0/16 +� S O CATCH BASIN WATER VALVE i mO POLE UC+Ii (SEE ELEC.) / • ` -a- SINGLE POST SIGN t£Agi PIT O / 0.151 .15 ' / O ELECTRIC MANHOLE g TEST BORING ODRAINAGE MANHOLE O DRYWELL w WATER MAIN G CAS MAIN 3 E UNDERGROUND (U,M)ELECTRIC FO- U.G. FIBER OPTIC CABLE MAP 28 PCL 59 0 U.G. OXYGEN PIPING T U.C. TELEPHONE ANN R. FACCHINI, TR. SANITARY SEWER EXISTING STORM DRAIN UNE -(isl FINISH GRADE CONTOUR DL^�0N FINISH GRADE SPOT EIEV, w o PROPOSED UTR/tt LINE E PLAN- PATIENT BED ADDITION/MATERIALS MGT, now,_■.:, CAPE COD HOSPITAL 1 _� 27 PARK STREET, HYANNIS, MA 02601 20 D i0 20 No 80 ( IN FEET) DATE: 9-15-04 1 inch = 9[7 /t. REVISED: 5-11-05 (MOVED2DE,NTR