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HomeMy WebLinkAboutNOI This project will consist of rebuilding two decks that were previously with my primary single-family house but were no longer safe for use and have since been removed. One deck will be on the back of the house and the other on the side. Once permits are approved, footings will be put in place with sonotubes per code. After a passed inspection, pressure treated wood will be used for the framing per code. After that successful inspection, Trex decking and vinyl handrails will be installed. 115/ 146/ / / DOWD JULIANA DOWD JEREMIAH T 11 SEMINOLE DR YARMOUTH PORT , MA 02675 115/ 145/ / / SHOVELIER WILLIAM T 7 SEMINOLE DR YARMOUTH PORT , MA 02675 115/ 144/ C1/ / MAHONEY JOHN J MAHONEY PATRICIA P O BOX 1071 DENNIS PORT , MA 02639-5071 115/ 144/ C2/ / MAHONEY JOHN J MAHONEY PATRICIA P O BOX 1071 DENNIS PORT , MA 02639-5071 115/ 143/ / / SEARLES MEGAN A 64 STARBUCK LN YARMOUTH PORT , MA 02675 115/ 142/ / / PETERSON STEPHEN PETERSON CYNTHIA 61 HORSEFOOT RD W DENNIS , MA 02670 115/ 119/ / / KONYN JOHN PATRICK BROOKS KERRY P 71 STARBUCK LN , YARMOUTH PORT , MA 02675 115/ 118/ / / RENAUD NEAL RENAUD BRIDGETTE 66 ARROWHEAD DR YARMOUTH PORT , MA 02675 115/ 94/ / / HARRINGTON JEFFREY T C/O HARRINGTON JEFFREY T TR 63 ARROWHEAD DR YARMOUTH PORT , MA 02675 115/ 93/ / / HARBOUR JOHN A C/O HARBOUR JOHN A JR 67 ARROWHEAD DR YARMOUTH PORT , MA 02675 115/ 92/ / / SECRETARY HUD C/O YOUNG THOMAS M 71 ARROWHEAD DR YARMOUTH PORT , MA 02675 , 115/ 91.1/ / / TOWN OF YARMOUTH 1146 ROUTE 28 SOUTH YARMOUTH , MA 02664 115/ 91.2/ / / TOWN OF YARMOUTH 1146 ROUTE 28 SOUTH YARMOUTH , MA 02664 NOTIFICATION TO ABUTTERS UNDER THE MASSACHUSETTS WETLANDS PROTECTION ACT & TOWN OF YARMOUTH WETLAND BY-LAW, CHAPTER 143 In accordance with the second paragraph of the Massachusetts General Laws Chapter 131, Section 40, you are hereby notified of the following: A. The name of the applicant is _Thomas Young______________________________ B. The applicant has filed a Notice of Intent with the Yarmouth Conservation Commission, seeking permission to remove, fill, dredge or alter an Area Subject to Protection under the Wetlands Protection Act (MGL c. 131 s. 40 & Town of Yarmouth Wetland By-Law, Chapter 143). C. The address of the lot where the activity is proposed is 71 Arrowhead Drive Yarmouthport D. Proposed work is to replace decks on the back and side of the house that were previously there ____________________________________________________________________________ E. Copies of the Notice of Intent may be examined at the Yarmouth Town Hall at the Conservation Commission office between the hours of 9:00 a.m. and 4:00 p.m. Monday thru Friday. For more information, call (508) 398-2231 ext. 1288. F. Copies of the Notice of Intent may be obtained from either the applicant or applicant’s representative. Applicant’s phone number _413-563-5846_____________________ Or Applicant’s representatives phone number ___________________________________ G. Information regarding the date, time and place of the public hearing may be obtained by calling the Yarmouth Conservation Commission office at (508) 398-2231 ext. 1288 H. Person sending this notification (applicant, representative or other) Name _Thomas Young____________________ Address _71 Arrowhead Drive___________________ Town Yarmouthport State MA Zip 02675 Telephone 413-563-5846 NOTES : • Notice of the public hearing, including date, time and place will be published at least five (5) days in advance in a newspaper of general circulation. • Notice of the public hearing, including date, time and place will be posted in the Town Hall not less than forty-eight hours in advance. • You may also contact the Southeast Regional Office of the Department of Environmental Protection at (508) 946-2800 for more information about this application. 4 mbar ion Number 6.75 ip Code 54 r Massachusetts Department of Environmental Protection Provided by Massl]EP Bureau of Resource Protection - Wetlands MaasDEP File Nu IPA Form 3 — Notice of intent - 6x_G m—en tTransad Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Town of Yarmouth Wetland By -Law, Chapter 143 City/Town important When filling out A. General Information Forms On the computer. use f . Project Location (None: electronic filers will click on button to locate project site)- only the tab key to move your 71 Arrowhead drive Yormouthport 02 Cursor - do rn 9. Street Address b. CitylTown C. Z use She return key. 41 ASS414-70.22046 Latitude and Longitude: d- Latitude a. Longitude VQ 115192 103fY065 f. Awamom MapMat Number o. ParuO fLot Number 2- Applicant: Thomas Young a First Name b Last Name Note- _ — Before c Organisation completing this 71 Arrowhead Drive form consult —' your IoCai d. Street Address Conservation Yarmouthport MA _ 02675` Commission c C,tyffown f, Stale gr Zip Code regarding any 413-563-5846 _ t315youn yahao.com mun cipai bylaw - or ordinance. h Phone. Number L Faz Number j. Email Address 3. Property owner (required if different fr❑rn applicant): ❑ Check if more than one owne a First Name t1 Last Name C. prganization d. 5tle9t Address e. Coffown f. State a- Zip Cade h. Phone Ntmtwr i- Fax Number j- Email address 4. Representative of any) 8. First Name b. Last Name d. 5traet Address — e. --- f State h. Phone Numttcr i. FOr Number j. Email address 5. Total WPA Fee Paid {from NOI Wetland Fee Transmittal Form}: $110 S42.50 - -- a. Total Fee Paid i b. State Fee Pald g. Z+p Code $67 50 C Cilyfrown Fee Paid wpaform3 doc -rev &1 &2020 Page 1 of 9 T Massachusetts Department of Environmental Protection Lo�ki Bureau of Resource Protection - Wetlands WPA Form 3 — Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Town of Yarrnouth Wetland By -Law, Chapter 143 A. General Information (continued) 6 General Project Description: Rebuild decks (a little larger) at their pre-existing locations 7a. Project Type Checklist: (Limited Project Types see Section A. 7b.) I. Single Family Horne 3- ❑ CommWeialllndustrial 5. ❑ Utilities 7. ❑ Agriculture (e.g., cranberries. forestry) 9. ❑ Olher '1 ProvidW by Mmast}EP: Ma9¢r}EP Fib Nu mbef Dpcument TranNrlCtlon Flunlbrr-J cityrrawn 2. ❑ Residenhaf Subdivision 4. ❑ DocklPier 6. ❑ Coastal engineering Structure 8. ❑ Transportabon 7b. Is any portion of the proposed activity eligible to be treated as a limited project (including Ecological Restoration Limited Project) subject to 310 CHAR 10.24 (coastal) or 310 CMR 10.53 (Wand)? 1 0 Yes ® No If yes, describe which limited project applies to this project. (See 310 CMR 10.24 and 10.53 for a complete list and description of limited project types) 2 LimrledProjedTM If the proposed activity is eligible to be treated as an Ecological Restoration Limited Project (310 CMR10.24(8). 310 CMR 14,53(4)}, complete and attach Appendix A: Ecological Restoration Limited Project Checklist and Signed Certification, B. Property recorded at the Registry of Deeds for: Barnstable s County b. Certificate # (If repfstemd land) 34896 250 C. Book d. Page Number B. Buffer 7-one & Resource Area Impacts {temporary & permanent} 1. f Buffer Zone Only — Check if the project is located only in the Buffer Zone of a Bordering Vegetated Welland, Inland Bank, or Coastal Resource Area. 2. 0 Inland Resource Areas (see 31fl CMR 10.54-10 58; if not applicable. go to Section B 3, Coastal Resource Areas). Check ail 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. Warorrt+3 duc • rev WB12020 Page 2 cf 9 4 Massachusetts Department of Environmental Protection ProwidedbyMassDEP: Bureau of Resource Protection - Wetlands Mass13EP File Number — — P►4 Farm 3 — Notice of intent Document Transaction Num16Er Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Town of Yarmouth Wetland By -Law, Chapter 143 Ci /Town — -- -- - B. Buffer Zone & Resource Area Impacts (temporary & permanent) (cont'd) Resource Aeea ix f Pr Alteration Proposed FeDlac ment if any] 8 ❑ Bank 1 linearfeet 2:lin@arfeet For all protects affecting other b. ❑ Bordering Vegetated _ Resource Areas. Wetland 1 square feet 2. square feet please attach a narrative explaining how c. ❑ Land Under 1. square feet Waterbodies and 2. square feet the resource Waterways - Brea was 3. cubic yards dredged delineated. Resource A SiZe gi Propgsed Alierafico Proposed ! ment if an d. ❑ Bordering Land Subject to Flooding 1. square feet 2. square feet 3. CUNC feet of hood storage lost 4 cubic feet replaced e. ❑ Isolated land Subject to Flooding t. Square feel 2 Cubic feet of flood storage lost 3. cubic feet replaced f. EJ Riverfront Area 1 Name of Waterway (if available) - specify coastal or inland 2. Width of Riverfront Area (check one); ❑ 25 ft. - Designated Densely Developed Areas only ❑ 100 ft- -blew agricultural projects only ❑ 200 ft. - All other projects 3 Total area of Riverfront Area on the site of the proposed project: square feet d. Proposed alteration of the Riverfront Area: a. total square feet b. square feel within 1f*} c. square feet between 100 ft and 200 ft. 5. Has an alternatives analysis been done and is it attached to this NGI? ❑ Yes ❑ No s. 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) Note: for coastal riverfront areas, please complete Section 13.21 above. wpaforrn3 doc - rev 6118/2020 Page 3 of 9 4 Massachusetts Department of Environmental Protection Provided by Mass17EP: Bureau of Resource Protection - Wetlands - MassDEP File Number WPA Farm 3 — Notice of Intent 1. Massachusetts Wetlands Protection Act M,G. L. c. 131, §40 Document Transact+on Number Town of Yarmouth Wetland By -Law, Chapter 143 'E.tyrrown Online Users. Indude your document transaction number (provided on your receipt page) with all supplementary information you 5ut]mrt to the DepdrtEftnt. B. Buffer Zane & Resource Area Impacts (temporary & permanent) (cont'd) 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. Resource_Areagiz e of Proposed Alteration Proposed Replacement if an a ❑ Designated Port Areas Indicate size under Land Under the Ocean, below b. ❑ Land Under the Ocean t; square feet c ❑ Barrier Beach d. ❑ Coastal Beaches e, ❑ Coastal dunes f ❑ Coastal Banks g ❑ Rocky Intertidal Shores h. ❑ Salt Marshes +. ❑ Land Under Salt Ponds i. ❑ Land Containing Shellfish k. ❑ Fish Runs 2. cubic yards dredged Indicate size under Coastal Beaches and/or Coastal Dunes below /.square 1 square feet Size of Proposed Alteration 1. linear feet i.squarefeet 1, square f0m 1.square feel 2. cubic yards dredged 2. Cubic yards beach nourishment 2. cubic yards dune nourishment Proposed Replacement if an 2 sq R restoration, rehab., creation 1. square feet Indicate size under Coastal Banks, inland Bank, Land Under the Ocean, and/or inland Land Under Waterbadies and Waterways. above 1 cubic yards dredged I. [ Land Subject to Coastal Slorm 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 8.2.b or 13,3-h above, please enter the additional amount here. a. square feet of BVW b. square feel of SaR Marsh 5. ❑ Project Involves Stream Crossings d, number of new stream Crossings b. number of replacement stream crossings wpaformIdoc • rev, 611812020 Page 4 of 9 4 Massachusetts Department of Environmental Protection Pmvidedby MassnEP. Bureau of Resource Protection - Wetlands Man_D_ P File Nurnber WPA Farm 3 — Notice of intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Town of Yarmouth Wetland By -Law, Chapter 143 C. Other Applicable Standards and Requirements Document Trans c6 n Number r,grrown ❑ This is a proposal for an Ecological Restoration Limited Project. Skip Section C and complete Appendix A: Ecological Restoration Limited Project Checklists — Required Actions (310 CMR 10.11), 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 Naturai Heritage Atlas or go to htt lfma _mas is. state ma.us)PRI EST HAB/viewer.htm. a ❑ Yes ® No If yes, include proof of mailing or hand delivery of NOI to: Natural Heritage and Endangered Species Program Division of Fisheries and Wildlife 1 Rabbit Hilt Road b. Pate of map Westborough, MA 01581 If yes, the project is also subject to Massachusetts Endangered Species Act (MESA) review (321 CMR 10.18). To qualify fora streamlined, 30-day, MESAPNetlands Protection Act review, please complete Section C.1-0, and include requested materials with this Notice of Intent (NOI); OR complete Section C.2.f, 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 tiling which may take tip to 90 days to review (unress rioted exceptions in Section 2 apply, see below). c. Submit Supplemental Information for Endangered Species Review' 1. ❑ Percentage/acreage of property to be altered' (a) within wetland Resource Area peroentagelacreage (b) outside Resource Area percentagelacreage - - 2. ❑ Assessors Map or right -cif -way plan of site 2. ❑ Project plans far entire project site, including wetland resource areas and areas outside of wetlands jurisdiction, showing existing and proposed conditions, existing and proposed treelvegetation 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 ' Some projects not in Estimated Habitat may be located in Priority Habitat, and require NHESP review (see hit s:flwww.m s _ lma- endan ere - s-act-mesa-re ulat0 -review _ Priority Habitat includes habilat 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. wpaforrO doc • rev. 611612020 Page 5 of 9 4 Massachusetts Department of Environmental Protection Provided by Mr+aspEP: �Bureau of Resource Protection - Wetlands ti MaeaREP Flle Numbrrr WPA Farm 3 - Notice of intent - CiBCumenl 7fansacUnn Number Massachusetts Wetlands Protection Act M.G.L. c, 131, §40 Town of Yarmouth Wetland By -Law, Chapter 143 cayrrown C. Other Applicable Standards and Requirements (cont'd) - (* ❑ MESA fling fee (Fee information available at htk s:tlwww.mass, vlhow- of - file-fQr- 0_-Mesa-i3roect-review). Make check payable to "Commonwealth of Massachusetts - NHESP" and mail to NHESP at above address Projects altefing ?R or more acres of land, also submit.' (d) ❑ Vegetation cover type map of site (e) ❑ Project plans showing Priority & Estimated Habitat boundaries t0 OR Check one of the Following i ❑ Project is exempt from MESA review. Attach applicant letter indicating which MESA exemption applies. (See 321 CMR 10.14, httns;llwww. mass. oovlservice-detailsiexemations-from-review-for-prolectsactivities-in- priority-habitat, the NQI 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 3. ❑ Separate MESA review completed. Include copy of NHESP "no Take" determination or valid Conservation & Management Permit with approved plan. 3- ;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, hand delivery, or electronic delivery of NCI to either: South Shore - Gohasset to Rhode Island border, and North Shore - Hull to New Hampshire border: the Gape & Islands: Division of Marine Fisheries - Southeast Marine Fisheries Station Attm Environmental Reviewer 836 South Rodney French Blvd. New Bedford, MA 02744 Email; dmf.envreview-southAmass.gov Division of Marine Fisheries - North Shore Office Atln: Environmental Reviewer 30 Emerson Avenue Gloucester, MA 01930 Email: dmf_envreview-northCZi)mass g_o_v Also if yes, the project may require a Chapter 91 license. For coastal towns in the Northeast Region, please contact MassIDEP's Boston Office. For coastal towns in the Southeast Region, please contact MassDEP's Southeast Regional office. G. ❑ Is this an aquaculture project? d. ❑ Yes ❑ No If yes, include a copy of the Division of Marine Fisheries Certification Letter (M.G.I,_ c- 130. § 57). wpaform3.dnc • rev_ 611812020 Page 6 of 9 4 Massachusetts Department of Environmental Protection Provided by MassDEP: - Bureau of Resource Protection - Wetlands Mass_d_E_P to Number 5 ' WPA Form 3 — Notice of Intent - Document Tran58dion Number Massachusetts Wetlands Pratectiarl Act M_131. c. 131, §40 Town of Yarmouth Wetland By -Law, Chapter 143 crtyrrown C. Other Applicable Standards and Requirements (cont'd) 4_ Is any portion of the proposed project within an Area of Critical Environmental Concern (ACEC)? Online users: a. ❑ 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 h-AcEc number (provided on your 5. Is any portion of the proposed project within an area designated as an Outstanding Resource Water receipt page) (ORVV) as designated in the Massachusetts Surface Water Quality Standards, 314 CMR 4.00? with all supplementary a. ❑ Yes ® No mformat+on you submd to the 6. 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. G. 130. § 105)? a ❑ Yes ® No 7. 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 CMR 10.05(6)(k)-(q) and check if: i ❑ Applyirig 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 s ❑ Proprietary BMPs are included in the Stormwater Management System. b- ® No. Check why the project is exempt; 1. ® single-family house 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 mufti -family housing project) with no discharge to Critical Areas. D. Additional Information T ❑ This is a proposal for an Ecological Restoration Limited Project. Skip Section D and complete Appendix A- Ecological Restoration Notice of Intent — Minimum Required Documents (310 CMR 10.12). 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. i. ❑ 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 ($VW) replication area or other mitigating measure) relative to the boundaries of each affected resource area. wpaform3.doc • rev 611M020 Page 7 of 9 4 Massachusetts Department of Environmental Protection Provided byMassDER Bureau of Resource Protection - Wetlands MmDEP File Numt*r 1PA Form Notice of Intent Qr7CumentTransaction isturtbet i Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Town of Yarmouth Wetland By -Law, Chapter 143 6Rrown D. Additional Information (cont'd) 3- ❑ Identify the method for BVW and other resource area t)oundary delineations (MassDEP BVVV Field Data Form(s), Determination of Applicability. Order of Resource Area Delineation, etc.), and attach documentation of the methodology. 4. iD List the titles and dates for all plans and other materials submitted with this NOI. Proposed Decks a. Plan TAW Engineed rig VVarks, Inc — Peter T. McEntee _- b. Prepared By e. Signed and Stan Ved by 11 /2312022 V=20' d. Final Ftev4ion Date — — e. Scale } l+Qtl t�Dnal Plan or CFO meet Tdle g. Date s. ❑ If there is more than one property owner, please attach a Gist 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. a ❑ Attach NOI Wetland Fee Transmittal Form 9. ❑ Attach 5tormwater Report, if needed. E. Fees t, ❑ 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 NQI Wetland Fee Transmittal Form) to confirm fee payment 2. Municipal Check Number 3. CCheck date 4. State Check Number 5. Check date Ttietm _ _yo U_-3k B. Payer name on check: Rmt Name 7. Payer name on check, Lest Name wpaform3 doc - rev. 6118121520 page a of 9 4 Massachusetts Department of Environmental Protection Provided by MassdER Bureau of Resource Protection - Wetlands MassoEP Re Number ' IPA Form 3 — Notice of Intent _ _ document TransactionsactioHumber Massachusetts Wetlands Protection Act M.G.L. c_ 131, §40 Town of Yarmouth Wetland By -Law, Chapter 143 City/Town -- 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 plicani - -- 2. bate 3. Signature of Property Owner (if different) 4. date 5. Signature of Repmentstive (if any) S. date For Conservation Commission: Two copies of the completed Notice of Intent (Farm 3). including supporting plans and documents, two copies of the Nat Wetland Fee Transmittal Form, and the cityltown 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 mall 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 611812C26 Page 9 of 9 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands N01 Wetland Fee Transmittal Form I Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Important: When A. Applicant Information filling out fafms On the computer, t Location of Project: use only the tab key to move your 71 Arrowhead Drina cursor - do not a Street Address — use the return key c Chedr numtser V`R'�774 2. Applicant Mailing Address: Thomas a. First Name c ❑rganiza;mn 71 Arrowhead Drive d. Mailing Address Yarmouthport e, City/Town 4135635546 h. Phone Number i. Fax Number 3. Property Owner (if different): a. First Name c. Organization d. Mailing Address e. 6tyliown Yarmouth b. CWrown d. Foe amount Young _ b. Last Marne MA 02675 _ f. State g Zip Code t315you n g @ya h oo. co_ rn j, Email Address b Last Name h. Phone Number i. Fax Number j. Email Address f. Staie g. Zip Code To calculate I Fees tofees• refgr to the category fee 1*1and free should be calculated using the following process & worksheet. Please see Instructions before examples rn the filfirrg out worksheeL instructions for frllina out WPA Step l Type of Activity: Des0be each type of activity that will occur in wetland resource area and buffer zone_ Form 3 (Notice of Intent). Stop 21Number of Activities: Identify the number of each type of activity. Step 31ind1viduat Activity fee. Identify each activity fee from the six project categories listed in the instructions Step 419ubtotaI Activity Fee: Mulbpiy the number of activities (identrfied in Step 2) times the fee per category (identified in Step 3) to reach a subtotal fee amount. dote: If any of these activities are in a Riverfront Area in addilion to another Resource Area or the Buffer zone• the fee per activity should be multiplied by 1.5 and there added to the subtotal amount. Step 5fTotal Project Fire: Determine the total protect fee by adding the subtotal amounts from Step 4. Step 6/Fee Payment's: I calculate the state share of the fee, divide the total fee In half and subtract $12.50. To Calculate the Cdtyftown share of the fee, divide the tatal fee in half and add $12.50 nafeetl doc • ~—d Fw Tien ,R.P F— • — 1W 711 P.yr! 1 ❑1 j Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands NOI Wetland Fee Transmittal Farm Massachusetts Wetlands Protection Act M-G.L. c. 131. §40 B. Fees (continued) Step 11Type of Activity Step 21Number Step Step 41Subtotal Activity of Activities 311ndividual Fee Activity Fee ReptacinLdecks on house �. $110 S' 1 G Step S1Total Project Fee: 5110 Step 61Fee Payments: Total Project Fee: $110 a. Total Fee from Step 5 State share of filing Fee: $42.50 b. 112 Total Fee Im $12.50 Cityfrowvn share of filling Fee: $67-50 c, 112 Tota' Fee plus $12.5a C. Submittal Requirements a.) Complete pages t and 2 and send with a check or money order forthe state share of the fee. payable to the Commonwealth of Massachuselis Department of Environmental Protection Box 4062 Boston. MA 02211 b.) To the Conservation Gommisslon: Send the Notice of Intent or Abbreviated Notice of Intent: a copy of this form; and the cityhown fee payment, To MassOEP Regional Office (see Insiructions): Send a copy of the Notice of Intent or Abbreviated Notice of Intent. a copy of Ihis form, and a copy of the state fee payment. (E-filers of Noiioes of Intent may submit these electron ical iy.) nodeed 3PQ- 3Veuerd Fee lramsminai Fa -rev IGvVt! F