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Home My WebLink AboutBLD-23-003047 fa l2 fz 01z2 R CE1VED E & WO FAMILY ONLY- BUILDING PERMIT 40V 2 9 22 Town of Yarmouth Building Department 1146 Route 28,South Yarmouth,MA 02664 4492 BUILDING p �Hrt I N hNT 508-398 2231 ext. 1261 Fax 508 398 0836 t • Fs; _ - - ---- Massachusetts State Building Code,780 CMR Building Permit Application To Construct, Repair, Renovate Or Demolish ''+ a One-or Two-Family Dwelling This Section For Official Use Only Building Permit Number: 3t,�0..7i3 'Ob 7 Date Applie • Building Official(Print Name) ' Signature Date SECTION 1:SITE INFORiMATION 1.1 Property A e reams`,0th 1.2 Assesso Map&Parcel Numbe 1.1 a Is this an accepted street?yes no Map Number Parcel Number 1.3 Zoning Information: 1.4,,�� Dimensions: , 5 Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required I Provided c/ Z. equ• ed Provided Required Provided 36" �� 977,6z- Z'- /30 1.6 Water Supply: (M.G.L c.40,§54) 1.7 lood Zone Informat on: 1.8 Sewage Disposal System: Zone: — Outside Flood Zone? Public 0 Private ' Check if yes❑ Municipal 0 On site disposal system XI SECTION 2: PROPERTY OWNERSHIP' 2�1�rt r of Inc ` P k°1 yam+-!/i ' /e5" # WAVI 6f24111. Name(Print) City,State,ZIP No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction Existing Building 0 I Owner-Occupied ❑ Repairs(s) ❑ Alteration(s) ❑ Addition ❑ Demolition ❑ Accessory Bldg. 0 Number of Units Other ❑ Specify; Brief Description of Proposed Work2: SECTION 4: ESTIMATED CONSTRUCTION COSTS. • Item Estimated Costs: Official Use Only (Labor and Materials) y 1.BuiIding $ /5 "11 1. Building Permit Fee:$ `1J0.0 Indicate how fee is determined: 2.Electrical $ / / GetEl Standard City/Town Application Fee v 0 Total Project Cost• I 6)x multiplier x ��3.Plumbing $ 2. Other Fees: $ C 02.(12, /„i ,d 4.Mechanical (HVAC) $ C�'h'N List: lY 5.Mechanical (Fire / Suppression) $ yryz) - Total All Fees:$ n Check No. Check Amount: Cash Amount: \(A\ t 6.Total Project Cost: $ 0 Paid in Full a Outstanding Balance Due:-rl G t5 a�� //)3I SECTION 5: CONSTRUCTION SERVICES 5.1 Constructionf Supervisor/ License(CSL) g//7� l/e, 4_ _' 4/0404102f License Number Expiration Date Name of CSL Holder . q !�//"//,// 7`, /�� l�,Z List CSL Type(see below) 7/ No. d Street "� Type Description )'4r j �/� ,�� 40Z 6 U I Unrestricted(Buildings up to 35,000 cu.ft.)(/►f �r 1 - R Restricted 18c2 Family Dwelling City/Town,State,ZIP / M Masonry RC I Roofing Covering WS Window and Siding /��s SF Solid Fuel Burning Appliances ?7�9(..17 #l"�;�,l[ aefekt.zi I Insulation Telephone Erna' address D I Demolition 5.2 Registered Home Improvement Contractor(HIC) z-A(-Jr HIC Registration Number Expiration Date HIC Company Nairneo HIC R an ame osd S ettnn �Z6` Emil address lth fhb-- City/Town,State,ZIP Telephone SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152.§ 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes Xs_. No 0 SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize 'k.E r4,t r`v'W� to act on my behalf,in all matters relative to work authorized by this building permit application. S a, / (4_ Print Owner's Name(Electronic Signature) Date • SECTION 7b: OWNER'OR AUTHORIZED AGENT DECLARATION By entering my name below,I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. 41 T )( -0 // � -a Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor{HIC)Program),will nor have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.nov/oca Information on the Construction Supervisor License can be found at www.mass.aov/dps 2. When substantial work is pl ed ovide the information below: Total floor area(sq.ft.) �5 (including garage,finished basement/attics,decks or porch) Gross living area(sq.ft.) Habitable room count V Number of fireplaces — Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/,porches ' Type of cooling system Enclosed .� Open 3. "Total Project Square Footage"may be substituted for"Total Project Cost" "4 lU v CJ��,, The Commonwealth of Massachusetts ewej ' Department of lndustrialAccidents 111 I Congress Street, Suite 100 e, l (: Boston,MA 02114-2017 ��%„J•' www.rnass.aov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH TEE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): Iv/ 7 , "am m 6 . Address: a9 Cl VA if/-t;, --A City/State/Zip: 3 X/V1 /446. DzGI,1 Phone#: -7"7/ �- ' 77 Are you an employer? Check the appropriate box: Type of project (required): Lig am a employer with �i employees(full and/or part-time).* 7. ZNew construction 2.:I am a sole proprietor or partnership and have no employees working for me in 8. ]Remodeling any capacity,[No workers'comp.insurance required.] — 3. I am a homeowner doingall work myself. t 9. — Demolition y [No workers'comp.insurance required.] 4.�I am a homeowner and will be hiring contractors to conduct all work on mY property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.E Electrical repairs or additions proprietors with no employees, 12.0 Plumbing repairs or additions 5.11 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp.insurance.; 13•❑Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption per MGL e. 14. Other 152,§1(4),and we have no employees.[No workers'comp.insurance required,] . *Any applicant that checks box ill must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees, If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. l Insurance Company Name: 4J,I 7 /rne TWA' Policy#or Self-ins.Lic.#: /Gt/G— 7 ',, --a Y2&- 3 W 4 Expiration Date: 3— a—"23 Job Site Address: V/ l nc— / v6 City/State/Zip: ,Vi 0n.,,t y d 4/1, er26,' Attach a copy of the workers' compensation policy declaration page(showing the policy number and e4iration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. • I do hereby certify under the p '' s and penalties of perjury that the information provided above is true and correct. /� ,/G Signature: Mel Jl Z Phone#: 97/ l,N Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: §TOWN OF YARMOUTH 1146 Route 28, South Yarmouth, MA 02664 508-398-22311 ext. 1261 Fax 508-398-0836 Office of the Building Commissioner BUILDING DEPARTMENT DEMOLITION DEBRIS DISPOSAL AFFIDAVIT Pursuant to M.G.L. Ch. 40, §54 and 780 CMR- Section 105.3.1. #4. I hereby certify that the debris resulting from the proposed work/demolition to be conducted at e 2,- 4 Work Address Is to be disposed of oat the following location: AePnieff/1 'f. Said disposal site shall be a licensed solid waste facility as defined by M.G.L. Ch. 111, §150A. Si re of Application Date Permit No. THE COMMONWEALTH OF MASSACHUSETTS Office of Consumer Affairs.&Business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration`":_"-'.'-EXpiration 1000 Washington Street -Suite 710 1!3588Z _08/14/2924 Boston, MA 02118 Al J NARDONE CARPENTRY LLC ACHAEL J. NARDONE 99 WHITES PATH �4 /t/(,t/LZ/7A.-"-- ;OUTH YARMOUTH, MA 02,664 Undersecretary of valid without signature Commonwealth of Massachusetts 111 Division of Professional Licensure Board of Building Regulations and Standards Constnit%Aispyrvisor CS-081139 O,pires:0911612023 'i MICHAEL J NARDONE r. 299 WHITES PATH e SOUTH YARMOUTH MA 02664 V 11()l55 :10*` Commissioner 0i��,• . �C�r,ckca Mike Nardone November 29, 2022 M.J. Nardone Carpentry, LLC 299 White's Path, South Yarmouth, MA 02664 Re: Building Permits/Demolition Permits Dear Mike, This letter authorizes you to obtain all construction and demolition permits on our behalf for the construction of the new house at 41 Uncle Roberts Road, West Yarmouth, MA. Best Regards, Peter GLGi bR`GIGSr Peter Fairbanks Owner ietZ.,z3 -dd3d 4-'I 01- k TOWN OF YARMOUTH c HEALTH DEPARTMENT `•r4CNt%4 A PERMIT APPLICATION SIGN OFF TRANSMITTAL it l i'r E 1 N., E D To be completed by Applicant: n. �1 / ?ea/Ail' JAN 0 3 2023 1 Building Site Location: 7/ ajyw i / BUILDING DEPAK I MENT Proposed Improvement: LtGYh5�pti Alviv 5 C GAGMY't O3i6- " Applicant: /"(� /t/ AC Tel. No.: c3U6- 3/ „FY Address: 0299 Mik. ?A.iel Ji 11T . Date Filed: / --7 2`- **If you would like e-mail notification of sign off,please provide e-mail address: Owner Name: ? '4i. �/►-f/2v19h,/ex Owner Address: y/ all,i4 .QIb Owner Tel. No.: . »/ ig 7 __._..._.... G? 76 (- 6.Y -�`7 �-7 5 RESIDENTIAL AND/OR COMMERCIAL BUILDING HEALTH DEPARTMENT: Determines Compliance to State and Town Regulations; i.e.,Requirements For Septage Disposal and other Public Health Activities. Please submit three (3) copies of plans, to include: (1.) Site Plan showing existing buildings, water line location, and septic system location; (2.) Floor plan labeling ALL rooms within building (all existing and proposed) — Note: Floor plans not required for decks, sheds, windows, roofing; (3.) If necessary, Title 5 application signed by licensed installer with fee. REVIEWED BY: . C."- CA, C%k DATE: r - ` _ ol, Z PLEASE NOTE COMMENTS/CONDITIONS: l •�,�'1Ls ( '✓t_irrC lri- S "bik [L-f tl iJYC ( t / 43Ja'- W`` 0Lc5 c-✓ ID ----; ENVIROTECH LABORATORIES,INC. 173.1Gr GVVI D MA CERT. NO.:M-MA 063 DEC 3 0 2022 8 Jan Sebastian Drive Unit 12 Sandwich,MA 02563 (508)888-6460 1-804-339-6460 HEALTH DEPT. FAX(508)888-6446 Client Nang: Jenkins&Son Well Drilling Location: Address: PO Box 5 41 Uncle Roberts S Orleans,MA Yarmouth,MA 02662 Lab Number: DW-225284 Collected By: P Jenkins Date Received: 12/20/22 Sample Type , New Wet - Well Specs: 30 X 13 r Location Source Date Collected Time Collected Comments A 12t1W22 17O Analysis Requested Units Recommended Limits Analysis Result Method Date Analyzed' Analyzed By pH pH units 6.5-8.5 5.86 SM 4500-H-B 12202022 KF Specific Conductances umhos/cm 500 85 EPA 120.1 1220/2022 KF Nitrite-N mg/L 1.00 <0.006 EPA 300.0 12/22/2022 KF Nitrate-N mg/L 10.0 0.30 EPA 300.0 12/22/2022 KF Sodium mg/L 20.0 11 EPA 200.7 12/212022 KB Total Iron mg/L 0.3 <0.01 EPA 200.7 12212022 KB Manganese mg/L 0.05 0.096 EPA 200.7 12/212022 KB Total Coliform(Presence/Absence) Present/Absent Absent Absent SM9223B 12/202022 IP @ 17:15 Comments: Drinking water may naturally have manganese and,when concentrations are greater than 0.050 mg/L,the water may be discolored and taste bad.Manganese is not a health hazard at levels 0.05-0.300 mg/L. Low pH indicates high corrosive characteristics. All samples were analyzed within the established guidelines of US EPA approved methods with all requirements met, unless otherwise noted at the end of a given sample's analytical results. We certify that the following results are true and accurate to the best of our knowledge. Water meets EPA standards and is suitable for drinking for parameters tested. irAA41114.41". '. 12/22/2022 Ronald J.Saari Laboratory Director BRL=Below Reportable Limits 'See Attached Page 1 of 1 Certification is not available for this analyie for potable water samples. TOWN OF YARMOUTH WATER DIVISION {'M`` ''1" C` 99 Buck Island Road �;' West Yarmouth,MA 02673 Telephone: 508-771-7921 Fax: 508-771-7998 September 7, 2022 To Whom it may concern, RE: 41 Uncle Robert's, West Yarmouth —NO Town Water The Yarmouth Water Department is confirming with MJ Nardone construction that there is NO Town water to 41 Uncle Roberts. This property is on well water on Great Island. If you have any questions please don't hesitate to give us a call 508-771-7921 • Sincerely, Yarmouth Water Department • C:\Users\Mike Nardone\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\J5ULELXE\4I uncle roberts.docx •'. t A;) Conservation Office _ p.• ,, y Town of Yarmouth bdirienzo(a�yarmouth.ma.us r`,.,�T'Ycaoupt �S �' Conservation Commission � o"' Building Permit Sign-off Application TO BE FILLED OUT BY BUIILDING// PERMIT APPLICANT: £ Building Site Location: / 47(. lc i2•1 ', lam Map # Lot(s) # 3 Property Owner: riakz ge'k, 2 Xj Date filed: //-2,-Z2- *Applicant: Ai, , / a / � r Applicant Address: �� l?j��S - �J ��i Email: �j!e 1,viuLaw . ek, Telephone: � F - 77717 Please note:by submitting tplication,the applicant grants permission to the Conservation Office to enter the location to conduct a site visit(if needed). Proposed Project Description: Site Plan Title/Date: S7 q�. .,E—`� zr r t,j 1� \i2 TO BE FILLED OUT BY CONSERVATION ADMINISTRATOR: Does the proposed project require a permit?_ ` ) Refer to: SE83- '71)5 1-) or DOA permit Comments from Conservation Commission: Approved Conditionally Approved Rejected Conservation Commission Sign-off Signature: I2�2-, Date: 11 12„ (1 1 Z Z *TO APPLICANT: All work-related debris shall be taken offsite or disposed in a legal upland location. At the end of each day, the area shall be clean and no debris shall be in the Resource Area. If work is permitted under an Order of Conditions, please arrange a pre-construction site visit with the Conservation Administrator. At the time of site visit, the MassDEP File Number sign must be installed, along with the erosion control/work-limit line. A copy of the Order of Conditions must remain on-site during construction. Please refer to the Order of Conditions for further details. °Y_ `0 TOWN OF YARMOUTH 0 `' 1146 ROUTE 28,SOUTH YARMOUTH,MASSACHUSETTS 02664-4451 Telephone(508)398-2231 Ext. 1292 Fax(508)398-0836 it HISTORICAL COMMITTEE MEMORANDUM TO: Mark Grylls,Building Commissioner FROM: Karen Greene,Director of Community Development DATE: December 4, 2020 SUBJECT: 41 Uncle Roberts Road—Demolition Request On February 20, 2020, the Yarmouth Historical Commission met on site to tour and consider the above referenced property in anticipation of a request to demolish. The intended purpose of the demolition is to enable construction of a new home. A demolition permit application was filed with the Building Department on March 25, 2020 by The Davenport Companies. This application along with a Notice of Intent to Demolish was considered by the Yarmouth Historic Commission at their meeting on September 3, 2020. While noting that the house was a classic structure, the Commission agreed that the structure was not historically significant. Accordingly, the Commission voted unanimously that the structure to be demolished was not significant, and that the applicant could proceed with demolition. Thank you. Cc: Yarmouth Historic Commission Davenport Building Company(Contractor) Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File#:083-2350 Bureau of Resource Protection-Wetlands eDEP Transaction#:1425494 WPA Form 5-Order of Conditions City/Town:YARMOUTH Massachusetts Wetlands Protection Act M.G.L.c. 131, §40 A. General Information 1. Conservation Commission YARMOUTH 2. Issuance a. OOC b.r Amended OOC 3.Applicant Details a.First Name PETER M. b.Last Name FAIRBANKS c.Organization d.Mailing Address 1243 UNION ST. e.City/Town MARSHFIELD f. State MA g.Zip Code 02050 4. Property Owner a.First Name PETER M. b.Last Name FAIRBANKS c.Organization d.Mailing Address 1243 UNION ST. e.City/Town MARSHFIELD f. State MA g.Zip Code 02050 5. Project Location a.Street Address 41 UNCLE ROBERTS ROAD b.City/Town YARMOUTH c.Zip Code 02664 d.Assessors 5 e. Parcel/Lot# 3 Map/Plat# f.Latitude 41.62178N g.Longitude 70.26809W 6. Property recorded at the Registry of Deed for: a.County b.Certificate c.Book d.Page BARNSTABLE 229863 7.Dates a.Date NOI Filed: 8/16/2022 b.Date Public Hearing Closed: 11/3/2022 c.Date Of Issuance: 11/16/2022 8.Final Approved Plans and Other Documents a.Plan Title: b.Plan Prepared by: c.Plan Signed/Stamped by: d.Revised Final Date: e.Scale: SUBSURFACE SEWAGE DISPOSAL ASA J.MINTZ PE AJM SITE DESIGN,LLC 10/25/2022 1"=20' SYSTEM SITE PLAN AND PROFILE FAIRBANKS RESIDENCE 41 UNCLE ROBERTS RD,WEST TM 10/27/2022 DESIGN 10/27/2022 AS NO 1' YARMOUTH MA GROUP SHEET L1.0,L2.0, L3.0,L4.0,AND D1.0 Page 1 of 12*ELECTRONIC COPY Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File#:083-2350 Bureau of Resource Protection-Wetlands eDEP Transaction#:1425494 WPA Form 5-Order of Conditions Cityf own:YARMOIJ I H Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Findings 1.Findings pursuant to the Massachusetts Wetlands Protection Act Following the review of the the above-referenced Notice of Intent and based on the information provided in this application and presented at the public hearing,this Commission fords that the areas in which work is proposed is significant to the following interests of the Wetlands Protection Act. Check all that apply: a. rr Public Water Supply b. r Land Containing Shellfish c.(� Prevention of Pollution d. r Private Water Supply e. r Fisheries f. r Protection of Wildlife Habitat g. r Ground Water Supply h. fr Storm Damage Prevention i. 1.7 Flood Control 2.Commission hereby fords the project,as proposed,is: Approved subject to: a.F 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. Denied because: b.r 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 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.1--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 interests of the Act,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). Buffer Zone Impacts:Shortest distance between limit of project disturbance and the wetland 3'� resource area specified in 310CMR10.02(1)(a). 37 a. linear feet Inland Resource Area Impacts:(For Approvals Only): Resource Area Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 4. r Bank a. linear feet b. linear feet c. linear feet d.linear feet 5.r Bordering Vegetated Wetland a. square feet b. square feet c. square feet d. square feet 6. r Land under Waterbodies and Waterways a.square feet b.square feet c.square feet d.square feet Page 2 of 12*ELECTRONIC COPY Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File#:083-2350 Bureau of Resource Protection-Wetlands eDEP Transaction#:1425494 PA Form 5- Order of Conditions Cityilown:YARMOUTH W Massachusetts Wetlands Protection Act M.G.L.c. 131, §40 e.c/y dredged f.c/y dredged 7.r Bordering Land Subject to Flooding a.square feet b. square feet c.square feet d. square feet Cubic Feet Flood Storage e. cubic feet f. cubic feet g.cubic feet h.cubic feet 8.r Isolated Land Subject to Flooding a.square feet b. square feet Cubic Feet Flood Storage c.cubic feet d.cubic feet e.cubic feet f.cubic feet 9.r Riverfront Area a.total sq. feet b.total sq. feet Sq ft within 100 ft c. square feet d. square feet e. square feet f. square feet Sq ft between 100-200 ft g.square feet h.square feet i. square feet j.square feet Coastal Resource Area Impacts: Resource Area Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 10.r Designated Port Areas Indicate size under Land Under the Ocean,below 11.r Land Under the Ocean a. square feet b. square feet c.c/y dredged d.c/y dredged 12.r Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes below 13.r Coastal Beaches a.square feet b.square feet c.c/y nourishment d.c/y nourishment 14.r Coastal Dunes a.square feet b.square feet c.c/y nourishment d.c/y nourishment 15.r Coastal Banks a.linear feet b. linear feet 16.r Rocky Intertidal Shores a.square feet b.square feet 17.r Salt Marshes a.square feet b.square feet c.square feet d. square feet 18.r Land Under Salt Ponds a.square feet b.square feet c.c/y dredged d.c/y dredged 19.r Land Containing Shellfish Page 3 of 12 * ELECTRONIC COPY Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File#:083-2350 Bureau of Resource Protection-Wetlands eDEP Transaction#:1425494 PA Form 5-Order of Conditions City/Town:YARMOLTfII W Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 a. square feet b. square feet c.square feet d.square feet Indicate size under Coastal Banks,inland Bank,Land Under the 20.r Fish Runs Ocean,and/or inland Land Under Waterbodies and Waterways, above c.c/y dredged d.c/y dredged 21.r Land Subject to Coastal Storm Flowage a.square feet b. square feet 22. r Restoration/Enhancement(For Approvals Only) 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.5.c&d or B.17.c&d above,please entered the additional amount here. a. square feet of BVW b. square feet of Salt Marsh 23. r Streams Crossing(s) If the project involves Stream Crossings,please enter the number of new stream crossings/number of replacement stream crossings. a.number of new stream crossings b.number of replacement stream crossings C. General Conditions Under Massachusetts Wetlands Protection Act The following conditions are only applicable to Approved projects 1. Failure to comply with all conditions stated herein,and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 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 exceed the issuance date of the original Final Order of Conditions. 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. Page 4 of 12*ELECTRONIC COPY Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File#:083-2350 Bureau of Resource Protection-Wetlands eDEP Transaction#:1425494 WPA Form 5-Order of Conditions City/Iown:YARMOUTH Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 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. 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:"083-2350" 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 Mass DEP. 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. 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) r is not(2)r subject to the Massachusetts Stormwater Standards. If the work is subject to 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 Page 5 of 12 * ELECTRONIC COPY Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File#:083-2350 Bureau of Resource Protection-Wetlands eDEP Transaction#:1425494 WPA Form 5-Order of Conditions CityfrowreYARMOUTH Massachusetts Wetlands Protection Act M.G.L.c. 131,§40 and,if applicable,the Stormwater Pollution Prevention Plan required by the National Pollutant Discharge Elimination System Construction General Permit as required by Stormwater Standard 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. 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 19(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 Pollutant 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 19(f)through 19(k)with respect to that BMP.Any failure of the proposed responsible party to implement the requirements of Conditions 19(f)through 19(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. 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 Page 6 of 12*ELECTRONIC COPY Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File#:083-2350 Bureau of Resource Protection-Wetlands eDEP Transaction#:1425494 PA Form 5-Order of Conditions City/Town:YARMOUTH W Massachusetts Wetlands Protection Act M.G.L.c. 131, §40 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: D.Findings Under Municipal Wetlands Bylaw or Ordinance 1.Is a municipal wetlands bylaw or ordinance applicable? Yes r No 2.The Conservation Commission hereby(check one that applies): a r DENIES the proposed work which cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw specifically: I.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 fmal Order or Conditions is issued.Which are necessary to comply with a municipal ordinance or bylaw: b.r APPROVES the proposed work,subject to the following additional conditions. 1.Municipal Ordinance or YARMOUTH 2.Citation CHAPTER 143 Bylaw WETLAND BYLAW 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: 1.THIS ORDER SHALL APPLY TO ANY SUCCESSORS AND ASSIGNS IN INTEREST OR CONTROL AND ANY OTHER PERSON ENGAGING IN ACTIVITY ON THE PROPERTY IDENTIFIED IN THE NOTICE OF INTENT.2.THE APPLICANT/OWNER SHALL BE RESPONSIBLE FOR HAVING A COPY OF THE"ORDER Page 7 of 12*ELECTRONIC COPY Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File#:083-2350 Bureau of Resource Protection-Wetlands eDEP Transaction#:1425494 PA Form 5-Order of Conditions Ciryffown:YARMOU H W Massachusetts Wetlands Protection Act M.G.L.c. 131, §40 OF CONDITIONS"ON THE JOB SITE AT ALL TIMES AND SHALL BE RESPONSIBLE FOR INSURING THAT ALL PERSONS PERFORMING THE PERMITTED ACTIVITY ARE FULLY AWARE OF ITS TERMS AND CONDITIONS.FAILURE TO DO SO MAY RESULT IN THE REVOCATION OF THESE"ORDERS",A FINE OR BOTH.3.THE CONSERVATION COMMISSION,ITS AGENT(S)OR ASSIGNED(S)SHALL HAVE THE EXPRESS RIGHT OF ENTRY UPON THE JOB SITE AT ALL REASONABLE TIMES FOR THE PURPOSES OF ESTABLISHING COMPLIANCE WITH THE"ORDER OF CONDITIONS","BY-LAWS"AND"REGULATIONS". COMMISSION MEMBERS AND THE CONSERVATION ADMINISTRATOR MAY ACQUIRE ANY INFORMATION,MEASUREMENTS,PHOTOGRAPHS,OBSERVATIONS AND/OR MATERIALS OR MAY REQUIRE THE SUBMITTAL OF ANY DATA/INFORMATION DEEMED NECESSARY BY THIS COMMISSION FOR THAT EVALUATION.4.A PRECONSTRUCTION REVIEW SHALL BE ARRANGED BY THE CONTRACTOR WITH THE CONSERVATION ADMINISTRATOR AND SHALL OCCUR PRIOR TO THE COMMENCEMENT OF ANY WORK.5.ANY CHANGE IN THE APPROVED PLAN(S)SHALL REQUIRE THE APPLICANT TO FILE,IN WRITING,A NOTICE OF PROJECT CHANGE WITH THIS COMMISSION. THE COMMISSION WILL DETERMINE THE SIGNIFICANCE OF THE CHANGE AND DETERMINE WHETHER ADMINISTRATIVE APPROVAL OR AN"AMENDED ORDER OF CONDITIONS"IS REQUIRED. SHOULD THE PROJECT BE CHANGED WITHOUT PERMISSION,OR FOUND BY THE YARMOUTH CONSERVATION COMMISSION TO BE ALTERED IN ANY WAY FROM THE APPROVED PLAN(S),ALL WORK WILL IMMEDIATELY CEASE UNTIL THE PROJECT IS REAPPROVED BY THE COMMISSION.6. THE"ORDER OF CONDITIONS"IS VALID FOR THREE YEARS FROM THE DATE OF ISSUANCE UNLESS OTHERWISE SPECIFICALLY NOTED IN THE"ORDERS".EXTENSION PERMIT REQUESTS MUST BE APPLIED FOR AT LEAST 30 CALENDAR DAYS PRIOR TO THE EXPIRATION DATE OF THE ORIGINAL ORDERS".FAILURE TO DO SO WILL RESULT IN A NEW"NOTICE OF INTENT"FILING.7. NONCOMPLIANCE WITH THESE CONDITIONS SHALL CONSTITUTE GROUNDS FOR AN ENFORCEMENT ORDER AND POSSIBLE FINES.FINES SHALL NOT EXCEED$300.00 PER DAY/PER VIOLATION.8.NO WORK PERMITTED BY THIS ORDER MAY BEGIN UNLESS AND UNTIL THE APPLICANT RECEIVES A SUBSURFACE SEWAGE DISPOSAL PERMIT FROM THE YARMOUTH BOARD OF HEALTH WHICH COMPLIES WITH BOTH THE REQUIREMENTS OF 111'LE 5 AND ANY MORE STRINGENT LOCAL STANDARDS,AND UNTIL A COPY OF SAID PERMIT IS SENT TO THE CONSERVATION COMMISSION.9.GUTTERS AND DOWNSPOUTS DIRE(;L ED INTO ADEQUATELY SI7FD DRYWELLS SHALL BE PROVIDED FOR ROOF DRAINAGE.THE COMMISSION MAY ALSO ALLOW "DRIP TRENCHES"INSTEAD OF GUTTER SYSTEMS.AT NO TIME SHALL ROOF RUN OFF BE DIREC:1 bD TO A WETLAND RESOURCE AREA OR ABUTTING PROPERTIES. 10.GRADING SHALL BE ACCOMPLISHED SO THAT THE PROJECT SHALL NOT CAUSE FLOODING OR STORM DAMAGE TO WETLAND RESOURCE AREAS. 11.A"WORK LIMIT"LINE SHALL BE ESTABLISHED WITH EROSION CONTROLS(I.E.STRAW BALES,STAKED FILTER FABRIC,BARK MULCH,?SILT SACKS?,PRODUCTS MADE WITH RICE STRAW,AND OTHER WEED-FREE PRODUCT IS OR APPROVED BY THE COMMISSION).HAY BALES ARE NOT ALLOWED.IT IS THE APPLICANTS RESPONSIBILITY TO IMPLEMENT AND MAINTAIN APPROPRIATE AND ADEQUATE EROSION CONTROLS MEASURES THROUGHOUT THE CONSTRUCTION PROCESS. 12.NO WORK OF ANY KIND SHALL OCCUR ON THE RESOURCE AREA SIDE OF THE WORK LIMIT LINE.THIS LINE SHALL BE ESTABLISHED PRIOR TO ANY CONSTRUCTION OR WORK. 13.ALL IMPORTED FILL SHALL BE CLEAN AND NOT CONTAIN ANY FOREIGN DEBRIS SUCH AS CEMENT,BITUMINOUS CONCRETE,RUBBER,METAL,TRASH, BOULDERS,ETC.BOULDERS WILL BE ALLOWED IN SPECIFIC INSTANCES IF PART OF THE PROJECT DESIGN. 14.DEBRIS,INCLUDING LT11'ER,SHALL BE PICKED UP IMMEDIATELY.ANY EXCESS MATERIAL THAT IS EXCAVA LED FROM THE JOB SITE SHALL BE DISPOSED OF AT A LOCATION APPROVED BY THE CONSERVATION ADMINISTRATOR OR IN A COVERED DUMPSTER.NO DEBRIS SHALL BE ALLOWED IN A WETLAND OR WATERWAY. 15.WASHING OF EQUIPMENT/TOOLS SHALL BE Page 8 of 12* ELECTRONIC COPY Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File#:083-2350 Bureau of Resource Protection-Wetlands eDEP Transaction#:1425494 WPA Form 5-Order of Conditions CityfFown:YARMOVIH Massachusetts Wetlands Protection Act M.G.L.c. 131, §40 DONE OFF-SITE OR HANDLED IN A MANNER APPROPRIATE BY THE CONSERVATION ADMINISTRATOR 16.NO EQUIPMENT SHALL BE REFUELED,NOR SHALL FUEL BE STORED WITHIN 100 FEET OF A RESOURCE AREA. 17.ANY AREA THAT IS DISTURBED DURING CONSTRUCTION SHALL BE REVEGETATED IMMEDIATELY OR AS SOON AFTER AS THE GROWING SEASON COMMENCES,WITH APPROPRIATE NATIVE PLANTINGS.PERMANENT STABILIZATION SHALL BE CARRIED OUT IN ORDER TO MINIMIZE EROSION. 18.A BUFFER STRIP OF NATIVE VEGETATION SHALL BE PLANTED PER THE APPROVED PLAN.THE BUFFER STRIP OF NATIVE VEGETATION SHALL BE LEFT UNDISTURBED.THIS IS AN ON-GOING CONDITION,IN-PERPETUITY,THAT DOES NOT EXPIRE WITH THE ISSUANCE OF A CERTIFICATE OF COMPLIANCE.THE APPLICANT MUST WAIT UNTIL THE SECOND GROWING SEASON IS COMPLETE BEFORE THE REQUEST FOR A CERTIFICATE OF COMPLIANCE IS SUBMITTED.DURING THIS TIME PERIOD,THE COMMISSION/CONSERVATION ADMINISTRATOR MAY REQUIRE ADDITIONAL PLANTINGS IF IT IS DETERMINED THAT ANY SPECIMENS ARE DEAD OR DYING AND NEED REPLACEMENT. 19.NO LAWN SHALL EXIST BEYOND ?9779?9977 AS SHOWN ON THE APPROVED PLAN.THIS IS AN ONGOING CONDITION,IN PERPETUITY, THAT DOES NOT EXPIRE WITH THE ISSUANCE OF A CERTIFICATE OF COMPLIANCE.20.ILEX CRENATA SHALL BE REPLACED WITH A NATIVE PLANT SPECIES FROM THE CAPE COD COOPERATIVE EXTENSION NATIVE PLANT LIST.21.LANDSCAPE DEBRIS,INCLUDING LEAVES, GRASS CLIPPINGS,BRUSH,OR OTHER SHALL NOT BE ALLOWED WITHIN THE WETLAND RESOURCE AREA.THIS IS AN ON-GOING CONDITION THAT DOES NOT EXPIRE WITH THE ISSUANCE OF A CER I'll ICATE OF COMPLIANCE.22.THE CONTENT OF WATER IN SWIMMING POOLS CAN BE DETRIMENTAL TO WETLANDS PLANT AND ANIMAL SPECIES.TO REMOVE HARMFUL CHEMICALS,IT IS THE APPLICANTS RESPONSIBILITY TO LEAVE THE POOL WATER STANDING WITHOUT THE ADDITION OF CHLORINE FOR A MINIMUM OF THREE(3)DAYS BEFORE DRAINING.IN THIS WAY CHLORINE CONCENTRATION WILL BE SIGNIFICANTLY REDUCED DUE TO VOLATILIZATION.ALL POOL WATER,WHEREVER POSSIBLE,SHALL BE DRAINED THROUGH A DRY WELL,RATHER THAN ALLOWED TO SPREAD OVER THE SURFACE OF THE LAND.SALTWATER POOLS MUST BE PUMPED TO A TANK AND DISPOSED OF AT A DIFFERENT LOCATION.THE CONSERVATION COMMISSION OFFICE SHALL BE NOT WILD PRIOR TO DRAINING AND SHALL APPROVE THE METHOD OF DRAINING.23.310 CMR 10.30(3)PROMULGATED UNDER MGL C. 131,S.40,REQUIRES THAT NO COASTAL STRUCTURE,SUCH AS A BULKHEAD,REVETMENT OR SEAWALL SHALL BE PERMITTED ON AN ERODING BANK AT ANY TIME IN THE FUTURE TO PROTECT THE PROJECT ALLOWED BY THIS ORDER OF CONDITIONS.THIS CONDITION SHALL BE AN ONGOING IN PERPETUITY AND DOES NOT EXPIRE WITH THE ISSUANCE OF THE CERI I ICATE OF COMPLIANCE.(WORK ON A COASTAL BANK ONLY.) Page 9 of 12* ELECTRONIC COPY Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File#:083-2350 Bureau of Resource Protection-Wetlands eDEP Transaction#: 1425494 WPA Form 5-Order of Conditions Cityirown:YARMOUTI-I • Massachusetts Wetlands Protection Act M.G.L.c. 131, §40 E. Signatures This Order is valid for three years from the date of issuance,unless otherwise specified pursuant to General Condition#4. If this is an Amended Order of l t 112 0 L Z Conditions,the Amended Order expires on the same date as the original Order of 1.Date of Original Order Conditions. Please indicate the number of members who will sign this form.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: rat 1_ by hand delivery on '-iby certified mail,return receipt requested,on Date Date \ \ (,Q `ZG Lt. F.Appeals 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 for 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 Page 10 of 12 * ELECTRONIC COPY Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File#:083-2350 Bureau of Resource Protection-Wetlands eDEP Transaction#:1425494 PA Form 5-Order of Conditions CityfFown YARMOIJTH W Massachusetts Wetlands Protection Act M.G.L.c. 131, §40 E.Signatures This Order is valid for three years from the date of issuance,unless otherwise specified pursuant to General Condition#4.If this is an Amended Order of 11/16/2022 Conditions,the Amended Order expires on the same date as the original Order of 1.Date of Original Order Conditions. Please indicate the number of members who will sign this form.This Order must 6 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: Pat Mulhearn Ed Hoopes Ellie Lawrence Rick Bishop Paul Huggins David Bernstein n by hand delivery on r by certified mail,return receipt requested,on Date Date F.Appeals 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 for 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 Page 10 of 12*ELECTRONIC COPY Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File#:083-2350 Bureau of Resource Protection-Wetlands eDEP Transaction#:1425494 WPA Form 5-Order of Conditions City/Town YARMOUTH Massachusetts Wetlands Protection Act M.G.L.c. 131, §40 (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. G. Recording Information 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: 41 UNCLE ROBERTS ROAD 083-2350 Project Location MassDEP File Number Has been recorded at the Registry of Deeds of: County Book Page for: Property Owner PETER M.FAIRBANKS 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 Page 11 of 12* ELECTRONIC COPY Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File#:083-2350 Bureau of Resource Protection-Wetlands eDEP Transaction#:1425494 WPA Form 5- Order of Conditions Cityrrown:YARMOUTH Massachusetts Wetlands Protection Act M.G.L.c. 131, §40 Signature of Applicant Rev 4 1g010 Page 12 of 12* ELECTRONIC COPY Doc_ : 1 .471 r 383 11-21-2022 9:06 BARNSTABLE LAND COURT REGISTRY Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File#:083-2350 Bureau of Resource Protection-Wetlands eDEP Transaction#:1425494 WPA Form 5- Order of Conditions City/Town:YARMOUTH Massachusetts Wetlands Protection Act M.G.L.c. 131, §40 A. General Information 1. Conservation Commission YARMOUTH 2.Issuance a OOC b.r Amended OOC 3.Applicant Details a.First Name PETER M. b.Last Name FAIRBANKS c.Organi ration d.Mailing Address 1243 UNION ST. e.City/Town MARSHFIELD f. State MA g.Zip Code 02050 4.Property Owner a.First Name PETER M. b.Last Name FAIRBANKS c. Organization d.Mailing Address 1243 UNION ST. e.City/Town MARSHFIELD f. State MA g.Zip Code 02050 5. Project Location a.Street Address 41 UNCLE ROBERTS ROAD b.CityfTown YARMOUTH c.Zip Code 02664 d.Assessors Map/Plat# 5 e. Parcel/Lot# 3 f.Latitude 41.62178N g.Longitude 70.26809W 6.Property recorded at the Registry of Deed for: a.County b.Certificate c.Book d.Page BARNSTABLE 229863 7.Dates Fr! a.Date NOI Filed: 8/16/2022 b.Date Public Hearing Closed: 11/3/2022 c.Date Of Issuance: 11/16/2022 8.Final Approved Plans and Other Documents .Q a.Plan Title: b.Plan Prepared by: c.Plan Signed/Stamped by: d.Revised Final Date: e.Scale: SUBSURFACE SEWAGE DISPOSAL ASA J.MINTZ PE ATM SI'I'h DESIGN,LLC 10/25/2022 1"=20' SYSTEM SITE, PLAN AND PROFILE FAIRBANKS RESIDENCE 41 UNCLE ROBERTS RD,WESTTM MULCAHY DESIGN 10/27/2022 AS NOI'h1) YARMOUTH MA GROUP SHEET L1.0,L2.0, L3.0,L4.0,AND D1.0 Page 1 of 12 *ELECTRONIC COPY Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File#:083-2350 Bureau of Resource Protection-Wetlands eDEP Transaction#:1425494 WPA Form 5-Order of Conditions Ciryffown:YARMOUTH Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 (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. G.Recording Information 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: 41 UNCLE ROBERTS ROAD 083-2350 Project Location MassDEP File Number Has been recorded at the Registry of Deeds of: County Book Page for: Property Owner PETER M.FAIRBANKS 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: Doc: 1 :471 .383 11-21-2022 9:06 Instrument Number BARNSTABLE LAND COURT REGISTRY If registered land,the document number identifying this transaction is: Document Number Page 11 of 12* ELECTRONIC COPY ��f-Y,qR TO.VN OF 1AR\tOI it 3}' c WATER DEPARTMENT ` 9')Buck Island RI pad ;I rr� 11est larmouth.M.\02( t . ^ ' "= 1,!,;,hont> , ir)to "1.7921 • Fax: 6titt -1-'9)98 co,,---- BUILDING PERMIT APPLICATION FOR WATER DEPARTMENT SIGN OFF TRANSMITTAL FORM BUILDING SETE LOCATION: // ," / &.,....,4 .„.., .__... PROPOSED WORK: ik..eJ ,,, APPl,IC'ANT: /tt /1/414(24.,_„,,,.._ ADDRESS: ( UV4'/ __a {* .I I',I..PI1O\E: " E J I j �. RI}SIDI'.\TI,\L AND OR CO\I\II:RCIAI. BUILDING Water I)epartment: Determines Compliance of Water Win lahilit) and or existing location I;itp:ineerug I)epanment; Determirie.Compliance for Parking and Drainage C'on.crxation Commission: I)eteritllnes Compliance to Wetlands \et: i e [lions)border any type of n etlands.streams.ponds.rix ers.ocean.hogs,hn�s.marshland. ETC. . IEealth Department: I)eicnnines Compliance to State and Ton u Regulations,t.e, requirement,for Scptage Disposal and other Public I Iealth Actixites I.ire l)cpanment: Determines Compliance to Slate and fow°n Requirements for Personal Safely.Property Protections.i.e.Smoke Detectors.Sprinkler Systerns,etc i A I.ICAN SIGNATURE DATE OFFICE:USE; ON PE:R\II I APPROVAL DENIAL__ RF:VIF:\ 'ED BY WATER DIVISION (SIGNATURE) DATE Home Energy Rating Certificate Rating Date: Projected Report Registry ID: Based on Plans Ekotrope ID: yLOZAA3v HERS® Index Score: Annual Savings Home: Your home's HERS score is a relative 41 Uncle Roberts Rd performance score.The lower the number, 6 546 5 West Yarmouth, MA 02673 the more energy efficient the home.To Builder: learn more,visit www.hersindex.com *Relative to an average U.S.home Mike Nardone Your Home's Estimated Energy Use: This home meets or exceeds the Use[MBtu] Annual Cost criteria of the following: Heating 91.3 $3,097 2015 International Energy Conservation Code Cooling 1.3 $81 2012 International Energy Conservation Code Hot Water 15.0 $503 2009 International Energy Conservation Code Lights/Appliances 31.9 $1,975 2006 International Energy Conservation Code Service Charges $0 Generation (e.g.Solar) 0.0 $0 Total: 139.6 $5,657 HERS'Index Home Feature Summary: Rating Completed by: Q More Energy Home Type: Single family detached Model: N/A Energy Rater. Chris Mazzola Community: N/A RESNET ID: 8873503 Existing ••-.n Homes • 10 Conditioned Floor Area: 4,971 ft2 Rating Company: Home Energy Raters LLC 120 Number of Bedrooms: 5 180 State Rd,Suite 2U Sagamore Beach MA 02562 10 Reference Primary Heating System: Furnace•Propane•96 AFUE 508-833-3100 Home 300 Primary Cooling System: Air Conditioner•Electric•13 SEER Rating Provider: Energy Raters of Massachusetts 80 Primary Water Heating: Residential Water Heater•Propane•0.92 Energy Factor 2 Woodlawn Street Amesbury,MA 01913 .m House Tightness: 1.9 ACH50 978-270-3911 rp•x•..; �� Ventilation: 100 CFM•100 Watts(Default) ✓ �: 55 `' so Duct Leakage to Outside: 10 CFM @ 25Pa(0.37/100 ft2) I w This Home Above Grade Walls: R-2130 -. """ ° 20 Ceiling: Vaulted Roof,R-43 10 Window Type: U-Value:0.29,SHGC:0.3 Zero Energy Home 0 Foundation Walls: R-21 Chris Mazzola,Certified Energy Rater VMSRES.(1 `�' u.,E,.,n Framed Floor: R 30 Date:12/15/22 at 7:33 AM e kot ro a Ekotrope RATER-Version:3.2.3.hf.3037 The Energy Rating Disclosure for this home is available from the Approved Rating Provider. This report does not constitute any warranty or guarantee. Building Specification Summary Property Organization Inspection Status 41 Uncle Roberts Rd Home Energy Raters LLC Results are projected West Yarmouth, MA 02673 Chris Mazzola 508-833-3100 Uncle Roberts Rd 41-yL0ZAA3v Uncle Roberts Rd 41 Pre Builder Mike Nardone Building Information Rating Conditioned Area [ft2] 4,971.00 HERS Index 55 Conditioned Volume [ft3] 59,956.00 HERS Index w/o PV 55 Thermal Boundary Area[ft2] 12,166.00 Number Of Bedrooms 5 Housing Type Single family detached Building Shell Ceiling w/Attic I None Windows(largest)I U-Value: 0.29, SHGC: 0.3 Vaulted Ceiling I R43,HDF+LDF,2"+8",10x16,C; U-0.029 Window/Wall Ratio 10.17 Above Grade Walls I R21,FG,6x16,G1; U-0.057 Infiltration 11.9ACH50 Found.Walls I R21,FG,6x16,G1; R-21 Duct Lkg to Outside 10 CFM @ 25Pa (0.37/ 100 ft2) Framed Floors I R30,FG,10x16,G1; R-30 Total Duct Leakage 108 CFM @ 25Pa(Post-Construction) Slabs R1OP; R-10 Mechanical Systems Heating Furnace • Propane •96 AFUE Cooling Air Conditioner•Electric• 13 SEER Water Heating Residential Water Heater• Propane•0.92 Energy Factor Programmable Thermostat Yes Ventilation System 100 CFM • 100 Watts (Default) Whole House Fan N/A Lights and Appliances Percent Interior LED 100% Clothes Dryer Fuel Electric Percent Exterior LED 100% Clothes Dryer CEF 3.4 Refrigerator(kWh/yr) 727.0 Clothes Washer LER(kWh/yr) 284.0 Dishwasher Efficiency 270 kWh Clothes Washer Capacity 4.2 Ceiling Fan None Range/Oven Fuel Electric Ekotrope RATER-Version 3.2.3.hf.3037 All results are based on data entered by Ekotrope users.Ekotrope disclaims all liability for the information shown on this report