SE83-1585 REQ CORT OF COMPCONSERVATION
OFFICE
• 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.
Stu/, ac�c L�ipeicatian:
1 complete hardcopy of the COC application, plan/sketch, and other supporting
information to the Conservation Office - mailed to or dropped off at Town Hall.
V 1 complete pdf of the COC application, plan/sketch, and other supporting information
emailed to bdirienzo(ayarmouth.ma.us.
JSigned statement from an Engineer or similar professional to who prepared the
approved plan. — Include in hardcopy and digital submission.
f � As -Built plan —Include in hardcopy and digital submission. Refer to 310 CMR
10.05(9)(d). *Refer to issued Order of Conditions: Special Conditions to determine if
required*.
JLocal 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.
*Click Yarmouth Street Index for parcel -related Conservation documents.
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 • bdiriezno(a�yarmouth.ma.us
Rev 2/2023
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 8A — Request for Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Town of Yarmouth Wetland By-law, Chapter 143
A. Project Information
Important: 1
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
of the work
authorized in
an Order of
Conditions, the
property owner
must request a
Certificate of
Compliance
from the issuing
authority stating
that the work or
portion of the
work has been
satisfactorily
completed.
This request is being made by:
Laurie M. Gallagher
Name
18 Lincoln Street
Mailing Address
Dedham,
City/Town
MA
State
This request is in reference to work regulated by a final Order of Conditions issued to:
McShane Construction
Applicant
3-13-02
Dated
3. The project site is located at:
13 Sagamore Road
Street Address
29
Assessors Map/Plat Number
SE83-1585
DEP File Number
West Yarmouth
City/Town
128
Parcel/Lot Number
4. The final Order of Conditions was recorded at the Registry of Deeds for:
Leonard Gallagher
Property Owner (if different)
Barnstable
County Book
Certificate (if registered land)
5. This request is for certific
ation that (check one):
DEP File Number:
SE83-1585
Provided by DEP
02026
Zip Code
I
❑ 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 work regulated by the above -referenced Order
® the above -referenced Order of Conditions has lapsed and is therefore no longer valid, and the
work regulated by it was never started.
wpaform8a.doc •• rev. 5/29/14 Page 1 of 2
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 8A — Request for Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Town of Yarmouth Wetland By-law, Chapter 143
A. Project Information (cont.)
DEP He Number:
SE8O-1585
Provided by DEP
6. Did the Order of Conditions for this project, or the portion of the project subject to this request, contain
an approval of any plans stamped by a registered professional engineer, architect, landscape
architect, or land surveyor?
® Yes If yes, attach a written statement by such a professional certifying substantial
compliance with the plans and describing what deviation, if any, exists from the plans
approved in the Order.
❑ No
B. Submittal Requirements
Requests for Certificates of Compliance should be directed to the issuing authority that issued the final
Order of Conditions (OOC). If the project received an OOC from the Conservation Commission, submit
this request to that Commission. If the project was issued a Superseding Order of Conditions or was the
subject of an Adjudicatory Hearing Final Decision, submit this request to the appropriate DEP Regional
Office (see http://www.mass.gov/eea/agencies/massdep/about/contacts/find-the-massdep-regional-office-
for-your-city-or4own. html).
�vpaform8a.doc •• rev. 5/29/14 Page 2 of 2
939 main street rt 6a
yarmouth port
mass 02675
land court
surveys
structural design I March 30 , 2023
site planning
down cape engineering, inc
civil engineers & land surveyors
Yarmouth Conservation Commission
sewage system 1146 Route 28
designs
South Yarmouth, MA 02664
inspections
Re: Request for Certificate of Compliance
SE 83-1585 (13 Sagamore Road)
permits
Dear Commission Members:
tel. (508) 3624541
fax(508)362-9880
Daniel A. Ojala, P.E., P.L.S.
Arne H. Ojala, P.E., P.L.S.
Daniel E. Gonsalves, P.E., S.E
Craig J. Ferrari, E.I.T., S.E.
On 3/13/2002, the Commission issued an Order of Conditions to
McShane Construction for the above -referenced site, for the raze
and replace of a dwelling.
According to the owner's relatives, no work commenced on this
project under this Order.
We hereby request the issuance of a Certificate of Compliance at
this time.
Thank you for your consideration.
Very truly yours,
Daniel A. Ojala, PE,/PLS
Down Cape Engineering, Inc.
cc: Laurie and Mark Gallagher
encl.