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Home My WebLink AboutCRUZ revised DEP formP-ev-,�,a -ol FL-uc- Jlzn) Massachusetts Department of Environmental Protection eDEP Transaction Copy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: NORTON010 Transaction ID: 1581665 Document: WPA Form 3 - NOI Size of File: 247.36K Status of Transaction: In Process Date and Time Created: 6/2112023:11:35:06 PM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy" from the Current Submittals page. Massachusetts Department of Environmental Provided byMassDEP: Protection MassDEP File #: Bureau of Resource Protection - Wetlands eDEP Transaction #:1581665 WPA Form 3 - Notice of Intent City/Town:YARMOUTH Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A.General Information 1. Project Location: a. Street Address b. City/Town d. Latitude f Map/Plat # 2. Applicant: W Individual F Organization 52 PRINCE ROAD YARMOUTH 41.65027N 29 a. First Name PAUL AND NANCY a Organization d. Mailing Address 574 SLOCUM RD e. City/Town NORTH DARTMOUTH h. Phone Number 774-930-5339 3.Property Owner: fi more than one owner a. First Name c. Organization d. Mailing Address e. City/Town h. Phone Number 4.Representative: a. First Name c. Organization d. Mailing Address e. City/Town h.Phone Number PAUL AND NANCY c. Zip Code e. Longitude g.Parcel/Lot # b.Last Name CRUZ 02673 70.25696W 88 f. State MA g. Zip Code 02747 i. Fax j. Email peruz@ccstaffnet b. Last Name CRUZ 574 SLOCUM RD NORTH DARTMOUTH f State MA g. Zip Code 02747 774-930-5339 i. Fax j.Email pcmz@ccstaffnet ROY b. Last Name OKUROWSKI WRS ENGINEERING 67 STETSON STREET HYANNIS f State MA 508-776-0956 LFax g. Zip Code 02601 j Email royokurowsld@gmail.com 5.Total WPA Fee Paid (Automatically inserted from NOI Wetland Fee Transmittal Form): a.Total Fee Paid 312.00 b.State Fee Paid 143.50 c.City/Town Fee Paid 168.50 6.General Project Description: PROPOSED PIER AND LIFT 7a.Project ype: Single Family Home 2. i- Residential Subdivision 3'r-� imited Project Driveway Crossing 4. r Commercialllndustrial S. Dock/Pier 6. t- Utilities 7. r Coastal Engineering Structure 8. r Agriculture (eg., cranberries, forestry) 9.>-Transportation 10. i Other 7b.Is any portion of the proposed activity eligible to be treated as a limited project subject to 310 CMR 10.24 (coastal) or 310 CMR 10.53 (inland)? Page 1 of 7 * ELECTRONIC COPY Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File #: Bureau of Resource Protection - Wetlands eDEP Transaction #:1581665 WPA Form 3 - Notice of Intent CitpTown:YARMOU M Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 1. i Yes W No If yes, describe which limited project applies to this project: 2. Limited Project 8.Property recorded at the Registry of Deeds for: a.County: b.Certifiicate: c.Book: d.Page: BARNSTABLE 33762 139 BARNSTABLE 146 135 B. Buffer Zone & Resource Area Impacts (temporary & permanent) I .Buffer Zone & Resource Area Impacts (temporary & permanent): r This is a Buffer Zone only project -Check if the project is located only in the Buffer Zone of a Bordering Vegetated Wetland, Inland Bank, or Coastal Resource Area. 2.1n1and Resource Areas: (See 310 CMR 10.54 - 10,58, if not applicable, go to Section B.3. Coastal Resource Areas) Resource Area Size of Proposed Alteration Proposed Replacement (if any) a. F Bank 1. linear feet 2. linear feet b. - Bordering Vegetated Wetland 1. square feet 2. square feet c. r Land under Waterbodies and Waterways 1. Square feet 2. square feet 3. cubic yards dredged d. F Bordering Land Subject to Flooding 1. square feet 2. square feet 3. cubic feet of flood storage lost 4. cubic feet replaced e. r- Isolated Land Subject to Flooding 1. square feet 2. cubic feet of flood storage lost 3. cubic feet replaced £ !- River&ont Area 1. Name of Waterway (if any) 2. Width of River&ont Area (check one) f 25 ft. - Designated Densely Developed Areas only i` 100 ft. - New agricultural projects only T- 200 ft. - All other projects 3. Total area of Riverf xmt Area on the site of the proposed project square feet 4. Proposed Alteration of the Riverfront Area: a. total square feet b. square feet within 100 ft. c. square feet between 100 ft. and 200 ft. Page 2 of 7 * ELECTRONIC COPY Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File #: Bureau of Resource Protection - Wetlands eDEP Transaction #:1581665 WPA Form 3 - Notice of Intent City/Town:YARMOUTH Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 5. Has an alternatives analysis been done and is it attached to this NOV 6. Was the lot where the activity is proposed created prior to August 1,1996? 3- Yes No Yesr-No 3.Coastal Resource Areas: (See 310 CMR 10.25 - 10.35) Resource Area Size of Proposed Alteration Proposed Replacement (if any) a. F Designated Port Areas Indicate size under Land under the ocean below, b. % Land Under the Ocean 14.14 t i 1' (ii 1-' S 1. square feet 2. cubic yards dredged c. F Barrier Beaches Indicate size under Coastal Beaches and/or Coatstal Danes, below d. r Coastal Beaches 3.14 1. square feet 2. cubic yards beach nourishment e. F Coastal Dunes 1. square feet 2. cubic yards dune nourishment f fi Coastal Banks 1. linear feet g. r- Rocky Intertidal Shores / 1. square feet h VSalt Marshes 3, i q 0 p � 1. square feet 2. sq ft restoration, rehab, crea. i t- Land Under Salt Ponds 1. square feet 2. cubic yards dredged j. , d Containing Shellfish + 1 q L 121irW) 1. square feet k. r- Fish Runs Indicate size under Coastal Banks, Inland Bank, Land Under the Ocean, and/or inland Land Under Waterbodies and Waterways, above 1, cubic yards dredged 1 W Land Subject to Coastal 454 Storm Flowage 1. square feet 4.Restoration/F.nhancement r- Restoration/Replacement 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.2.b or B.3.h above, please entered the additional amount here. a. square feet of BV W b. square feet of Salt Marsh 5.Projects Involves Stream Crossings f- Project Involves Streams Crossings Page 3 of 7 * ELECTRONIC COPY Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File #: Bureau of Resource Protection - Wetlands eDEP Transaction #:1581665 WPA Form 3 - Notice of Intent City/Town.YARMOUTH Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 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. Other Applicable Standards and Requirements Streamlined Massachusetts Endangered Species Act/Wedands Protection Act Review 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 of Endangered Species program (NHESP)? a. F Yes W No ff yes, include proof of mailing or hand delivery of NOI to: Natural Heritage and Endangered Species Program Division of Fisheries and Wildlife 1 Rabbit Hill Road Westborough, MA 01581 b. Date of map:FROM MAP VIEWER If yes, the project is also subject to Massachusetts Endangered Species Act (MESA) review (321 CMR 10.18).... c. Submit Supplemental Information for Endangered Species Review * (Check boxes as they apply) 1.1- Percentage/acreage of property to be altered: (a) within Wetland Resource Area percentage/acreage (b) outside Resource Area percentagelacreage 2.1-- Assessor's Map or right-of-way plan of site 3. I- Project plans for entire project site, including wetland resource areas and areas outside of wetland jurisdiction, showing existing and proposed conditions, existing and proposed tree/vegetation clearing line, and clearly demarcated limits of work ** a. F Project description (including description of impacts outside of wetland resource area & buffer zone) b. r Photographs representative of the site c. l` MESA filing fee (fee information available at: http://www.mus.2ov/eea/agencies/dfg/dfw/natural-hcntaae/regulatory- review/mass-endangered-species-act-mesa/mesa-fee-schedule.hh l ) Make check payable to "Natural Heritage & Endangered Species Fund" and mail to NHESP at above address Projects altering 10 or more acres of land, also submit: d. F Vegetation cover type map of site e. F Project plans showing Priority & Estimated Habitat boundaries d. OR Check One of the following 1. r- Project is exempt from MESA review. Attach applicant letter indicating which MESA exemption applies. (See 321 CMR 10.14, http://www.mass.govleea/agencies/dfg[dfw/taws-regulationslcmr/321-cmr-1000-massachusetts-endangered- Vgcies-act.html#1 0.14; the NOI must still be sent to NHESP if the project is within estimated habitat pursuant to 310 CMR 10.37 and 10.59.) 2. r Separate MESA review ongoing. a. NHESP Tracking Number b. Date submitted to NHESP Page 4 of 7 * ELECTRONIC COPY Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File #: Bureau of Resource Protection - Wetlands eDEP Transaction #:1581665 WPA Form 3 - Notice of Intent City/rown:YARMOUTH Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 3. r Separate MESA review completed Include copy of NHESP "no Take" determination or valid Conservation & Management Permit with approved plan * Some projects not in Estimated Habitat may be located in Priority Habitat, and require NHESP review... 2. For coastal projects only, is any portion of the proposed project located below the mean high waterline or in a fish run? a. F Not applicable - project is in inland resource area only b. tv Yes f" No 117yes, include proof of mailing or hand delivery of NOI to either: South Shore - Cohasset to Rhode Island, and the Cape & Islands: Division of Marine Fisheries - Southeast Marine Fisheries Station Attn: Environmental Reviewer 836 S. Rodney French Blvd New Bedford, MA 02744 North Shore - Hull to New Hampshire: Division of Marine Fisheries - North Shore Office Attn: Environmental Reviewer 30 Emerson Avenue Gloucester, MA 01930 If yes, it may require a Chapter 91 license. For coastal towns in the Northeast Region, please contact MassDEP's Boston Office. For coastal towns in the Southeast Region, please contact MassDEP's Southeast Regional office. 3. Is any portion of the proposed project within an Area of Critical Environmental Concern (ACEC)? a. r Yes F%i No b. ACEC Name If yes, provide name of ACEC (see instructions to WPA Form 3 or DEP Website for ACEC locations). Note: electronic filers click on Website. 4. Is any portion of the proposed project within an area designated as an Outstanding Resource Water (ORW) as designated in the Massachusetts Surface Water Quality Standards, 314 CMR 4.00? a. t` Yes S-e No 5. Is any portion of the site subject to a Wetlands Restriction Order under the Inland Wetlands Restriction Act (M.G.L.c. 131, § 40A) or the Coastal Wetlands Restriction Act (M.G.L.c. 130, § 105)? a. f ° Yes fv- No 6. Is this project subject to provisions of the MassDEP Stormwater Management Standards? a. F 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: 1. Applying for Low Impact Development (LID) site design credits (as described in Stormwater Management Handbook r Vol.2, Chapter 3) 2. A portion of the site constitutes redevelopment r- 3. Proprietary BMPs are included in the Stormwater Management System r b. Fv- No, Explain why the project is exempt: 1. Single Family Home r- Emergency Road Repair Page 5 of 7 * ELECTRONIC COPY Massachusetts Department of Environmental Provided by MassDEP: Protection MassDEP File #: Bureau of Resource Protection - Wetlands eDEP Transaction #:1581665 WPA Form 3 - Notice of Intent Citylfown:YARMOUTH Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 3. Small Residential Subdivision (less than or equal to 4 single-family houses or less than or equal to 4 units in multi -family r- housing project) with no discharge to Critical Areas. D. Additional Information 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 by regular mail delivery. 1. USGS or other map of the area (along with a narrative description, if necessary) containing sufficient information for the W 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 Fw [BV W] replication area or other mitigating measure) relative to the boundaries of each affected resource area 3. Identify the method for BV W and other resource area boundary delineations (MassDEP BV W Field Data Form(s). f— Determination of Applicability, Order of Resource Area Delineation, etc.), and attach documentation of the methodology. 4. List the titles and dates for all plans and other materials submitted with this NOI. Wo a. Plan Title: b. Plan Prepared By: c. Plan Signed/Stamped By: c. Revised Final Date: e. Scale: PROPOSED PIER AND BOAT LIFT (2 ROY OKUROWSKI 6-19-23 PLANS) 5. If there is more than one property owner, please attach a list of these property owners not listed on this form. r- 6. Attach proof of mailing for Natural Heritage and Endangered Species Program, if needed. r Attach proof ofmailing for Massachusetts Division of Marine Fisheries, if needed. ry 8. Attach NOI Wetland Fee Transmittal Form. 9. Attach Stormwater Report, if needed. F Page 6 of 7 * ELECTRONIC COPY Massachusetts Department of Environmental Provided by MassDEP: Protection MmDEP File #: Bureau of Resource Protection - Wetlands eDEP Transaction #:1581665 WPA Form 3 - Notice of Intent City/ ovuYARMOUTH Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 E. Fees 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 10gILl 2. Municipal Check Number i`'y 0 4. State Check„limber / 6. Payer name on check:First Name F. Signatures and Submittal Requirements 1 and 2 of the NOI Wetland Fee Transmittal Form) to confirm fee payment: 3. Check da %A,9 i a3 5. Check date 7. Payer name on check: Last Name 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. Paul Cruz 6/21 /2023 1. Signature of Applicant 2. Date Paul Cruz 6/21/2023 3. Signature of Property Owner(if different) 4. Date Roy Okurowski 6/21 /2023 5. Signature of Representative (if any) 6. Date For Conservation Commission: Two copies of the completed Notice of Intent (Form 3), including supporting plans and documents, two copies of the NOI Wetland Fee Transmittal Form, and the city/town 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 mail or hand delivery. Other: If the applicant has checked the "yes" box in Section C, Items 1-3, 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. Page 7 of 7 * ELECTRONIC COPY Massachusetts Department of Environmental Protection Provided byMassDEP: Bureau of Resource Protection - Wetlands MassDEP File #: WPA Form 3 - Notice of Wetland FeeTransmittal eDEP Transaction #:1581665 Form City/rown:YARMOUTH Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. Applicant Information 1. Applicant: a. First Name PAUL AND NANCY b.Last Name CRUZ c. Organization d. Mailing Address 574 SLOCUM RD e. City/Town NORTH DARTMOUTH f. State MA g, Zip Code 02747 h. Phone Number 7749305339 i. Fax j. Email peruz@ccstaff net 2.Pioperty Owner:(if different) a. First Name PAUL AND NANCY b. Last Name CRUZ c. Organization d. Mailing Address 574 SLOCUM RD e. City/Town NORTH DARTMOUTH f.State MA g. Zip Code 02747 h. Phone Number 7749305339 i.Fax j.Email pmz@ccstaffnet 3. Project Location: a. Street Address 52 PRINCE ROAD b. City/Town YARMOUTH Are you exempted from Fez? (- Note: Fee will be exempted if you are one of the following: • City/Town/County/District • Municipal Housing Authority • Indian Tribe Housing Authority • MBTA State agencies are only exempt if the fee is less than $100 B. Fees Activity Type N�be Activity Fee RF Multiplier Sub Total A.) WORK ON DOCKS, PIERS, REVETMENTS, 78 4.00 312.00 DIKES, ETC. (COASTAL OR INLAND). City/Town share of filling fee State share of filing fee Total Project Fee $168.50 $143.50 $312.00 Pago 1 of 1 * ELECTRONIC COPY