HomeMy WebLinkAboutBLD-23-005230 ONE & TWO FAMILY ONLY- BUILDING PERMIT
.
Town of Yarmouth Building Department of
1146 Route 28,South Yarmouth,MA 02664-4492 ''��
508-398-2231 ext. 1261 Fax 508-398-0836 gf`1rr��' s
Massachusetts State Building Code,780 CMR C_ --1 '
Building Permit Application To Construct, Repair, Renovate Or Demolish
a One-or Two-Family Dwelling
��� -a 3_, q t�Z 1�
This 'on For Official Use y
Building Permit Number: LI - V e U v Date Appli
Building Official(Print Name) ignature a R-. E V F.: D
SECTION 1:SITE INFORMATION , �.- ��,
1.1 Property Address: 1.2 Assessors Map&Parcel Numbers MAR 2 2 2023
143 PAWKANNAWKUT DR SOUTH YARMOUTH 25 23
1.1 a Is this an accepted street?yes no Map Number Parcel Number !J'L DING D E R T M E N T
1.3 Zoning Information: 1.4 Property Dimensions:
R-25
RES 13500 96.72
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards Rear Yard
Required I Provided Required Provided Required Provided
30' 39.7' 15' 22.1' 20' i 50.9'
1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System:
PublicV Private 0Zone: AE Outside Flood Zone? Municipal 0 On sae disposal system Ni
EL.11 Check if yes❑
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
CAPE COD OZ PROPERTY II LLC EAST FALMOUTH, MA 02536
Name(Print) City,State,ZIP
169 METOXIT RD 508-737-20E13 nUl-com
No.and Street Telephone Email Address
SECTION 3:DESCRIPTION OF PROPOSED WORK'(check all that apply)
New Construction 0 Existing Building Owner-Occupied 0 i Repairs(s) ❑ Alteration(s) 0 1 Addition i
Demolition Accessory Bldg. 0 Number of Units 1 Other ❑ Specify:
Brief Description of Proposed Work`:
171 sf addition to the rear of the property,interior and exterior renovations:siding,trim,floor,tile,kitchen;,bathrooms,insulation.
We are under the impression that the new energy code is being implemented in June,and we are in the rgancy period.
We are less than 50%of the building value with the renovation and thus not triggering any FEMA upgrades.
SECTION 4: ESTIMATED CONSTRUCTION COSTS. .
Item Estimated Costs: Official Use Only
(Labor and Materials)
1.Building $ 1 1. Building Permit Fee:$1 G to Indicate how fee is d - ;
I(Standard City/Town Application Fee
2.Electrical $ 0 Total Project Costa(Item 6)x multiplier x
3.Plumbing $ 2. Other Fees: $
4_Mechanical (HVAC) $ List tt 6' DV aii ISO
5.Mechanical (Fire $ I
Suppression) Total All Fees:$
Check No. CheckAmount Cash Amount
6_Total Project Cost: $ 210000 0 Paid in Full teli outstanding dance Due: )0
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor License(CSL)
Trevor Meyer, Meyer and Sons Builders CS-101957 9/272024
License Number Expiration Date
Name of CSL Holder
852 Main St List CSL Type(see below) u
No.and Street Type YP i Description ,
West Dennis, MA 02670 U ¢ Unrestricted(Buildings up to 35,000 cu.it)
City/Town,State,ZIP R E Restricted 1&2 Family Dwelling
M t Masoruy
RC ( Roofing Covering
WS yl Window and Siding
5087766027 SF Solid Fuel Burning Appliances
tmeyer@meyerandsons.com I Insulation
Telephone Email address D 1 Demolition
5.2 Registered Home Improvement Contractor(HIC)
Meyer and Sons Builders Inc 187252 3/19/25
HIC Company Name or HIC Registrant Name 1ITC Registration Number Expiration D
852 Main St tmeyer@rneyerandsonsaoom
No.and Street
West Dennis, MA 02670 5087766027 Email address
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
X No ❑
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
to act on my behalf,in all matters relative to work authorized by this building permit application.
see other sheet
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.
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
I. 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 not 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.stovIota Information on the Construction Supervisor License can be found at www.mass.eov/'dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) Habitable room count
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" i'
§TOWN OF IL'ARMO UT? _.
1146 Route 28, South Yarmouth, MA 02664
508-398-2231 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 143 PAWKANNAWKUT DR SOUTH YARMOUTH
Work Address
Is to be disposed of oat the following location: TOWN OF YARMOUTH
Said disposal site shall be a licensed solid waste facility as defined by M.G.L.
Ch. 111, §150A.
• -T \ 3/21/23
a*_Signature of App 'on Date
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!PIy� Commonwealth of Massachusetts
Division of Occupational Licensure
Board of Building Regulations and Standards
Cons ISrvisor
(;S-101957
fiNEVOR J IMO� 1 � ,f'ires: 09/27/2024
892 MAIN STREET '� f
•
WEST DENNfl1 MA 02% 410
Commissioner df/,
Pf
uocuslgn tnvelope lu:8b4126/9-5U2b-4Fyt-13151-:526tbA/tkriit9
To: Town of Yarmouth
From: Trevor Meyer
Meyer and Sons Builders, Inc.
RE: 143 Pawkannawkut South Yarmouth
To Whom It May Concern:
Jordan Fl i egel as Owner's Agent of the above-mentioned
property, hereby allow Meyer and Sons Builders Inc to act on my behalf in regard to all
matters pertaining to the building permit.
Any questions please call 508.776.6027
Jordan Fliegel
^DocuSigned by:
.lor 3/21/2023
�—J7vauDo irw6..
t The Commonwealth of Massachusetts
m�;: Department of Industrial Accidents
, Office of investigations
Lafayette City Center
2Avenue de Lafayette, Boston,MA 02111-1750
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): Meyer And Sons, Inc
Address:852 Main St
City/State/Zip: West Dennis MA 02670 Phone#:5083622922
Are you an employer?Check the appropriate box: Type of project(required):
1.Ill I am a employer with 5 4. ❑ I am a general contractor and I
employees (full and/or part-time).* have hired the sub-contractors 6. New construction
2.❑ I am a sole proprietor or partner listed on the attached sheet. 7. ❑■ Remodeling
shipand have no employees These sub contractors have
8. ❑Demolition
working for me in any capacity. employees and have workers'
comp. insurance.$ 9. ❑Building addition
[No workers' comp. insurance
required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
officers have exercised their 11.❑ Plumbing repairs or additions
3.❑ I am a homeowner doing all work
myself. [No workers' comp. right of exemption per MGL 12 ❑Roof repairs
insurance required.] t c. 152, §1(4),and we have no
employees. [No workers' 13.11]Other
comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all wirk and then hire outside contractors must submit a new affidavit indicating such.
:Contractors that check this box must attached an additional sheet show.ng the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide tt eir 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.
Insurance Company Name: Selective Insurance of America
Policy#or Self-ins. Lic.#:WC 9083575 Expiration Date: 10\28\23
Job Site Address: 143 Pawkannawkut Rd City/State/Zip:S Yarmouth, MA 02664
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that 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 pains and penalties of perjury that the information provided above is true and correct.
Signature: Trevor Meyer Digitally signed by 1 revor Meyer
g Date:2023.03.21 1':51:49-04'00' Date: 3/21/23
Phone#: 5087766027
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority(check one):
1 Board of Health 21:Building Department 3❑City/Town Clerk 4.0 Electrical Inspector 50Plumbing
Inspector 6.0Other
Contact Person: Phone#:
YARMOUTH WATER DIVISION
99 BUCK ISLAND ROAD
WEST YARMOUTH, MA 02673
PH.: 508.771 .7921
FAX: 508-771-7998
BUILDING PERMIT APPLICATION
DEPARTMENTAL SIGN OFF TRANSMITTAL SHEET
Bldg. Site Location 143 PAWKANNAWKIJT DR Map #: 25 Lot #: 23
Proposed Improvement: 171 sf addition to the rear of the property,interior and exterior renovations:siding,trim,floor,tile,kitchens,bathrooms,insulation.
Applicant: Trevor Meyer, Meyer and Sons Builders
Address 852 Main St West Dennis,MA 02670 Tel. #: 5087766027 Date Filed: 3/21/23
RESIDENTIAL AND / OR COMMERCIAL BUILDING
Water Department: Determines Compliance of Water Availability and or Existing Location
Engineering Department: Determines Compliance for Parking and Drainage
Conservation Commission: Determines Compliance to Wetlands Acts; i.e. If Lot(s) Border any Type of
Wetlands, Streams, Ponds, Rivers, Ocean, Bogs, Bays, Marshland, Etc...
Health Department: Determines Compliance to State and Town Regulations, i.e., Requirements
for Septage Disposal and other Public Health Activities
Fire Department: Determines Compliance to State and Town Requirements for Personal,
Safety, Property Protection;, i.e. Smoke Detectors, Sprinkler Systems, Etc...
T-=1 3/21/23
Signature of app Ica„- Date
PLEASE NOTE:
COMMENTS:
Reviewed by: Water Division Date
3/28/23,9:24 AM Mail-Sears,Tim-Outlook
143 Pawkannawkut Dr
Sears, Tim <tsears@yarmouth.ma.us>
Tue 3/28/2023 9:24 AM
To:Trevor Meyer <tmeyer@meyerandsons.com>
1 attachments(391 KB)
work in flood zone packet.PDF;
Trevor,
I have reviewed your application and there are some items needed.
{op, , �,,Y• ����e 0= 06 1^ �'�� v����
c 1. This property is in a flood zone. Attached is apacket to review,
p Y e ew, we need the cost worksheet filled
out along with the contractor and owners affidavits notarized and returned. The final affidavit will
IVbe required at the time of final inspection.
2. Health Department sign off(under review)
3. Water Department sign off
4. Conservation building transmittal
�5. Site plan needs to be stamped
6. The new Stretch Energy Code went into effect on Jan 1st. Existing buildings are now a part of the
new code. It appears that the scope of work falls under the new requirements. A HERS Certificate
will be needed
225 CMR 22: Massachusetts Residential Stretch Energy Code
R503.1.5 Level 3 Alterations or Change of Use.Alterations that meet the IEBC definition for Level 3
Alteration or the IRC definition for Extensive Alteration, exceeding 1,000 sq ft or exceeding 100% of the
existing conditioned floor area, shall require the dwelling unit to comply with the maximum HERS ratings
for alterations, additions or change of use shown in Table R406.5
IRC 2015 Appendix J
AJ501.3 Extensive alterations. Where the total area of all of the work areas included in the alteration
exceeds 50 percent of the area of the dwelling unit, the work shall be considered to be a reconstruction
and shall comply with the requirements of these provisions for reconstruction work.
Please submit these items for review
This email is considered a written denial of your permit application per Section 105.3.1 of the
Massachusetts State Building Code. Section 105.3.2 states in part that "an application for a permit for
any proposed work shall be deemed to have been abandoned 180 days after the date of filing, unless
such application has been pursued in good faith"
You may appeal this denial to the Building Code Appeals Board in accordance with M.G.L. c. 143 §100,
within 45 days of this notice.
https://outlook.office.com/mail/sentitems/id/AAQkADE3MDQ5NWZmLTkOYzItNDIwNi1 iMDQxLWNkMGQyNmE4NzE5NAAQAAa14dL%2FN6FBvc08B1... 1/2
3/28/23e:24Aw Mail'Sears,Tim'Outlook
Timothy Sears CB(J
Deputy Building Commissioner
Town ofYarmouth
50Q-39O'2I31 Ext. IZ59
mai|toftsears-A-yarnnouth.nna.us
_
hupo://buUook«ffino.00m/mai xAoE3mDQ5wvvzmLTk0vzxwDkwwi1iMoQxumwNNGQywmE4wzs5w*AOAxal4dL%2pw8FovoU8a1... 2/2
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9. 2-28-2O22 a 02 a 380
Massachusetts Department of Environmental Provided by MassDEP:
Protection MassDEP File#:083-2366
Bureau of Resource Protection-Wetlands eDEP Transaction#:1459308
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. ;I OOC b.i- Amended OOC
3.Applicant Details
a. First Name JORDAN b.Last Name FLIEGEL
c.Organization CAPE COD OZ PROPERTY 11 LLC
d.Mailing Address 169 METOXIT RD
e.City/Town EAST FALMOUTH f.State MA g.Zip Code 02536
4.Property Owner
a.First Name JORDAN b.Last Name FLIEGEL
c.Organization CAPE COD OZ PROPERTY II LLC
d.Mailing Address 169 METOXIT RD
e.City/Town EAST FALMOUTH f. State MA g.Zip Code 02536
5. Project Location
a.Street Address 143 PAWKANNAWKUT DRIVE
h.City;Town YARMOUTH c.Zip Code 02664
d. Assessors
tilap/Plat# 25 c.ParcelfLot# 23
f Latitude 41.64305N g.Longitude 70.21936W
6.Property recorded at the Registry of Deed for:
a.County b.Certificate c.Book d.Page
BARNSTABLE 35397 188
7.Dates
a.Date NOI Filed: 1 1/17/2022 b.Date Public Hearing 12/1/2022 c.Date Of 12/14/2022
Closed: Issuance:
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:
PROPOSED
ADDITION&
SEPTIC PLAN
PREPARED FOR JOHN L CHURCHILL
CAPE COD OZ JR.PLS,PE JC ENGINEERING,INC 11/16/2022 1"= 10"
PROPERTY II,LLC
AT 143
PAWKANNAWKUT
DRIVE
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
Page 1 of 11 *ELECTRONIC COPY
Massachusetts Department of Environmental Provided by MassDEP:
Protection MassDEP File#:083-2366
Bureau of Resource Protection-Wetlands eDEP Transaction#:1459308
WPA Form 5-Order of Conditions Cih/Town:I'ARMOUTII
Massachusetts Wetlands Protection Act M.G.L.c. 131,§40
application and presented at the public hearing,this Commission finds that the areas in which work is proposed is
significant to the following interests of the Wetlands Protection Act.
Check all that apply:
a. R7 Public Water Supply b. r Land Containing Shellfish c.Fi Prevention of Pollution
d.go- Private Water Supply e. r Fisheries
Fi Ground Water Supply g fl ProtectiondC of Wildlife Habitat
g.
pp y h. r� Storm Damage Prevention i. Ni Flood Control
2.Commission hereby finds the project,as proposed,is:
Approved subject to:
a.r 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.r 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).
3 r Buffer Zone Impacts:Shortest distance between limit of project disturbance and the wetland
resource area specified in 310CMR10.02(1)(a).
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
e.c/y dredged f.c/y dredged
7.r Bordering Land Subject to Flooding
Page 2 of 11 *ELECTRONIC COPY
Massachusetts Department of Environmental Provided by MassDEP:
Protection MassDEP File#:083-2366
Bureau of Resource Protection-Wetlands eDEP Transaction#:1459308
WPA Form 5-Order of Conditions City/Town:YARMOUTH
Massachusetts Wetlands Protection Act M.G.L.c. 131, §40
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.f Riverfront Area 42 42
a.total sq.feet b.total sq.feet
Sq ft within 100 ft 42 0
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.E 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
a.square feet b.square feet c.square feet d.square feet
Page 3 of 11 *ELECTRONIC COPY
Massachusetts Department of Environmental Provided by MassDEP:
Protection MassDEP File#:083-2366
Bureau of Resource Protection-Wetlands eDEP Transaction#:1459308
WPA Form 5-Order of Conditions Cityirown YAItMOVTH
Massachusetts Wetlands Protection Act M.G.L.c. 131,§40
20.n Fish Runs Indicate size under Coastal Banks,inland Bank,Land Under the
Ocean,and/or inland Land Under Waterbodies and Waterways,
above
c.c/y dredged d.c/y dredged
21.to Land Subject to Coastal Storm Flowage 42 42
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.
E 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 Massachusefts 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 pennittee 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.
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.
Page 4 of 11 *ELECTRONIC COPY
Massachusetts Department of Environmental Provided by Masslif;P:
Protection MassDE.P File a:0$3 33:
Bureau of Resource Protection-Wetlands eDEP Transaction a:1439AM
WPA Form 5-Order of Conditions Cay/forovn.4'AItM tfflJ
Massachusetts Wetlands Protection Act M.O,L,c. 131,$40
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
priyerty. In the ease 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 oldie 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
is the commencement or work::
I ti: A sign shall be displayed at the site not less then two square feet or more than three square feet in size bearing
the cords.
Massachusetts Department of Environmental Protection"
lor'MassDEP"j
File Number:"O83-236"
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 SA)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 lithe 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,
IS, 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(I) r is not(2)w 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
and,if applicable,the Stormwater Pollution Prevention Plan required by the National Pollutant Discharge
Elimination System Construction General Permit as required by Stonnwater Standard S.Construction period
erosion,sedimentation and pollution control measures and best management practices(BMPs)shall remain
Page 5 off 11 '`ELECTRONIC CC,Py
Massachusetts Department of Environmental Provided by MassDEP:
Protection MassDEP File#:083-2366
Bureau of Resource Protection-Wetlands eDEP Transaction#:1459308
WPA Form 5-Order of Conditions oin/TONnYMovTi1
Massachusetts Wetlands Protection Act M.G.L.c. 131,§40
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
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
Page 6 of 11 *ELECTRONIC COPY
Massachusetts Department of Environmental Provided by MassDEP:
Protection MassDEP File#:083-2366
Bureau of Resource Protection-Wetlands eDEP Transaction#:1459308
WPA Form 5-Order of Conditions ciryrrown:YARMouTH
Massachusetts Wetlands Protection Act M.G.L.c. 131,§40
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 stonnwater 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.
I) 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
l.Is a municipal wetlands bylaw or ordinance applicable?P Yes No
2.The Conservation Commission hereby(check one that applies)z
a.r DENIES the proposed work which cannot be conditioned
to meet the standards set forth in a municipal ordinance
or bylaw specifically:
1.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. APPROVES the proposed work,subject to the
following additional conditions.
1.Municipal Ordinance or YARMOUTH
Bylaw WETLAND BYLAW 2.Citation CHAPTER 143
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 OF CONDITIONS"ON THE JOB Si Th 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
Page 7 of 11 *ELECTRONIC COPY
MassaetiWiett6 Department of Environmental Provided by Ma DEP::
Protection MYsiDEP File#:081-3366
Bureau of Resource Protection-Wetlands eDEP Tr4n action#:1459MJ$
WPA Form 5-Order of Conditions C"y�4 'Y' M°> I
Msgssehusettb Wrtlrnds Protection Act M,O,L,c, 131,#40
"ORDERS",A FINE OR BOTH, .___ 3:THE CONSERVATION COMMISSION,ITS
MANTIS)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
CONDTIIONS","BY-LAWS"AND"REGULATIONS".COMMISSION MEMBERS AND THE CONSERVATION
ADMINISTRATOR MAY ACQUIRE ANY INFORMATION,MEASUREMENTS,PHOTO,
OBSERVATIONS AND/OR MATERIALS OR MAY REQUIRE THE SUHMITFAL OF ANY
DATA/INFORMATION DEEMED NECESSARY BY THIS COMMISSION FOR THAT EVALUATION..
4. A
PRECONSTRUCTION REVIEW SHALL BE ARRANGED H'r "11IF CON"IRAC1 OR WITH THE
CONSERVATION ADMINISTRATOR AND SHALL OCCUR PRIOR'10 fit (Tom MLN 'OFA 4y
WORK, ANY CHANGE IN THEAPPROVED PLANS)SHALL REQUIRE THE
APPLICANT TO FILE,IN WRI I IN(;,A N(YIICE OF PROJECT CHANGE WITH THIS COMMISSION:THE
COMMISSION WILL DETERMINE'I i 1 E 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 PLANS),ALL
WORK WILL IMMEDIATELY CEASE UNTIL THE PROJECT IS REAPPROVED BY THE COMMISSION..
— —— -- 6.
THE"ORDER OF CONDITIONS"1S 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 oITENP PILING.
7,NONCOMPLIANCE WITH THESE CONDITIONS SHALL
CONSTIT'I.ITE GROUNDS FOR AN ENFORCEMENT ORDER AND POSSIBLE FINES.FINES SHALL NOT
E:(CI I I)¶100:00 PER DAY/PER VI�)i.A L ION,— — 4.A"WORK LIMIT"LINT SHALL BE
ESTABLISHED WITH EROSION CONTROLS(I.E.STRAW BALES,S"I AKLI)FILTER I ABIZJC,13ARJC
MULCH,'?SILT SACKS?,PRODLI I S Si vl)I.w'ITI I IZI( I STR.vv1� �yNI)(II II.R A I;#;D i,RLE FIODUCTS
OR APPROVED BY THE COMMISSION):HAY I3A LES ARE NOT ALLOWED:IT IS THE APPLICANTS
RESPONSIBILITY TO IMPLEMENT AND MAINTAIN APPROPRIATE AND ADEQUATE EROSION
CONTROLS MEASURES THROUGHOUT THE CONSTRUCTION PROCESS.
9,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, _ 10,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. 11:DEBRIS,
INCLUDING L - - -.-- -iTTER,SHALL BE PICKED UP IMMEDIATELY,ANY EXCESS MATERIAL THAT IS
EXCAVATED 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, 12:WASHING
OF EQUIPMENT/TOOLS SHALL BE DONE OFF-SITE OR HANDLED IN A MANNER APPROPRIATE BY
THE CONSERVATION ADMINISTRATOR,
13,REFUELED,NOR SHALL FUEL BE STORED WITHIN 100 FEET OF A RESOURCE UAREA,ENT SHALL BE
14,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
Page S of I I *ELECTRONIC COPY
Massachusetts Department of Environmental Provided by MassDEP::
Protection MassDEP File#: 83=2366
Bureau of Resource Protection-Wetlands eDEP Manselion#::14593O$
WPA Form S-Order of ConditionsCity/Town:YARMOUTH
Massachusetts Wetlands Protection Act M.B.L.c. 131,#401
SHALL BE CARRIED OUT IN ORDER TO MINIMIZE EROSION. ------ 1S,NO LAWN SHALL
EXIST BEYOND 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 1 b:
LANDSCAPE DEBRIS,INCLUDING LEAVES,GRASS CLIPPINGS,BRUSH,OR OIlIER SHALL NOISE
ALLOWED WITHIN THE WETLAND RESOURCE AREA,THIS IS AN ON-GOING CONDITION THAT DOES
NOT EXPIRE WITH THE ISSUANCE OF A CERTIFICATE,OF COMPLIANCE,
17,A MITIGATION PLAN SHOWING 84 SQUARE FEET OE REQUIRED
MITIGATION CONSISTING OF NATIVE PLANT SPECIES SIIAI.L BE SUBMI El ED FOR APPROVAL BY THE
CONSERVATION ADMINISTRATOR. 1 K MITIGATION WILL BE PLANTED ADJACENT TO
THE RESOURCE AREA PER TI I APPROVED PLAN.I IRTI EIR��E 1 f,RATJc)\ y'1'1`1IIrN !Ill
RESTORATION OR MITIGATION AREA IS PROHIBIT,' [),EXCEPT AS MAY BE REQUIRED TO MAINTAIN
THE AREA IN ITS RESTORED OR MITIGATED CONDITION,THIS IS AN ON430ING CONI3mON,IN=
PERPETUITY,THAT DOES NOT EXPIRE WITH THE ISSUANCE OF A CEE I I IICATE OF COMPLIANCE:
PRIOR TO REQUESTING THE ISSUANCE OF THE CERTIFICATE OF COM PI,i.\.NCE,THE APPLICANT
SMALL,DEMONSTRATE THE MITIGATION HAS BEEN SUCCESSFULLY COMPL LEAST
TWO GROWING SEASONS.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 REPLACI MI=N'7
19,THE UNPER.MI"I"LED GAZEBO SHALL BE REMOVED
BY MAY I, 2023. _ 20,FLOATS SIIALL BE RI MOVED DITRIN(
THE NON—BOATING SEASON, 21,A STAEPI I)"AS BUST
PLAN"SHALL HE CERTD1E )BY THE DESIGN ENGINEER(MASSACHUSETTS REGISTERED
PROFESSIONAL ENGINEER OR LAND SURVEYOR)AND WILL CERTIFY THAT THIS PROJECT HAS
BEEN COMPLETED IN ACCORDANCE WITH THE"ORDER OF CONDITIC)ti S"BEFORE A CERTIFICATE
OF COMPLIANCE WILL BE ISSUED,TH%';AS-BUILT PLAN SHALL INDICATE ME STRUM
LOCATION,GRADIENTS,DISTANCES TO'11llE RESOURCE AREAS,AND OTHER PERTINENT
INFORMATION DESCRIBED IN THE APPLICATION AND APPROVED PLANS,ANY DEVIATION FROM
THE APPROVED PLAN SHALL BE IDENTIFIED, 22.
UPON COMPLETION OF THE PROJECT,A"REQUEST FOR A"CERTIFICATE OF COMPLIANCE"SHALL
BE SUBMITTED BY THE APPLICANT TO THE CONSERVATION COMMISSION FOR REVIEW..THE
ORDER OF CONDITIONS"SHALL BE CONSIDERED INCOMPLETE UNTIL THE"CERTIFICATE OF
COMPLIANCE"IS ISSUED BY THE CONSERVATION COMMISSION AND RECORDED AT THE REGISTRY
OF DEEDS,
Page 9 of I I ELECI`RO1IC COPY
Massachusetts Department of Environmental Providcdby MassDEP;
Protection MassDCP File#:
llureau or Resource Protection-Wetlands tDEP Transadrierrr#: ►tJ GOCA
WPA Form 5-Order of Conditions Ciry/fc»vnilAttMOUftI
11nssachuxetts Wetlands Protection Act M,G.1,,c, 131,*40
F.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
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 5
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 C
`i ..7(2/ •
4-1zt- '
by hand delivery on 'Vby certified mail,return receipt requested,on
Date Date `Z l tI `zo vz-
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 edit
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 10ofA*ELECTRONIC COM'
Massachusetts Department of Environmental Provided by MassDEP:
Protection MassDEP File#:083-2366
Bureau of Resource Protection-Wetlands eDEP Transaction#:1459308
WPA Form 5-Order of Conditions City/Iown:YARMotTIH
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 12/14/2022
Conditions,the Amended Order expires on the same date as the original Order of I.Date of Original Order
Conditions.
Please indicate the number of members who will sign this form.This Order must 5
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: Elinor Lawrence
Ed Hoopes Paul Huggins
Rick Bishop
David Bernstein
r 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
(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
Page 10 of 11 *ELECTRONIC COPY
Massachusetts Department of Environmental Provided by MassDEP:
Protection MassDEP File#:083-2366
Bureau of Resource Protection-Wetlands eDEP Transaction#:1459308
WPA Form 5-Order of Conditions city/rown:YARMotrtH
Massachusetts Wetlands Protection Act M.G.L.c. 131,§40
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:
143 PAWKANNAWKUT DRIVE 083-2366
Project Location MassDEP File Number
Has been recorded at the Registry of Deeds of:
County Book Page
for:
Property Owner JORDAN FLIEGEL
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
Signature of Applicant Rev 4,1/2010
Page 11 of 11 *ELECTRONIC COPY
: � Yr',� TOWN OF YARMOUTH
1 HEALTH DEPARTMENT
y h4,"i
' '�.[N'` PERMIT APPLICATION SIGN OFF TRANSMITTAL SHEET
To be completed by Applicant:
Building Site Location: 143 PAWKANNAWKUT DR
Proposed Improvement:
171 sf addition to the rear of the property, interior and exterior renovations:siding,trim,floor,tile, kitchens, bathrooms,kit:Mahon.
Applicant:Trevor Meyer, Meyer and Sons Builders Tel.No.:5087766027
Address:852 Main St West Dennis, MA 02670 Date Filed: 3121/23
**If you would like e-mail notification of sign off,please provide e-mail address:tmeyer@meyerandsons.com
Owner Name:Cape Cod Oz Property II LLC
Owner Address: 169 Metoxit Rd Falmouth , MA 02536 Owner Tel.No.: 508-737-2083
RESIDENTIAL AND/OR COMMERCIAL BUILDING
HEALTH DEPARTMEN T: Determines Compliance to State and Town Regulations;i.e.,Requirements
n gnia-=,, For Septage Disposal and other Public Health Activities.
MAR 2 2 20Z3 Please submit three (3) copies of plans,to indude:
HEALTH DEPT. (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: 4?/Y ) DATE: ,5 —' 7 ' ,.„,23
PLEASE NOTE
COMMENTS/CO ITIONS: