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HomeMy WebLinkAboutRDA applicationCONSERVATION OFFICE Town of Yarmouth Conservation Commission 21-DAY WAIVER Please complete this form, sign at the bottom and return to the Conservation Office. I, rlcJ e� hereby waive the 21-day time period for a public hearing/meeting and/or issuance of the: OOC / DOA / COC / ORAD following receipt of my filing of a: ❑ Notice of Intent D' Request for Determination of Applicability ❑ Request for Certificate of Compliance ❑ Other by the Yarmouth Conservation Commission under Massachusetts General Laws, Ch. 131, sec. 40, and/or under Yarmouth Wetland Bylaw. The application was submitted on for work at /oZi✓'c% K tom; (project address/location) I am the: [Applicant ❑ Applicant's Representative ❑ Property Owner Signahrre by FFA Dat NOTE: Please be advised that you will be notified of the meeting date once this application has been assigned to a Conservation Meeting Agenda at the email address listed on the application. 21 day waiver oC:i r itwvue n may[;, ' [,!�} CONSERVATION MATTAC NE ./f� O F F I C L'. SC 3 t All filings must be made on Town of Yarmouth forms. The filing deadline is two weeks prior to the next scheduled Conservation Commission meeting for new applications. Failure to follow this Checklist shall result in an Administratively Incomplete Application and will not be advertised for a Public Hearing. Refer to the meeting schedule. Contact the Conservation Office if you need assistance. S y#m iCtr y ,aura ((v p t caa ` Hardcopy filing dropped off or mailed to the Conservation Office including: V 1 RDA Administrative Checklist 1 complete RDA application with original signatures (double sided). _ Detailed narrative of the project with sufficient information to enable the Commission to determine whether the proposed work will alter an area subject to protection. BVW delineation sheet(s), coastal bank calculation and other relevant material if applicable (not / applicable for flood zone only projects). Yarmouth Assessor's locator map highlightin parcel(s) where work is proposed, including map and parcel numbers o43 /Y%lo 1�qn/,-el 7/00 Z1 original and 5 photocopies of the plan/sketch, folded separately, right side out with title and address visible. All plans shall reference NAVD1988 unless otherwise noted. Landscape plans shall be detailed to show proposed and existing conditions, native species, size and spacing. - f 7< By-law filing fee: Separate check made payable to "Town of Yarmouth" 'l J�Legal ad fee: Separate check made payable to "Town of Yarmouth" Please list project property's street address on checks. Refer to Fee Schedule. Digital and DEP filing A pdf of the entire application emailed to bdirienzo(d.)yarmouth.ma.us, kbrooks(d_)yarmouth.ma.us and DEP Southeast Region at SERO NOI(a)mass.gov in the same email. Subject line shall be "YARMOUTH - RDA — Street Address - Applicant Name" Please list project property's street address in the pdf file name. IniNd below tt' (' I CERTIFY that all on -site requirements will be completed by noon on the Friday prior to the hearing date. All proposed structures must be staked, and all relevant resource areas and buffer zones must be staked or flagged. Please consult the Yarmouth Wetland Regulations, page 17. If the applicant is NOT the property owner: Please submit a signed Site Access Authorization Form; AND The owner must be sent a copy of the application via Certified Mail on the same day it is filed with this office. Please submit a copy of the Certified Mail receipt with application. If Applicable Certified Mail Receipt for Massachusetts Natural Heritage and Endangered Species Program Certified Mail Receipt for Massachusetts Division of Marine Fisheries. If filing via email, CC bdirienzo(@yarmouth.ma.us and kbrooks(aDvarmouth.ma.us Yarmouth Conservation Commission • 1 146 Route 28 • South Yarmouth, MA 02664-4492 Tel. (508)-398-2231 Ext. 1288 • Fax (508)-398-0836 • TTD# (508) 398-2231 • bdirienzo(d� a�uth.ma.us Rev. 3/2023 Massachusetts Department of Environmental Protection Lr'I'i Bureau of Water Resources - Wetlands WPA Form1- Request for Determination of ApplicabilityMunicipality Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. General Information Important: 1 . Appl� nt: When filling out forms on the r` PCrgu/ computer, use only First Name Last Name the tab key to move / P ,/6 Q,-n �` your cursor - do not � J use the return key. Address 1 J/ M 0,9673 reb City/Town State Zip Code - cP0 4/(�? Do ,41eySlar4lc e Phone Number Fm it Address 2. Property Owner (if different from Applicant): First Name Last Name Address City/Town State Zip Code Phone Number Email Address (if known) 3. Representative (if any) How to find Latitude and Longitude and how to convert to decimal degrees First Name Company Name Address City/Town Phone Number B. Project Description Last Name State Email Address (if known) Zip Code a. Project Location (use maps and plans to identify the location of the area subject to this request): / a &owe5 4 .r Street Address City/Town //. C 0 / 6 /V 2 . 7.3S,7 7 Latitude Degrees Format with 5 digits after decimal Longitude (Decimal Degrees Format with 5 digits after e.g. XX.XXXXX) decimal e.g.-XX.XXXXX) Assessors' Map Number Assessors' Lot/P cel Number b. Area Description (use/eydditional paper, if necessary): D L�J CJI / 1 C'-t _ _ c. Plan and/or Map Reference(s): (use additional paper if necessary) Title ". /0-N Lnc Title Date wpaformt.doc • rev. 4/10/2023 WPA Form 1 — Request for Determination of Applicability • Page 1 of 3 Massachusetts Department of Environmental Protection \ �< Bureau of Water Resources - Wetlands WPA Form 1- Request for Determination of Applicability t . Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Municipality B. Project Description (cont.) .'' .. /a. Activity/Work Description Luse additional paper and/or provide plan(s) of Activity, if necessary): V"2 q-,'C ©nq�rl d �, iGf P/1 , ivn oaer r4 4f� hg i� r cr�✓17. tr,%jh'h Ju�rrcY� // Pvr� f �. 8 on� d�j�/f •/rl� td �i ✓v/WI.UM. ��o✓%� �W ���ohe up 4✓`P OQ��i'1 ���vPh��'hGY .�/frX/:s'I f­,r ,,l Jae "eWJo✓Poo, b. Identify provisions of the Wetlands Protection Act or regulations which may exempt the applicant from having to file a Notice of Intent for all or part of the described work (use additional paper, if necessary). 3. a. If this application is a Request for Determination of Scope of Alternatives for work in the Riverfront Area, indicate the one classification below that best describes the project. ❑ Single family house on a lot recorded on or before 8/1/96 ❑ Single family house on a lot recorded after 8/1/96 ❑ Expansion of an existing structure on a lot recorded after 8/1/96 ❑ Project, other than a single-family house or public project, where the applicant owned the lot before 8/7/96 ❑ New agriculture or aquaculture project ❑ Public project where funds were appropriated prior to 8/7/96 ❑ Project on a lot shown on an approved, definitive subdivision plan where there is a recorded deed restriction limiting total alteration of the Riverfront Area for the entire subdivision ❑ Residential subdivision; institutional, industrial, or commercial project ❑ Municipal project ❑ District, county, state, or federal government project ❑ Project required to evaluate off -site alternatives in more than one municipality in an Environmental Impact Report under MEPA or in an alternatives analysis pursuant to an application for a 404 permit from the U.S. Army Corps of Engineers or 401 Water Quality Certification from the Department of Environmental Protection. b. Provide evidence (e.g., record of date subdivision lot was recorded) supporting the classification above (use additional paper and/or attach appropriate documents, if necessary.) wpaforml.doc • rev. 4/10/2023 WPA Form 1 — Request for Determination of Applicability • Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Water Resources - Wetlands WPA Form 1- Request for Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Municipality B. Project Description (cont.) 2. a. Activity/Work Description (use additional paper and/or provide plan(s) of Activity, if necessary): b. Identify provisions of the Wetlands Protection Act or regulations which may exempt the applicant from having to file a Notice of Intent for all or part of the described work (use additional paper, if necessary). 3. a. If this application is a Request for Determination of Scope of Alternatives for work in the Riverfront Area, indicate the one classification below that best describes the project. ❑ Single family house on a lot recorded on or before 8/1/96 ❑ Single family house on a lot recorded after 8/1/96 ❑ Expansion of an existing structure on a lot recorded after 8/1/96 ❑ Project, other than a single-family house or public project, where the applicant owned the lot before 8/7/96 ❑ New agriculture or aquaculture project ❑ Public project where funds were appropriated prior to 8/7/96 ❑ Project on a lot shown on an approved, definitive subdivision plan where there is a recorded deed restriction limiting total alteration of the Riverfront Area for the entire subdivision ❑ Residential subdivision; institutional, industrial, or commercial project ❑ Municipal project ❑ District, county, state, or federal government project ❑ Project required to evaluate off -site alternatives in more than one municipality in an Environmental Impact Report under MEPA or in an alternatives analysis pursuant to an application for a 404 permit from the U.S. Army Corps of Engineers or 401 Water Quality Certification from the Department of Environmental Protection. b. Provide evidence (e.g., record of date subdivision lot was recorded) supporting the classification above (use additional paper and/or attach appropriate documents, if necessary.) wpaforml.doc • rev. 4/10/2023 WPA Form 1 — Request for Determination of Applicability • Page 2 of 3 A 11 Massachusetts Department of Environmental Protection Bureau of Water Resources - Wetlands WPA Form 1- Request for Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Municipality C. Determinations I request the make the following determination(s). Check any that apply: Conservation Commission ❑ a. whether the area depicted on plan(s) and/or map(s) referenced above is an area subject to jurisdiction of the Wetlands Protection Act. R(b. whether the boundaries of resource area(s) depicted on plan(s) and/or map(s) referenced above are accurately delineated. ❑ c. whether the Activities depicted on plan(s) referenced above is subject to the Wetlands Protection Act and its regulations. ❑ d. whether the area and/or Activities depicted on plan(s) referenced above is subject to the jurisdiction of any municipal wetlands' ordinance or bylaw of: Name of Municipality ❑ e. whether the following scope of alternatives is adequate for Activities in the Riverfront Area as depicted on referenced plan(s). D. Signatures and Submittal Requirements I hereby certify under the penalties of perjury that the foregoing Request for Determination of Applicability and accompanying plans, documents, and supporting data are true and complete to the best of my knowledge. I further certify that the property owner, if different from the applicant, and the appropriate DEP Regional Office were sent a complete copy of this Request (including all appropriate documentation) simultaneously with the submittal of this Request to the Conservation Commission. Failure by the applicant to send copies in a timely manner may result in dismissal of the Request for Determination of Applicability. Signatures: I also understand that notification of this Request will be placed in a local newspaper at my expense in accordance with Se on 10.05(3)(b)(1) of the Wetlands Protection Act regulations. 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