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Home My WebLink AboutRDA applicationwpaform1.doc • rev. 4/28/2023 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 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Yarmouth Municipality A. General Information Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. 1. Applicant: Anthony P. First Name Russo Last Name 63 Cleveland Way Address West Yarmouth City/Town MA State 02673 Zip Code 207-229-4607 Phone Number trusso0819@yahoo.com Email 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) Paul First Name Shea Last Name Company Name 162 West Long Pond Road Address Plymouth City/Town MA State 02360 Zip Code 508-274-0310 Phone Number paulshea162@gmail.com Email Address (if known) B. Project Description 1. a. Project Location (use maps and plans to identify the location of the area subject to this request): 63 Cleveland Way Street Address West Yarmouth City/Town How to find Latitude and Longitude Latitude (Decimal Degrees Format with 5 digits after decimal e.g. XX.XXXXX) Longitude (Decimal Degrees Format with 5 digits after decimal e.g. -XX.XXXXX) and how to convert to decimal degrees 36 Assessors’ Map Number 50 Assessors’ Lot/Parcel Number b. Area Description (use additional paper, if necessary): Existing residential house located at 63 Cleveland Way, wetland located across the street (62). c. Plan and/or Map Reference(s): (use additional paper if necessary) Plan for 63 Cleveland Way, West Yarmouth, MA, for Anthony & Jane Russo Title 9-30-20203 Date prepared by Paul E. Sweetser, Professional Land Surveyor Title Date wpaform1.doc • rev. 4/28/2023 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 Yarmouth Municipality B. Project Description (cont.) 2. a. Activity/Work Description (use additional paper and/or provide plan(s) of Activity, if necessary): Proposed addition and wooden deck to the existing house located at 63 Cleveland Way. There is a BVW wetland located off property, across the street within an undeveloped, wooded property. The subject property is located within a FEMA Flood Zone AE (Elevation 11). The BVW wetland boundary has been flagged in the field with the flags A1 - A6. There is a minor inland bank feature located at the edge of wetland (BVW). The 50' buffer zone and the 100' buffer zone associated with this wetland extends across the street to 63 Cleveland Way. The limit of work line for the proposed addition and deck are located 90 feet from the wetland across the road (Cleveland Way). Erosion controls will be installed at the limit of work line to protect the off property BVW wetland, other side of the road. 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.) wpaform1.doc • rev. 4/28/2023 WPA Form 1 – Request for Determination of Applicability • Page 3 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 Yarmouth Municipality C. Determinations 1. I request the Yarmouth Conservation Commission make the following determination(s). Check any that apply: 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. 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: Yarmouth 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 Section 10.05(3)(b)(1) of the Wetlands Protection Act regulations. Signature of Applicant Date Signature of Representative (if any) Date Massachusetts Department of Environmental Protection `. Bureau of Water Resources - Wetlands WPA Form 1- Request for Determination of Applicability Yarmouth _ Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Municipality C. Determinations 1. 1 request the Yarmouth 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. ❑ 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: Yarmouth 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 Section 10.Q )(b)(1) of the Wetlands Protection Act regulations. agaF-1141 - Signature of Ap ' nt Date Signature of Represe tative if any) Date wpaforml doe • rev. 4/2812023 WPA Form 1 - Request for Determination of Applicability • Page 3 of 3 Notification to Abutters – Request for Determination of Applicability application Anthony P. Russo 63 Cleveland Way West Yarmouth, MA 02673 As an abutting property owner of 63 Cleveland Way, West Yarmouth, you are being notified of a public hearing before the Yarmouth Conservation Commission, scheduled for November 15, 2023, at 5:00 pm (remote conference call) at the Yarmouth Town Hall to review a Request for Determination of Applicability application filed by the applicant to construct an addition and a wooden deck, within the subject property located at 63 Cleveland Way in West Yarmouth, MA. The subject property is located within a 100 year flood zone, AE El. 11. Proposed site alterations will occur within the 100’ buffer zone of an off-property BVW wetland. This project requires an approval from the Yarmouth Conservation Commission. If you have any questions contact the Yarmouth Conservation Commission at 508-398- 2231, ext. 1288, or bdirienzo@yarmouth.ma.us. 36/ 49/ / / LYNCH JEANNETTE M TR LYNCH LIVING TRUST (THE) 15 KINGS WAY UNIT 26 WALTHAM , MA 02451 36/ 50/ / / RUSSO ANTHONY RUSSO JANE PO BOX 1552 TYBEE ISLAND , GA 31328 36/ 51/ / / RULE ALEX J 57 CLEVELAND WAY, WEST YARMOUTH , MA 02673 36/ 54/ / / CROWTHER JOHN W TRS CROWTHER DEANA TRS 9 KARLA LN EAST SANDWICH , MA 02537 36/ 55/ / / LAWTON RUSSELL S C/O LAWTON RUSSELL S TR 24 VIRGINIA ST WEST YARMOUTH , MA 02673 36/ 56/ / / CERBONE JOSEPH TRS CERBONE MARCO TRS 76 BELLEVUE ST ANDOVER , MA 01810 36/ 44/ / / PIQUETTE JON CHRISTOPHER TRAN DOAN TRANG 52 CLEVELAND WAY WEST YARMOUTH , MA 02673 36/ 45/ / / OROURKE BRIAN J C/O HORNE GAYLE 2 VIRGINIA ST WEST YARMOUTH , MA 02673 36/ 57/ / / FINNEMORE JOSEPH R FINNEMORE SUSAN K 34 COCHESET PATH WEST YARMOUTH , MA 02673 36/ 46/ / / ENGLERT DONALD W (PER REP) ENGLERT WALTER H ESTATE OF 41 WEETAMOE DR WARWICK , RI 02888 Please use this signature to certify this list of propertiesabutting within 100' of the parcel located at:63 Cleveland Way, West Yarmouth, MA 02673Assessors Map 36, Lot 50______________________________________Andy Machado, Director of AssessingOctober 10, 2023 I Town of Yarmouth Conservation Commission 21-DAY WAIVER CONSERVATION OFFICE Please complete this form, sign at the bottom and return to the Conservation Office. 1S, 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 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 /&4 -- a 6 - Q-,3 (d to r ceived by Co servation Office) c � for work at � /,� V J ' rr�� (project addressllocation) I am ❑ the: Applicant VN Applicant's Representative ❑ Property Owner Signature `Z) _ a� Date