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Home My WebLink AboutRDA Jan 2024�-7< of Y9R� IA N� giye Q ' / a3 t CONSERVATION Mgrr^ OFFICE l7efenifrrzx 1%�Cz3 ation of "f r[.LL:(.L(J�-_--a" N (. 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. Hardcopy filing dropped off or mailed to the Conservation Office including: 1 RDA Administrative Checklist ✓1 complete RDA application WPA form 1 with original signatures (double sided). * _�1/ 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. If BVW or w are pre eation sheet LVGoastarb_anR_CB1cuIation and other nt materi pplicable { pplicable for flo ne only projects). Yarmouth Assessor's locator map highlighting parcel(s) where work is proposed, including map and parcel numbers original and 6 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, quantity, size and spacing. By-law filing fee: - Separate check made payable to "Town of Yarmouth" 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 pelf of the entire application emailed to bdirienzo()varmouth.ma.us and DEP Southeast Region ,__>,at SERO NOIOmass.gov inthe same email. Subject line shall be "YARMOUTH - RDA — Street Address - Applicant Name" Please list project property's street address in the pdf file name. Initia below 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 bdidenzo(g)varmouth.ma.us Yarmouth Conservation Commission • 1146 Route 28 • South Yarmouth, MA 02664-4492 Tel. (508)-398-2231 Ext. 1288 • Fax (508)-398-0836 • TrD# (508) 398-2231 • bdirienzogyarmouth.ma.us Rev. 312023 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. Q rein 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, F440 Municipality A. General Information Applicant: Last Name y�,�, QI. tMw- Gx,6y City/Town State Zi Code _ c�9-7-17/ — -7i3 4 el; z Joc{f-.. Sara toc d @ cow cetci rl efi Phone Number Email Address 2. Property Owner (if different from Applicant): Last Name State Zip Code Phone Number Email Address (if known) 3. Representative (if any) Po�r�z.�—c�ac.o`oS �ct�o(oS' First Name Last Name f, Ta coEo GUs imW. Cor ryv �. h , f 1� 4sict�r Company Name P O, KoK 3�t� Address ykrvKaoiti 14- QD(o7i City/Town State Zip Code 77q— aess a s4a- oy c`Ov'x Phone Number E if kn7) B. Project Description 1. a. Project Location (use maps and plans to identify the location of the area subject to this request): B o (C(A e. (U. S. Y0-nvkoAty _ Street Address City/Town How to find Latitude � I * � LI (000 — % 0e a l � (;L q 0 and Lonaitude Latitude (Decimal Degrees Format with 5 digits after decimal Longitude (Decimal Degrees Format with 5 digits after e.g. XX.XXXXX) decimal e.g.-XX.XXXXX) �a/ Sb sand how to convert na to decimal degrees Assessors' Map Number Assessors' t/Parce Number b. Area Description (use additional paper, if necessary): 1-lOnd zaf.a _ c. Plan and/or �Map ([Refe�rence(s): (use additional paper if necessary) San &C4,xLP Title Date Waformt.doc • rev. 4/10/2023 WPA Form 1 —Request for Determination of Applicability • Pagel of 3 Massachusetts Department of Environmental Protection LBureau of Water Resources - Wetlands i WPA Form 1- Request for Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Municipailty B. Project Description (cont.) 2. a. Activity/Work Description (use additional paper and/or provide plan(s) of Activity, if necessary): g,, \c a is K 3a aacLN-Zb W x(o' &ecL o4 bae-ric— b. Identify provisions of the Wetlands Protection Actor 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). Yct.r-oue),_ti trA -&pco 7OV JF 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 9 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.) vpaforml.doc • rev. 4/10/2023 WPA Fonn 1 — Request for Detemnation of Applicability • Page 2 of 3 LI,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 1. 1 request the �L!"wOn 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: ❑ 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 accordancew Sepp�i on�10.05(3)(b)(1) of the Wetlands Protection Act regulations. Signature ofAppricaany/ Date f any) Date wpaforml.doc • rev. 4/10/2023 WPA Form 1 — Request for Determinabon of Applicability • Page 3 of 3 CONSERVATION OFFICE Town of Yarmouth Conservation Commission 21-DAY WAIVER Please complete this form, sign at the bottom and return to the Conservation Office. 1, V &_C0VL;5 , 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 a 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 date ecei d by Conservation Office) for work at B� c�iG�ncE?g�f (project addresMocation) I am the: Applicant ❑ Applicant's Representative Property Owner Signature Date 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 Mn! ogo a gn 19 - @, � of . �• ■ Lj` Qu a �5 MR an ; M�� <. ._. ..or6- all 12.7.2023 TO WhOrn 1t May Concern; i, Elizabeth Serena Samford have contracted vAth Pat Jacobs of P Jacobs Carpentry and Remodeling to work on % add an addition to my Property at 80 Eldridge Road South Yarmouth effective December of 2023: Regards 4f t '2. /7 /207--3 )ZtlizabeSerena San rri 267-971-7183