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Home My WebLink AboutRDAMassachusetts Department of Environmental Protection Bureau of Water Resources - Wetlands WPA Form 1- Request for Determination of Applicabilityti MunicipalityMassachusettsWetlandsProtectionActM.G.L. c. 131, §40 A. General Information Important: 1. Applicant: When filling out forms on the computer, use only First Name the tab key to move do I r ) )4i your cursor - not use the return key. Address LAI P'C/ -l`/ City/ Town ICI 6D6 q Phone Number 2. Property Owner (if different from Applicant): First Name Address Cityrrown Phone Number 3. Representative ( if any) First Name Company Name Address Cityrrown Last Name D'-"6 > State Zip Code t t- r' oT aI-/ yI Email Address Last Name State Zip Code Email Address ( if known) Last Name state Phone Number Email Address (if known) B. Project Description Zip Cade 1. a. Project Location (use maps and plans to identify the location of the area subject to this request): t3j[) / a 9 w , v7oY Yelk -fStreet Address City/Town Dot" ) How to find Latitude and Longitude Latitude (Decimal Degrees Format with 5 digits after decimal Longitude (Decimal Degrees Format with 5 digits after e.g. XX.X XXXX) decimal e.g.-XX.XXXXX) L and howtoconvertito decimal dearees Assessors' Map Number Assei sons' Lot/Parcel Number b. Area Description (use additional paper, if necessary): c. Plan and/or Map Reference(s): (use additional paper if necessary) Qt 126 56 (90 t t S 2, 1 42a2 Title ` Date Title Date wpaformtdoc - rev 4110r2023 WPA Farts 1 - Request for Delerminalm orAppficabiity - Page 1 of 3 41.643913, -70.252962 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 Muncipality B. Project Description (cont.) 2. a. ActivitylWork Description (use additional paper and/or provide plan(s) of Activity, if necessary): 1, A4 er C, S r1,z.t Ci C 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). 3. a. If this application is a Request for Determination of Scope of Alternatives for work in the iverfront Area, indicate the one classification below that best describes the project. tv*single family house on a lot recorded on or before 811/96 Single family house on a lot recorded after 8/1196 Expansion of an existing structure on a lot recorded after 811/96 Project, other than a single-family house or public project, where the applicant owned the lot before 817196 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.) wpefortnl doc • rev 411W023 WPA Form 1— Request for beterrninaflon of Applicabitity • 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 C. Determinations 1. 1 request the % Q f/i / make the following determination(s). Check any that apply: Conservation Commission a. whether the area depicted on plan(s) andlor 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. Q'c. whether the Activities depicted on plan(s) referenced above is subject to the Wetlands Protection Act and its regulations. Ly'/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: also understand that notification of this Request will be placed in a local newspaper at my expense in accordance with Section 1L0.05 3)(b)(1) of the Wetlands Prote 'on Act regulations. Signatuob of Appficant Date Iture of Representative (if any) Date wpaformt.doc - rev. M1012023 WPA Form 1 — Request for Determination of Applicability • Pape 3 of 3 221 121 1 1 SYLVESTER HORACE C JR TR SYLVESTER JEANNE G TR 261 DERRY MEETING ROAD COCHRANVILLE , PA 19330 221 111 1 1 DELISO JOHN C 15 BAY RD WEST YARMOUTH , MA 02673 221 13.11 1 1 OCOIN JOHN P CIO OCOIN JOHN P TR 11 BAY ROAD WEST YARMOUTH , MA 02673 Please use this signature to certify this list of properties directly abutting the parcel located at: 15 Bay Rd., West Yarmouth, MA 02673 Assessorspqp 22, L t 1 Andy Ma ado, Director of Assessing February 21, 2024 NOW NOTIFICATION TO ABUTTERS UNDER THE TOWN OF YARMOUTH WETLAND BY-LAW, CHAPTER 143 In accordance with the Town of Yarmouth Wetland Regulations Section 2.03, you are hereby notified of the following: A. The name of the applicant is _.f-J t!-= LT B. The applicant has filed a Request for Determination of Applicability with the Yarmouth Conservation Commission, seeking knowledge of whether a project is subject to the Wetlands Protection Act (MGL c. 131 s. 40) or Bylaw (Town of Yarmouth Wetland By -Law, Chapter 143). C. The address of the lot where the activity is proposed is H 4V, yA J 'V V t-7' ' ram( D. Proposed work is 1 i V?KP& A vc& 4 5;1 7 $f- t-4 57_ 99A--4 7-0 E ki y i r' cyG- 1,Cy, ?' oy e K_, '( _ E. Copies of the Request for Determination of Applicability may be examined at the Yarmouth Town Hall at the Conservation Commission office between the hours of 9:00 a.m. and 4:00 p.m. Monday thru Friday. For more information, call (508) 398-2231 ext. 1288. F. Copies of the Request for Determination of Applicability may be obtained from either the applicant or applicant's representative. Applicant's phone number Fes_ 6 9 ? 06 9 7 Or Applicant's representatives phone number G. Information regarding the date, time and place of the public hearing may be obtained by calling the Yarmouth Conservation Commission office at (508) 398-2231 ext. 1288 H. Person sending this notification (applicant, representative or other) Name _T O f I i/ G t 6 Address o Town.UZ, Yw&VV'MI State M A Zip Q A 67 ? Telephone 6 Note: Notice of the public hearing, including date, time and place will be published at least five (5) days in advance in a newspaper of general circulation. Notice of the public hearing, including date, time and place will be posted on the Town Website not less than forty-eight hours in advance. You may also contact the Southeast Regional Office of the Department of Environmental Protection at (508) 946-2800 for more information about this application. 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, 7 V HAl D L L f1; 0 , hereby waive the 21-day time period for a public hearing/meeting and/or issuance of the: OOC / DOA 1 COC / ORAD following receipt of my filing of a: Notice of Intent 0 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 d — 2 ` A date received by Conservation Office) for work at 1 3 /3 9 f n u. )ra4 '1 ''`im Uri P119 O, 6% project address4ocation) I am the: [P Applicant Applicant's Representative Property Owner dz -ate Sign ure 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 L tJ 15 BAY RD WEST YARMOUTH, MA 02673 Sources: Esri, HERE, Garmin, Intermap, increment P Corp., GEBCO, USGS, FAO, NPS, NRCAN, GeoBase, IGN, Kadaster NL, Ordnance Survey, Esri Japan, METI, Esri China (Hong Kong), (c) OpenStreetMap contributors, and the GIS User Community February 29, 2024 0 7515037.5 ft 0 204010 m 1:1,128 Data and scale shown on this map are provided for planning and informational Powered by Esri Technology