The URL can be used to link to this page

Home My WebLink AboutWPA Form 3 - NOI Forms Maps Kane NOIn Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. re Note: Before completing this form consult your local Conservation Commission regarding any municipal bylaw or ordinance. Massachusetts Department of Environmental Protection Provided by MaasDEP: BUreaU Of fZeSOUFCe PCOteCtlOn -Wetlands MassDEP File Number WPA Form 3 -Notice of Intent Document Transaction Number Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Yarmouth CitylTown A. General Information 1. Project Location (Note: electronic filers will click on button to locate project site): 41 Tanglewood Drive a. Street Address Latitude and Longitude: f3. Assessors Map/Plat Number 2. Applicant: Kelly A. a. First Name c. orgamzaaon 1414 E. 39 St., Apt d. Street Address Tulsa e. City/Town 617-721-9073 h. Phone Number 215 i. Fax Number West Yarmouth 02673 b. Cily/rown c. Zip Code 41.649663-70.248840 d. Latitude e. Longitude 89 g. Parcel /Lot Number Kane OK kellykane1971 @gmail.com j. Email Address 74105 g. Zip Code 3. Property owner (required if different from applicant): ❑Check if more than one owner Same a. First Name b. Last Name c. d. Street Address e. Citylrown h. Phone Number i. Fax Number 4. Representative (if any): John O'Reilly, P.E., P.L.S. a. First Name b. Last Name J.M. O'Reilly & Associates,lnc. c. Company 1573 Main Street g. Zip Code Brewster MA 02631 e. Citylrown f. Slate g. Zip Code 508-896-6601 508-896-6602 joreilly@jmoreillyassoc.com h. Phone Number i. Fax Number j. Email address 5. Total WPA Fee Paid (from NOI Wetland Fee Transmittal Form): 165.00 70.00 95.00 a. Total Fee Paid b. State Fee Paid c. City/Town Fee Paid wpaform3.doc •rev. 12/4/2023 Page 1 of 9 0 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands WPA FOrm 3 —Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. General Information (continued) 6. General Project Description: Provided by MassDEP: MassDEP Flle Number Document Transaction Number Yarmouth Citylrown Project proposes to reconfigure an un-permitted deck. Proposal includes pulling the proposed reconfigured deck back away from the wetland resource. Project includes establishment of a vegetated buffer strip adjacent to the wetrland resource. 7a. Project Type Checklist: (Limited Project Types see Section A. 7b.) 1. ®Single Family Home 3. ❑Commercial/Industrial 5. ❑ Utilities 7. ❑Agriculture (e.g., cranberries, forestry) 9. ❑ Other 2. ❑Residential Subdivision 4. ❑ DocklPier 6. ❑Coastal engineering Structure 8. ❑Transportation 7b. Is any portion of the proposed activity eligible to be treated as a limited project (including Ecological Restoration Limited Project) subject to 310 CMR 10.24 (coastal) or 310 CMR 10.53 (inland)? �. ❑ Yes ® No If yes, describe which limited project applies to this project. (See 310 CMR 10.24 and 10.53 for a complete list and description of limited project types) If the proposed activity is eligible to be treated as an Ecological Restoration Limited Project (310 CMR10.24(8), 310 CMR 10.53(4)), complete and attach Appendix A: Ecological Restoration Limited Project Checklist and Signed Certification. 8. Property recorded at the Registry of Deeds for: Barnstable a. Counlv c. Book b. Certificate # (if registered land) d. Page Number B. Buffer Zone &Resource Area Impacts (temporary &permanent) 1. ®Buffer Zone Only —Check if the project is located only in the Buffer Zone of a Bordering Vegetated Wetland, Inland Bank, or Coastal Resource Area. 2. ❑Inland Resource Areas (see 310 CMR 10.54-10.58; if not applicable, go to Section B.3, Coastal Resource Areas). Check all that apply below. Attach narrative and any supporting documentation describing how the project will meet all performance standards for each of the resource areas altered, including standards requiring consideration of alternative project design or location. wpaform3.doc •rev. 12/4/2023 Page 2 of 9 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands ' WPA FOrrx� � -Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by MassDEP: MassDEP File Number Document Transaction Number Yarmouth Cily/rown B. Buffer Zone & Resource Area Impacts (temporary & permanent) (conrd) Resource Area a. ❑ Bank For all projects affecting other b. ❑ Bordering Vegetated Resource Areas, Wetland please attach a narrative c. ❑ Land Under explaining how Waterbodies and the resource Waterways area was delineated. Resource Area d. ❑ Bordering Land Subject to Flooding e. ❑ Isolated Land Subject to Flooding Size of Pr000sed Alteration 1. linear feet 1. square feet 1. square feet 3. cubic yards dredged Size of Proposed Alteration 1. square feet 3. cubic feet of flood storage lost 1. square feet Proposed Reolacement (if any 2.linearfeet square 2. square feet Proposed Replacement (if any) square 4. cubic feet replaced 2. cubic feet of good storage lost 3. cubic feet replaced f. ® Riverfront Area 7. Name of Waterway (if available) -specify coastal or Inland 2. Width of Riverfront Area (check one): ❑ 25 ft. -Designated Densely Developed Areas only ❑ 100 ft. -New agricultural projects only ® 200 ft. -All other projects 3. Total area of Riverfront Area on the site of the proposed project: 19,730 sf square feet a. Proposed alteration of the Riverfront Area: 370 sf 0 370 a. total square feet b. square feet within 100 ft. c. square feel between 100 ft. and 200 ft. s. Has an alternatives analysis been done and is it attached to this NOI? s. Was the lot where the activity is proposed created prior to August 1, 1996? 3. ❑Coastal Resource Areas: (See 310 CMR 10.25-10.35) Note: for coastal rivertront areas, please complete Section 6.2.f. above. wpaform3.doc •rev. 12/a/2023 Page 3 of 9 e. ❑ Isolated Land Subject to Flooding Size of Pr000sed Alteration 1. linear feet 1. square feet 1. square feet 3. cubic yards dredged Size of Proposed Alteration 1. square feet 3. cubic feet of flood storage lost 1. square feet Proposed Reolacement (if any 2.linearfeet square 2. square feet Proposed Replacement (if any) square 4. cubic feet replaced 2. cubic feet of good storage lost 3. cubic feet replaced f. ® Riverfront Area 7. Name of Waterway (if available) -specify coastal or Inland 2. Width of Riverfront Area (check one): ❑ 25 ft. -Designated Densely Developed Areas only ❑ 100 ft. -New agricultural projects only ® 200 ft. -All other projects 3. Total area of Riverfront Area on the site of the proposed project: 19,730 sf square feet a. Proposed alteration of the Riverfront Area: 370 sf 0 370 a. total square feet b. square feet within 100 ft. c. square feel between 100 ft. and 200 ft. s. Has an alternatives analysis been done and is it attached to this NOI? s. Was the lot where the activity is proposed created prior to August 1, 1996? 3. ❑Coastal Resource Areas: (See 310 CMR 10.25-10.35) Note: for coastal rivertront areas, please complete Section 6.2.f. above. wpaform3.doc •rev. 12/a/2023 Page 3 of 9 0 Online Users: Include your document transaction number (provided on your receipt page) with all supplementary information you submit to the Department. Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 3 - Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by MassDEP: MassDEP File Number Document Transaction Number Yarmouth City/rown B. Buffer Zone &Resource Area Impacts (temporary &permanent) (cont'd) Check all that apply below. Attach narrative and supporting documentation describing how the project will meet all performance standards for each of the resource areas altered, including standards requiring consideration of alternative project design or location. Resource Area Size of Proposed Alteration Proposed Replacement (if anvl a. ❑ Designated Port Areas b. ❑ Land Under the Ocean �. ❑ Barrier Beach d. ❑ Coastal Beaches e. ❑ Coastal Dunes f. ❑ Coastal Banks g. ❑ Rocky Intertidal Shores n. ❑ Salt Marshes �. ❑ Land Under Salt Ponds ). ❑ Land Containing Shellfish I<. ❑ Fish Runs Indicate size under Land Under the Ocean, below square 2. cubic yards dredged Indicate size under Coastal Beaches and/or Coastal Dunes below square square Size of Proposed Alteration t.linearfeet square 2. cubic yards beach nourishment 2. cubic yards dune nourishment Proposed Replacement (if anvl 1. square feet 2. sq ft restoration, rehab., creation 1. square feet 2. cubic yards dredged square Indicate size under Coastal Banks, inland Bank, Land Under the Ocean, and/or inland Land Under Waterbodies and Waterways, above 1. cubic yards dredged 1. ❑ Land Subject to Coasial Storm Flowage 1. square feet 4. ❑Restoration/Enhancement 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 B2.b or 6.3.h above, please enter the additional amount here. a. square feet of avw 5. ❑Project Involves Stream Crossings a. number of now stream crossings b. square feet of Salt Marsh b. number of replacement stream crossings wpaform3.doc •rev. 12/4/2023 Page 4 of 9 �. ❑ Barrier Beach d. ❑ Coastal Beaches e. ❑ Coastal Dunes f. ❑ Coastal Banks g. ❑ Rocky Intertidal Shores n. ❑ Salt Marshes �. ❑ Land Under Salt Ponds ). ❑ Land Containing Shellfish I<. ❑ Fish Runs Indicate size under Land Under the Ocean, below square 2. cubic yards dredged Indicate size under Coastal Beaches and/or Coastal Dunes below square square Size of Proposed Alteration t.linearfeet square 2. cubic yards beach nourishment 2. cubic yards dune nourishment Proposed Replacement (if anvl 1. square feet 2. sq ft restoration, rehab., creation 1. square feet 2. cubic yards dredged square Indicate size under Coastal Banks, inland Bank, Land Under the Ocean, and/or inland Land Under Waterbodies and Waterways, above 1. cubic yards dredged 1. ❑ Land Subject to Coasial Storm Flowage 1. square feet 4. ❑Restoration/Enhancement 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 B2.b or 6.3.h above, please enter the additional amount here. a. square feet of avw 5. ❑Project Involves Stream Crossings a. number of now stream crossings b. square feet of Salt Marsh b. number of replacement stream crossings wpaform3.doc •rev. 12/4/2023 Page 4 of 9 ). ❑ Land Containing Shellfish I<. ❑ Fish Runs Indicate size under Land Under the Ocean, below square 2. cubic yards dredged Indicate size under Coastal Beaches and/or Coastal Dunes below square square Size of Proposed Alteration t.linearfeet square 2. cubic yards beach nourishment 2. cubic yards dune nourishment Proposed Replacement (if anvl 1. square feet 2. sq ft restoration, rehab., creation 1. square feet 2. cubic yards dredged square Indicate size under Coastal Banks, inland Bank, Land Under the Ocean, and/or inland Land Under Waterbodies and Waterways, above 1. cubic yards dredged 1. ❑ Land Subject to Coasial Storm Flowage 1. square feet 4. ❑Restoration/Enhancement 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 B2.b or 6.3.h above, please enter the additional amount here. a. square feet of avw 5. ❑Project Involves Stream Crossings a. number of now stream crossings b. square feet of Salt Marsh b. number of replacement stream crossings wpaform3.doc •rev. 12/4/2023 Page 4 of 9 0 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands MassDEP File Number WPA Form 3 — Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 Document Transaction Number Yarmouth City/rown C. Other Applicable Standards and Requirements ❑ This is a proposal for an Ecological Restoration Limited Project. Skip Section C and complete Appendix A: Ecological Restoration Limited Project Checklists — Required Actions (310 CMR 10,11), Streamlined Massachusetts Endangered Species ActfWetlands Protection Act Review 1. Is any portion of the proposed project located in Estimated Habitat of Rare Wildlife as indicated on the most recent Estimated Habitat Map of State -Listed Rare Wetland Wildlife published by the Natural Heritage and Endangered Species Program (NHESP)? To view habitat maps, see the Massachusetts Natural Heritage Atlas or go to http://mai)s.massgis.state.ma.us/PRI EST HAB/viewer.htm. a. ❑Yes ® No 4!2/2024 b. Date of map If yes, include proof of mailing or hand delivery of NOI to: Natural Heritage and Endangered Species Program Division of Fisheries and Wildlife 1 Rabbit Hill Road Westborough, MA 01581 If yes, the project is also subject to Massachusetts Endangered Species Act (MESA) review (321 CMR 10.181. To qualify for a streamlined, 30-day, MESANVetlands Protection Act review, please complete Section C.1.c, and include requested materials with this Notice of Intent (NOI); OR complete Section C.2.f, if applicable. if MESA supplemental information is not included with the NOI, by completing Section f of this form, the NHESP will require a separate MESA filing which may take up to 90 days to review (unless noted exceptions in Section 2 apply, see below). c. Submit Supplemental Information for Endangered Species Review' 1. ❑Percentage/acreage of property to be altered: (a) within wetland Resource Area (b) outside Resource Area percentage/acreage percentage/acreage 2. ❑Assessor's Map or right-of-way plan of site 2. ❑Project plans for entire project site, including wetland resource areas and areas outside of wetlands jurisdiction, showing existing and proposed conditions, existing and proposed tree/vegetation clearing line, and clearly demarcated limits of work " (a) ❑ Project description (including description of impacts outside of wetland resource area & bufferzone) (b) ❑ Photographs representative of the site ' Some projects not in Estimated Habitat may be located in Priority Habitat, and require NHESP review (see hops://www.mass.gov/ma- endanaered-s pecies-act-mesa-reaulatorv-review). Priority Habitat includes habitat for slate -listed plants and strictly upland species not protected by the Wetlands Protection Act. " MESA projects may not be segmented (321 CMR 10.16). The applicant must disclose full development plans even if such plans are not required as part of the Notice of Intent process. wpaform3.doc • rev. 12/V2023 Page 6 of E Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection -Wetlands MassDEP File Number WPA Form 3 -Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 Document Transaction Number Yarmouth Cily/Town C. Other Applicable Standards and Requirements (con . mass.govlhow-to/how-to-file-for- a-mesa-project-review). Make check payable to "Commonwealth of Massachusetts - NHESP" and mail to NHESP at above address Projects altering 10 ormore acres ofland, also submit: (d) ❑ Vegetation cover type map of site (e) ❑ Project plans showing Priority &Estimated Habitat boundaries (0 OR Check One of the Following �. ❑ Project is exempt from MESA review Attach applicant letter indicating which MESA exemption applies. (See 321 CMR 10.14, ht�s:l/www. mass.00v/service-details/exemptions-from-review-for-proiectsactivities-in- priorily-habitat; the NOI must still be sent to NHESP if the project is within estimated habitat pursuant to 310 CMR 10.37 and 10.59.) 2. ❑ Separate MESA review ongoing. a. NHESP Tracking # b. Dale submitted to NHESP 3. ❑ Separate MESA review completed. Include copy of NHESP "no Take" determination or valid Conservation &Management Permit with approved plan. 3. For coastal projects only, is any portion of the proposed project located below the mean high water line or in a fish run? a. ® Not applicable —project is in inland resource area only b. ❑ Yes ❑ No If yes, include proof of mailing, hand delivery, or electronic delivery of NOI to either: South Shore -Bourne to Rhode Island border, and the Cape &Islands: Division of Marine Fisheries - Southeast Marine Fisheries Station Attn: Environmental Reviewer 836 South Rodney French Blvd. New Bedford, MA 02744 Email: dmf.envreview-southCa�mass.gov North Shore -Plymouth to New Hampshire border: Division of Marine Fisheries - Norlh Shore Office Altn: Environmental Reviewer 30 Emerson Avenue Gloucester, MA 01930 Email: dmf.envreview-northt7a mass.gov Also if yes, the project may require a Chapter 91 license. For coastal towns in the Northeast Region, please contact MassDEP's Boston Office. For coastal towns in the Southeast Region, please contact MassDEP's Southeast Regional Office. c. ❑ Is this an aquaculture project? d. ❑ Yes ®No If yes, include a copy of the Division of Marine Fisheries Certification Letter (M.G.L. c. 130, § 57). wpaform3.doc •rev. 12/4/2023 Page 6 of 9 0 Massachusetts Department of Environmental Protection Provided by MassDEP: �r Bureau of Resource Protection - Wetlands MassDEP File Number WPA FOPIl1 3 -Notice of Intent Document Transaction Number Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Yarmouth CilyRown C. Other Applicable Standards and Requirements (cont'd) 4. Is any portion of the proposed project within an Area of Critical Environmental Concern (ACEC)? Online users: a. El Yes ® No If yes, provide name of ACEC (see instructions to WPA Form 3 or MassDEP Include your Website for ACEC locations). Note: electronic filers click on Website, document transaction b. ACEC number (provided on 5. Is any portion of the proposed project within an area designated as an Outstanding Resource Water your receipt (ORW) as designated in the Massachusetts Surface Water Quality Standards, 314 CMR 4.00? page) with all supplementary a. ❑ Yes ® No information you submit to the 6. Is any portion of the site subject to a Wetlands Restriction Order under the Inland Wetlands Department. Restriction Act (M.G.L. c. 131, § 40A) or the Coastal Wetlands Restriction Act (M.G.L. c. 130, § 105)? a. ❑ Yes ® No 7. Is this project subject to provisions of the MassDEP Stormwater Management Standards? a. ❑ Yes. Attach a copy of the Stormwater Report as required by the Stormwater Management Standards per 310 CMR 10.05(6)(k)-(q) and check if: 1, ❑ Applying for Low Impact Development (LID) site design credits (as described in Stormwater Management Handbook Vol. 2, Chapter 3) 2. ❑ A portion of the site constitutes redevelopment 3. ❑ Proprietary BMPs are included in the Stormwater Management System. b. ® No. Check why the project is exempt: 1. ® Single-family house z. ❑ Emergency road repair 3. ❑ Small Residential Subdivision (less than or equal to 4singte-family houses or less than or equal to 4 units in multi -family housingproject) with no discharge to Critical Areas. D. Additional Information ❑ This is a proposal for an Ecological Restoration Limited Project. Skip Section D and complete Appendix A: Ecological Restoration Notice of Intent —Minimum Required Documents (310 CMR 10.12). Applicants must include the following with this Notice of Intent (NOI). See instructions for details. Online Users: Attach the document transaction number (provided on your receipt page) for any of the following information you submit to the Department. 1. ❑ USGS or other map of the area (along with a narrative description, if necessary) containing sufficient information for the Conservation Commission and the Department to locate the site. (Electronic filers may omit this item.) z. ❑ Plans identifying the location of proposed activities (including activities proposed to serve as a Bordering Vegetated Wetland [BVWJ replication area or other mitigating measure) relative to the boundaries of each affected resource area. wpaform3.doc •rev. 12/4/2023 Page 7 of 9 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection -Wetlands MassDEP File Number WPA Forrx� � -Notice of Intent Document Transaction Number Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Yarmouth Cily/Town D. Additional Information (cont'd) 3. ❑ Identify the method for BVW and other resource area boundary delineations (MassDEP BVW Field Data Form(s), Determination of Applicability, Order of Resource Area Delineation, etc.), and attach documentation of the methodology. a. ❑ List the titles and dates for all plans and other materials submitted with this NOI. Proposed Site Plan a. Plan Title John M. O'Reilly, P.E., P.L.S. John M. O'Reilly, P.E., P.L.S. b. Prepared By c. Signed and Stamped by 4-15-2024 1" = 20' d. Final Revision Date e. Scale f. Additional Plan or Document Title g. Date 6. ❑ If there is more than one property owner, please attach a list of these property owners not listed on this form. s. ❑ Attach proof of mailing for Natural Heritage and Endangered Species Program, if needed. �. ❑ Attach proof of mailing for Massachusetts Division of Marine Fisheries, if needed. s. ® Attach NOI Wetland Fee Transmittal Form s. ❑ Attach Stormwater Report, if needed. E. Fees �. ❑Fee Exempt: No filing fee shall be assessed for projects of any city, town, county, or district of the Commonwealth, federally recognized Indian tribe housing authority, municipal housing authority, or the Massachusetts Bay Transportation Authority. Applicants must submit the following information (in addition to pages 1 and 2 of the NOI Wetland Fee Tra mittal Form) to confirm fee payment: 2. Municipal Check Number 3. Check date 13�51 VI-1�•2�j 4. State Check Number 5. Check date J.M. O'Reilly &Associates, Inc. 6. Payor name on check: First Name 7. Payor name on check: Last Name wpaform3.doc •rev, t2/4/2023 Page 8 of 9 Massachusetts Department of Environmental Protection Provided by MassDEP; Bureau of Resource Protection - Wetlands MassDEP File Number WPA Form 3 — Notice of intent Document Transaaian Number El Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Yarmouth City/Town F. Signatures and Submittal Requirements I hereby certify under the penalties of perjury that the foregoing Notice of Intent and accompanying plans, documents, and supporting data are true and complete to the best of my knowledge. I understand that the Conservation Commission will place notification of this Notice in a local newspaper at the expense of the applicant in accordance with the wetlands regulations, 310 CMR 10.05(5)(a). I further certify under penalties of perjury that all abutters were notified of this application, pursuant to the " requirements of M.G.L. c. 131, §.40. Notice must be made by Certificate of Melling or In writing by hand delivery or certified mail (return receipt requested) to all abutters within 100 feet of the property line of the project location.. C: 240 / C7 r ant 2. Date i 3. Signature f Property Owner (iid8ferenQ 4. Dal 5. Signature of Repregonlative (if any) 6. Dew U For Conservation Commission: Two copies of the completed Notice of Intent (Form 3), Including supporting plans and documents, two copies of the NO) Wetland Fee Transmittal Form, and the city/town fee payment, to the Conservation Commission by certified mail or hand delivery. For MassDEP: One copy of the completed Notice of Intent (Form 3), including supporting plans and documents, one copy of the NO] Wetland Fee Transmittal Form, and a copy of the state fee payment to the MassDEP Regional Office (see Instructions) by certified mail or hand delivery. Other: If the applicant has checked the "yes" box In any part of Section C, Item 3, above, refer to that section and the Instructions for additional submittal requirements. The original and copies must be sent simultaneously. Failure by the applicant to send copies In a timely manner may result in dismissal of the Notice of Intent. wpatorm3.doc •rev. 12/4/2023 Page 9 of 9 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands NOI Wetland Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. m PA A. Applicant Information Location of Project: 41 Tanglewood Drive a. Street Address 13�51 c. Check number 2. Applicant Mailing Address: West Yarmouth b. Cily/fown r, 10 . c) o d. as amount Kelly A. Kane a. First Name b. Last Name C. Urganl2atl0n 1414 E. 39th St, Aot. 215 d. Mailing Address Tulsa OK 74105 e. Cily/rown f, slate g. Zip Code 617-721-9073 kellykanel971@gmail.com h. Phone Number I. Fax Number j. Email Address 3. Property Owner if different): Same a. First Name b. Last Name c. Organization d. Mailing Address e. City/Town f. State g. Zip Code h. Phone Number I. Fax Number 1. Email Address To calculate B, Fees filing fees, refer to the category Fee should be calculated using the following process & worksheet. Please see Instructions before fee list and 9 9 examples in the filling out worksheet instructions for filling out WPA Step 1/Type of Activity: Describe each type of activity that will occur in wetland resource area and buffer zone. Form 3 (Notice of Intent). Step 2lNumber of Activities: Identify the number of each type of activity. Step 31individual Activity Fee: Identify each activity fee from the six project categories listed in the instructions. Step 4/Subtotal Activity Fee: Multiply the number of activities (identified in Step 2) times the fee per category (identified in Step 3) to reach a subtotal fee amount. Note: If any of these activities are in a Riverfront Area in addition to another Resource Area or the Buffer Zone, the fee per activity should be multiplied by 1.5 and then added to the subtotal amount. Step 51Total Project Fee: Determine the total project fee by adding the subtotal amounts from Step 4. Step 5/Fee Payments: To calculate the state share of the fee, divide the total fee in half and subtract $12.50. To calculate the city/town share of the fee, divide the total fee in half and add $12.50. rwifeeH.tloc • Wellantl Fee Transmittal Form • rev. 70/11 Page 1 of 2 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands NOI Wetland Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Fees (continued) Step 11Type of Activity Cat 1A in the Riverfront C. Submittal Requirements Step 21Nurn er Step Step 41Subtotal Activity of Activities 3/individual Fee Activity Fee 110.00 x 1.5 165.00 Step 5/Total Project Fee: Step 61Fee Payments: Total Project Fee: 165.00 a. Total Fee from Step 5 ,00 State share of filing Fee: b. 112 b. 1/2 Total Fee less $12.50 City/Town share of filling Fee: g5.00 c. 1/2 Total Fee plus $12.50 a.) Complete pages 1 and 2 and send with a check or money order for the state share of the fee, payable to the Commonwealth of Massachusetts. Department of Environmental Protection Box 4062 Boston, MA 02211 b.) To the Conservation Commission: Send the Notice of Intent or Abbreviated Notice of Intent; a copy of this form; and the city/town fee payment. To MassDEP Regional Office (see Instructions): Send a copy of the Notice of Intent or Abbreviated Notice of Intent; a copy of this form; and a copy of the state fee payment. (E-filers of Notices of Intent may submit these electronically.) no'rfeelf.doc • Wellantl Fee Transmittal Form •rev. 10111 Page 2 of 2 30/ 9/ / / TOWN OF YARMOUTH 1146 ROUTE 28 SOUTH YARMOUTH, MA 02664.4463 30/ 13/ / / NORENJOHN 45 WIMBLEDON DR WEST YARMOUTH, MA 02673 LENANE MICHAEL J GOVER CASEY R 33 TANGLEWOOD DR, WEST YARMOUTH , MA 02673 POWELL RICHARD F POWELL ELIZABETH M 1286 W 65TH ST CLEVELAND , OH 44102 SOMMA SHAWN W SOMMA LAURIE S 18 DEBBIE DR SOUTH WINDSOR , CT 06074 KUCHERTHOMAS PO BOX 1351 SOUTH YARMOUTH , MA 02664 KANE KELLY A 1414 E 39TH ST #215 TULSA . OK 74105 30/ 901 / SHEAJOHN PAPPPER ROBIN 37 SASSAMON AVE MILTON , MA 02186 CONNELLY FREDERICK E JR CIAMPA MARIA-ELISA 23 WENDELL PARK MILTON , MA 02186 30/ 104/ I / KEENAN DIANE S TRS C/O PIETERS THOMAS 40 TANGLEWOOD DR SOUTH YARMOUTH , MA 02664 30/ 103/ CATALONI RAYMOND J CO-TRS CATALONI ROSEMARY CO-TRS 20 PILGRIM RD WEST YARMOUTH, MA 02673 301 14/ / / VINCENTE ANA C SINGH INDRA 41 WIMBLEDON DR, WEST YARMOUTH. MA 02673 Please use this signature to certify this list of properties abutting within 100' of the parcel located at: 41 Tanglewood Dr., West Yarmouth, MA 02673 Assessors Map 30, Lot 89 Andy M ado, Director of Assessing April8, 024 4/15/24, 4:14 PM abouLblank ow 30.150.1� • / �Q�� + l 30�26 4Z lot/4C!31057.1 I �► e� �R9cF s 1 o q� Q• I ` / ORO y 30:2�5 30.23Rothe * /l J 3040 3o.22.zc • )p 30.2201C 30.21 � � ��,♦ v� 30.141 1y tyo�A 1' LN/E$ R • ♦ '� �oqw 7 30=e6 i wry 1. ~ ��"�♦ j� �0.89` •, ♦ �► WAY Off A too 30.94 30.10 �. •1 r TANGL'EW00� 4r ,K vo +'�i�► ++� 30 97 �30'.96 ARC 3Q�oEgVF E r 0,7 F� : ♦ ♦ ♦ 410 f ♦FRS. M 30.115 22.659 40 , �♦ ♦ F9F N ` 22.58� C�3 jOP •Q�yo* `• 1. 21.30ot 40 '°INKS l.'I' �► _.. `2210.1.1 qw♦ �� y v ��♦� � � �t �� ♦ '►r��F�. ' ♦ �''�► �' r► Its' *40 ♦ • . ♦ ♦� �e e,��♦F�N`'� �!' aboutblank 2/3 NOTIFICATION TO ABUTTERS UNDER THE MASSACHUSETTS WETLANDS PROTECTION ACT & TOWN OF YARMOUTH WETLAND BY-LAW, CHAPTER 143 In accordance with the second paragraph of the Massachusetts General Laws Chapter 131, Section 40, you are hereby notified of the following: A. The name of the applicant is Kelly A. Kane B. The applicant has filed a Notice of Intent with the Yarmouth Conservation Commission, seeking permission to remove, fill, dredge or alter an Area Subject to Protection under the Wetlands Protection Act (MGL c. 131 s. 40 & Town of Yarmouth Wetland By -Law, Chapter 143). C. The address of the lot where the activity is proposed is 41 Tanslewood Drive, West Yarmouth D. Proposed work is: The project involves the reconfiguration of a deck previously constructed without approval. The Proposal is to reposition the deck area off the rear side of the dwelling. The project proposes to establish a vegetated buffer to the wetland resource and riverfront. E. Copies of the Notice of Intent 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. Copies of the Notice of Intent may be obtained from either the applicant or applicant's representative. Applicant's phone number Or Applicant's representatives phone number 508-896-6601 (J.M. O'REILLY &ASSOCIATES, 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: John O. Reilly, P.E. P.L.S. (J.M. O'ReiliV &Associates, Inc.) Address: 1573 Main St., P.O. Box 1773 Town: Brewster State: MA Zip: 02631 Telephone: 508-896-6601 NOTES • 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 in the Town Hall 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. John M. O'Reilly, P.E., P.L.S. ,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 (date received by Conservation Office) for work at 41 Tanglewood Drive, W. Yarmouth (project addressAocation) 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 dzy �rziver DEPARTMENT OF CONSERVATION y'elwuze &I Y44! unaticr.n: If the applicant is not the property owner, please submit this form with your application. The owner must be sent a copy of the application on the same day it is filed with this office. Property Address: 41 Tanglewood Drive, W. Yarmouth Assessors Map/Lot: 30 / 89 I (we) hereby authorize the individual members of the Yarmouth Conselation Commission and its agents to enter upon the referenced property for the purpose of gathering information regarding the application filed with the Commission pursuant to the Wetlands Protection Act (M.G.L. Ch. 131, s. 40) and/or the Yarmouth Wetlands Protection Bylaw (Chapter 143). Authorized Signature: Z� Date: n Ue - Z Please Print Name: John M. O'Reilly, P.E., P.L.S. If other than owner, please state whether tenant, agent, or other: Agent Mailing Address: P.O. Box 1773 Brewster, MA 02631 Phone:508-89(i-6601 Cell: Email: Joreilly@jmoreillyassoacom Fax: Yarmouth Conservation Commission • 1146 Route 28 •South Yarmouth, MA 02664-4492 Tel. (508)-398-2231 Ext. 1288 •Fax (508)-398-0836 • TTD# (508) 398-2231 v e$ °as Y Y -- �q Y 4 y s x` wns� s �y f ..s Qj We wcortu ¢wpm cavxEu .aa Loh All DID I s e t � �'`-� �� O • �'� I— � � � � � � �' , N � c co � --* ; Y !`. 7 .� i 5 � @ � N o s � � �9.E v f w � ` o u � � �g8c �oox � 8 a� 8�€` �� oom� a`��$s�q }H� ��ia LLp �� b rc o o m 'rUU/$ � � a` �I � � ' o� o B o C � a N 8 � w� �g N LL J � inx od d, (=7 W L N (a 2 O O LL v • H � � w Z� �� E m bon m m �� t� � r ., v � agp oaf '�oEf v8�� 8 U ``r 8 � a m a` A Q E� �aB �nq�E o�E�a E� € Y o p vL9�', v cy a 14 ��' E"a� En oaE v o9€ �oo s_ �«�9�c �yt � � � 5° �a� ��6 �e��o Eao�q � � �° ` u � � x j .a � Q o y3 � ? y � S a > Yi '� 8 v ='� i � E m � $ a a i> � 3 $'oS -', fiai o z° ` b_ �uo „ E._u u c x�'_ a .I o� I I I I nNA o �ne`�S m aqa� € � = I E ❑I:Jf�I �a g.t�E =�a""q� .�AEvE '$g EEnc �crosN vBnEc� Gt� €� �" e � �.�r;i� nc_vA °d� � o� Z _ 8�80�85€" �nEa �� n 0 E¢n�« � E Eucf - F` a F` � � ry � : E a � ar d � � m 0 (V 0 0 N 0