HomeMy WebLinkAboutRDA 10.20.20253i O Conservation
Office
9
CO PORATV)�
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:
_ V 1 RDA Administrative Checklist
1 complete RDA application WPA form 1 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.
If BVW or vegetated wetlands are present, delineation sheet(s), coastal bank calculation and other
relevant material if applicable (not applicable for flood zone only projects).
Yarmouth Assessor's locator map highlighting parcel(s) where work is proposed, including map and
parcel numbers.
1 current abutters list identifying the property owners who are to be notified and abutter notification form.
All abutters to be notified via certified mail, Certified Mail Receipts (PS Form 3800) must be provided.
1 original and 7 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"110®,
Legal ad fee: Separate check made payable to "Town of Yarmouth" I
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 bdirienzoAvarmouth.ma.us and iierolimoAyarmouth.ma.us
and DEP Southeast Region at SERO_NOI@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.
Initial 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.
I understand that in person representation is required at the scheduled hearing to present to the
conservation commission.
* If the applicant is NOT the property owner:
V 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,
dmf.envreview-south Amass.gov, Amanda. Davis(cDmass.gov
CC bdirienzo(c,)yarmouth.ma.us, to
erolimo(yarmouth.ma.us
Yarmouth Conservation Commission • 1146 Route 28 •South Yarmouth, MA 026644492 t
Tel. (508)-398-2231 Ext. 1288 •Fax (508)-398-0836 • TTD# (508) 398-2231 • bdirienzo(cr�yarmouth.ma.us
Rev. 7/2025
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
Important: 1
When filling out
forms on the
computer, use only
the tab key to move
your cursor - do not
use the return key.
How to find Latitude
and Longitude
anA how to convert
to decimal degrees
General Information
Applicant:
Robert & Ann Wiggins
First Name
1539 County Road 67
Address
Bremen
City/Town
205-213-9861
Phone Number
Property Owner (if different from Applicant):
First Name
Address
City/Town
Phone Number
epresentative
George
First Name
George Davis, Inc.
Company Name
33 North Main Street
Address
South Yarmouth
City/Town
508-394-0832
Phone Number
Last Name
AL
35033
State Zip Code
rwiggins@wigginschilds.com
Email Address
Last Name
State
Email Address (if known)
Davis
Last Name
Zip Code
MA 02664
State Zip Code
plarson@georgedavisinc.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):
61 Pheasant Cove Circle Yarmouthport
Street Address City/Town
Latitude (Decimal Degrees Format with 5 digits after decimal
e.g. XX.XXXXX)
149
Longitude (Decimal Degrees Format with 5 digits after
decimal e.g.-XX.X)WCX)
50
Assessors' Map Number Assessors' Lot/Parcel Number
b. Area Description (use additional paper, if necessary):
c. Plan and/or Map Reference(s): (use additional paper if necessary)
Title
Title
Date 1
wpaforml.doc • rev. 4/28/2023 WPA Form 1 —Request for Determination of Applicability • Page t of 3
Massachusetts Department of Environmental Protection
Bureau of Water Resources - Wetlands
NPA Form 1- Request for Determination of Applicability Yarmouth
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Municipality
B. Project Description (coot.)
2, a. Activity/Work Description (use additional paper and/or provide plan(s) of Activity, if necessary):
Add 6' x 20' to rear of the existing home; convert the garage to living space. New
addition is on a crawl space.
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
Rivenront 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.)
WPA Form 1 —Request for Determination of Applicability •Page 2 of 3
wpaformt.doc • rev. 4/28/2023
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. I request the Yarmouth
Conservation Commission
make the following determination(s). Check any that apply:
am whether the area depicted on planks) and/or maps) referenced above is an area subject to
jurisdiction of the Wetlands Protection Act.
❑ b. whether the boundaries of resource areas) depicted on planks) and/or maps) referenced
above are accurately delineated.
� c. whether the Activities depicted on planks) referenced above is subject to the Wetlands
Protection Act and its regulations.
❑ d. whether the area and/or Activities depicted on planks) 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.
4-
also
understand that notification of this Request will be placed in a local newspaper at my expense
in accor e with Se i 0.05(3)(b)(1 of the Wetlands Protection Act regulations.
10/20/25
Signature,o€Qppli t Date
of Representative (if any)
10/20/25
Date
f
wpaforml.doc •rev. 4/28/2023 WPA Form t —Request far Determination of Applicability •Page 3 of 3
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149/ ---531 / - / --�--
TOWN OF YARMOUTH
1146 ROUTE 28
SOUTH YARMOUTH , MA 026644463
149/ 49/ / / �
TOWN OF YARMOUTH
1146 ROUTE 28
SOUTH YARMOUTH , MA 02664
WIGGINS ANN K
1539 COUNTY RD 67
BREMEN , AL 35033
LYNN GARY D
C/O LYNN ROBERT G TR
146 SHORE RD
MT SINAI , NY 11766
COMMONWEALTH OF MASS
DEPT OF FISHERIES
100 CAMBRIDGE ST, RM 1901
BOSTON , MA 02202-0044
CARROLL RICHARD D TRS
CARROLL JUDITH E TRS
58 PHEASANT COVE CIR
YARMOUTH PORT , MA 02675
LANIER KRISTI J
68 PHEASANT COVE CIR
YARMOUTH PORT , MA 02675
Please use this signature to certify this list of properties
abutting within 100' of the parcel located at:
61 Pheasant Cove Cir., Yarmouth Port, MA 02675
Assessors Map 149, Lot 50
Andy Mac#'iado, Director of Assessing
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 Bob &Ann WigJU HO George Davis, Inc.
B. The applicant has filed a Reauest 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 61 Pheasant Cove Rd Yarmouthport, MA 02675
D. Proposed work is add 6' x 20' to rear of the existing house; convert the garage to living space.
New addition is on a crawl
E. Copies of the Request for Determination of Applicability maybe 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) 39&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
Or Applicant's representatives phone number 50M94-0832
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 George Davis, Inc.
Address 33 North Main Street
Town South Yarmouth State MA
Telephone 508-394-0832
Note:
Zip 02664
® 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.
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DEPARTMENT
OF
CONSERVATION
.�ORPORATED�
�IML V g. A!!L yr
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: U I �11 ILL TQ' A V L C UC C ; y(1_r 1210 (A ��� Q UL
Assessors Map/Lot:
I (we) hereby authorize the individual members of the Yarmouth Conservation 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:
Please Print Name:
Date• �
If other than owner, please state whether tenant, agent, or other: I'l.
Mailing Address:
J
Email:^(]�J'�j-h CI�r�QP.C�L�.VtJ� Fax: A
t MUS C®ru
Yarmouth Conservation Commission • 1146 Route 28 •South Yarmouth, MA 02664-4492 f
Tel. (508)-398-2231 Ext. 1288 •Fax (508)-398-0836 • TTD# (508) 398-2231