HomeMy WebLinkAboutRDA 12.1.2025o Conservation
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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.
Sa&iiigM an, appeicaturn.
` Q Does the property have any outstanding/expired Orders of Conditions? If so, please file a Request
for Certificate of Compliance for each outstanding/expired Order, as the Commission may not issue a
DOA until any outstanding/expired Orders have been closed and recorded. (?see page 2)
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). ('see below)
' 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).
V, 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.
V 1 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.
u,//By-law filing fee: Separate check made payable to "Town of Yarmouth"
ti'' 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 pdf of the entire application emailed to bdirienzo(crwarmouth.ma.us and iierolimota)yarmouth.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:
P�_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.
1 understand that in person representation is required at the scheduled hearing to present to the
conservation commission.
'If the applicant is N T the property owner:
4/4Please 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.
Yannouth Conservation Commission • 1146 Route 28 • South Yannouth, MA 02664-4492
Tel. (508)-398-2231 Ext. 1288 • Fax (508)-398-0836 • TTD# (508) 398-2231 - bdirienzo(ir yannouth.ma.us
Rev 11/5/2025
Important:
When filling out
forms on the
computer, use only
the tab key to move
your cursor - do not
use the return key.
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
A. General Information
1. Applicant:
First Name
Last Name
( C_StC�t /%1`- 02-
Cityrrown State Zip Code
l i 9 r7'�
Phone Number 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)
First Name Last Name
Company Name
Address
City/Town State Zip Code
Phone Number 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):
H & IYM M 011t?fl� "PUT11
Street Address Cityrrown
How to find Latitude �f �r q 6 o 7� ? o, / 73 1/0 O Y
and Longitude 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)
and how to convert / {� 0 /
to decimal degrees Assessors' Map Number Assessors' Lot/Parcel Number
b. Area Description (use additional paper, if necessary):
T' q/ KNO8 r#LgC"S"
c. Plan and/or Map Reference(s): (use additional paper if necessary)
Title
Title
Date
Date
wpaformt.doc • rev. 4/28/2023 WPA Forth 1 — Request for Determination of Apphcab&y • 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 Municipality
B. Project Description (cont.)
2. a. Activity/Work Description (q�e additional paper and/or provide plan(s) of Activity, if necessary):
qO U S ,L� r)'J O l C. l T% j� ,/`7 %! e%r Pl1 r{C C� 7" �/•'J L/
t'D�1 / Oos-c 11i�CJ-1 AO C��hcan � C- 7rom �,%/Z/ 7U^ le)l Z
/qC ded �L�t' 9E'd'` '%�° r���9r� JUG' S�CQ•7d S%LG/4j
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.)
wpaformt.doc - rev. 4/28/2023 WPA Form 1— Request for Determination of Applicability • Page 2 of 3
'mw I 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. I request the 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.
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
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 accordaQce with Sect' n 10 (3)(b)(1) of the Wetlands Protection Act regulations.
/Z 1 2 c Z,�—
$fir ature of Applie n Date
Signature of Representative (if any)
Date
wparorml.doc- rev.4128/2023 WPA Form 1— Request for Determination of Applicability - Page 3 of 3
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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
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 13-1-s-�0)-or-Bylaw-(Town-of Yarmouth _W-etland.. _By=Law,Chapter143_)
C. The address of the lot where the activity is proposed is1
D. Proposed work is 6a� e 01 d
-1-0 ' 0' Z a c�-e d .�G�f 9r► e r r>?.��' �v.r Z.n ;ter • l o'rCf .
Of:, N3) a uJ 4N E W
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 r �7 8 9g
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 Ro` et-'T E ke �l y !"
Address / S pi/1 c
Town BOWDA _ State �� ZiP+-y Z
Telephone &' 7 0 ` 3 '�J
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.