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HomeMy WebLinkAboutRDA 5.13.2026 Page 1 of 2 '' Y �- ite /Og 1'0. r r hatule CiechtVJt Conservation ii4 Office genenat 9n/oiunation: 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. Submitting an app&cation: 14- 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. To view all Conservation files/permits for the property address online, go to www.yarmouth.ma.us/LF Hardccpy filing dropped off or mailed to the Conservation Office including: ' RDA Administrative Checklist 1 complete RDA application WPA form 1 with original signatures (double sided). ('see page 2) 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. Confirm that the work described in the /V A narrative, abutter notification, and plan matches and includes all proposed work/structures. If BVW or vegetated wetlands are present, delineation sheet(s), coastal bank calculation and other /rlevant material if applicable (not applicable for flood zone only projects). c7 1 Yarmouth Assessor's locator map highlighting parcel(s) where work is proposed, including map and �cel numbers. 1 ,current abutters list identifying the property owners who are to be notified via certified mail. 1 abutter notification form accurately describing all work proposed in the narrative and plan. Certified Mail Receipts (PS Form 3800)for all abutters notified. 0 / (A,e ; /w`4:y 11 v i ` I were d original and 7 photocopies of the plan/sketch, folded separately, right side out with title and address sv'sible. All plans shall reference NAVD1988 unless otherwise noted. Landscape plans shall be detailed to how proposed and existing conditions, native species, quantity, size an spacing. ,,✓✓✓ By-law filing fee: Separate check made payable to "Town of Yarmouth" (QC 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 bdirienzoyarmouth.ma.us and jierolimo(a�varmouth.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. nitial 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. 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 •bdirienzo(a,yarmouth.ma.us Rev 12/18/2025 Page 2 of 2 If the ap i ant is NOT the property owner: Please submit a signed Site Access Authorization Form;AND /(J 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 /�/0 Certified Mail Receipt for Massachusetts Natural Heritage and Endangered Species Program. Information / n on MESA project review can be found here. .�/6/ Certified Mail Receipt for Massachusetts Division of Marine Fisheries. If filing via email, dmf.envreview- south(a�mass.gov, Amanda.Davis@mass.gov, CC: bdirienzo(c�yarmouth.ma.us and jlerolimo(a�yarmouth.ma.us. 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 •bdirienzo(a,yarmouth.ma.us Rev 12/18/2025 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 Important: 1. When filling out forms the Applicant: on computer, use only the tab key to move First Name P your cursor - do not use the return key. Address Q r � fTw *1-k\1> Phone Number 2. Property Owner (if different from Applicant): First Name Address City/Town Last Name fl\O \ OAS State Zip Code S r.c+r�cv� © c� rv. �Q , +tee Email Address Last Name 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): Street Address r Cityrrown How to find Lalitude —10 . \?y 4 r w 1 , %- , 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) a -id how to convert O �j to decimal degrees 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) p i S10 c3 5' r i 3 2 Z Csr Title Date Title Date wparorm 1.doc • rev, 4tMa23 WPA Form 1 — Request for Determination of Applicability • Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Water Resources - Wetlands F WPA Form 1- Request for Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 MunicipaEitf B. Project Description (cont.) 2. a. Activity/Work Description (use additional paper and/or provide plan(s) of Activity, if necessary): p 10g0sV.A ')-3eC- "sZ>r, r-od c-YN 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.) wpsiorml.doc • rev. 4r2W023 WPA Form 1 - Request for belermination of Applicability - Page 2 of 3 Massachusetts Department of Environmental Protection LkiBureau 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 �c - re, , e, 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. Vc 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: 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. 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 acco ance with Section 10.0 )�of the Wetlands Protection Act regulations. Signature of Applicant Date Signature of Representative (if any) Date wpalorrn 1 doc • rev 4/28/2023 WPA Form 1 - Request for Determinalion of Applicability - Page 3 of 3 Si 6 g� DEPARTMENT OF CONSERVATION gkgod J ` 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: 't�' 0� Assessors Map/Lot: f (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 Signat r: Date: r c \2 le>U, Please Print Name: S -It- -a- %.r rt ^, N\ \'-, a u} If other than owner, please state whether tenant, agent, or other: Mailing Address: Phone: Cell: Ak3 2C� L— \2Csz1 S --'r' w C'& � 6-?ra n-k�� Email: 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 N011FIGNMON TO ABUTTERSUNDER THE TOWN OF YARM OUTH 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 B. The applicant hasfiled a Reguest for Determination of Applicability with the Yarmouth Conservation Commission, seeking knowledge of whether a project is subject to the Wetlands Protection Act (MGLc. 131 s. 40) or Bylaw (Town of Yarmouth Wetland By -Law, Chapter 143). Cv The address of the lot where the activity is proposed is._ lQk�r�'�r l- . D. Proposed work is 3 - S Aso 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 ''1' - 26L_ - 1 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 9�C`V\14%-Z Address Town Sate M r+ 2Jp d Telephone '\' - . 2%4�-1 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 5butheast Regional Office of the Department of Environmental Protection at (508) 946-2800 for more information about this application. 5/10126, 7:26 AM Vision GIS Portal QPan and Zoom 15- 7 999.999 14,56 % I S-11 \ d\C",e k 5 5 14.57 e� 14.58 1 1 lom 14 i ��k2 Qr� n �e�n AVM �� P � �-.� ors J � Y � '�: a• n (� c� � s` , - - - - - - - - - httos://gis.vgsi.com/YarmouthMAMap! 111 U.S. Postal Service-" U.S. Postal Service" m CERTIFIED MAIL@ RECEIPT W CERTIFIED MAIL® RECEIPT Domestic Mail Only Domestic Mail Only For delivery information,visit our website at www.usps.com rp For delivery information,visit our website at www.usps.com O Evanston, IL 60 t i 0 Melrose, 0217t6 Certified Mail Fee $�.- I U664 Certified Mail FeeUl s" I r g $ 1, In 11J . r-1 $ lE_1r Extra Services&Fees(check box,add fee lite) (r.. 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D ['Certified Mali Restricted Delivery $ $Ii.Il i t Here r- ❑Adult Signature Required $ $0,00 N ❑Adult Signature Required $ ��/ ru El Adult Adult Signature Restricted Delivery$ Adult Signature Restricted Delivery$ ${"? t r Lri iil Postage Postage $0,78 $ $11.78 r )[ Cl $ 05/13/202A t5llil/i1115 r- Total Postage and Fees ra Total Postage and Fees 1_ Cl $• $4.08 r- 6"OS O Sent To Sent To IT" Street and Apt.No.,or PO Sox No. co Street and Apt.No.,or PO Sox No. 03 to 0 City,State,ZIP+44 0— City,State,ZIP+45 PS Form 3800,January 2023 PSN 7530.02-000-9047 See Reverse for Instructions __. 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