HomeMy WebLinkAboutBSHD-26-66 application 0� TA, Ra 1yf +
br' +1?O t - Office Use Only
os ��j y r JUL 1 r 202 Permit# -
v.cck s• Amount 90
RPORASE� ~r BUIL Itd t3E -,1r �'��
✓ �y _^ Permit expires 180 days from
- --' issue date
EXPRESS SHED PERMIT APPLICATION
TOWN OF YARMOUTH
Yarmouth Building Department
1146 Route 28
South Yarmouth, MA 02664
(508)398-2231 Ext. 1261
�
CONSTRUCTION ADDRESS: (0 C..'e at/ks5� ^ l �� l irk 0 z(0C Y
OWNER: R L uLt� Vl(lLtYZDSS f_ hL tcSe_ (L7O Z 2/ 62C/Z
NAME PRESENT ADDRESS TEL. #
l �s t :CONTRACTOR:—0t N e,
Q, NAME cot MAILING ADDRESS TEL#
EMAIL: /"i t.4 VL& J 10 l e �`c C� (.•Drc.-
,Residential 0 Commercial ❑Est.Cost of Construction$ S { OOD
Home Improvement Contractor Lic.# Construction Supervisor Lic.#
SHED INFORMATION
rr
New Size L I a W it) x H 4 /Z$ Corner Lot: Yes No ?Q
Per Town of Yarmouth Zoning By-Law Sec 203.5 Note E:
Side and rear yard setbacks for accessory buildings containing one hundred_ffty (150)square feet or less and single story,
shall be six(6) feet in all districts. but in no case shall said accessory buildings be built closer than twelve (12)feet to any
other building on an adjacent parcel. All sheds are required to be located thirty(30) feet from any front lot line
Replace existing* Size L x W x H
*The debris will be disposed of at:
Location of Fadlity
I declare under penalties of perjury that e sta- herein contained are true and correct to the best of my knowledge and belief. I understand that any false answer(s)
will be just cause for denial or r- • :+.n of my;j� se an' for prosecution under M.G.L.Ch.268,Sgction 1.
Applicant's Signature: 4, ,i_awl__ Date: x /
Owners Signature(or atta• l W Date: -.77/,j z 61
Approved By: All Date:
Build' g Offi ial(or -signee)
Zoning District
Historical District: ❑ Yes X No
**Conservation review will be required if shed is placed within 100ft of
wetland,200ft from riverfront,or located within a flood zone**
t)24
The Commonwealth of Massachusetts
Department of Industrial Accidents
y ip
Office of Investigations
Lafayette City Center
4.7
2 Avenue de Lafayette, Boston,MA 02111-1750
.,�
-�-� www.mass.gov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual):
Address:
City/State/Zip: Phone #:_
Are you an employer? Check the appropriate box:
Type of project(required):
1.❑ I am a employer with 4. 0 I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. ®New construction
2.12I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have g. D Demolition
working for me in any capacity. employees and have workers' 9. ❑Building addition
[No workers' comp. insurance comp. insurance.
required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs
insurance required] t c. 152, §1(4),and we have no 13.❑Other
employees. [No workers'
comp. insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins. Lic. #: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature: Date:
Phone#:
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(check one):
1DBoard of Health 20 Building Department 31:City/Town Clerk 4.DElectrical Inspector 50Plumbing
Inspector 6.0Other
Contact Person: Phone#:
•
The Commonwealth of Massachusetts
" " / Department oflndustrialAccidents •
::a:-.mar
-_=n= 7 1 Confess Stree4 Sabi 100
`]E+=>' Boston,MA 0211 4-2 01 7
www mass.gov/&a
Workers'Compess€Nao Wars ore Affidavit:Builder&JCortractorafElsitricuoa/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Ambient information Peast Print L4E114
Name(¢tines/OrgwimiioonAndwidoa)): 1 ii gA4Y 14150 N5 14 n
LL 1.
Address:ZS ti LyJAQgjh T'CYp>sq- y--4r.
City/State/Zip: Y'W i M tR. S Phone it:ScB " th 3 0 -Z p M
Aen as employer?Creek the appropriate hart Type of project(required):
I. +t am a employer wih?S employee(full and/or pattime)• ' 7."'New construction
2❑1 era a sole proprietor at partnership trod have no empby.e,working for me'fF-. i „ 6.0 Remodeling
any capacityRh waters'camp.imams required] I?''
sat am a homeowner doing all soak myself.(No waken'comp.bourne required]t 9 0 Demolition
4.1:1I am a hanm d waer an will be hm tie eonaacars tooviductanweek m my Popery.1 will l0 0 Building addition
ensure tint all coronation either lava workers'compensation buvaoce or are sole 11.9 Electrical repairs or additions
propnetat with m employee,.
12.a N•n)ir s,repair;•or rdditioas
501 era a geonercontraew axe I We hired the orbtontmdas listed on the cubed sheet
These,aM:maactas have employees and have workers'comp.insunroe.I 13.0Roef repairs
6.0 We ate a corporation end is officers lave exorcised their rigle of exemption pa MGI a (4.QOtber
152,61(4).end on have no employees No waken'rap insurance required.]
•Arry applicant that cheeks box al moor also fill as the emtion below showing their workers'compemetioe policy information.
t N encewnere who autumn rhea affidavit indimiag dry arc doing all work and then hire outside contractors mat admit•new affidavit f di:sena such
ICadruriors dm cheek this boa mat attached an eddicaml sleet'towing that eve of die ta'}cen taetas end state Matter a not thov ersinn have
ernplgm.If the nb-armacaes hoot employees,they mull,,lie their woekao'ramp.policy number.
/am an employer that B providing when'eempearedett Insurance for my employees. Belay is the policy a dfsb she
Insurance Company Name d U� I tDQJ(� I�f,'TQ (�� -a s(15(A l� fy1(71 L14Qif1C�
I, p
Policy d or Self-ins.Lic.Jt:�'C_'�-600— l'Z 4 cl— 0�Expiration DMZ(2 r„a 12 7
Job Site Address: a(O —11, . �AtIsa. ?, awl'City/Stwig/Zip• Mir 112(v(4
Attach a copy et the workers'compensation policy declaration page(showing the policy member and expiration date).
Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by a fine up to 51,500.00
and/or one•year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a
day against the violator.A copy of this ent forwarded to the Office of Investigations of the DIA for insurance
coverage verification
I do hereby ceMtfy aka a of perjury that the infornaanton provided /abo/(v/r_is true and correctcorrectSignatwc Date: _[ C c
Phone/. S a 8 c(3 b— 7.iImes
Official' use only. Do not write in this area to be eoOpdeted by city or town official
City or Tows: Permit/License h —___
isaeioy Authority(circle oat):
I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Numbing Inspector
6.Other
Contact Person: ..... Phone a:
l awes Conwnontvsahh of Massachusetts co natruenon supervisor I E 2 Forney
Division of Occupational Uconsurs
MP Board of Building Regulations and Standards
Cii
Conatruc ��
Hl I3 2 Family _,--"'\l-------'4'
C$FA O73S66 t • ` •
JAMES FtMc or' i C.....I. : r
204 CRANVI 0
BREYfSTER Q
2
y4.0I.6/d(t°° Failure to poetess s cement'Union of the Masfachusata state
�� Building code a th
taus*for revocation of e license
e.
Commissioner a ,er Contact OPsI:(917)727-200 or Vet wnnanws.g°Maggogl
f 1 I
THE COMMONWEALTH OF MASSACHUSETTS
Office of Consumer Atfaftiand Business Regulation
1000 WashUlrt.Sub 710
11$
Home I . ..••• ,•..•ration �l )
a -il
41 2 . ,}'� •
r
=sue Type: Corporation
MU
MOOMTH POST♦8EAM CORPORATION lam' '. 'r`r- + t
DMA PINE HAMS VM000 PROD. ;:I -- 10�00/2026
WO WEDS ANNE 111D. �'_ • f -_ .: )
MARwWCN,MA 0264E r -
:. _, LadsN Address end Man owe
TIE 0041SONr[ANq Of NMEA6M1 eirrYs
Odes M Csttnaatsr AMs s ewp attendee 604Issdwt wild der(sestet aes only talent tets
MOIL ald0itO01fMACTOh =!ate ta4M led.
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MITIGATION CALCULATIONS:UNDER TOM OF YARMOUTH WETLAND
��%
PROTECTION REGULATIONS SECTION 6.02 i BUFFER ng 17
i.ii, pi
(VARIANCE REQ. h EXIST NO PROPOSED NET CHANGE MPROPOSED ITIGATION _V/�� r�` l�MITIGATION AT (SIR) (S.F.) (S.F.) '/ if
i,,t No1"a° INV •�
COMMISSIONS pSCRE110N) (SF.) ,0%
AREA OF STRUCTURES IAA A Ii /-` I
0 0 0 o -...TWA LOE 04, rr ,,,�
*AREA OF MINOR .: I."-
---p \'"- " � ` - \ „fir I �R� `/�
STRUCTURES (DECKS t 711 711 0 0 -- _ - `- "�. �� iO
• a HASCAPE -- 12, irTOTAL 0'-J5' 711 711 0 0 - `R-�~ -�--i�' -- , \\�a� /// o ' J. -'..N.
EXLSTING PROPOSED NET CHANGE PRCMSm r_^ATP - -'t7,e101-&F:15-- r11, N N�. \ y
- M111GA710N /1:1T UPUWO • \
(3 1 M11GJ1110N REQ) (SJ'.) (S F.) (S F.) (S.F.) , 4 4
-- `1� � j 9.83_AC-16—— **"AREA LS$1RUCTUIlQ 278 278 0 0 ._•--... -1 ,t� . J �' +` \ \ Ali 01. 1111k 1
As POOLS +A, 011 •
STRUC• OF MINORTURES (GEL' S & 833 633 0 0 —_- / - i '' E \ \\\ \ LOCUS MAP
SHEDS) I HARDSCAPE r.» '17- \ ; :, 1 \ 1
I \ \\ 1� ` SCALE 1' 2000'f
TOTAL 35'-50' 1.111 1.111 0 0 '�o• .4444` O \\\
\ ~ /f ti l 1 ASSESSORS MAP 59 PARCEL 136
1 PA
50=100' BUFFER DOSING PROPOSED NET CHANGE IGATION ,� * ,�\ PATIO ' �! // / /� f LOCUS
ItOFs IMTHIN MINIMAL A FLOOD OODHAZARDZONE Xa?X
(2:1 MITIGATION REQ.) (SIR) (S R) (s F.) (S.F.) �,r• U 4 p. i / / / /�/ ANNUAL CHANCE FLOOD HAZARD))_AS SHOWN
�� '` t �1` •‘ / / / / !' ON COMMUNITY PANEL #25001C0557J DATED
AREA OF STRUCTURES l ,� �" \yt, ,.; / 1 / Al / 7/1 e/2014
• POOLS 1,6/2 1,512 d 0 S 5:` / ^v> / / r
AREA OF MINOR I \ - • °' � ,�\/ % / // i /'k �/ ZONING SUMMARY
STRUCTURES (DECKS I 2.476 3,140 171 342 PAVED „A
SHEDS ! HARDSCAPE 1 DRIVEWAY ` �� 60 ,\ ,/ // // // // ZONING DISTRICT: R-40 DISTRICTED E)OS11N0 PROPOSED
TOTAL 50'-100r 4,�W0 4,061 171 342 + �' �• � • 1� \ / // // /*./ // / MIN. LOT SIZE 40,000 S.F. 27.610t SF 27,610t SF
'TOTAL RIMMED (0 X 3) + (0 x 3) + (171 x 2) - 342 S.F. 1 ,!r' '�'� `"¢� i I , /, / •/+///// /' MIN. LOT FRONTAGE 150' 52.00' Q200'
MITIGATION 363* S.F. PROPOSED ` �\ , y \ t - / / / / / 1 MIN. FRONT SETBACK 30' 131.7 131.7'
\ / , ,/,,/I / MIN. SIDE SETBACK 20' 7.0' 7.0'
NOTES /"/ •,�,/ \• • / / /// MIN. REAR SETBACK 20 47.7' 47.7'
, ' f B-- _ •,/ / / , / / /A MAX BUILDING COVERAGE 25x 7.0* 7.6%
i J -- _ / •. / / / / i' MAX. BUILDING HEIGHT 35' < S 435.
NOTES �'� I / / / / / /
\ ,� ' � �� .." ./ / / / / / / SITE IS LOCATED WITHIN MASS DEP ZONE II WELLHEAD PROTECTION
i. DATA b�)!)» t,;' /S� kti\ '' + a - //�%/ //// // OVERLAY DISTRICT
Z THIS PLAN IS FOR PROPOSED WOW ONLY AND NOT TO SE USED FOR LOT , � n _ / / /
LIE SVAR,NG OR ANY OTHER PURPOSE. \ •'Y / -' / / OWNER OF RECORD
S CONTACTOR SHALL BE REIPONIB1E FOR CAL NIG DIO5AFE(S11)AND .a ` `_--` tiS, .1 S -- � �'/ / / // THE SHAWCROSS TRUST
1O1C MM THE DITOFLOCATION OF ALL UNDERGROUND« OVERHEAD PRIOR \ 14- -` ~� � . / // , ALAN J & JULIE T SHAWCROSS. IRS
TO COiAFliOEMENT OF N010f.
�,,� S60B WEST RONEL RD
4,ClSTf G SEPTIC LOCATION PER TE-CARD ON FLi WTI TOM do, •
1YORIC LIMIT �,,I , /' // / PHOENIX, AZ 56083
14.
O. WETLAND PLAOam BY NEED+ JOHNSON OF KUU1 AX DEEM LLc. 3/13//s. / s��o,� FEN SLT '' /� ,?!, ..," -ice.., REFERENCES
S.RIFE1OICf M1IOATION PLANING PLAN IY ANDIIEMI OARNJ►Y 0/20//2Sttvt' \ +CE / .* DEED BOOK
\� 'G. ' + • �/ 'erg,' PLAN BOOK 13168 PAGE 14121i5
LEGEND �► -'5� Are
-- - �><,.m comma ,,., ,�� �.. / /• PROPOSED GARAGE
x.a' EAST. ED �. ' 1 ', "r�;Sri, ,QO SITE PLAN
--1911- PROPOSED CONTOUR ej 1 \ t ,I / // /
C.� r / �c` or
(8441 PROPOSED SPOT 0.. ` of�/� � // / ',•-,- ]I \?
�. TEST HOLE PPN .,:f, . _ , / , # .4'*0./+ / //� /' M NY #60 ICE HOUSE ROAD
a SOUND '�, -�c4c� - l' �. 4 / •pA SOUTH YARMOUTH, MA
raf
�� unLrn POLE �� '' tvi ,w,� '`n / > PREPARED FOR
NOW / N/2/ �4 V// ,' ALAN SHAWCROSS
OCATCH R►ASN 0 ,/ /i / ^�- / A9
0 uan POW Ito
///• f
/'` { // REV: JUI DATE:i i. i PORT °i.mrr L�I+b
.
NITER SIRlT OFF - / Illte
/� REY: JUNE 23. 2028 (REDUCED PROJECT TO A SHED)
7I— FENCE N\ / / ///
/ /iT#14 `n�
—M— WATER LNE -?' 805-362-4341
G_ OAS UNE `Qj doancA i
Pe.eom r
'� r0 we CE 1 t� ° rag in.
—� — OVERHEAD �"� c/vi! engineers
—s— SEWER UNE
rII Ng ALL mils xw MITI I INURE Scale:1"-20' _ land surveyors SURVEY: NHO
— 5 DATE DANIEL A. OJALA, P.E, P.LS. Y.U39M�P Street
T (Rt02B73 CHECKED VA) DRAFTED I /NC
SCE
#2'_38' 0 10 20 30 40 50 FEET 21--361 SHAWCROSS 2026 -2.dwg
ds"//'-,,,, i
1011, •
r � ,
\ /
� \N � / '�' MITIGATION PLANTING SCHEDULE
\ � / � ,- -- +, �-- SYMBOL PLANT NAME SIZE WANT.
\\ I \ / /// 1'� /' IKfX GiLABRA 4-5'QG /S 4
�` , "OAK /��.
•
4,r 4111.14)
-- - •r�4 C ENRAAALA 1A 4'QG /3 3
ERBUSH
! OAK
�'/ // • / HN:FiBUSH BLUEBERRY/ 'OAK / VACCpWUM CQ4YMBQSUM 6-8 QG N 4
s�i: f�' /f °'°NC 1a,-' PLANT SCHEDULE NOTE:
-./i + , / ,- /- PLANT SELECTION. SIZES AND SPACING PER CAPE COD COOPERATIVE
/ , • / , i EXTENSION 'TREES&SHRUBS FOR COASTAL ENVIRONMENTS' OR
/ �9' 'FRESH WATER RESOURCE BUFFER ZONE IKttS & SHRUBS' AND
/ / 71.
1 .i b� � • / // -, • FURTHER SELECTED PER SITE CONDITIONS.
/ ti- •` /
'"T3_� /���� u•oAX /' // /'� / ION
MITIGAT
• "'E o.w PLANTING PLAN
/ O' LOCATED AT
w
'� ricr / / #3A / #60 ICE HOUSE ROAD
44
\ oz , , ”. ,., SOUTH YARMOUTH, MA
/ /: \\ / 14. f�) ,,,, i s
i �� PREPARED FOR
/// 1 i 4„, // • w465�'N / / O ` ALAN SHAWCROSS
/' 40._ //��// / / �� REVISED: JUNE DATE: MAY O23,O28
2028
/ / / / ff/ n/
/
ei
/ f i/ / , el* 508-382-4541
iWI�-� / 0 1/ e) d\-teewa
w capeen inesrin int.
// / , / i / #2A 1,
i Q- / • / / �• civil engineers
\ c)- 12''OAK „ land surveyors
/ / // 14 ail Sca1�1 �10, 939 Main Street (Rte 6A)
/ ANDREW R. GARULAY, RLA YARMOU7NPORT MA 02675
DCE #2 -38 1 0 5 10 15 25 FEET 21-381 SHAWCROSS 2028 -2.dwg
•
Massachusetts Department of Environmental Protection Provided by MassDEP:
0Bureau of Resource Protection-Wetlands MassDEP File#:083-2546
WPA Form 5-Order of Conditions eDEP Transaction
Massachusetts Wetlands Protection Act M.G.L.c.131,§40 #:2030576
City/fown:YARMOUfH
A.General Information
1.Conservation Commission YARMOUTH
2.Issuance a a OOC b.r Amended OOC
3.Applicant Details
a.First Name ALAN J.AND JULIE T. b.Last Name SHAWCROSS,TRUSTEES
c.Organization
d.Mailing Address 5809 WEST ROWEL ROAD
e.City/Town PHOENIX f State AZ g.Zip Code 85083
4.Property Owner
a.First Name ALAN J.AND JULIE T. b.Last Name SHAWCROSS,TRUSTEES
c.Organization
d.Mailing Address 5809 WEST ROWEL ROAD
e.City/Town PHOENIX f.State AZ g.Zip Code 85083
5.Project Location
a.Street Address 60 ICE HOUSE ROADS
b.City/fown YARMOUTH c.Zip Code 02664
d.Assessors 59 e.Parcel/Lot# 136
Map/Plat#
f.Latitude 41.66858N g.Longitude 70.19937W
6.Property recorded at the Registry of Deed for:
a.County b.Certificate c.Book d.Page
BARNSTABLE 36093 295 l
7.Dates
a.Date NOI Filed:6/1 S/2026 b.Date Public Hearing Closed:7/2/2026 c.Date Of Issuance:7/15/2026
8.Final Approved Plans and Other Documents
a.Plan Title: b.Plan Prepared by: c.Plan Signed/Stamped by: d.Revised Final Date:e.Scale:
MITIGATION
PLANTING PLAN
LOCATED AT#60 DOWN CAPE ANDREW R.GARULAY, 6/23/2026 1"=10'
ICE HOUSE ROAD ENGINEERING,INC. R.L.A.
SOUTH
YARMOUTH,MA.
PROPOSED
GARAGE SITE
PLAN OF#60 ICE DOWN CAPE DANIEL A.OJALA,P.E.,
HOUSE ROAD ENGINEERING,INC P.L.S. 6/23/2026 1"=20'
SOUTH
YARMOUTH,MA.
B.Findings
Page 1 of 9•ELECTRONIC COPY
Massachusetts Department of Environmental Provided by MassDEP:
` -- Protection MassDEP File#:083-2546
.. Bureau of Resource Protection-Wetlands eDEP Transaction#:2030576
WPA Form 5-Order of Conditions ciry/Iown:vARMO[IIH
Massachusetts Wetlands Protection Act M.G.L.c. 131,§40
I.Findings pursuant to the Massachusetts Wetlands Protection Act
Following the review of the the above-referenced Notice of Intent and based on the information provided in this
application and presented at the public hearing,this Commission finds that the areas in which work is proposed is
significant to the following interests of the Wetlands Protection Act.
Check all that apply:
a. Public Water Supply b. r Land Containing Shellfish c.I.7 Prevention of Pollution
d. R Private Water Supply e. f Fisheries f. Protection of Wildlife Habitat
g. R Ground Water Supply h. R Storm Damage Prevention i. R Flood Control
2.Commission hereby fords the project,as proposed,is:
Approved subject to:
a.P.The following conditions which are necessary in accordance with the performance standards set forth in the
wetlands regulations.This Commission orders that all work shall be performed in accordance with the Notice of
Intent referenced above,the following General Conditions,and any other special conditions attached to this
Order.To the extent that the following conditions modify or differ from the plans,specifications,or other
proposals submitted with the Notice of Intent,these conditions shall control.
Denied because:
b.r The proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations.
Therefore,work on this project may not go forward unless and until a new Notice of Intent is submitted which
provides measures which are adequate to protect interests of the Act,and a final Order of Conditions is issued.A
description of the performance standards which the proposed work cannot meet is attached to this
Order.
c.r The information submitted by the applicant is not sufficient to describe the site,the work or the effect of the
work on the interests identified in the Wetlands Protection Act.Therefore,work on this project may not go
forward unless and until a revised Notice of Intent is submitted which provides sufficient information and
includes measures which are adequate to protect the interests of the Act,and a final Order of Conditions is
issued. A description of the specific information which is lacking and why it is necessary is attached to
this Order as per 310 CMR 10.05(6)(c).
3 R Buffer Zone Impacts:Shortest distance between limit of project disturbance and the wetland 50.4
resource area specified in 310CMR 10.02(1)(a). a. linear feet
Inland Resource Area Impacts:(For Approvals Only):
Resource Area Proposed Permitted Proposed Permitted
Alteration Alteration Replacement Replacement
4. r Bank
a. linear feet b. linear feet c. linear feet d. linear feet
5.r Bordering Vegetated Wetland
a.square feet b. square feet c. square feet d. square feet
6. r-Land under Waterbodies and Waterways
a. square feet b.square feet c.square feet d. square feet
Page 2 of 9*ELECTRONIC COPY
Massachusetts Department of Environmental Provided by MassDEP:
- Protection MassDEP File#:083-2546
Bureau of Resource Protection-Wetlands eDEP Transaction#:2030576
PA Form 5-Order of Conditions city/Iown:vARMOUTH
W
Massachusetts Wetlands Protection Act M.G.L.c. 131,§40
e.c/y dredged f.c/y dredged
7.r Bordering Land Subject to Flooding
a.square feet b. square feet c.square feet d.square feet
Cubic Feet Flood Storage
e.cubic feet f. cubic feet g.cubic feet h.cubic feet
8.r Isolated Land Subject to Flooding
a. square feet b. square feet
Cubic Feet Flood Storage
c.cubic feet d.cubic feet e.cubic feet f.cubic feet
9.r Riverfront Area
a.total sq. feet b.total sq. feet
Sq ft within 100 ft
c.square feet d. square feet e. square feet f.square feet
Sq ft between 100-200 ft
g.square feet h. square feet i.square feet j. square feet
Coastal Resource Area Impacts:
Resource Area Proposed Permitted Proposed Permitted
Alteration Alteration Replacement Replacement
10.r Designated Port Areas Indicate size under Land Under the Ocean,below
II.r Land Under the Ocean
a.square feet b. square feet
c.ely dredged d.c/y dredged
12.r Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes below
13.r Coastal Beaches
a. square feet b.square feet c.c/y nourishment d.c/y nourishment
14.r Coastal Dunes
a.square feet b.square feet c.c/y nourishment d.c/y nourishment
15.r Coastal Banks
a. linear feet b. linear feet
16.7 Rocky Intertidal Shores
a. square feet b.square feet
17.r Salt Marshes
a. square feet b. square feet c. square feet d. square feet
18.r Land Under Salt Ponds
a. square feet b. square feet
c. c,y dredged d.c/y dredged
19.r Land Containing Shellfish
a.square feet b.square feet c.square feet d.square feet
Page 3 of 9•ELECTRONIC COPY
L711Massachusetts Department of Environmental Provided by MassDEP:
Protection MassDEP File#:083-2546
Bureau of Resource Protection-Wetlands eDEP Transaction#:2030576
WPA Form 5-Order of Conditions Cityrrown:YARMovIil
Massachusetts Wetlands Protection Act M.G.L.c. 131,§40
Indicate size under Coastal Banks,inland Bank,Land Under the
20.r Fish Runs Ocean,and/or inland Land Under Waterbodies and Waterways,
above
c.c/y dredged d.c/y dredged
21.1—Land Subject to Coastal Storm Flowage
a. square feet b.square feet
22.
r Restoration/Enhancement(For Approvals Only)
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 B.5.c&d or B.17.c&d above,please entered the additional amount here.
a.square feet of BVW b. square feet of Salt Marsh
23.
r Streams Crossing(s)
If the project involves Stream Crossings,please enter the number of new stream crossings/number of replacement
stream crossings.
a. number of new stream crossings b.number of replacement stream
crossings
C.General Conditions Under Massachusetts Wetlands Protection Act
The following conditions are only applicable to Approved projects
1. Failure to comply with all conditions stated herein,and with all related statutes and other regulatory measures,
shall be deemed cause to revoke or modify this Order.
2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to
private property or invasion of private rights.
3. This Order does not relieve the permittee or any other person of the necessity of complying with all other
applicable federal,state,or local statutes,ordinances,bylaws,or regulations.
4. The work authorized hereunder shall be completed within three years from the date of this Order unless either
of the following apply:
a.the work is a maintenance dredging project as provided for in the Act;or
b. the time for completion has been extended to a specified date more than three years,but less than five
years, from the date of issuance. If this Order is intended to be valid for more than three years,the
extension date and the special circumstances warranting the extended time period are set forth as a
special condition in this Order.
5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon
application to the issuing authority at least 30 days prior to the expiration date of the Order.
6. If this Order constitutes an Amended Order of Conditions,this Amended Order of Conditions does not exceed
the issuance date of the original Final Order of Conditions.
7. Any fill used in connection with this project shall be clean fill.Any fill shall contain no trash,refuse,rubbish,
or debris,including but not limited to lumber,bricks,plaster,wire,lath,paper,cardboard,pipe,tires,ashes,
refrigerators,motor vehicles,or parts of any of the foregoing.
8. This Order is not final until all administrative appeal periods from this Order have elapsed,or if such an appeal
has been taken,until all proceedings before the Department have been completed.
Page 4 of 9 * ELECTRONIC COPY
•
Massachusetts Department of Environmental Provided by MassDEP:
1--- Protection MassDEP File#:083-2546
• �. Bureau of Resource Protection-Wetlands eDEP Transaction#:2030576
WPA Form 5-Order of Conditions ciry/Town:vARMOUTII
Massachusetts Wetlands Protection Act M.G.L.c. 131, §40
9. No work shall be undertaken until the Order has become final and then has been recorded in the Registry of
Deeds or the Land Court for the district in which the land is located,within the chain of title of the affected
property. In the case of recorded land,the Final Order shall also be noted in the Registry's Grantor Index under
the name of the owner of the land upon which the proposed work is to be done. In the case of the registered
land,the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon
which the proposed work is done.The recording information shall be submitted to the Conservation
Commission on the form at the end of this Order,which form must be stamped by the Registry of Deeds,prior
to the commencement of work..
10. A sign shall be displayed at the site not less then two square feet or more than three square feet in size bearing
the words,
"Massachusetts Department of Environmental Protection"
[or'MassDEP"J
File Number:"083-2546"
11. Where the Department of Environmental Protection is requested to issue a Superseding Order,the
Conservation Commission shall be a party to all agency proceedings and hearings before Mass DEP.
12. Upon completion of the work described herein,the applicant shall submit a Request for Certificate of
Compliance(WPA Form 8A)to the Conservation Commission.
13. The work shall conform to the plans and special conditions referenced in this order.
14. Any change to the plans identified in Condition#13 above shall require the applicant to inquire of the
Conservation Commission in writing whether the change is significant enough to require the filing of a new
Notice of Intent.
15. The Agent or members of the Conservation Commission and the Department of Environmental Protection shall
have the right to enter and inspect the area subject to this Order at reasonable hours to evaluate compliance with
the conditions stated in this Order,and may require the submittal of any data deemed necessary by the
Conservation Commission or Department for that evaluation.
16. This Order of Conditions shall apply to any successor in interest or successor in control of the property subject
to this Order and to any contractor or other person performing work conditioned by this Order.
17. Prior to the start of work,and if the project involves work adjacent to a Bordering Vegetated Wetland,the
boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden stakes or flagging.
Once in place,the wetland boundary markers shall be maintained until a Certificate of Compliance has been
issued by the Conservation Commission.
18. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully stabilized
with vegetation or other means.At no time shall sediments be deposited in a wetland or water body.During
construction,the applicant or his/her designee shall inspect the erosion controls on a daily basis and shall
remove accumulated sediments as needed.The applicant shall immediately control any erosion problems that
occur at the site and shall also immediately notify the Conservation Commission,which reserves the right to
require additional erosion and/or damage prevention controls it may deem necessary. Sedimentation barriers
shall serve as the limit of work unless another limit of work line has been approved by this Order.
NOTICE OF STORMWATER CONTROL AND MAINTENANCE REQUIREMENTS
19. The work associated with this Order(the"Project")is(1) r is not(2)I7 subject to the Massachusetts
Stormwater Standards.If the work is subject to Stormwater Standards,then the project is subject to the
following conditions;
a) All work,including site preparation,land disturbance,construction and redevelopment,shall be implemented
in accordance with the construction period pollution prevention and erosion and sedimentation control plan
and,if applicable,the Stormwater Pollution Prevention Plan required by the National Pollutant Discharge
Elimination System Construction General Permit as required by Stormwater Standard 8.Construction period
erosion,sedimentation and pollution control measures and best management practices(BMPs)shall remain
Page 5 of 9* ELECTRONIC COPY
Massachusetts Department of Environmental Provided by MassDEP:
Protection MassDEP File#:083-2546
Bureau of Resource Protection-Wetlands T on#:2030576
WPA Form 5-Order of Conditions cnyRown YARMovrH
Massachusetts Wetlands Protection Act M.G.L.c. 131,§40
in place until the site is fully stabilized.
b) No stormwater runoff may be discharged to the post-construction stormwater BMPs unless and until a
Registered Professional Engineer provides a Certification that: i. all construction period BMPs have been
removed or will be removed by a date certain specified in the Certification. For any construction period
BMPs intended to be converted to post construction operation for stormwater attenuation,recharge,and/or
treatment,the conversion is allowed by the MassDEP Stormwater Handbook BMP specifications and that the
BMP has been properly cleaned or prepared for post construction operation,including removal of all
construction period sediment trapped in inlet and outlet control structures;ii..as-built final construction
BMP plans are included,signed and stamped by a Registered Professional Engineer,certifying the site is
fully stabilized;iii. any illicit discharges to the stormwater management system have been removed,as per
the requirements of Stormwater Standard 10;iv. all post-construction stormwater BMPs are installed in
accordance with the plans(including all planting plans)approved by the issuing authority,and have been
inspected to ensure that they are not damaged and that they are in proper working condition; v. any vegetation
associated with post-construction BMPs is suitably established to withstand erosion.
c) The landowner is responsible for BMP maintenance until the issuing authority is notified that another party
has legally assumed responsibility for BMP maintenance. Prior to requesting a Certificate of Compliance,or
Partial Certificate of Compliance,the responsible party(defined in General Condition 19(e))shall execute
and submit to the issuing authority an Operation and Maintenance Compliance Statement("O&M Statement")
for the Stormwater BMPs identifying the party responsible for implementing the stormwater BMP Operation
and Maintenance Plan("O&M Plan")and certifying the following: i.)the O&M Plan is complete and will be
implemented upon receipt of the Certificate of Compliance,and ii.)the future responsible parties shall be
notified in writing of their ongoing legal responsibility to operate and maintain the stormwater management
BMPs and implement the Stormwater Pollution Prevention Plan.
d) Post-construction pollution prevention and source control shall be implemented in accordance with the long-
term pollution prevention plan section of the approved Stormwater Report and,if applicable,the Stormwater
Pollution Prevention Plan required by the National Pollutant Discharge Elimination System Multi-Sector
General Permit.
e) Unless and until another party accepts responsibility,the landowner,or owner of any drainage easement,
assumes responsibility for maintaining each BMP.To overcome this presumption,the landowner of the
property must submit to the issuing authority a legally binding agreement of record,acceptable to the issuing
authority,evidencing that another entity has accepted responsibility for maintaining the BMP,and that the
proposed responsible party shall be treated as a permittee for purposes of implementing the requirements of
Conditions 19(f)through 19(k)with respect to that BMP. Any failure of the proposed responsible party to
implement the requirements of Conditions 19(f)through 19(k)with respect to that BMP shall be a violation
of the Order of Conditions or Certificate of Compliance. In the case of stormwater BMPs that are serving
more than one lot,the legally binding agreement shall also identify the lots that will be serviced by the
stormwater BMPs. A plan and easement deed that grants the responsible party access to perform the required
operation and maintenance must be submitted along with the legally binding agreement.
f) The responsible party shall operate and maintain all stormwater BMPs in accordance with the design plans,
the O&M Plan,and the requirements of the Massachusetts Stormwater Handbook.
g) The responsible party shall:
1. Maintain an operation and maintenance log for the last three(3)consecutive calendar years of
inspections,repairs,maintenance and/or replacement of the stormwater management system or any part
thereof,and disposal(for disposal the log shall indicate the type of material and the disposal location);
2. Make the maintenance log available to MassDEP and the Conservation Commission("Commission")
upon request;and
Page 6 of 9*ELECTRONIC COPY
Massachusetts Department of Environmental Provided by MassDEP:
--
It_-.- Protection MassDEP File#:083-2546
Bureau of Resource Protection-Wetlands eDEP Transaction#:2030576
WPA Form 5-Order of Conditions Cdyrrown Y'
RMOUTH
Massachusetts Wetlands Protection Act M.G.L.c. 131,§40
3.Allow members and agents of the MassDEP and the Commission to enter and inspect the site to evaluate
and ensure that the responsible party is in compliance with the requirements for each BMP established in
the O&M Plan approved by the issuing authority.
h) All sediment or other contaminants removed from stormwater BMPs shall be disposed of in accordance with
all applicable federal,state,and local laws and regulations.
i) Illicit discharges to the stormwater management system as defined in 310 CMR 10.04 arc prohibited.
j 1 The stormwater management system approved in the Order of Conditions shall not be changed without the •
prior written approval of the issuing authority.
k) Areas designated as qualifying pervious areas for the purpose of the Low Impact Site Design Credit(as
defined in the MassDEP Stormwater Handbook,Volume 3,Chapter 1,Low Impact Development Site Design
Credits)shall not be altered without the prior written approval of the issuing authority.
1) Access for maintenance,repair,and/or replacement of BMPs shall not be withheld.Any fencing constructed
around stormwater BMPs shall include access gates and shall be at least six inches above grade to allow for
wildlife passage.
Special Conditions:
D. Findings Under Municipal Wetlands Bylass or Ordinance
1.1s a municipal wetlands bylaw or ordinance applicable?W Yes T No
2.The Conservation Commission herebyfcheck one that applies):
a-r DENIES the proposed work which cannot be conditioned
to meet the standards set forth in a municipal ordinance
or bylaw specifically:
1. Municipal Ordinance or Bylaw 2.Citation
Therefore,work on this project may not go forward unless and until a revised Notice of Intent is submitted which
provides measures which are adequate to meet these standards,and a final Order or Conditions is issued.Which
are necessary to comply with a municipal ordinance or bylaw:
b.R APPROVES the proposed work,subject to the
following additional conditions.
1.Municipal Ordinance or YARMOUTH
Bylaw WETLAND BYLAW 2.Citation CHAPTER 143
3.The Commission orders that all work shall be performed in accordance with the following conditions and with the
Notice of Intent referenced above.To the extent that the following conditions modify or differ from the plans,
specifications,or other proposals submitted with the Notice of Intent,the conditions shall control.
The special conditions relating to municipal ordinance or bylaw are as follows:
SEE SPECIAL CONDITIONS ATTACHED PAGES 7A-7B
Page 7 of 9*ELECTRONIC COPY
Tmtvn of Yarmouth SPECIAL CONDITIONS
SE83-2546 Alan and Julie Shawcross,60 Ice House Road.
Approved: Mitigation Planting Plan Located at#60 Ice House Road South Yarmouth,MA.Prepared by Down Cape
Engineering,stamped by Andrew R.Garulay,R.L.A.dated 6/23/2026.
Proposed Garage Site Plan of#60 Ice House Road South Yarmouth,MA.Prepared by Down Cape Engineering,stamped by
Daniel A.Ojala,P.E.,P.L.S.dated 6/23/2026
Project description:Proposed shed with mitigation in the buffer zone to a BVW.
GENERAL:
I. The applicant/owner shall be responsible for always having a copy of the Order of Conditions on the job site and
shall be responsible for ensuring that all people performing the permitted activity are fully aware of its terms and
conditions.Failure to do so may result in the revocation of this permit,a fine or both.
2. This Order of Conditions shall be recorded at the registry of deeds/land court and proof of the recording shall be
submitted to the Conservation Commission prior to the Pre-Construction meeting.
3. The Conservation Commission,its agents and employees,shall have the right of entry upon the job site at all
reasonable times for the purposes of inspecting for compliance with the terms of this Order of Conditions until a
Certificate of Compliance is obtained and recorded at the Barnstable Registry of Deeds.Commission members and
the Conservation Administrator may acquire any information,measurements,photographs,observations and/or
materials or may require the submittal of any data/information deemed necessary by this Commission for that
evaluation.
4. This Order of Conditions authorizes only the activities described on the approved plan(s)and approved documents
referenced in this Order of Conditions.Any other or additional activities in areas within jurisdiction of the
Conservation Commission require a separate review and approval by the Conservation Commission.
5. Any change in the approved plan(s)which may or will alter an area subject to protection under the Wetlands
Protection Act(310 CMR 10.00)and the Town of Yarmouth Wetlands Protection Regulations,shall require the
Applicant to file,in writing,a notice of project change with this Commission and/or Staff prior to implementing the
change in the field to determine the significance of the change and determine whether administrative approval or an
Amended Order of Conditions or new Notice of Intent is required.Any errors in plans or information submitted by
the Applicant or their Representative shall be considered changes,and the above process shall be followed.Should
the project be changed without permission or found by the Yarmouth Conservation Commission to be altered in any
way from the approved plan(s),all work will immediately cease until the project is reapproved by the Commission.
6. The Commission reserves the right to amend this Order of Conditions prior to the completion of construction,after a
legally advertised public hearing if plans or circumstances are changed or if new conditions or information so
warrant.
7. The Commission reserves the right to require additional information from the Applicant or his/her Representative
prior to completion of construction,after a legally advertised public hearing,if plans or circumstances are changed or
if new conditions or information so warrant. If the Applicant will not provide such information,the Commission
reserves the right to hire a third party applicant at the homeowner's expense to obtain the information needed.
S. Noncompliance with these conditions shall constitute grounds to revoke this permit and/or for an Enforcement Order
and fines.Fines shall not exceed S300.00 per day/per violation.
PRE-CONSTRUCTON:
9. Prior to any site disturbance,a pre-construction meeting shall be arranged by the applicant to be held with the
responsible contractors(or those performing the work)and Conservation Administrator(CA)to review the Order of
Conditions,the work protocol and other required materials identified in this Order of Conditions.Notice of work start
and completion along with the name(s)and telephone number(s)of the person(s)responsible on site for compliance
with this Order shall be given in writing before or during the Pre-Construction meeting.Work shall not begin until a
pre-construction meeting is held,and the CA determines the work can proceed.
10. Prior to the pre-construction meeting,
a. All sedimentation controls(i.e.silt fences,and/or straw wattles at the work limit)shall be in place and ready
for inspection.The CA may instruct the contractors to modify the sedimentation controls to protect wetland
Resource Areas.Hay is not acceptable. It is the applicant's responsibility to implement and maintain
appropriate and adequate erosion controls measures until the site is stable.
b. Resource Areas,buffer zones,and structures shall be staked in the field.Such markers shall be placed by a
professional Land Surveyor or Engineer.The engineer or land surveyor for the project shall take
responsibility for the placement of the stakes and refreshing the stakes as necessary to reflect the approved
plan until the construction is complete.No work shall occur on the Resource Area side of the work limit
line.
Page 7a of 9*ELECTRONIC COPY
Town of Yarmouth SPECIAL CONDITIONS
SE83-2546 Alan and Julie Shawcross, 60 Ice House Road.
c. A sign shall be displayed on the site visible from the roadway showing the DEP file number and shall
remain posted until the issuance of a Certificate of Compliance.
DEMOLITION AND CONSTRUCTION
11. Debris, including litter, shall be picked up immediately. Any excess material that is excavated from the job site shall
be disposed of at a location approved by the CA or in a covered dumpster. No debris shall be allowed in a Wetland or
Waterway.
12. Washing of equipment/tools shall be done OFF -SITE
13. No equipment shall be refueled, nor shall fuel be stored within 100 feet of a resource area.
14. No material of any kind shall be buried, placed or dispersed in areas within jurisdiction of the Conservation
Commission, except as expressly permitted by the Order of Conditions or the plan(s) approved herein.
15. Machinery and vehicles, when not in use, shall be parked on the existing driveway, unless otherwise specified in the
Order of Conditions or on the approved site plan(s).
VEGETATION AND MITIGATION PLANTINGS:
16, All lawn is to be removed from the mitigation area and the area seeded or plugged with native groundcovers
17. Any area that is disturbed shall be revegetated with suitable native plant materials according to the site plan
immediately or as soon as the growing season commences until permanent stability is reached.
18. The planted Mitigation Area shall be allowed to naturalize in perpetuity. The area must be left undisturbed and there
shall be no use of fertilizers, removal of leaf litter, subsurface irrigation system, hardscape, structures of any kind, or
creation of lawn. Periodic weeding of invasive vegetation is allowed.
19. Mulch may only be applied under the drip line of each plant at the time of planting for moisture retention, soil
stabilization, and weed control during establishment. Native groundcovers will be utilized in the spaces between
larger plantings. At no time shall a mitigation or restoration area be sheet mulched.
20. Plantings shall be cared for to ensure their survival. Temporary above surface irrigation is permitted for the first three
(3) years for establishment.
21. Dumping Prohibited: There shall be no dumping of leaves, grass clippings, brush, or other debris within any
Resource Area or associated buffer zones. This condition shall be recorded as an on-going condition on the
Certificate of Compliance.
22. The applicant shall notify the CA in writing when the mitigation or restoration plants are installed.
23. Fertilizers and permanent irrigation are not permitted within the 50' buffer
24. The applicant must wait until the plants have been in place for at least 2 years before the Request for a Certificate of
Compliance is submitted. 90% survival is required; the CA may require additional plantings if this is not reached.
CERTIFICATE OF COMPLIANCE:
25. Upon completion of the project, a Request for a Certificate of Compliance shall be submitted by the applicant to the
Conservation Commission for review.
26. The request shall include the following:
a. A written statement from a similar professional as prepared the approved plan, such as a Massachusetts
registered professional engineer or land surveyor, certifying that a site inspection has been performed, the
date of this inspection, and that the work has been conducted in compliance with the plan(s) and documents
referenced above, as conditioned by the Commission. Any deviation from the approved plan(s) shall be
identified.
27. This Order of Conditions shall be considered in non-compliance until the applicant has obtained a Certificate of
Compliance and it has been recorded at the Barnstable Registry of Deeds. A copy of the recording information must
be submitted to the Commission.
Page 7h of 9 *ELECTRONIC COPY
Massachusetts Department of Environmental Provided by MassDEP:
Protection MassDEP File a:SE83-2546
Bureau of Resource Protection-Wetlands eDEP Transaction#:2030576
WPA Form 5-Order of Conditions City rrowreYARMOu'n-1
Massachusetts Wetlands Protection Act M.G.L.c.131,§40
E.Signatures
This Order is valid for three years from the date of issuance,unless otherwise 11 6 ZOZ(O
specified pursuant to General Condition#4.If this is an Amended Order of
Conditions,the Amended Order expires on the same date as the original Order of 1.Date of Original Order
Conditions.
Please indicate the number of members who will sign this form.This Order must Li
be signed by a majority of the Conservation Commission. 2.Number of Signers
The Order must be mailed by certified mail(return receipt requested)or hand delivered to the applicant.A copy also
must be mailed or hand delivered at the same time to the appropriate Department of Environmental Protection
Regional Office,if not filing electronically,and the property owner,if different from applicant.
Signatutes I /
r by hand delivery on 1/by certified mail,return receipt requested,on
Date Date 7I 5\ZLu
F.Appeals
The applicant,the owner,any person aggrieved by this Order,any owner of land abutting the land subject to this
Order,or any ten residents of the city or town in which such land is located,are hereby notified of their right to
request the appropriate MassDEP Regional Office to issue a Superseding Order of Conditions.The request must be
made by certified mail or hand delivery to the Department,with the appropriate filing fee and a completed Request
for Departmental Action Fee Transmittal Form,as provided in 310 CMR 10.03(7)within ten business days from the
date of issuance of this Order.A copy of the request shall at the same time be sent by certified mail or hand delivery
to the Conservation Commission and to the applicant,if he/she is not the appellant.
Any appellants seeking to appeal the Department's Superseding Order associated with this appeal will be required to
demonstrate prior participation in the review of this project.Previous participation in the permit proceeding means the
submission of written information to the Conservation Commission prior to the close of the public hearing,requesting
a Superseding Order,or providing written information to the Department prior to issuance of a Superseding Order.
The request shall state clearly and concisely the objections to the Order which is being appealed and how the Order
does not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act
(M.G.L.c.131.§40),and is inconsistent with the wetlands regulations(310 CMR 10.00).To the extent that the
Order is based on a municipal ordinance or bylaw,and not on the Massachusetts Wetlands Protection Act or
regulations,the Department has no appellate jurisdiction.
G.Recording Information
This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in which the
land is located,within the chain of title of the affected property.In the case of recorded land,the Final Order shall
also be noted in the Registry's Grantor Index under the name of the owner of the land subject to the Order.In the case
of registered land,this Order shall also be noted on the Land Court Certificate of Title of the owner of the land
Page%of r 5 ELECTRONIC COPY
Massachusetts Department of Environmental Provided by MassDEP:
Li Protection MassDEP File#:083-2546
Bureau of Resource Protection-Wetlands eDEP Transaction#:2030576
TH
WPA Form 5-Order of Conditions City/TOWf`Y' a
Massachusetts Wetlands Protection Act M.G.L.c. 131,§40
subject to the Order of Conditions.The recording information on this page shall be submitted to the Conservation
Commission listed below.
YARMOUTH
Conservation Commission
Detach on dotted line,have stamped by the Registry of Deeds and submit to the Conservation Commission.
To:
YARMOUTH
Conservation Commission
Please be advised that the Order of Conditions for the Project at:
60 ICE HOUSE ROAD' 083-2546
Project Location MassDEP File Number
Has been recorded at the Registry of Deeds of:
County Book Page
for:
Property Owner ALAN J.AND JULIE T.SHAWCROSS,
TRUSTEES
and has been noted in the chain of title of the affected property in:
Book Page
In accordance with the Order of Conditions issued on:
Date
If recorded land,the instrument number identifying this transaction is:
Instrument Number
If registered land,the document number identifying this transaction is:
Document Number
Signature of;\pplieant ac, 41 2010
Page 9 of 9*ELECTRONIC COPY