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RDA 8.17.2026
m undoUm`ku� d . Conservation Office 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. Su�rrrit€ie _all_ (1p rY` 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 filesipermits for the property address online, go to www.yarmouth.ma.us/LF 11 copy filing dropped off or mailed to the Conservation Office including: 171 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 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 ` relevant material if applicable (not applicable for flood zone only projects). V 1 Yarmouth Assessor's locator map highlighting parcel(s) where work is proposed, including map and parcel numbers. V 1 current abutters list identifying the property owners who are to be notified via certified mail. -i7— 1 abutter notification form accurately describing all work proposed in the narrative and plan. \1 Certified Mail Receipts (PS Form 3800) for all abutters notified. V1 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. V By-law filing fee: Separate check made payable to "Town of Yarmouth" 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(c)yarmouth.ma.us and iierolimo@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. 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 Re ulations, page 17. 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 • TTD11 (508) 398-2231 • hdirienzoL,anuouth.ma.us Rev 12/18/2025 'e applicant is NOT the properly owner: If tiPlease 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 A plicakle �R Certified Mail Receipt for Massachusetts Natural Heritage and Endangered Species Program. Information on MESA project review can be found here. Certified Mail Receipt for Massachusetts Division of Marine Fisheries. If filing via email, dmf.envreview- south _mass. gov, Amanda. Davis(c).mass.gov, CC: bdirienzo@yarmouth.ma.us and iierolimo(o),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 • bdirienzonayarniouth.ma.us Rev 12/ 18/2025 Massachusetts Department of Environmental Protection Bureau of Water Resources - Wetlands i ii] WPA Farm 1 - Request for Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Municipality A. General Information Important: 1. Applicant: When filling out forms on the Thomas J. Mendosa & Deborah E. Mendosa computer, use only First Name Last Name the tab key to move your cursor - do not 82 Massachusetts Avenue - use the return key. Address West Yarmouth MA 02673 r�5 City/Town State Zip Code 330-283-6214 tommendosa@aol.com Phone Number Email Address 2_ Property Owner (if different from Applicant): First Name Last Name Address Ma 02601 City/Town State Zip Code tommendosa@aol.com Phone Number Email Address (if known) 3. Representative (if any) CARLOS ROBERTO PEREIRA First Name Last Name Roberts Home & Yard Improvement Company Name 20 WAYLAND RD Address HYANNIS MA 02601 City/Town State Zip Code robertsimprovement@gmaii.com 774.3686012 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): 82 MASSACHUSEfTS AVENUE WEST YARMOUTH- MA - 02673 Street Address City/Town How to find Latitude 41,6420676 -70.2491727 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 022 430 to decimal degrees Assessors' Map Number Assessors' Lot/Parcel Number b. Area Description (use additional paper, if necessary): 15,000 sq.ft, reidential lot improved with a two-story singl-family dwelling, relatively level topography, paved driveway, located within FEMA Flood Zona AE-11. A mapped wetland and associated 100-foot buffer Zone are located in the rear portion of the property. c. Plan and/or Map Reference(s): (use additional paper if necessary) Existing condition Plan - July22,2026 Title Date Proposed Addition Plan July 28,2026 Title Date wpaforml.doc • rev. 4/28/2023 WPA Form 1 — Request for Determination of Applicability • Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Water Resources - Wetlands WPC, Fore l ^ Request for [determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Municipality L�kj y S. Project Description (cont.) 2. a. Activity/Work Description (use additional paper and/or provide plan(s) of Activity, if necessary); The proposed work consists of constructing a rear addition to an existing single-family residence. The addition will include a new laundry room, half bathroom, exterior deck, French doors, an outdoor shower, relocation of one existing window. There will not be any additional fill or change in elevation, all areas of disturbance outside of the addition will be returned to their original condition. 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 8/1196 ❑ 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.) wpaiormI.doc • rev. 412812023 WPA Form 1 - Request for Determination of Applicability • Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Water Resources -Wetlands P Fore I - Request for Determination of Applicability i+nunicipalit _�. i1 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 G. Determinations 1. 1 request the Yarmouth 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. 0 c. whether the Activities depicted on plan(s) referenced above is subject to the Wetlands Protection Act and its regulations. x❑ 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: Yarmouth 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. Signatures: also understand that notification of this Request will be placed in a local newspaper at my expense in accordance w4th Section 10.05(3)(b)(1) of the Wetlands Protection Act regulations. � L_ 07/31/2026 Date 07/31/2026 Date wpatarml.doc • rev. 4128/2023 WPA Form 1 — Request for Determination of Applicability - Page 3 of 3 vision GI5 Portal Pan and Zoom /. 2 v4G..v/- .3 - - d e���;lj J jll,// r 16. @ ~` .428 8f 12126, 2:04 PM https://gis.vgsi.com/YarmouthMAMap/ Page 1 of 1 q �q D PAP.TIUMN-r OF fN CONSERVATION sitea"e,66 authw&zatian 9"In If the applicant is not the property owner, please submit this form with your application. The owner must be scut a copy of the application on the saute day it is filed with this office. Property Address: 82 Massachusetts Avenue West Yarmouth MA o2ma t#ssessors MaplT,at: 22-430 I (we) hereby authorize the individual members of the Yanuouth 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 OA.G_I._ Ch _ 131, s. 40) andlor the Yarmouth Wetlands protection Bylaw (Chapter 143). Authorized gna hA FIease Fruit Ftiame: Thomas J. Mendosa & DebD€ah E. Mandosa If other than owner, please state whether tenant, :agent, or other: ALliliiig Address: 82 Massachusetts Avenue West Yarmouth, MA oar Phone: Cefl: WO-283.6214 Eniail: tommendosa@ad.eom FIx. Yarmouth Conservation Conmmission • 1146 Route 28 - South Yutuouth, MA 0266-1 1492 Tel. (508)-398-2231 Eat.1288 - Fax (508)-398-0836 • TTDN (508) 398-2231 y }o � aGed 11 t?S 6 �k /deWbNltllnowieA/WO3'lS6n•sl6/l:sd11U gzoz 'v isnBnv wv ov:a 'gzlvla Abutting Properties for 82 MASSACHUSETTS AVE WEST YARMOUTH, MA 02673 22/ 430/ 1 1 (50 Feet) Location: `22/431/// 87 MASSACHUSETTS AVE Owner: HILLIARD JAMES P TRS HILLIARD JOY C TRS 35 WEST RD WEST YARMOUTH, MA 02673 Location: 16/ 18/ / / 19 VERMONT AVE Owner: WAINWRIGHT STEPHEN E TRS STEPHEN E WAINWRIGHT REV TRUST 16 RACE POINT RD LACONIA, NH 03246 Location: 16/ 19/ / 1 17 VERMONT AVE Owner: MORIN KEVIN R MORIN DAWN M 218 TOWER RD LUDLOW , MA 01056 Location: 22/ 4261 / / 7 11 &15 VERMONT AVE Owner: TOWN OF YARMOUTH 1146 ROUTE 28 SOUTH YARMOUTH, MA 02664 Location: 22/ 432/ 81 MASSACHUSETTS AVE Owner: SIDOROVICH JON SIDOROVICH JACQUELINE 81 MASSACHUSETTS AVE WEST YARMOUTH, MA 02673 Location: 16/ 13/ / / 88 MASSACHUSETTS AVE Owner: CONNELLY FREDERICK E CONNELLY NELL P 1320 OSPREY AVE NAPLES, FL 34102 Location: 22/ 4291 / / 80 MASSACHUSETTS AVE Owner: MENDOSA THOMAS J MENDOSA DEBORAH E 27000 PARADISE SHORES DR ENGLEWOOD, FL 34223 Location: 22/ 433/ 79 MASSACHUSETTS AVE Owner: SMITH AUSTIN L JR SMITH SUSAN K 29 GEORGE ST MEDFORD, MA 02155 Location: 22/ 430/ / / 82 MASSACHUSETTS AVE Owner: MENDOSA THOMAS J MENDOSA DEBORAH E 27000 PARADISE SHORES DRIVE ENGLWOOD, FL 34223 Location: 22/ 428/ 78 MASSACHUSETTS AVE Owner: HELLMAN DAVID R TR HELLMAN SUSAN L TR 20 JUNIPER RIDGE RD WESTWOOD , MA 02090 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 is Thomas J, Mendosa & Deborah E. Mendosa 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.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 82 MASSACHUSETTS AVE W.Y. D. Proposed work is Construction of a modest rear addition to the existing residence. The addition will include a new laundry room, half bathroom, 15" x14"exterior deck, outdoor 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 n/a Or Applicant's representatives phone number 774.3686012 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) Note: Name Carlos Roberto Pereira - Roberts Home & Yard Improve ent Address 20 wayland rd Town Hyannis State Ma Zip 02601 Telephon e 774.368.6012 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. I till . j n f O. 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