The URL can be used to link to this page

Home My WebLink AboutRDA 8.18.2026Massachusetts 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. Applicant: When filling out forms on the Gene Bisol computer, use only the tab key to move your cursor - do not use the return key. Q rem How to find Latitude and Longitude and how to convert to decimal degrees First Name Last Name 4 Swan Lake Rd Address West Yarmouth MA 02673 City/Town State Zip Code 9782045868 gbbisol@gmail.com 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): 4 Swan Lake Rd West Yarmouth Street Address City/Town 41.65741-70.22138 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) 40 65 Assessors' Map Number Assessors' Lot/Parcel Number b. Area Description (use additional paper, if necessary): Residential area (1st house on Swan Lake Rd) just off Winslow Gray Rd c. Plan and/or Map Reference(s): (use additional paper if necessary) Title Date Title Date wpaform 1.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 WPA Form 1- Request for Determination of Applicability Massachusetts Wetlands L Protection Act M.G.L. c. 131, §40 Municipality B. Project Description (cont.) 2. a. Activity/Work Description (use additional paper and/or provide plan(s) of Activity, if necessary): Pine Harbor will build a 12' X 18' shed (model: Quivett Cape) that will be achored on a cement pad they will pour. Much of Swan Lake Rd is in Zone AE. Shed will be approximately 88' from the nearest wetland flag and over 140' from Seine (Swan) Pond. The shed is from Pine Harbor's "Classic" collection and is solid wood (no partical board) - very attractive and functional. 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). Approximately 88' from any wetlands designation. 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.) wpaform1.doc • rev. 4/28/2023 WPA Form 1 — Request for Determination of Applicability • Page 2 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 C. 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. ■❑ c. whether the Activities depicted on plan(s) referenced above is subject to the Wetlands Protection Act and its regulations. OF 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: I also and rst h notifi tion of is Request will be placed in a local newspaper at my expense in accordanc wi ecti 10.05(3) )(1) of the Wetlands Protection Act regulations. August 18, 2026 Signature of Applicant Date Signature of Representative (if any) Date wpaforml.doc • rev. 4/28/2023 WPA Form 1 — Request for Determination of Applicability • Page 3 of 3 Page 1 of 2 a&nittb tuitftw t PO RA�:/ �'��ae�taP 9 taatic�a: 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. NAO 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.varmouth.ma.us/LF Hardcopy filing dropped off or mailed to the Conservation Office including: 1 RDA Administrative Checklist V_1 complete RDA application WPA form 1 with original signatures (double sided). ('see page 2) V/ 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. TA 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). 1 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 via certified mail. V1 abutter notification form accurately describing all work proposed in the narrative and plan. l/ Certified Mail Receipts (PS Form 3800) for all abutters notified. 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" (6 Legal ad fee: Separate check made payable to "Town of Yarmouth" t'S Please list project property's street address on checks. Refer to Fee Schedule. Digital and DEP filing V A pdf of the entire application emailed to bdirienzo cDyarmouth.ma.us and jjerolimo(cDyarmouth.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. 1 below: 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. 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 yannouth.ma.us Rev 12/18/2025 Page 2 of 2 'If the applicant is NOT the property owner: 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. 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(a_mass.gov, Amanda. Davis(aD-mass. gov, CC: bdirienzo(awarmouth.ma.0 - and jjerolimo(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 &yarmouth.ma.us Rev 12/18/2025 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 -V 3C= -i�\ SOL 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 1' Gf-J,�ft3 LWE 19D D. Proposed work is YL" �-� �� ray X f I N AdZ�,C>m� S Q`�LdW o�) G _ALA- SSTt3AG Jz� iyl F� n S S�4ts� w «� 3� �t Fk! `10D 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 cl:'6 • Ac�+- 58 G S 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 G _--w-�_ -ilVS0L-- Address 4 SO.3�'-,eJ Town State Mk Zip r_Q) & 3 Telephone CP8• ao 4 S 86 8 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. ABUTTERS' LIST FOR 4 SWAN LAKE R® Neal Ellis 10 Swan Lake Rd West Yarmouth, MA 02673 Equity 1 Services, LLC 17 Arnold St Suite 100 Wakefield, RI 02879 Of .. M I n Qom., Ms! ar;ifsult I = i1f4 {{ ._ R T yM gyp, !ti Certified Mail Fee $5 n cc J {� 664 O 0 $ ({ t{{I Extra Services & Fees (check box, addteeegpr�to) 7i M ❑ Return Receipt (ha dcopy) $ _ ❑ Return Receipt (electronic) $ >{J , I {{.{ q �( pk� 2026 ❑ Certified Mail Restricted Delivery $ St rI . i I{ 1 ittj'Ft er, 9 ti 8 ru ❑Adult Signature Required $ tF, f_�I,E-t_ U-) ❑Adult Signature Restricted Delivery $ y Postage 82 t_{ n O $ Ate -t tIS r"3 C�- T tal P13r t�ge and Fees �shn,i; 1--3 $ Sent To Er � ---------- - - - - ------------ . Street and L No., or PO Box No - -------"-------"--------'-----""-"' u'7 CI" aiii State. 2%P+4®-----------------------------------------------•------------------ ---- ..0 CERTIFIED MAIL@ RECEIPT s. I Y nLi'S i'; : € { F; i " b F : vn {_{28'2 7 r,L Certified Mail Fee cc P T ®:�•-'-f r-1 , Extra Services & Fees (check box, add tee �� m ) •_., El Return Receipt (hardcopy) $�,;.:=_:-_:•• , ❑ Return Receipt (electronic) $ '{,{ Postfn ❑ Certified Mail Restricted Delivery $ { ill { ru _ []Adult Signature Required $_ -•T!— '_ AUG I e Lr) ❑Adult Signature Restricted Delivery $ Postage �0 E3 $ltn- r �, TtaIPsSs;age and Fees e � O $M�nwi� USPs Sent To Cr rO Street and -t. No., or PO Box No. '---------------------------------------------------- u1 Er City. States_ _______________________________________________________________________