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Home My Public Portal About2020 05 26 Public Meeting Packet4 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. Note: Before completing this form consult your local Conservation Commission regarding any municipal bylaw or ordinance. Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 3 - Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by MassDEP: MassDEP File Number Document Transaction Number City/Town A. General Information Project Location (Note: electronic filers will click on button to locate project site): I C3 TT a. Street Address Latitude and Longitude: f. Assessors Map/Plat Number 2. Applicant: %\1-6-1/ a. First Name b. City/Town d. Latitude g/Parcel /Lot Num b. Las Nam A/ e r -,z(-3 c. Zip Code e. Longitude gp c. Organization 'J d tr et Ad ress )1 /A)e. City/Town f. State g. Zip Code h. Phone Nu ier 'i. Fax Number y&i ' L5-6--Esivkc• I 3. Prpperty owner (required if different from applicant): fi N /4k 7/4 7/- V Check if more than one owner b. Last Name c. Organiza 9 _ d. Street Addrress e. Citcown Sre 4 1 TV-- h. Phone Number i. Fax Number 4. Revesentative (if any): it? ir( a. First Namq f. State g. Zip Code j. Email address b. Last Name c. Company d. Street AAdres4eSi/ e. City/Town h. Phone Number i. Fax Number 04 171Ten f. State )44 -7/ Email address 5. Total WPA Fee Paid (from NOI Wetland Fee Transmittal Form): a. Total Fee Paid b. State Fee Paid g. Zip Code c. City/Town Fee Paid wpaform3.doc • rev. 2/8/2018 Page 1 of 9 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 3 - Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by MassDEP: MassDEP File Number Document Transaction Number City/Town A. General Information (continued) 6. General roject Description: IA) /111 LC,i(6 7a. Project Type Checklist: (Limited Project Types see Section A. 7b.) 1. 1:ci Single Family Home 2. 0 Residential Subdivision 3. 0 Commercial/Industrial 4. q Dock/Pier 5. El Utilities 6. E Coastal engineering Structure 7. 0 Agriculture (e.g., cranberries, forestry) 8. q Transportation 9. 0 Other 7b. Is any portion of the proposed activity eligible to be treated as a limited project (including Ecological Restoration Li ited Project) subject to 310 CMR 10.24 (coastal) or 310 CMR 10.53 (inland)? If yes. describe which limited project applies to this project. (See 310 CMR 1. E Yes No 10.24 and 10.53 for a complete list and description of limited project types) 2. Limited Project Type If the proposed activity is eligible to be treated as an Ecological Restoration Limited Project (310 CMR10.24(8), 310 CMR 10.53(4)), complete and attach Appendix A: Ecological Restoration Limited Project Checklist and Signed Certification. Property recorded at the Registry of Deeds for: tt\)_ctb(f_ a. County c. Book l-Co1.3 I b. Certificate # (if istered land) Number B. Buffer Zone & Resource Area Impacts (temporary & permanent) 1. If Buffer Zone Only — Check if the project is located only in the Buffer Zone of a Bordering Vegetated Wetland, Inland Bank, or Coastal Resource Area. 2. 0 Inland Resource Areas (see 310 CMR 10.54-10.58; if not applicable, go to Section B.3, Coastal Resource Areas). Check all that apply below Attach narrative and any supporting documentation describing how the project will meet all performance standards for each of the resource areas altered, including standards requiring consideration of alternative project design or location. Page 2 of 9 wpaform3.doc • rev. 2/8/2018 4 For all projects affecting other Resource Areas. please attach a narrative explaining how the resource area was delineated. Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 3 - Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131. §40 Provided by MassDEP: MassDEP File Number Document Transaction Number City/Town B. Buffer Zone & Resource Area Impacts (temporary & permanent) (cont'd) Resource Area a b c. Bank Size of Proposed Alteration Proposed Replacement (if any) 1. linear feet 2. linear feet Bordering Vegetated 3 coo Wetland 1. square feet 2. square feet Land Under Waterbodies and Waterways Resource Area d. q Bordering Land Subject to Flooding 1. square feet 2. square feet 3. cubic yards dredged Size of Proposed Alteration Proposed Replacement (if any) 1. square feet 2. square feet 3. cubic feet of flood storage lost 4. cubic feet replaced e. q Isolated Land Subject to Flooding 1. square feet f. q Riverfront Area 2. cubic feet of flood storage lost 3. cubic feet replaced 1. Name of Waterway (if available) - specify coastal or inland 2. Width of Riverfront Area (check one): q 25 ft. - Designated Densely Developed Areas only q 100 ft. - New agricultural projects only q 200 ft. - All other projects 3. Total area of Riverfront Area on the site of the proposed project: 4. Proposed alteration of the Riverfront Area: a. total square feet square feet b. square feet within 100 ft. c. square feet between 100 ft. and 200 ft. 5. Has an alternatives analysis been done and is it attached to this NOI? 6. Was the lot where the activity is proposed created prior to August 1, 1996? 3. q Coastal Resource Areas: (See 310 CMR 10.25-10.35) Note: for coastal riverfront areas, please complete Section B.2.f. above. q Yes q No q Yes q No wpaforrn3.doc • rev. 2/8/2018 Page 3 of 9 4 Online Users: Include your document transaction number (provided on your receipt page) with all supplementary intonation you submit to the Department. Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 3 - Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by MassDEP: MassDEP File Number Document Transaction Number City/Town B. Buffer Zone & Resource Area Impacts (temporary & permanent) (cont'd) Check all that apply below. Attach narrative and supporting documentation describing how the project will meet all performance standards for each of the resource areas altered, including standards requiring consideration of alternative project design or location. Resource Area Size of Proposed Alteration a. 0 Designated Port Areas b. E Land Under the Ocean c. E d. q e. q f. q g. E] h. E i. q k. q Barrier Beach Coastal Beaches Coastal Dunes Coastal Banks Rocky Intertidal Shores Salt Marshes Land Under Salt Ponds Land Containing Shellfish Fish Runs I. E Land Subject to Coastal Storm Flowage 4. q Restoration/Enhancement 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.2.b or B.3.h above. please enter the additional amount here. Proposed Replacement (if any) Indicate size under Land Under the Oc,an, below 1. square feet 2. cubic yards dredged Indicate size under Coastal Beaches and/or Coastal Dunes below 1. square feet 2. cubic yards beach nourishment 1. square feet 2. cubic yards dune nourishment 4 ize of Proposed Alteration 1. linear feet 1 square feet Proposed Replacement (if any) 1. square feet 2. sq ft restoration. rehab., creation 1. square feet 2. cubic yards dredged 1. square feet Indicate size under Coastal Banks, inland Bank, Land Under the Ocean. and/or inland Land Under Waterbodies and Waterways. above 1. cubic yards dredged 1 square feet a. square feet of BVW 5. E Project Involves Stream Crossings a. number of new stream crossings b. square feet of Salt Marsh b. number of replacement stream crossings wpaform3.doc • rev. 2/8/2018 Page 4 of 9 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 3 - Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by MassDEP: MassDEP File Number Document Transaction Number City/Town C. Other Applicable Standards and Requirements q This is a proposal for an Ecological Restoration Limited Project. Skip Section C and complete Appendix A: Ecological Restoration Limited Project Checklists — Required Actions (310 CMR 10.11). Streamlined Massachusetts Endangered Species Act/Wetlands Protection Act Review Is any portion of the proposed project located in Estimated Habitat of Rare Wildlife as indicated on the most recent Estimated Habitat Map of State-Listed Rare Wetland Wildlife published by the Natural Heritage and Endangered Species Program (NHESP)? To view habitat maps. see the Massachusetts Natural Heritage Atlas or go to http://maps.massois.state.ma.us/PRI EST HAB/viewer.htm. a. El Yes 4/716 -7 b. Date of map No If yes, include proof of mailing or hand delivery of NOI to: Natural Heritage and Endangered Species Program Division of Fisheries and Wildlife 1 Rabbit Hill Road Westborough, MA 01581 If yes, the project is also subject to Massachusetts Endangered Species Act (MESA) review (321 CMR 10.18). To qualify fora streamlined, 30-day. MESA/Wetlands Protection Act review, please complete Section C.1.c, and include requested materials with this Notice of Intent (NOI); OR complete Section C.2.f, if applicable. If MESA supplemental information is not included with the NOI, by completing Section 1 of this form, the NHESP will require a separate MESA filing which may take up to 90 days to review (unless noted exceptions in Section 2 apply, see below). c. Submit Supplemental Information for Endangered Species Review' 1. E] Percentage/acreage of property to be altered: (a) within wetland Resource Area percentage/acreage (b) outside Resource Area percentage/acreage 2. Ej Assessor's Map or right-of-way plan of site 2. 0 Project plans for entire project site, including wetland resource areas and areas outside of wetlands jurisdiction, showing existing and proposed conditions, existing and proposed tree/vegetation clearing line, and clearly demarcated limits of work — (a) El Project description (including description of impacts outside of wetland resource area & buffer zone) (b) q Photographs representative of the site • Some projects not in Estimated Habitat may be located in Priority Habitat, and require NHESP review (see http://www.mass.00vieea/aqencies/dfq/dfw/natural-heritace/requlatory-review/). Priority Habitat includes habitat for state-listed plants and strictly upland species not protected by the Wetlands Protection Act. ▪ MESA projects may not be segmented (321 CMR 10.16). The applicant must disclose full development plans even if such plans are not required as part of the Notice of Intent process. Page 5 of 9 wpaform3.doc • rev. 2/8/2018 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 3 - Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131. §40 Provided by MassDEP: MassDEP File Number Document Transaction Number City/Town C. Other Applicable Standards and Requirements (cont'd) (cj 0 MESA filing fee (fee information available at http://www.mass.qov/dfwele/dfw/nhespireoulatory review/mesa/mesa fee schedule.htm). Make check payable to "Commonwealth of Massachusetts - NHESP" and mail to NHESP at above address Projects altering 10 or ore acres of land, also submit: (d) 0 Vegetation cov r type map of site (e) q Project plans sh wing Priority & Estimated Habitat boundaries (f) OR Check One of the f ollowing 1. 0 Project is exempt f m MESA review. Attach applicant lett r indicating which MESA exemption applies. (See 321 CMR 10.14, http://www.mass.qo dfwele/dfw/nhespirequlatory review/mesa/mesa exemptions.htm; the NOI must still be Sent to NHESP if the project is within estimated habitat pursuant to 310 CMR 10.37 and 10.59.) 2. D Separate MESA review ongoing. a. NHESP Tracking # b. Date submitted to NHESP 3. q Separate MESA review completed. Include copy of NHESP "n ' Take" determination or valid Conservation & Management Permit with approved plan. 3. For coastal projects only, is any portion of the proposed project located below the mean high water line or in a fish run? a. Not applicable — project is in inland resource area only b. [1] Yes q No If yes, include proof of mailing, hand deliVry, or electronic delivery of NOI to either: South Shore - Cohasset to Rhode Island border. and the Cape & Islands: Division of Marine Fisheries - Southeast Marine Fisheries Station Attn: Environmental Reviewer 836 South Rodney French Blvd. New Bedford, MA 02744 Email: DMF.EnvReview-South state.ma.us North Shore - Hull to New Hampshire border Division of Marine Fisheries - North Shore Office Attn: Environmental Reviewer 30 Emerson Avenue Gloucester, MA 01930 Email: DMF.EnvReview-North state.ma.us Also if yes, the project may require a Chapter 91 license. For coastal towns in the Northeast Region, please contact MassDEP's Boston Office. For coastal towns in the Southeast Region, please contact MassDEP's Southeast Regional Office. wpaform3.doc • rev. 2/8/2018 Page 6 of 9 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 3 - Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by MassDEP: MassDEP File Number Document Transaction Number City/Town C. Other Applicable Standards and Requirements (cont'd) 4. Is any portion of the proposed project within an Area of Critical Environmental Concern (ACEC)? Online Users: Include your document transaction number (provided on your 5. receipt page) with all supplementary information you submit to the Department. a. E Yes No If yes. provide name of ACEC (see instructions to WPA Form 3 or MassDEP Website for ACEC locations). Note: electronic filers click on Website. b. ACEC Is any portion of the proposed project within an area designated as an Outstanding Resource Water (ORW) as desirated in the Massachusetts Surface Water Quality Standards, 314 CMR 4.00? a. q Yes No 6. Is any portion of the site subject to a Wetlands Restriction Order under the Inland Wetlands Restriction Act (M.G.L. c. 131, § 40A) or the Coastal Wetlands Restriction Act (M.G.L. c. 130, § 105)? a. E1 Yes No 7. Is this project subject to provisions of the MassDEP Stormwater Management Standards? a. E] Yes. Attach a copy of the Stormwater Report as required by the Stormwater Management Standards per 310 CMR 10.05(6)(k)-(q) and check if: 1. E Applying for Low Impact Development (LID) site design credits (as described in Stormwater Management Handbook Vol. 2, Chapter 3) 2. 0 A portion of the site constitutes redevelopment 3. E Proprietary BMPs are included in the Stormwater Management System. No. Check why the project is exempt: Single-family house 2. 0 Emergency road repair 3. E Small Residential Subdivision (less than or equal to 4 single-family houses or less than or equal to 4 units in multi-family housing project) with no discharge to Critical Areas. D. Additional Information LI This is a proposal for an Ecological Restoration Limited Project. Skip Section D and complete Appendix A: Ecological Restoration Notice of Intent — Minimum Required Documents (310 CMR 10.12). Applicants must include the following with this Notice of Intent (N01). See instructions for details. Online Users: Attach the document transaction number (provided on your receipt page) for any of the f (lowing information you submit to the Department. 1. USGS or other map of the area (along with a narrative description. if necessary) containing sufficient information for the Conservation Commission and the Department to locate the site. (Electronic filers may omit this item.) wpaform3.doc • rev. 2/8/2018 Plans identifying the location of proposed activities (including activities proposed to serve as a Bordering Vegetated Wetland [BVW] replication area or other mitigating measure) relative to the boundaries of each affected resource area. Page 7 of 9 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 3 - Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by MassDEP: MassDEP File Number Document Transaction Number City/Town D. Additional Information (cont'd) Identify the method for BVW and other resource area boundary delineations (MassDEP BVW Field Data Form(s), Determination of Applicability, Order of Resource Area Delineation, etc.), and attach documentation of the methodology. 4. q List the titles and dates for all plans and other materials submitted with this NOI. 4_4/40 SCAM a. Plan Title SAivN. \NAP-.6 b. Prepared By /0A -ti c. Signed and Stamped by ..LcA LE d. Final Revision Date e. Scale f. Additional Plan or Document Title g. Date 5. q If there is more than one property owner, please attach a list of these property owners not listed on this form. 6. q Attach proof of mailing for Natural Heritage and Endangered Species Program. if needed. 7. q Attach proof of mailing for Massachusetts Division of Marine Fisheries, if needed. 8. Attach NOI Wetland Fee Transmittal Form 9. q Attach Stormwater Report, if needed. E. Fees 1. q Fee Exempt: No filing fee shall be assessed for projects of any city. town, county, or district of the Commonwealth, federally recognized Indian tribe nousing authority, municipal housing authority, or the Massachusetts Bay Transportation Authority. Applicants must submit the following information (in addition to pages 1 and 2 of the NOI Wetland Fee Transmittal Form) to confirm fee payment: 2. Municipal Check Number 3. Check date 4. State Check Number 5. Check date 6. Payor name on check: First Name 7. Payor name on check: Last Name wpaform3.doc • rev. 2/8/2018 Page 8 of 9 4 Lid Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 3 - Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by MassDEP: MassDEP File Number Document Transaction Number City/Town F. Signatures and Submittal Requirements I hereby certify under the penalties of perjury that the foregoing Notice of Intent and accompanying plans. documents, and supporting data are true and complete to the best of my knowledge. I understand that the Conservation Commission will place notification of this Notice in a local newspaper at the expense of the applicant in accordance with the wetlands regulations, 310 CMR 10.05(5)(a). I further certify under penalties of perjury that all abutters were notified of this application, pursuant to the requirements of M.G.L. c. 131. § 40. Notice must be made by Certificate of Mailing or in writing by hand delivery or certified mail (return receipt requested) to all abutters within 100 feet of the property line of the project location. Z(i f.) 7 k-fe41 •=5 ge),z-e7 1. Signature of Applicant 2. Date 3. Signatur of Property Owner (if ifferent) 4. Date 5. Signature of Representative (if a ) 6. Date For Conservation Commission: Two copies of the completed Notice of Intent (Form 3). including supporting plans and documents, two copies of the NOI Wetland Fee Transmittal Form, and the city/town fee payment, to the Conservation Commission by certified mail or hand delivery. For MassDEP: One copy of the completed Notice of Intent (Form 3), including supporting plans and documents, one copy of the NOI Wetland Fee Transmittal Form. and a copy of the state fee payment to the MassDEP Regional Office (see Instructions) by certified mail or hand delivery. Other: If the applicant has checked the "yes" box in any part of Section C, Item 3, above, refer to that section and the Instructions for additional submittal requirements. The original and copies must be sent simultaneously. Failure by the applicant to send copies in a timely manner may result in dismissal of the Notice of Intent. wpaform3.doc • rev. 2/8/2018 Page 9 of 9 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key .06 To calculate filing fees. refer to the category fee list and examples in the instructions for filling out WPA Form 3 (Notice of Intent). d. Mailing Address e. City/Town Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands NOI Wetland Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131. §40 A. Applicant Information 1. Location of Project: F:.3 1-1/471/. a. Street Address 31 b. City/Town c. Check number d. Fee amount 2. Applicant Mailing Address: g. Zip Code ‘12kk i h. Phone Num r i. Fax Number j. Email Ad kid-iv ss 1 C0 71 3. Property Owner if different): a First Name b. Last Name 4 ))(//11/ /73 /it / L c. Organization q ,tgefkie Oac_.,u%_f"-c_ knA-- 141A- f. State a. First Name 11/1 b. Last Name c. Organization d. Mailing Address e. City/Town h Phone Number f. State g. Zip Code i. Fax Number j. Email Address B. Fees Fee should be calculated using the following process & worksheet. Please see Instructions before filling out worksheet. Step 1/Type of Activity: Describe each type of activity that will occur in wetland resource area and buffer zone. Step 2/Number of Activities: Identify the number of each type of activity. Step 3/Individual Activity Fee: Identify each activity fee from the six project categories listed in the instructions. Step 4/Subtotal Activity Fee: Multiply the number of activities (identified in Step 2) times the fee per category (identified in Step 3) to reach a subtotal fee amount. Note: If any of these activities are in a Riverfront Area in addition to another Resource Area or the Buffer Zone. the fee per activity should be multiplied by 1.5 and then added to the subtotal amount. Step 5/Total Project Fee: Determine the total project fee by adding the subtotal amounts from Step 4. Step 6/Fee Payments: To calculate the state share of the fee, divide the total fee in half and subtract $12.50. To calculate the city/town share of the fee, divide the total fee in half and add $12.50. noifeett.cloc • Wetland Fee Transmittal Form • rev. 10/11 Page 1 of 2 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands NOI Wetland Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Fees (continued) Step 1/Type of Activity Step 2/Number Step Step 4/Subtotal Activity 3/Individual Activity Fee of Activities Step 5/Total Project Fee: Step 6/Fee Payments: Total Project Fee: State share of filing Fee: City/Town share of filling Fee: Fee /0, - a. Total Fe from Step 5 172- b. 1/2 Total Fee less $12.50 c. 1/2 Total Fee plus $12 50 C. Submittal Requirements a.) Complete pages 1 and 2 and send with a check or money order for the state share of the fee. payable to the Commonwealth of Massachusetts. Department of Environmental Protection Box 4062 Boston, MA 02211 b.) To the Conservation Commission: Send the Notice of Intent or Abbreviated Notice of Intent, a copy of this form: and the city/town fee payment. To MassDEP Regional Office (see Instructions): Send a copy of the Notice of Intent or Abbreviated Notice of Intent; a copy of this form: and a copy of the state fee payment. (E-filers of Notices of Intent may submit these electronically.) -loifeetf.doc *Wetland Fee Transmittal Form • rev. 10/11 Page 2 of 2 Code of the Town of Brewster Wetlands Protection Chapter 172 Brewster Wetlands Protection By-law Wetlands Fee Transmittal Form Fee Categories The fee must be calculated using the following process and worksheet and included in the Notice of Intent or Abbreviated Notice of Resource Area Delineation Application: Step 1/Type of Activity: Describe each type of activity (from the Category of Activities and Fees) which will occur in a wetland resource area and buffer zone. If a variance is requested. add "w/var." - for example: Cat. 1a): work on a single family lot: addition w/var. Step 2/Number of Activities: Identify the number of each type of activity. Step 3/Individual Activity Fee: Identify the fee associated with each type of activity using the categories of projects and fees listed. Add applicable variance fee for each activity requiring a variance. Step 4/Subtotal Activity Fee: Multiply the number of activities (identified in Step 2) times the fee per category (identified in Step 3) to reach a subtotal fee amount. Step 5/Total Project Fee: Determine the total BWP By-law fee for the project by adding the subtotal amounts identified in Step 4. Step 6/Advertising Fee: Add $15 for advertising Step 7/Processing and Mailing Fee: Add $20 for processing and mailing Step 8/Town Portion of State Fee: Amount calculated in Massachusetts NOI Wetland Fee Transmittal Form, WPA Form 3. Step 9/Total Paid to the Town of Brewster: Total of By-law fee, consultant fee, advertising fee. processing & mailing fee. and town portion of state fee. Make checks payable to the Town of Brewster. Step 1 Step 2 Step 3 Step 4 Type of Activity Number of Individual Subtotal Activities Activity Fee ke6,H4 4z_e_e/c ACT e.,e47.6eree Step 5! Total BWP By -Law Project Fee Step 6/Advertising Fee: Step 7/Processing & Mailing Fee: Step 8/Town Portion of State Fee: Step 9/Total Paid to the Town of Brewster: Submit only this page of the Fee Schedule with the Notice of Intent. NOI TOWN OF BREWSTER, MA BOARD OF ASSESSORS 2198 Main Street Brewster, MA 02631 Abutters List Within 300 feet of Parcel 48/19/0 4IY - - R LANE 3 7/45/0 -------4EU21/0 0 BRIER LANE 0 LOWER ROAD . -----48/20/0 197 BRIER LANE I 4 15/0 97 PR 48/19/0 183 BRIER. LAN 48/46/0 174 BRIER 48/45/0 200 BRIER LANE 100 0 100 ft Key Parcel ID Owner Location Meiling Street Mailing City ST ZipCd/Country 2154 37-45-0-E BREWSTER TOWN OF 0 LOWER ROAD MAIN STREET BREWSTER MA 02631 (19.25) CONSERVATION COMMISSION 2200 48-15-0-R i BERRY JOHN S & KATHLENE M 97 SPRING LANE 23 FORREST STREET E HAMPSTEAD NH 03826 (19-65) 2166 48-16-0-R MOORE DONALD JAMES & RUTH MARIE TI 107 SPRING LANE 701 MCGUIRE CIRCLE BERRYVILLE VA 22611 (19-36) ' THE MOORE FAMILY TRUST 2197 48-17-0-R JULIE L 121 SPRING LANE BOX 1 DENNISPORT MA 02639 (19-61) /'MITCHELL 2165 48-18-0-R DELGIZZI DAVID 141 SPRING LANE 3 BITTERSWEET LANE WESTON MA 02493-1903 (19-35) 2184 48-19-0-R FREDERICK R & MAUREEN T 183 BRIER LANE 197 BRIER LANE BREWSTER MA 02831 (19-34) "RYAN TRUSTEES RYAN FAMILY 2002 RT 2160 48-20-0-R RYAN FREDERICK R & MAUREEN T 197 BRIER LANE 197 BRIER LANE BREWSTER MA 02631 (19-31) TRUSTEES RYAN FAMILY 2002 RT 2159 48-21-0-E BREWSTER CONSERVATION TRUST 0 BRIER LANE 38 RED TOP ROAD BREWSTER MA 02631 (19-30) TRUSTEES 2158 48-22-0-E BREWSTER CONSERVATION TRUST 0 BRIER LANE 38 RED TOP ROAD BREWSTER MA 02831 (19-29) TRUSTEES 2161 46-45-0-R DRAKE JACK V & NANCY A 200 BRIER LANE P 0 BOX 935 BREWSTER MA 02631 (19-32) TRUSTEES BRIAR LANE NOM TRUST 2162 48-46-0-R SHEA JOHN B TRUSTEE & 174 BRIER LANE 174 BRIER LANE BREWSTER MA 02631 (19-33-1) SHEA JULIA P TRUSTEE Certified by: James M. Gallagher, MAA Deputy Assessor 2/2112020 Page 1 Spring Lane 112 130 — _ SPRING SPRING LANE LANE 153 BRIER LANE Town Map and NHESP Priority and Estimated Habitats of Rare Wildlife I 50t =1:1.12E 316.252 2 2.— .32 4 642.37-r MaisGIS T000grapn.: Fea:..•es ShSerr3C 0 cc.a e 1:4 514 Vi a.esc'1— a 34.13-60.83-n MassGIS T000grapnic Fames 3asemap USGS Topographic Map TOWN OF BREWSTER 1657 Main STREET BREWSTER, MA 02631 PHoNE: (508) 896-4546 FAx: (508) 896-8089 CONSERVATION ceiRREwSTER-MA.CrOV Notice of Intent Filing Checklist Brewster Wetlands Protection By-law Before you submit your Notice of Intent to the Conservation Commission and other applicable agencies. please complete and sign this check -list. showing that you understand and have completed all of the forms and procedures required for a Notice of Intent filing. The Conservation Commission will not open the hearing if the filing is not complete. The Conservation Commission requires one (1) electronic coov and three (3) paper (hard) copies of the Notice of Intent and attached plans for each filing. Include each item of the application, with pages numbered consecutively and in the order designated on this checklist. Staple these pages together, and attach the plan or plans with a paper clip. All of the pages and plan represent one copy of the application. The Conservation Commission members now require only plans and a narrative/variance narrative, and not the full NOI. Please send ten (10) plans and narrative, stapled to the plan Submit only ONE copy of this checklist to the Conservation Department. Components of the Application . Contact the Brewster Assessors' Office to provide to you a certified abutter's list and a photocopy of the appropriate section of the Town of Brewster Assessors' Map. showing the property of your project and all abutting properties required for a legal wetland filing under the Brewster Wetlands By-law. This list will provide the names of all direct abutters to the property (first abutters). all that abut the first abutters (second abutters) if they are within 300 feet of the lot lines of the property. and lot(s) directly across the street from your lot. The street is the first abutter and lots directly across, second abutters. If abutters are in another town, obtain a certified list of these abutters from the assessors' office in that town. and submit it and the appropriate assessors' map in the application also. V2. Notify all abutters on the list of your proposed project on the "Notice to Abutters" form letter, by certified, return receipt mail before or on the day of filing, and submit the Certified Mail Receipts (Form 3800) as part of the filing. Submit the Certified Mail Receipt of the application sent to the DEP and, if applicable, the MA Division of Fisheries and Wildlife's Natural Heritage & Endangered Species Program. Submit the US Postal Service Form 3811 at the hearing. OFFICE OF CONSERVATION CONNISSION Sti 3. Complete and include all applicable sections of the Notice of Intent (WPA Form 3). _ 4. Include MA Department of Environmental Protection (DEP) State Appendix G. Field Data Form(s) for bordering vegetated wetlands and other indicators of wetland hydrology. Submit one form for each area tested: one form for the wetland area and one for upland. 1:15. Include a photocopy of an 8" by 10" section of the appropriate United States Geological Survey (USGS) Quadrangle Map clearly showing the location of the project. C 6. If applicable, send copies of the Notice of Intent application and supporting documents by return receipt mail to the Massachusetts Natural Heritage and Endangered Species Program, the US Army Corps of Engineers, etc. Submit these certified mail receipts (Form 3800) to the Conservation Department. Lt?/7. Calculate the DEP fee on the DEP Wetland Fee Transmittal Form and include it with the application. Send the form with a check or money order for the state share, to the DEP Lock Box. Include a copy of the fee transmittal form and the check in the filing. ✓8. Include a clear ; comprehensive narrative, describing all aspects of the project. a/9. Include the Brewster Wetlands Protection By-law Notice of Intent Addendum. r 10. If applicable to this filing, include a variance request with alternatives analysis. 11. If applicable to this filing, include a copy of the "Appendix A MA Historical Commission" (MHC) form; the original of which shall be sent to MHC by certified, return receipt mail, and the Form 3800 to the Conservation Department with the other return receipts. At this time, the Brewster Conservation Commission requires this notification only in cases in which the lot is undisturbed by an existing structure. 1.12. Calculate the town filing fee on the Brewster WP By-law Transmittal Form. and add the advertising fee, processing & mailing fee, and the town portion of the state fee in the area provided. Include this with the application. 13. Include one check or money order for the total amount designated on the Brewster WP By-law Transmittal Form. d 14. Include a copy of the "Notice to Abutters" form letter. V15. Include a professional site plan, scale, 1" = 20", dearly showing: • In color, the wetland line (green), fifty foot buffer zone (red) and one hundred-foot buffer zone (dark blue) delineations, • wetland flags numbered to correspond with each Field Data Form, • topography (minimum 2 foot), contour line and spot elevation, • the insignia of the applicable professional(s) who designed the plan, in compliance with the Brewster Conservation Commission Policy for Plans for Wetlands Permitting of 3/8/05. All site plans: original and revised. shall show the wetland and buffer zones in color. 16. Include elevation drawings of the proposed structure(s) on paper of 8 1/2" x 11" or 11" x 17". 7 17. If the lot is an undeveloped, secluded, or otherwise unidentifiable area, identify the lot on the plan by the number of the nearest telephone pole or the nearest road intersection. If there is no pole on the lot, describe the lot's proximity to the nearest; for example. "the lot is twelve feet east of telephone pole no.167". _8. Fold each plan separately, right side out with title visible, and attach it to each copy of the application. 9. Include signed Site Access Authorization Form 20. Properly stake and flag the project site to identify all required portions of the project. prior to the day of filing. • Clearly stake all boundaries and limits of work. 4,- Clearly identify all stakes and flags in the field, showing the one hundred foot and 50 foot buffer zones and all wetland areas. • Designate each wetland type on the flag as "BVWT (bordering vegetated wetland), "TOB" (top of bank), "LSF" (land subject to flooding). etc. Conservation Commissioners and Department staff will inspect the site. Unless a holiday interferes. the filing deadline for all applications is noon on the Thursday at least ten (10) business days before the hearing. The hearing must be advertised in a local newspaper (at this time. the Cape Codder Newspaper) no less than five business days before a hearing. When a holiday interferes with the Friday production, the newspaper will notify the town of its earlier submittal deadline. Additional information or revised plans for continued hearings must be submitted no later than Monday at 4:00 PM. eight (8) days prior to the hearing. Submit twelve (12) hard copies (unless stated otherwise) in addition to the digital copy, and paper clip documents to the folded plan with the plan title on the outside. Anyone proposing a structure within 50 feet of a wetland resource area shall contact the Brewster Zoning Agent before the Co servation Co ission will open your hearing. , confirm that this application is complete Environmental consultant/engineer/surveyor Notice of Intent Filing Checklist 2018 Are you proposing an activity on land within 50 feet of any resource area protected under the Town of Brewster Wetlands Protection By-law? Yes n No If your answer to the above is yes, are you requesting a variance pursuant to Part 5 of the regulations promulgated pursuant to the Brewster Wetlands Protection By-law? 14 Yes C: No If so. please describe on a separate sheet in complete detail using the Brewster Wetlands Protection By-law Variance Justification form, the reasons for the variance, and the facts upon which the Commission should find that there has been a clear and convincing showing that the proposed work and its natural and consequential effects will not have any adverse effect upon any of the interests specified in the By-law and listed on the variance justification form. Is the lot to be altered by the proposed work currently unaltered (without a structure). and located on the Brewster Archaeological Sensitivity Map (available for view in the Conservation Department) with respect to historic or prehistoric (archaeological) interests? El Yes No If both apply, have you completed and mailed by certified mail or hand delivery the attached 950 CMR State Appendix A form from the Massachusetts Historical Commission, so that the Commission shall have received the Appendix A response prior to the filing of the Notice of Intent? E Yes 2 No ts,,A. Brewster Wetlands Protection By-law Notice of Intent Addendum Brewster Conservation Commission Notice of Intent Addendum Brewster Wetlands Protection By-law Chapter 172 Within 100 feet of the following - check all applicable resource areas: Coastal Wetlands Coastal Bank Coastal Dune Coastal Beach Coastal Marsh Flat Ocean Estuary Land Subject to Flooding or Inundation by Tidal Action Land Subject to Flooding by Coastal Storm Flowage Inland Wetlands 0 C 0 Inland Bank Meadow Marsh Bog -05.-RDf-4Q-1 A Swamp Lake Pond River Stream Land Under Said Waters Land Subject to Flooding or Inundation by Groundwater or Surface Water TOWN OF BREWSTER Date: CONSERVATION COMMISSION SITE ACCESS AUTHORIZATION FORM Project: Jesi Location: Property Owner: itg ,1,1),SA)) Agoit i•ifrat 4 IMue0 c.k I (we) hereby authorize the individual members of the Brewster 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 Brewster Wetlands Protection Bylaw (Chapter 172). Additionally, if an Order of Conditions is issued for the project, I (we) grant permission for Commission members and the Commission's agents to enter the above referenced property for the purpose of inspecting for compliance with the Order of Conditions. This site access authorization is valid until a Certificate of Compliance is issued by the Conservation Commission. Authorized Signature: Date: t 74-1V Please Print Name: If other than owner, please state whether tenant, agent, or other: Mailing Address: Phone: Email: Cell: Fax: Landscape Associates Landform Hardscape Plant Communities Sam Ward 127 Baron's Way Brewster, MA 02631 508-360-3201 183 Brier La Brewster Mass 02631 Project Narrative: This project remediates conditions within the 50 ft. buffer along existing wetland. The disturbed area has been inadvertently cleared of underbrush, bittersweet and briars. Deciduous and evergreen trees will be installed with blueberry shrubs and ground covers to establish levels of habitat while stabilizing the perimeter of the wetland. All plant materials are located and specified on the plan provided dated 02/20/19. The work zone is currently defined by flags and there will no activity beyond that area. All work will be performed without the use of hydraulic equipment. Wheelbarrows and dollies are used for transporting materials and fallen debris. No additional ground will be disturbed from the completion of this project. ru 111 0 rR D D D D D D P-- U -rtiI t-a D N 1-4 rr ru a- D D D D D N ru D N ru cr ru D D D ra D N CERTIFIED MAIL® RECEIPT Domestic Mail Only For delivery information. visit our website at www.usps.cone. BREWSTER, dIA 504F)1 Certified Mail Fee $3.55 Extra Services & Fees (cheek box, add lee aNpr44te q Retum Receipt (hardcopy) $ V./.1.11.1 q Return Receipt (electronic) S $0.00 q Certified Mall Restricted Delivery $ f 0 00 q Adult Signature Required $ 0 Adult Signature Restricted Delivery $ $0.00 Postage $0.55 $6.95 0631 vI I Postmark Here 05/04/2020 48-20-0-R RYAN FREDERICK R & MAUREEN T TRUSTEES RYAN FAMILY 2002 RT 197 BRIER LANE BREWSTER, MA 02631 U.S. Postal Service- CERTIFIED MAIL® RECEIPT Domestic Mail Only or Instructions For delivery information, visit our website at www.usps.com . BREWSTER, t.1-,""631 Certified Mall Fee $ $ J.55 VExtra Services & Fees (check box, add fee alSierite) 0 Return Receipt (harcloopy) $ I I . 1111 0 Return Receipt (akir-Ironic) $ $0,00 0 Certified Mail Restricted Delivery $ $1:1. 00 0 Adult Signature Required $ 0 Adrift Signature Restricted Delivery $ $ .00 Postage $ $0.55 $6.95 0631 30 Postmark Here 05/04/2020 48-45-0-R DRAKE JACK V & NANCY A TRUSTEES BRIAR LANE NOM TRUST P 0 BOX 935 BREWSTER, MA 02631 R v for Instructions U.S. Postal Service'' CERTIFIED MAIL® RECEIPT Domestic flail Only For delivery information, visit our website at www.usps.comn, • I NH 03°2 Certified Mail Fee $3 . 55 oc. Extra Services & Fees (check box, add fee arpror(tafe) q Return Receipt (hardoopy) q Return Receipt (electronic) $11.1111 Certified Mall Restricted Delivery $ $ l.J, Off q Adult Signature Required $ $0.00 Ei Adult Signature Restricted Delivery $ O r N $0.55 a- ru $6.95 BERRY JOHN S & KATHLENE M 23 FORREST STREET E HAMPSTEAD, NH 03826 PS Form 3800, April 2015 PSN 7530-02440-9047 020 See Reverse for Instructions N ru ru I-1 D D D D D 7019 m D r9 17- 11.1 0- r-1 O D D D D D N IT' RJ - i--1 D N N U) ru 17- 11.J a- D D D D D -cr- f1J CERTIFIED MAIL° RECEIPT Domestic Mail Only For delivery information, visit our website at www.usps.com BERRYVILLE? VA 22611 Certified Mail Fee $ $3.55 ra ices & Fees (check box, add fee .50 te) El Return Receipt (hardcopy) $ ['Return Receipt (electronic) $ ____sa.sici_ 0 Certified Mail Restricted Delivery $ ____.$31,44.4-_ n Adult Signature Required $ q —44tel7f.$15—Adult Signature Restricted Delivery $ Postage $0.55 0631 Postmark Here 30 48-1-40i , 2020$6.9` MOORE DONALD JAMES & RUTH MARIE T THE MOORE FAMILY TRUST 701 MCGUIRE CIRCLE BERRYVILLE, VA 22611 PS Form 3800, April 2015 PSN 7530-02-000-9047 See Reverse for Instructions U.S. Postal Service' CERTIFIED MAIL® RECEIPT Domestic Mail Only For delivery information, visit our website at www.usps.com'. BRy)TiR y itA Certified Mail Fee , $ Extra Services & Fees (check box, add fee 'Tate) D Return Receipt (hardcopy) $ I I IN ID Return Receipt (electronic) $ $0.00 0 Certified Mail Restricted Delivery $ $0 .00 0 Adult Signature Required $ $1.1.00 ID Adult Signature Restricted Delivery$ Postage $0.55 $6.95 SHEA JOHN B TRUSTEE & SHEA JULIA P TRUSTEE 174 BRIER LANE BREWSTER, MA 02631 0631 30 Postmark Here 05/04/2020 48-46-0-R r e for Instructions U.S. Postal Service' CERTIFIED MAIL° RECEIPT Domestic Mail Only For delivery information, visit our website at www.usps.com". WE N 114 112493 $ at ;4 111 1 Extra Services El Return Receipt (hardcopy) $ !I ices & Fees (check box, add fee lira) !: El Return Receipt (electronic) $ $111,00 ['Certified Mail Restricted Delivery $ DAdult Signature Required $0.121) 0 Adult Signature Restricted Delivery $ Certified Mail Fee $6 .55 Postage $0.55 $6.95 DELGIZZI DAVID 3 BITTERSWEET LANE WESTON, MA 02493-1903 :1631 30 Postmark Here 48gri-W2020 PS Form 3800, April 2015 PSN 7530-02-000-9047 See Reverse for Instructions U.S. Postal Service"' CERTIFIED MAIL° RECEIPT Domestic Mail Only For delivery information. visit our webslte at www.usps.com". Extra Services & Fees (check box, add fee dp te) 0 Return Receipt (hardcopy) $ I Ill! 0 Return Receipt (electronic) $ $11 00 C] Certified Mall Restricted Delivery $ Li Adult Signature Required $ ID Adult Signature Restricted Delivery $ 05/1*29,20 CHELL JULIE L i.?!..`X LENNASPORT, MA 02639 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands Massachusetts Wetlands Protection Act (M.G.L. C.131 S. 40) Brewster Conservation Commission Brewster Wetlands Protection By-law Chapter 172 Notice to Abutters Date: 10 To: Abutters of property located at: 1 1? ?_kt rG )411//i kek615 12-le &("2k 3 I Assessors' Map Parcel jg . Formerly Map iq Parcel 37 — From: Applicant Owner of Property: In accordance with the requirements of G.L c. 131. §40, Massachusetts Wetlands Protection Act and Section 5. the Town of Brewster Wetlands Protection By-law. this is notification to you that a filing has been submitted to the Brewster Conservation Commission on behalf of the applicant for a proposed project at the above captioned location. The Project includes the following: The proposed work will occur within feet of: Inland Wetlands Coastal Wetlands q The project will occur within an Inland Wetland. 0 The project will occur within a Coastal Wetland. The information and plans for the project may be reviewed between 8:30 AM and 4:00 PM at the Conservation Department. 1657 Main Street. A digital copy of the filing may be requested from the Conservation Department as an alternative. Contact information is available on the Conservation Department web page. A public hearing will be held Tuesday, 0-40At 50' , at the Brewster Town Offices. Hearings begin at 6:00 PM. The hearing notice will be publicized in the Cape Codder Newspaper no less than five (5) days prior to the hearing. If you have any questions. please call the Brewster Conservation Department at 896-4546, between the hours of 8:30 AM and 4:00 PM. Sincerely. 17,1"1 4 11 Representative for Applicant