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Notice of Intent MOV Tti.� Dartmouth Building Department x; 'r 400 Slocum Road • P.O.Box 79399 I664 Dartmouth,MA 02747 Tele.hone No. 508-910-1820 • Fax No. 508-910-1838 MEMORANDUM To: Dartmouth Conservation Commission From: Joel S. Reed, Director of Inspectional Services piA, Date: November 15, 2007 For: Technical review and written report on the Notice of Intent and plan(s) from Randall Medeiros re: Map 79 Lot 6-12 on Medeiros Lane. Reviewed,no comments at this time. C:\DOCUMENTS AND SETTINGS\SGONSALVES\MY DOCUMENTS\MY DOCUMENTS OLD PC\LETTER07\M7906-12.COM.DOC C DAR TMOUTH :� �, , MASSACHUSETTS CONSERVATION COMMISSION 3 �� y MICHAEL O'REILLY 400 SLOCUM ROAD•P. O. Box 79399 1 ' ENVIRONMENTAL AFFAIRS COORDINATOR DARTMOUTH, MA 02747-0985 TEL: (508) 910-1822 • FAX: (508) 910-1897 http://www.town.dartmouth.ma.us November 6, 2007 TO: Building Department Department of Public Works Planning Board Board of Health FROM: Dartmouth Conservation Commission SUBJECT: Request for review and written comments on the accompanying Notice of Intent and plan(s) from Randall Medeiros re: Map 79, Lot 6-12 on Medeiros Lane . Please review the attached Notice of Intent and plan(s). If you have any comments, please submit them to the Conservation Commission office by November 19, 2007. Thank you for your cooperation and assistance in this er. A/2 DF:df Randall Medeiros 822 State Road Dartmouth, MA 02747 Sitec, Inc. C/o John Keegan 449 Faunce Corner Rd Dartmouth, MA 02747 DARTMOUTH ��•�''r,s\ MASSACHUSETTS OO ) CONSERVATION COMMISSION z i yc� MICHAEL O'REILLY 400 SLOCUM ROAD•P. O. Box 79399 3o� l6Q j ENVIRONMENTAL AFFAIRS COORDINATOR DARTMOUTH, MA 02747-0985 TEL: (508) 910-1822 • FAX: (508)910-1897 http://www.town.dartmouth.ma.us November 6, 2007 The Chronicle P.O. Box 268 Dartmouth, MA 02748 news a.chroniclenewsonline.com LEGAL AD: Please run the following legal ad once in your issue of November 14, 2007 PRE-PAYMENT CHECK TO FOLLOW DARTMOUTH CONSERVATION COMMISSION NOTICE OF PUBLIC HEARING Notice is hereby given in accordance with the provisions of the Dartmouth Wetlands Protection Bylaw and M.G.L., Ch. 131, §40, the Wetlands Protection Act, that a hearing will be held on the Notice of Intent of Randall Medeiros who wishes to construct a single family dwelling on land located at Map 79, Lot 6-12 on Medeiros Lane in Dartmouth. The hearing will be held on Tuesday,November 20, 2007 at 7:00 p.m., in Room 103 at the Dartmouth Town Hall, 400 Slocum Road in Dartmouth and all interested parties should be present at that time. Jacquelyn McDonald, Chair CC: Chronicle D.E.P. Dartmouth Board of Health Dartmouth Building Dept. Dartmouth Planning Board Dartmouth D.P.W. Owner Applicant Applicant's representative(s) • Massachusetts Department of Environmental Protection Provided by DEP: Bureau of Resource Protection - Wetlands DEP File Number WPA Form 3 - Notice of Intent Document Transaction Number Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DARTMOUTH City/Town Important: A. General Information When filling out forms on the computer,use 1. Project Location (Note: electronic filers will click on button for GIS locator): only the tab key to move your MEDEIROS LANE DARTMOUTH 02747 cursor-do not a.Street Address b.City/Town c.Zip Code use the return key. Latitude and Longitude: d.Latitude e.Longitude All 79 6-12 f.Assessors Map/Plat Number g.Parcel/Lot Number IMPAIR 2. Applicant: RANDALL MEDEIROS a.First Name b.Last Name c.Company Note: 822 STATE ROAD Before d.Mailing Address completing this DARTMOUTH MA 02747 form consult your local e.City/Town f.State g.Zip Code Conservation Commission h.Phone Number i.Fax Number j.Email address regarding any municipal bylaw 3. Property owner(if different from applicant): ❑ Check if more than one owner or ordinance. a.First Name b.Last Name c.Company d.Mailing Address e.City/Town f.State g.Zip Code h.Phone Number i.Fax Number j.Email address 4. Representative (if any): ____ SITEC, INC. o a.Firm EMI JOHN KEEGAN ®e VD b.Contact Person First Name c.Contact Person Last Name z 449 FAUNCE CORNER ROAD co o o d.Mailing Address Ina -o DARTMOUTH MA 02747 xi:: e.City/Town f.State g.Zip Code �cc 508-998-2125 508-998-7554 JKEEGAN@SITEC-ENGINEERING.COM am I h.Phone Number i.Fax Number j.Email address v� 5. Total WPA Fee Paid (from NOI Wetland Fee Transmittal Form): 1000.00 487.50 512.50 a.Total Fee Paid b.State Fee Paid c.City/Town Fee Paid 6. General Project Description: THE PROJECT CONSISTS OF A DRIVEWAY CROSSING A BORDERING VEGETATED WETLAND TO ACCESS A SINGLE FAMILY DWELLING. THE SINGLE FAMILY DWELLING, ALONG WITH ASSOCIATED GRADING AND UTILITIES, FALLS WITHIN THE 100' BUFFER ZONE TO THE BVW. EROSION CONTROL IS PROPOSED DOWNGRADIANT OF ALL WORK. wpaform3.doc•rev.11/30/06 Page 1 of 9 Massachusetts Department of Environmental Protection Provided by DEP: LI Bureau of Resource Protection - Wetlands DEP File Number WPA Form 3 - Notice of Intent Document Transaction Number Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DARTMOUTH City/Town A. General Information (continued) 7. Project Type Checklist: a. ® Single Family Home b. ❑ Residential Subdivision c. ❑ Limited Project Driveway Crossing d. ❑ Commercial/Industrial e. ❑ Dock/Pier f. ❑ Utilities g. ❑ Coastal Engineering Structure h. ❑ Agriculture—cranberries, forestry i. ❑ Transportation j. ❑ Other 8. Property recorded at the Registry of Deeds for: BRISTOL 195 a.County b.Page Number 3493 c.Book d.Certificate#(if registered land) 9. Has work been performed on the property under an Order of Resource Area Delineation involving Simplified Review within 3 years of the date of this application? a. ❑ Yes b. ® No If yes, no Notice of Intent or Request for Determination of Applicability may be filed for work within the 50-foot-wide area in the Buffer Zone along the resource area during the three-year term of an Order of Resource Area Delineation, or any Extended Order, or until the applicant receives a Certificate of Compliance, whichever is later. 10. Buffer Zone Only- Is the project located only in the Buffer Zone of a bordering vegetated wetland, inland bank, or coastal resource area? a. ❑ Yes-answer 11 below, then skip to Section C. b. ® No- skip to Section B. 11. Buffer Zone Setback—For projects that involve work only in the buffer zone, select the applicable adjacent resource area (check one): a. ❑ BVW b. ❑ inland bank c. ❑ coastal resource area The distance between the closest project disturbance and the associated resource area is: d.linear feet wpaform3.doc•rev. 11/30/06 Page 2 of 9 • l Massachusetts Department of Environmental ProtectionL Provided by DEP: Bureau of Resource Protection - Wetlands DEP File Number WPA Form 3 - Notice of Intent Document Transaction Number Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DARTMOUTH City/Town B. Resource Area Effects 1. Inland 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. Online Users: Include your Resource Area Size of Proposed Alteration Proposed Replacement(if any) document transaction number a. ❑ Bank 1.linear feet 2.linear feet (provided on b. ® Bordering Vegetated 1230 1400 your receipt page)with all Wetland 1.square feet 2.square feet supplementary information you c. ❑ Land Under 1.square feet 2.square feet submit to the Waterbodies and Department. Waterways 3.cubic yards dredged d. ❑ Bordering Land Subject to Flooding 1.square feet 2.square feet 3.cubic feet of flood storage lost 4.cubic feet of flood storage replaced e. ❑ Isolated Land Subject to Flooding 1.squarefeet 2.cubic feet of flood storage lost 3.cubic feet of flood storage replaced f. ❑ Riverfront area 1.Name of Waterway(if available) El For projects 1.Width of Riverfront Area (check one): impacted by the riverfront area ❑ 25 ft. - Designated Densely Developed Areas only and a buffer zone of another resource area, ❑ 100 ft. New agricultural projects only add 50%to the total fee. ❑ 200 ft. -All other projects 2. Total area of Riverfront Area on the site of the proposed project: Square Feet 3. Proposed alteration of the Riverfront Area: a.Total Square Feet b.Square Feet within 100 ft. c.Square Feet between 100 ft.and 200 ft. 4. Has an alternatives analysis been done and is it attached to this NOI? ❑ Yes❑ No 5.Was the lot where the activity is proposed created prior to August 1, 1996? ❑ Yes❑ No wpaform3.doc•rev.11/30/06 Page 3 of 9 • Massachusetts Department of Environmental Protection Provided by DEP: Bureau of Resource Protection - Wetlands DEP File Number WPA Form 3 - Notice of Intent Document Transaction Number Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DARTMOUTH City/Town B. Resource Area Effects 2. Coastal Resource Areas: 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. Online Users: Include your Resource Area Size of Proposed Alteration Proposed Replacement(if any) document transaction a. ❑ Designated Port Areas Indicate size under Land Under the Ocean, below number (provided on your receipt b. El Land Under the Ocean 1.Square feet page)with all supplementary information you 2.Cubic yards dredged submit to the Indicate size under Coastal Beaches and/or Coastal Dunes Department. c. ❑ Barrier Beach below d. El Coastal Beaches 1.Square feet 2.Cubic yards beach nourishment e. El Coastal Dunes 1.Square feet 2.Cubic yards dune nourishment f. El Coastal Banks 1.Linear feet g. ❑ Rocky Intertidal Shores 1.Square feet h.El Salt Marshes 1.Square feet 2.Sq ft restoration,rehab.,or creation i. El Land Under Salt Ponds 1.Square feet 2.Cubic yards dredged j. ❑ Land Containing Shellfish 1.Square feet 2.Square feet restoration,rehab. k. ❑ Fish Runs Indicate size under Coastal Banks, inland Bank, Land Under the Ocean, and/or inland Land Under Waterbodies and Waterways, above 1.Cubic yards dredged I. El Land Subject to Coastal Storm Flowage 1.Square feet 3. Limited Project: Is any portion of the proposed activity eligible to be treated as a limited project subject to 310 CMR 10.24 or 310 CMR 10.53? a. ❑ Yes ® No If yes, describe which limited project applies to this project: b.Limited Project wpaform3.doc•rev.11/30/06 Page 4 of 9 • 1 Provided by DEP: Massachusetts Department of Environmental Protection 117:1 Bureau of Resource Protection - Wetlands DEP File Number WPA Form 3 - Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Document Transaction Number --- ---- DARTMOUTH City/Town C. Bordering Vegetated Wetland Delineation Methodology Check all methods used to delineate the Bordering Vegetated Wetland (BVW) boundary: Online Users: 1. ® Final Order of Resource Area Delineation issued by Conservation Commission or DEP Include your (attached) document transaction 2. ❑ DEP BVW Field Data Form (attached) number (provided on your receipt 3. ❑ Final Determination of Applicability issued by Conservation Commission or DEP (attached) page)with all supplementary a. ® Other Methods for Determiningthe BVW Boundary(attach information you documentation): submit to the Department. a. ® 50°/0 or more wetland indicator plants b. ❑ Saturated/inundated conditions exist For all projects c. ❑ Groundwater indicators affecting other d. ❑ Direct observation Resource Areas, please attach a e. ❑ Hydric soil indicators narrative f. ❑ Credible evidence of conditions prior to disturbance explaining how the resource 5. Other resource areas delineated: area was delineated. D. Other Applicable Standards and Requirements Streamlined Massachusetts Endangered Species Act/Wetlands Protection Act Review 1. 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://www.mass.aov/dfwele/dfw/nhesp/nhregmap.htm. a. ❑ Yes ® No If yes, include proof of mailing or hand delivery of NOI to: Natural Heritage and Endangered Species Program Division of Fisheries and Wildlife 2006 Route 135, North Drive b.Date of map Westborough, MA 01581 If yes, the project is subject to Massachusetts Endangered Species Act(MESA) review(321 CMR 10.18). To qualify for a streamlined, 30-day, MESA/Wetlands Protection Act review, please complete Section D.1.A, and include requested materials with this Notice of Intent(NOI); OR complete Section D.1.B, if applicable. If MESA supplemental information is not included with the NOI, by completing Section 9 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). A. Submit Supplemental Information for Endangered Species Review* ❑ Percentage/acreage of property to be altered: (1)within wetland Resource Area percentage/acreage (2) outside Resource Area percentage/acreage ❑ Assessor's Map or right-of-way plan of site wpaform3.doc•rev.11/30/06 Page 5 of 9 Massachusetts Department of Environmental Protection Provided by DEP: Bureau of Resource Protection - Wetlands DEP File Number WPA Form 3 - Notice of Intent Document Transaction Number j Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DARTMOUTH City/Town D. Other Applicable Standards and Requirements (cont.) ❑ 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** ❑ Project description (including description of impacts outside of wetland Resource Area & Buffer Zone) El Photographs representative of the site ❑ MESA filing fee(fee information available at: http://www.mass.gov/dfwele/dfw/nhesp/n henv mesa.htm) Make check payable to"Natural Heritage & Endangered Species Fund" and mail to NHESP at above address Projects altering 10 or more acres of land, also submit: ❑ Vegetation cover type map of site El Project plans showing Priority& Estimated Habitat boundaries B. OR Check One of the Following ❑ Project is exempt from MESA review. Attach applicant letter indicating which MESA exemption applies. (See 321 CMR 10.14, http://www.mass.gov/dfwele/dfw/nhesp/nhenvexemptions.htm) ❑ Separate MESA review ongoing. NHESP Tracking Number Date submitted to NHESP El Separate MESA review completed. Include copy of NHESP"no Take" determination or valid Conservation & Management Permit with approved plan. * Some projects not in Estimated Habitat may be located in Priority Habitat, and require NHESP review(see www.nhesp.org regulatory review tab). 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. 2. For coastal projects only, is any portion of the proposed project located below the mean high water line or in a fish run? a.❑ Yes ❑ No If yes, include proof of mailing or hand delivery of NOI to either: South Shore-Cohasset to Rhode North Shore- Hull to New Hampshire: Island, and the Cape& Islands: Division of Marine Fisheries- Division of Marine Fisheries- North Shore Office Southeast Marine Fisheries Station Attn: Environmental Reviewer Attn: Environmental Reviewer 30 Emerson Avenue 838 South Rodney French Blvd. Gloucester, MA 01930 New Bedford, MA 02744 b. ❑ Not applicable—project is in inland resource area only wpaform3.doc•rev. 11/30/06 Page 6 of 9 Massachusetts Department of Environmental Protection Provided by DEP: LI Bureau of Resource Protection - Wetlands DEP File Number WPA Form 3 - Notice of Intent Document Transaction Number Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DARTMOUTH City/Town D. Other Applicable Standards and Requirements (cont.) 3. Is any portion of the proposed project within an Area of Critical Environmental Concern (ACEC)? If yes, provide name of ACEC(see instructions to WPA Form 3 or DEP a. ❑ Yes ® No Website for ACEC locations). Note: electronic filers click on Website. b.ACEC Online Users: 4. Is any portion of the site subject to a Wetlands Restriction Order under the Inland Wetlands Include your Restriction Act(M.G.L. c. 131, § 40A)or the Coastal Wetlands Restriction Act(M.G.L. c. 130, § 105)? document transaction a. ❑ Yes ® No number (provided on 5. Is any activity within any Resource Area or Buffer Zone exempt from performance standards of the your receipt page)with all wetlands regulations, 310 CMR 10.00. supplementary information you a. ElYes ElNo If yes, describe which exemption applies to this project: submit to the Department. b.Exemption 6. Is this project subject to the DEP Stormwater Policy? a. ❑ Yes ® No If yes, stormwater management measures are required. Applicants should complete the Stormwater Management Form and submit it with this form. b. If no, explain why the project is exempt: SINGLE FAMILY DWELLING E. Additional Information Applicants must include the following with this Notice of Intent(NOI). See instructions for details. Online Users:Attach the document transaction number(provided on your receipt page)for any of the following 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.) 2. ® 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. 3. ❑ Other material identifying and explaining the determination of resource area boundaries shown on plans(e.g., a DEP BVW Field Data Form). 4. ❑ List the titles and dates for all plans and other materials submitted with this NOI. 5. ❑ If there is more than one property owner, please attach a list of these property owners not listed on this form. 6.❑ Attach proof of mailing for Natural Heritage and Endangered Species Program, if needed. 7. ❑ Attach proof of mailing for Massachusetts Division of Marine Fisheries, if needed. wpaform3.doc•rev.11/30/06 Page 7 of 9 • 1 Massachusetts Department of Environmental Protection Provided by DEP: Bureau of Resource Protection - Wetlands DEP File Number Document Transaction Number WPA Form 3 - Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DARTMOUTH City/Town E. Additional Information (cont.) 8. ® Attach NOI Wetland Fee Transmittal Form 9. El Attach Stormwater Management Form, if needed. F. Fees The fees for work proposed under each Notice of Intent must be calculated and submitted to the Conservation Commission and the Department (see Instructions and NOI Wetland Fee Transmittal Form). No filing fee shall be assessed for projects of any city, town, county, or district of the Commonwealth, federally recognized Indian tribe housing 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: lio6 CI, Icy 7/4) 7 1. Municipal Check Number 2.Check dat < �� 0 0 -7 /fri 7 07 3.State Check Number 4.Check da e 1-2-ikiVDI¢(.t. /K e-L)E"r t vl-i?S 5. Payor name on check: First Name 6. Payor name on check:Last Name G. 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 .G.L. c. 131, §40. Notice must be made in writing by hand delivery or certified mail (return rece. s to al e within 100 feet of the property line of the pro ect location. ..,-- i0 fie-7 Sinatu e of Applicant Date Signatufe of Pro elty Owner if di ent) Date G 1 ignatt of Rep e n ive(i any) Date For/Conservation Commis on: wo copies of the completed Notice of Intent (Form 3), including supporting plans and documents; two copies of pages 1 and 2 of the NOI Wetland Fee Transmittal Form; and the city/town fee payment must be sent to the Conservation Commission by certified mail or hand delivery. For DEP: One copy of the completed Notice of Intent(Form 3), including supporting plans and documents; one copy of pages 1 and 2 of the NOI Wetland Fee Transmittal Form; and a copy of the state fee payment must be sent to the DEP Regional Office (see Instructions) by certified mail or hand delivery. (E-filers may submit these electronically.) wpaform3.doc•rev. 11/30/06 Page 8 of 9 Y e Massachusetts Department of Environmental Protection Provided by DEP: ID Bureau of Resource Protection - Wetlands DEP File Number WPA Form 3 - Notice of Intent Document Transaction Number Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DARTMOUTH City/Town G. Signatures and Submittal Requirements (cont.) Other: If the applicant has checked the"yes" box in any part of Section D, 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.11/30/06 Page 9 of 9 • s Massachusetts Department of Environmental Protection 10 Bureau of Resource Protection - Wetlands NOI Wetland Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Important: A. Applicant Information When filling out forms on the 1. Applicant: computer, use RANDALL MEDEIROS only the tab key to move a.First Name b.Last Name c.Company your cursor- 822 STATE ROAD do not use the d.Mailing Address return key. DARTMOUTH MA 02747 e.City/Town f.State g.Zip Code ammink 2. Property Owner (if different): a.First Name b.Last Name c.Company d.Mailing Address e.City/Town f.State g.Zip Code h.Phone Number 3. Project Location: MEDEIROS LANE DARTMOUTH a.Street Address b.City/Town To calculate B. Fees filing fees, refer to the category Notice of Intent(Form 3) or Abbreviated Notice of Intent(Form 4): fee list and examples in the The fee should be calculated using the following six-step process and worksheet. Please see instructions for filling out WPA Instructions before filling out worksheet. Form 3(Notice of Intent). 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. Wpaform3.doc•NOI Wetland Fee Transmittal Form•rev.3/1/05 Page 1 of 2 k Massachusetts Department of Environmental Protection LN,‘, , 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 of Activities 3/Individual Fee Activity Fee SINGLE FAMILY HOUSE 1 500.00 500.00 CROSSING FOR DRIVEWAY 1 500.00 500.00 Step 5/Total Project Fee: 1000.00 Step 6/Fee Payments: Total Project Fee: 1000.00 a.Total fee from Step 5 State share of filing fee: 487.50 b.1/2 total fee less$12.50 City/Town share of filling fee: 512.50 c.1/2 total fee plus$12.50 C. Submittal Requirements a.) Complete pages 1 and 2 and send with a check or money order for the state share of the fee, payable to the Commonwealth of Massachusetts. Department of Environmental Protection Box 4062 Boston, MA 02211 b.) To the Conservation Commission: Send the Notice of Intent or Abbreviated Notice of Intent; a copy of this form; and the city/town fee payment. c.) To DEP Regional Office(see Instructions): Send a copy of the Notice of Intent or Abbreviated Notice of Intent; a copy of this form; and a copy of the state fee payment. (E-filers of Notices of Intent may submit these electronically.) 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O �3 j 2 66 22-7' @' .zv46-25� 48-34 Q SO.Fl. /.,T 1 <O9 be - 3/ pq� m O ` 1 c oQ B22 SSA 44. O N. ' f zpe sos s, R 'MAP 76 LOT �� zss9y ,$ 51s aszee P/O 76-t 4.? %-I - <oI ,Ii' 69 •r ss.g• .$v:FG UP 76 1 3 P3, -eases' O v . w. 41,56522-0 w P 3 _ 4 ®. 9 2os.9/' 46'4T - q. 3• � • , , ./➢4c.• t f/s C (C.. 'r2 a 15.' 4,- 4�'-33 f DATE OF AERIAL. PHOTOGRAPHY 3-29-E3 -2I lS .I9 c, DATE OF COMPLETION I-I_DS - at 8- MAP 76 For LOTS DATE OF REVISIONS $-.-769_ _I_I_95 _ 46-2o Tnfu 46-32 $. ;-€-p? LEGEND 3_I=9O _ t-I-99 48-48 Tn9u 48 4? PARCEL IERS 2 I-I-91 1_1_� ),/,. ....„.........,... ..,...,.......,..„_see MATCH LIR1E a I-I-92 2-9-49 _ z - 1-1-93 I-I-000 _ For AssessO,env Purposes -- I 1-02 Idofi IS be $550 for Conveyances I-1-03 I-I-O5 ABUTTERS LIST RANDALL L. MEDEIROS MAP 79—LOT 6-12 MAP 79 Lot 6-12 (Locus) Randall L. Medeiros 822 State Road N. Dartmouth, MA 02747 Lot 6-3 Walter A. Brown, III 305 Collins Corner Road N. Dartmouth, MA 02747 Lot 6-11 Frank P. Evangelho, Jr. & Suzanne Lerias 9 Medeiros Lane N. Dartmouth, MA 02747 Lot 6-6 David J. & Debra R. Hill 10 Medeiros Lane N. Dartmouth, MA 02747 Lot 6-5 Troy Allen Morgado & Lisa Avilla-Morgado 6 Medeiros Lane N. Dartmouth, MA 02747 Lot 6-4 Timothy L. and Lisa Medeiros 2 Medeiros Lane N. Dartmouth, MA 02747 Lot 6-2 Lynn E. Garnett 303 Collins Corner Road N. Dartmouth, MA 02747 Lot 8-1 Maurice H. &Ann E. Lemieux 287 Collins Corner Road N. Dartmouth, MA 02747 , Notification to Abutters Under the Massachusetts Wetlands Protection Act In accoroance with the second paragraph of Massachusetts General Laws Chapter 131, Section 40,you are hereby notified of the following. A. The name of the applicant is RANDY MEDEIROS B. The applicant has filed a Notice of Intent with the Conservation Commission for the municipality or DARTMOUTH seeking permission to remove, fill, dredge or alter an Area Subject to Protection Under the Wetlands Protection Act(General Laws Chapter 131, Section 40). C. The address of the lot where the activity is proposed is MEDEIROS LANE ASSESSORS MAP 79/LOT 6-12 D. Copies of the Notice of Intent may be examined at DARTMOUTH CONSERVATION COMMISSION between the hours of 9:00 a.m. and 4:00 p.m, on the following days of the week: MONDAY- FRIDAY For more information,call: (508 ) 910- -1822 Check One:This is the applicant , representative I f I ,or other X (specify) DARTMOUTH CONSERVATION COMMISSION E Copies of the Notice of intent may be obtained from either(check one)the applicant or the applicant's representative X , by calling this telephone number( 508) 998 - 2125 between the hours of 9:00 and 4:00 on the following days of the week: MONDAY-FRIDAY F. information regarding the date.time,and place of the public hearing may be obtained from DARTMOUTH CONSERVATION COMMISION by calling this number(508 )910 -1804_between the hours of 9:00 and 4:00 on the following days of the week: MONDAY- FRIDAY Check One:This is the applicant I , representative ,or other X (specify) DARTMOUTH CONSERVATION COMMISION NOTE:Notice of the public hearing, including its date time and place,will be published at least five(5)days in advance in the THE CHRONICLE Srwnre yr newspaper) NOTE:Notice of the public hearing,including its date,time,and place,will be posted in the City or Town Hall not less than forty-eight(48) hours in advance. NOTE:You also may contact your local Conservation Commission or the nearest Department of Environmental Protection Regional office for more information about this application or the Wetlands Protection Act. To contact DEP, call: Central Region: 508-792-7650 Northeast Region: 781-935-2160 Southeast Region: 508-946-2800 Western Region: 413-784-1100 i s AFFIDAVIT OF SERVICE Under the Massachusetts Wetlands Protection Act (to be submitted to the Massachusetts Department of Environmental Protection and the Conservation Commission when filing a Notice of Intent) I, KIMBERLY SOARES , hereby certify under the pains and penalties of perjury that on 11/05/07 gave notification to abutters in compliance with the second paragraph of Massachusetts General Laws Chapter 131, Section 40, and the 'DEP Guide to Abutter Notification dated April 8, 1994, in connection with the following matter: A Notice of Intent filed under the Massachusetts Wetlands Protection Act by RANDY MEDEIROS with the DARTMOUTH Conservation Commission on 11/05/07 for property located at MAP 79/LOT 6-12- MEDEIROS LANE The form of the notification, and a list of the abutters to whom it was given and their addresses, are attached to this Affidavit of Service. 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FIGURE 1 RANDY MEDEIROS 449 Faunce Corner Rood Dartmouth, MA 02747 (508) 998-2125 FAX (508) 998-7554 1 ROUTE 6 AUTO & MARINE Ira 822 STATE ROAD PH-(508)991-7373 "I NORTH DARTMOUTH,MA 02747 1i `� 5-7515-110 F. t DATE I u 1 1 11 1—J} _ ! r PAY j ORDER OF I � OL.A)Y (i {- ci.k.__r ,r \)fir"""k---) I $ r513 �J 2 ii r 0\--)--' / • , 1E , r 1. \ .I I U ` DOLLARS L Sovereign Bank® iF li FOR - - "p IL H'0 L 1,065 ' 1:0 L L075 LED: L33000097380 1 11066 ROUTE 6 AUTO & MARINE 822 STATE ROAD PH.(508)991-7373 'F NORTH DARTMOUTH,MA 02747 I 1 `S� 1 U� � 5-7515-1 10 DATE._ 1 ' kl PAY �' } I RDER O OFU � C.) 1l `- V t\ `'s-t'� I $ f' I Y hu n s -e j v,e �' �� % / j , a 1 DOLLARS @ :e,..a,3,`s I PV Sovereign Bank® II FOR — —m- l' H®0LL066u® 1:0LLO75L50': L3 30000 9 7 38H. `- �I a :� 11064 s 11 ROUTE 6 AUTO & MARINE E ifs 822 STATE ROAD PH.(508)991-7373 e NORTH DARTMOUTH,MA 02747 E l'ij '} i� tt� 5-7515 1 10 e IDATE ! L 1 1 1 i la�`'�1 10. 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