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Request for Determination of Applicability 7 ..Mou rH ,M7 ' •••. DARTMOUTH ��i``E ° � 9 ' MASSACHUSETTS ir CONSERVATION COMMISSION 'e t: MICHAEL O'REILLY 400 Slocum Road•P.O.BOX 79399 `:�� Environmental Affairs Coordinator .. !864 ; • TI:I.,: 508-910-1822 FAX: 508 910-1897 Dartmouth, MA 02747 ' ••........... c �� r c http://www.town.dartmouth.ma.us February 16, 2012 ti gait TO: Building Department Department of Public Works ra Planning Board 1 Board of Health co R( 1: Dartmouth Conservation Commission SUBJECT: Request for review and written comments on the accompanying Request for tx w Determination of Applicability and plan(s) from Jerry Souza re: t.. Map79 Lot 24 on 85 Pine Island Road. o N Please review the attached Request for Determination and plan(s). If you have any comments, please submit them to the Dartmouth Conservation Commission by February 27, 2012. Thank you for your cooperation and assistance in this matter. DF:df Jerry Souza 100 Lucy Little Road Dartmouth, MA 02747 WED, Inc. Lenfpl@aol.com DARTMOUTH �� °uic 9J;�•. MASSACHUSETTS CONSERVATION COMMISSION =.u— 21 �� j n, MICHAEL O'REILLY 400 Slocum Road•P.O.BOX79399 ':�� - S?::</. Environmental Affairs Coordinator Dartmouth,MA 02747 «r'4.•••'" TEL: 508-910-18221"FAX: 508 910-1.897 http://www.town.dartmouth.ma.us February 16, 2012 The Standard-Times Lockbox 223546 P.O. Box 223546 Pittsburgh, PA 15251-2546 news@chroniclenewsonline.com LEGAL AD: Please run the following legal ad once in your issue of February 22, 2012 Advertiser#300329 PRE-PAYMENT CHECK TO FOLLOW DARTMOUTH CONSERVATION COMMISSION NOTICE OF PUBLIC MEETING Notice is hereby given that a meeting will be held in accordance with the provisions of the Dartmouth Wetlands Protection Bylaw and M.G.L., Ch. 131, § 40, the Wetlands Protection Act, on the Request for Determination of Applicability from Jerry Souza regarding land located at Map 79 Lot 24 on Pine Island Road in Dartmouth. The meeting will begin at 7:00 p.m., on Tuesday, February 28, 2012 in Room 103 at the Dartmouth Town hall, 400 Slocum Road in Dartmouth and all interested parties should be present at that time. Michael Kehoe, Chair cc: Chronicle D.E.P. Dartmouth Board of Health Dartmouth Building Department Dartmouth DPW Owner Applicant Applicant's representative(s) Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands1 DARTMOUTH WPA Form 1- Request for Determination of Applicability City/Town Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. General Information Important: When filling out 1. Applicant: forms on the JERRY SOUZA computer,use Name only the tab key E-Mail Address to move your 100 LUCY LITTLE ROAD cursor-do not Mailing Address use the return DARTMOUTH' MA 02747 key. City/Town State Zip Code ilitab Phone Number Fax Number(if applicable) 2. Representative (if any): re'w" jl WED, INC. Fimi 7 LEN POTTER LENFPI@AOL.COM '''c3,,, {.a Contact Name E-Mail Address r''' PO BOX 3302 - Mailing Address _ :C) WESTPORT MA 02790 -;"�"1 City/Town State Zip Code <' 508-636-2757 508-636-5743 c Phone Number Fax Number(if applicable) C W .13 —1 B. Determinations 1. I request the WESTPORT make the following determination(s). Check any that apply: Conservation Commission O a. whether the area depicted on plan(s)and/or map(s)referenced below 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 below are accurately delineated. ® c.whether the work depicted on plan(s)referenced below is subject to the Wetlands Protection Act. ❑ d. whether the area and/or work depicted on plan(s)referenced below is subject to the jurisdiction of any municipal wetlands ordinance or bylaw of: Name of Municipality ❑ e.whether the following scope of alternatives is adequate for depicted on referenced plan(s). RECEIVED —, DA.R MOII -F; CO I'I wnafnrml Arr. ------__.. . Pant.1 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DARTMOUTH LI City/rown WPA Form 1- Request for Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 C. Project Description 1. a. Project Location (use maps and plans to identify the location of the area subject to this request): 85 PINE ISLAND ROAD DARTMOUTH Street Address City/Town MAP 79 LOT 24 Assessors Map/Plat Number Parcel/Lot Number b. Area Description (use additional paper, if necessary): c. Plan and/or Map Reference(s): SUBSURFACE SEWAGE DISPOSAL REPAIR PLAN 2/1/12 Title Date Title Date Title Date 2. a. Work Description (use additional paper and/or provide plan(s)of work, if necessary): TO REPLACE EXISTING FAILED SEPTIC SYSTEM IN THE BUFFER ZONE TO WETLANDS. wnafnrm1 Ann. Penn 7 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DARTMOUTH j City/Town WPA Form 1- Request for Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 C. Project Description (cont.) 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). NORMALLY SEPTIC REPAIRS ARE NOT SUBJECT TO NOI FILINGS 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.) wnafnrml an. Pane 1 of d LIMassachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DARTMOUTH WPA Form 1- Request for Determination of Applicability Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 City/Town 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. Name and address of the property owner: JERRY SOUZA Name 100 LUCY LITTLE ROAD Mailing Address DARTMOUTH City/Town MA 02747 State Zip Code Signatures: I also understand that notification of this Request will be placed in a local newspaper at my expense in accordance with Section 10.05(3)(b)(1)of the Wetlands Protection Act regulations. Signature of Applicant Date 2/16/12 ure of Represent 1 Date wnafnrm1 tine. Panty 4 of 4