Wetland Site InspectionC
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Town of Dartmouth D _E C E � V E
400 Slocum Road _ P.O.Box 79399 APR 2 9 2009
Dartmouth,Massachusetts 02747-0985
CONSERVATION COMMISSION (508)910-1822
FAX:( fi T
Wetland Site Inspection (Form A-1) i V ISSION
DA Ab iml.ANICoNl LJ /12109
Name of Person Making Request Date
22. SuNDANICC ROAD Z2 SuNhANCE t?.o/aD
Mailing Address Street Location Of Property To Be Viewed
N• DACTMom 4 JJlll. 02:147 (Y17C) LLi.'=v.-NOi V
City/Town,State Zip Code Dartmouth Assessors Map and Lot Number
Sob-6o-79 -090 Qo%igtx aAaAGS AvJrTtcrJ
Telephone-Day Reason spection:(House,addition,septic system repair etc.)
508 - 995-I qaq "
Telephone-Evening Signature of Person Making Request
bitN)qt. MCLI4.notJ -/CAltb 1NIELANICot4
Name of Owner of Site To Be Viewed Print Name
.adk: � �� .' �
22 ,SuNrzwarstce WAD ignature of Owner of Site to be Viewed(If not Applicant)
Owner's adds
NS� oUTJ4 VOA b od y7
O Zip
Print Name
I f person-m`1.g request is NOT the owner,the person is:
ciReal Esta e :roker ❑Engineer ❑Contractor ❑Consultant ❑Real Estate Appraiser o Other(explain)
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All filing forais•are available in the Conservation Commission office,room 107 at the Dartmouth Town Hall,400 Slocum Rd.from 9AM-4PM Monday and 9:00AM-
4:30PM Tummy through Friday.
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For parcels from 1 to 5 acres only,the Conservation Inspector is available to flag the wetland edge. However it is the Applicant's option to acquire the services of a private
consultant to delineate the wetlands on a parcel of that size. The Inspector has the right to require the Applicant to obtain the services of a private consultant to perform a
wetland delineation on areas less than 5 acres where abnormal site conditions or extensive use of soils evaluation would require an excessive amount of time be spent by the
Conservation Inspector in malting a determination of the wetland areas present Sites over 5 acres must be flagged by a wetland scientist,botanist or other qualified person
prior to submitting the A-1 site inspection form. The Conservation Inspector will then review the flagging in the field and make adjustments where necessary. The
Conservation Commission may require proof of the qualifications of the person performing the delineation.
Note:The A-1 Site Inspection is a procedure outlined in the Dartmouth Wetlands Protection Bylaw.It is a service available for the purpose of identifying wetland areas on a
site. The issuance of this completed Site Inspection is NOT a final determination of wetland boundaries or their jurisdictional status under the Massachusetts Wetlands
Protection Act(MGL Ch.131§40)or the Dartmouth Wetlands Protection Bylaw. Only the issuance of a Determination of Applicability,Order of Resource Area
Delineation or Order of Conditions by the Conservation Commission fmalizes the determination of wetland boundaries and\or their jurisdictional status under these Laws.
The completion of this Site Insnection is not an authorization to proceed with works This site inspection expires three(3)years from the date of issuance.
FILING FEES:
$100.00 Improvement to existing,non-commercial structure(septic repair)Inspection limited to within 250 feet of existing structure(s),area
to be inspected must be clearly marked on a site plan submitted with the application and area to be inspected must be easily
identifiable the in the field(staked,flagged,etc.)
$200.00 Improvement to existing,non-commercial structure(addition,in-ground pool,garage,barn,etc.) Inspection limited to within 250
feet of existing structure(s),area to be inspected must be clearly marked on a site plan submitted with the application and area to be
inspected must be easily identifiable the in the field(staked,flagged,etc.)
$250.00 Up to 2 acres-wetland inspection with or without wetland delineation,or verification of wetland delineation by applicant's
consultant(residential,no subdivision of land,no real estate transaction involved or anticipated,no existing structure
$400.00 Up to 2 acres-wetland inspection with or without wetland delineation,or verification of wetland delineation by applicant's
consultant(commercial,real estate subdivision or real estate transaction involved)
$500.00 2-5 acres-verification of wetland delineation by applicant's wetland consultant(residential,non-commercial of land,no real estate
transaction involved or anticipated)
$600.00 2-5 acres-verification of wetland delineation by applicant's wetland consultant(commercial,real estate subdivision or real estate
transaction involved)
$600.00 5-10 acres-verification of wetland delineation by applicant's wetland consultant(residential,no subdivision of land,no real estate
transaction involved or anticipated)
$800.00 5-10 acres-verification of wetland delineation by applicant's wetland consultant(commercial,real estate subdivision or real
estate transaction involved)
$1200.00 10-20 acres-verification of wetland delineation by applicant's wetland consultant
$1800.00 20-100 acres-verification of wetland delineation by applicant's wetland consultant
$3000.00 above 100 acres-verification of wetland delineation by applicant's wetland consultant
(Revised 1/6/09 MJO/DF) G:\CONCOM\DONNA\Forms\CURRENT FORMS\A-1 Form Rev 1-6-09 front page.doc
CONSERVATION:COMMISSION INSPECTOR COMMENTS-AND RECOMMENDATIONS
a No wetlands or other.areas_subject to the jurisdiction ofthe Conservation Commission exist on site or within 100 feetofsite.
Na other filing,with the Conservation-Commission required.
a The proposed workis nctlocatedwithin 100-feet ofa wetland area. Other wetlands may exist on site. Any further work to
be located outside ofir pected area requires the filing_ofan additional A-1.
VWetlands exist oil(^Northt South, :::::"Vest )of site.Please refer to drawing(if provided by inspector)for location
information. All locations on sketchpravidgd by inspector are approximate.
Cy Edge of wetland has been marked on site.by Inspector. Flag numbers:
1/CC wet Through `/ CC- wet
Additionalwe lands marked
wet Through wet ; wet Through- wet
0 A Request for Determination(permit application)should be filed with the Conservation Commission before anywork begins
on site.
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A Notice ofIntent(permitapplication)..should be(p filed wrth.the ConservattonCommission.hefore any work begins on site.
❑ Coastal Bank exists on site. Engineer must delineate Coastal Bank per DEP Wetland Program Policy 92-1. Delineation
must be submitted to the Conservation Commission office-for review and approval.
.
❑ Riverfront Area may exist on site. Ifwork is located in Riverfront Area then a further filing with Conservation Commission
is required before any work begins on site,
❑- 100-year floodplain-may bepresent on site. Engineer and/or DartmouthBuilding Departulpnt must determine ifproposed
worlds located within flood plain. If work is located in flood plain then a further filing with Conservation Commission is
required before.anywork begins on site.
O A survey plan of the wetland delineation should be submitted to the Conservation Commission office.
O Due to abnormal site conditions_and/or the necessity ofgathering an extensive amnnnt of soils information to adequately
describe-the.wetlandson.sitetheapplicantmust obtain the services ofa private consultant to perform a wetland delineation.
The delineation must.be-submitted to the Conservation Commission for review and approval.
CO Other C Amy hand drawnsketekon-the.attaehedplan_bythe.Conservaiionlnspectorisnottoscale. To determine
the actual extent of the wetlands on the site itisrecom:nendedthat the applicant/owner lupe the flag line surveyed onto a
plan,
IMPORTANT: Any.activity(clearing;d'ppng,removal of vegetation,etc..)in a-wetland Resource Area(as noted by
inspector on this form)or within.100 feet of a wetland requires a permit from the Conservation Commission pursuant to
Massach»sPtts Wetland protection-Act(MGLDh1 .1s rtinn 40)and/or the Dartmouth Wetlands Protection Bylaw. No
work shall begin until permit is received. This completed form is not a permit. '
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Date of Issuanc •e Y �O'Reill /
ental-34 's€C tor
(Revisal'11/1/06 moo/
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Results From[Dartmouth` Conservation Commission
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Im rtant.
>; The Wetland Site Ins peetioq procedure
'=i ApP{•OX`-Wetland`BOunda is a service available pursuant to the
„y Dartmouth Wetlands Protection Bylaw.
A and all w
;:,r�,�:-. :: `f,p' ,C:�:-."_•�,.. : rry ettand'flay,locatlons..
'100-foot Buffer'Zone : and,BufferZone,deplcted on the above
:5- -,.,te_ " ''i'r - -,graphicareapproximateonl A roximate
'; Please refer to the attached Wetland y' fr
,`%_:Wetland-Fla, Locations';.^ i shown. ll wetland drawn Lions an po9nts
g,•, ,,: Sitelnspectionform(formA-1�,_ shorrri .ALLwetlaodflaglncationsand
- -- for address,location and purpose -'BufferZone are for en`z�ryn<,;'�t'$ g eral;reference _.
Parcel Boundaries : .1. of the site inspection. Inspector comments, purposes aril shall not be considered
%n s,,,; ;,;,: :': }.5 ',',- : recommendations and/or requirements .-a final delineation for regulatory purposes_
are shown on the reverse side of the farm. Asubmittal of the above flag locations.Aerial r-hotog[aph ialfen - tamanartmouthcnnsenationcommissi :.
Sgrtng_2005: uttlimrg State of,Massachusetts procedures
N is required for compliance with me
All lNetlAnCd„delineation flags '""• Massachusetts Wetlands Protection Act ',
3 ;' f><henResource Area delineation
are(Jlrilf'arrd:are tnal ECed.: .. w E `Jr r requirements may appear an rear of fain:
,lF,DCC,wet,#'through DCCWet# Town of Dartmouth NowontwithinBufforZone 1OOyear
`SeeafOIT''fiOr'actua!flagn Geographic Flood Plain orotherwetland
\_y 1„ _-_ . umbers) S InformationSystem Resource Areas can begin until a permit
„ font ttreConservation Coorarissionisgraated .
WSI A-1 Aitadimert 12-0307 Rev.MJO,DF