Request for Determination of Applicability 2000 ourN.,1,
2artinOttg
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30 y 400 Slocum Road • P. O. Box 79399
'/sea• y Dartmouth, Massachusetts 02747-0985
CONSERVATION COMMISSION {.,. (5q8) 9994 .22 a
PAX: (508) 999-0797
http: 'www.town.dartmouth.ma.us
October 11, 2000
r pir-t, Ti
TO: Building Department
Department of Public Works
Planning Board U`
Board of Health
FROM: Dartmouth Conservation Commission
SUBJECT: Request for technical review and written report on the accompanying Request for
Determination and plans from Robbi Staples re: Map 80, Lot 6, at 27 Pine Island
Road.
Please review the attached Request for Determination and plan(s). If you have any comments
regarding the proposal and/or plans, please submit them to the Conservation office by October 16,
2000.
Thank you for your cooperation and assistance in this matter.
TORC:rcW DARTMOUTH
ZONING
a
Any 3 Must
I' .Rr'es3Pbimitt?C
SEE REPORT
Date Q$ Review
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3o ti 400 Slocum Road • P. O. Box 79399
�'leea Dartmouth, Massachusetts 02747-0985
CONSERVATION COMMISSION (508) 999-0722
FAX: (508) 999-0797
http://www.town.dartmouth.ma.us
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 Robbi Staples regarding land located at
Map 80, Lot 6, Pine Island Road in Dartmouth. The meeting will begin at 7:00 p.m., Tuesday,
October 17, 2000 in Room 103 at the Dartmouth Town Hall, 400 Slocum Road in Dartmouth,
and all interested parties should be present at that time.
Gerald Franklin
Chairman
CC: D.E.P. u..�
Dartmouth Board of Health
Dartmouth Building Department
Dartmouth D.P.W.
Owner
Applicant
Engineering Firm
THE CHRONICLE:
LEGAL AD: Please run once in your issue of October 11, 2000
•
Massachusetts Department of Environmental Protection
P �yy
f, Bureau of Resource Protection -Wetlands c /Town
0140 WPA Form 1- Request for Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. General Information
Important
When filling out 1• Appcant:
forms on the / t hoe/'
computer, use Name E-Mail Address(if applicable)
only the tab key
to move your :K 7 ,Pi 'e ,LS �el r+ i�
cursor-do not Mailing Ad
use the return y 1 yy,0 41, )21 A y 7 '9 7
key. City/Town S State Zip Code
11I Phone Number`��' `7 s- / `//
Fax Number(if applicable)
2. Representative (if any):
New
/ 1
Firm
Contact Name E-Mail Address(If applicable)
Mailing Address
City/Town State Zip Code
Phone Number Fax Number(if applicable)
B. Determinations
1. I request the etrI make the following determination(s). Check any that apply:
Conservation Commission
❑ 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 work in the Riverfront Area as
depicted on referenced plan(s).
WPA Fonn1
Rev.0?/00 Page 1 of 4
Massachusetts Department of Environmental Protection
�' Bureau of Resource Protection -Wetlands City/Townf�rid.
o. WPA Form 1- Request for Determination of Applicability
tow/ 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):
r71 7 Pin e n /Ofl [1.,/ C r jsyt c� 4'11
Street AddressCity/Town
1
Vo fit, / 4S
Assessors Map/Plat Number ParceULot Number
b. Area Description (use additional paper, if necessary):
c. Plan and/or Map Reference(s): y
I'"`.5 `t /X f'n s/c j'l
The Dat
-7 P/,-.7 ti
2. a. Work�Description (use additional paper and/or provide�plan(s) of work, if necessary):
�cic11 !`C�1 Gam' r7f� 1-7 / KC25/[ Iva ,!r
I
0 TO )2c' I 70 de, /c2 c '5%-/f
t) c r- Ie 1 ,
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).
WPA Form?
Rev.02/00 Page 2 of 4
•
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands City/Town
eta*�, WPA Form 1- Request for Determination of Applicability
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
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(see Appendix A)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 caner.
g G� sfct P,
Name
27 Piie /4d
Mailing Address
N. ari P‘i,4 '1
City/Town
Y'1 A 027 I/ 7
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( )(b)(1) of the Wetlands Protection Act regulations.
627-141' //Ole,0
Signature of pplicant Date
Signature of Representative(if any) Date
WPA Fonol
Rev.02/00 Page 4 of 4
PAGE 1
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16' • 2 '1 TO EAST
24' PROPERTY
.
.. ....`::. ... .....:�::.. : :.._:,.16 X PROPOSED ADDITION:.. ;:'.;;::.::: :::::;'
::.....::::.:-....:;.:-:::. .....,. ........ LINE
NOTE.
SEE PAGE 2
FOR ADDITI
OAL
PROPERTY LINES
{
26' x 24' EXISTING GARAGE
26' OWNER
ROBBI STAPLES
27 PINE ISLAND RD
N. DARTMOUTH, MA 02747
TEL. 508 985-1941
SCALE;
1/4"= 1'
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Prepared For
TOM BELL %eerie Jew Oyu'ler a s (7 7/2.1/97)
February 18, 1987 Scale: 1" : 80'
Arthur C. Thompson, Inc.
Engineers do Surveyors b r' S to ies
Marion,MA.
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Notes