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Revised Plan Request
SE3- ______ OOC expiration date: __________ Applicant Name:________________________
Project Location _________________________________________ Map: ______ Parcel: ______
1. Why is a revised plan being submitted? ______________________________________________
______________________________________________________________________________
2. Is the revision proposed or as-built ? ________________________________________________
3. If a revised site plan is being submitted, what is its revision date? _________________________
4. Does the revised site plan have an original stamp, signature, and initials in the revision block? ___
5. Submit previously approved plan copies along with the proposed revised plan or a revised plan with
color markup indicating requested revisions.)
6. What parts of project are completed? ________________________________________________
______________________________________________________________________________
7. What parts of project are not completed?
______________________________________________________________________________
8. Are completed parts of project in compliance with the approved plan and Order of Conditions?
_____________________________________________________________________________
9. Have special conditions been met to date (e.g., Forms A & B, photographs of undisturbed buffer,
certified foundation plan)? _______________________________________________________
10. Are sediment controls in good working condition? _____________________________________
___________________________________________ _____________________________
Representative’s Signature Date
Please submit: Cover letter, this form, the previously approved plan copy along with two (2) proposed revised plans with
colored stamp and original signature or two (2) original revised plans with color markup indicating requested revisions with
colored stamp and original signature, and 8 collated sets (there should be 9 packets total). Enclose a $50 check made
payable to the Town of Barnstable, and email all materials to Kimberly.cavanaugh@town.barnstable.ma.us . If this revision
includes activities not part of the original application, please add the appropriate activity fee.
Town of Barnstable
Conservation Commission
230 South Street
Hyannis Massachusetts 02601
Office: 508-862-4093 E-mail: conservation@town.barnstable.ma.us
Form R
Submission deadline is
Monday NOON the week before
the next 3:00 p.m. hearing