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HomeMy WebLinkAbout20221011 NOI CCMA 915 Craigville Beach RoadAPPLICANT Christian Camp Meeting Association 39 Prospect Ave. Centerville, MA 02632 REPRESENTATIVE Environnemental Consulting & Restoration, LLC P.O. Box 4012 Plymouth, MA 02361 (617) 529-3792 NOTICE OF INTENT 915 Craigville Beach Road, Centerville SUBMITTED TO Barnstable Conservation Commission September 2022 P.O. Box 4012, Plymouth, Massachusetts 02361 617-529-3792 | www.ecrwetlands.com September 21, 2022 Town of Barnstable Conservation Commission 367 Main St Barnstable, MA 02601 Attn.: Darcy Karle, Conservation Administrator RE: Notice of Intent, Proposed Beach Sand Relocation Project, 915 Craigville Beach Road, Centerville, MA 02632 Dear Ms. Karle & Members of the Barnstable Conservation Commission: Please accept this Notice of Intent application for the proposed beach sand relocation project at 915 Craigville Beach Road in Centerville (the site). The Town of Barnstable Assessors Department references the site as Parcel ID #225001. The proposed project includes relocating the accumulated beach sand from under the existing structures within the back shore beach to a portion of the beach seaward. The proposed project is located within a Barrier Beach/Coastal Beach and Land Subject to Coastal Storm Flowage. This application is being submitted in accordance with the Massachusetts Wetlands Protection Act and the Town of Barnstable Wetlands Protection Bylaw. If you have any questions or require additional information, please contact me at (508) 648-3957. Sincerely, Environmental Consulting & Restoration, LLC Cameron Larson, WPIT Manager CC: Department of Environmental Protection, Wetland Division, 20 Riverside Drive, Lakeville, MA 02347 Christian Camp Meeting Association MA NHESP, 1 Rabbit Hill Road, Westborough, MA 01581 Barnstable Marine & Environmental Affairs, Attn.: Shellfish Biologist, 1189 Phinney's Lane, Centerville MA 02632 Barnstable Harbormaster, 1189 Phinney's Lane, Centerville, MA 02632 NOTICE OF INTENT TABLE OF CONTENTS Item Attachment Barnstable NOI Application Checklist 1 Notice of Intent Form 2 Project Narrative 3 Photograph Pages 4 USGS Site Locus Map 5 FEMA Map 6 Massachusetts Natural Heritage & Endangered Species Map 7 Abutter Information 8 Property Access Form 9 Barnstable Waiver 10 Site Plan 11 Chap 707/rev. March 2022 Page 1 CHAPTER 707 Regulation Governing Minimum Submission Requirements for a Notice of Intent Application The Barnstable Conservation Commission has adopted the following requirements in order to obtain more consistently complete submission documents necessary for a thorough and efficient review of all Notice of Intent (NOI) applications. Failure to complete any of the items in this checklist may result in your application being denied. Applicant or applicant’s agent should check each box denoting that the task has been completed or in certain instances, like field staking, denoting that the task will be completed. The following submission checklist covers the requirements of Chapter 237, Wetlands Protection, of the Part I General Ordinances of the Code of the Town of Barnstable. This checklist shall be submitted to the Barnstable Conservation Division with the NOI application. 1.Requirements a. The applicant understands, unless they’ve instructed otherwise, they are applying both under the Massachusetts Wetlands Protection Act M.G.L. c.131,§40 and Chapter 237 of the Town of Barnstable General Ordinances. b. Attach a written narrative to the NOI application (WPA Form 3), available at: www.mass.gov/eea/agencies/massdep/service/approvals/wpa-form-3.html describing any project impacts and proposed mitigation as they relate to the following: 1) Any of the interests of Chapter 237 of the General Ordinances and the MassDEP Wetlands Protection Act M.G.L. 131, §40. 2) The performance standards contained in the MassDEP Wetlands Protection Regulations (310 CMR 10.00) 3) Chapter 704: Regulation Governing Activity in the 100-ft. Buffer Zone. 4) Chapter 703: Private Docks and Piers. 5) Any other applicable regulations (310 CMR 10.00 or as promulgated under Chapter 237 of the General Ordinances). c. Enclose proper payment to cover the fee for Chapter 237 filings. Consult current Fee Schedule at www.townofbarnstable.us/Conservation d. Please indicate who is to record the Order of Conditions (check one): Applicant Agent 2.Abutter Notification (See Abutter Notification Regulation, Chapter 706) Town of Barnstable Conservation Commission 200 Main Street Hyannis Massachusetts 02601 Office: 508-862-4093 E-mail: conservation@town.barnstable.ma.us FAX: 508-778-2412 Chap 707/rev. March 2022 Page 2 a. Contact the Conservation Division office at (508) 862-4093 regarding the docketing process, or see current schedule of Conservation Hearings and submission deadlines at: www.townofbarnstable.us/Conservation/ b. Provide a copy of the list of abutters within a 100 ft radius of the project parcel. c. Provide a copy of the Assessor’s Map indicating the parcel of the project site and showing the 100 ft radius of the project parcel. d. Provide a copy of the abutter notification letter. Use the form letter provided in our Abutter Notification Regulation (Chapter 706), available on the Conservation Division website. e. Bring the green return receipts, from the certified mailings to the abutters, as proof of notification to the public hearing. If any mailings are returned, bring the entire envelope, indicating by postal service stamp the reason for return. You will retain the receipts afterwards, not the Conservation Division. f. I further certify under the penalties of perjury that all abutters were notified of the Notice of Intent Application, pursuant to the requirements of Chapter 237 of the General Ordinances of the Code of the Town of Barnstable. Notice must be made in writing by certified mail to all abutters within 100 ft of the property line of the project location. _______________________________________ Signature of Applicant or Representative Date 3.Field Staking: a. On or before Tuesday, @ 8:30 a.m., one week prior to the scheduled public hearing, have your project staked by a professional engineer or registered land surveyor showing all outside corners of all proposed structures and the continuous proposed “limit of work” line. b. Have a wetland scientist or other qualified professional flag all wetland resource areas on or within 100 ft of the work area. Make sure that the flags are sequentially numbered. c. Provide a project identification stake with bright painted top and applicant name and address, easily visible from the street approaching the site. 4.Legal Advertisement Fees: a. Conservation will submit the legal ad for publication in a local newspaper. The applicant or his/her agent is responsible for payment, by check (payable to the Town of Barnstable), at the hearing or by mail. The cost of the legal ad will be pre-calculated and posted on the hearing agenda prior to the hearing. 5.Minimum Documentation for a Complete Application: a. Provide a completely filled-out (in all parts) NOI application as locally adopted for the Town of Barnstable, including MassDEP Vegetated Wetland Field Data Form. Indicate Assessor’s map and parcel of the project, as well as the street or road address, and pertinent village (i.e., Hyannis, Centerville, Barnstable, etc). b. Provide two (2) original project plans, stamped in blue or red ink (wet stamp). Plans must be signed and dated by a Massachusetts licensed, professional engineer, land surveyor, architect or landscape architect (as applicable), and shall be drawn at a readable scale (1" = 20' preferred). For multi-acre sites, a second site plan, drawn at larger scale showing the entire site, should also be provided. 9/21/2022 Chap 707/rev. March 2022 Page 3 c. Provide a signed Permission to Access Property, Form PA. The form must be signed by the property Owner, or legal representative and submitted prior to NOI being docketed and application advertised. Form PA is available at www.townofbarnstable.us/Conservation/. Do not send the abutter letter out until the form is submitted to the Conservation Division office. d. For projects requiring mitigation plantings under Chapter 704-3, 704-4, and 704-5, mitigation planting location(s) shall clearly be shown on landscaping planting plan. The planting plan shall include species list (chosen from the Town of Barnstable Conservation Commission approved planting lists), sizes, densities and/or quantities. The plan shall also provide area calculations between 0 to 50 and 50 to 100 separately for the amount of mitigation planting required, and the amount of mitigation planting proposed. e. Provide detailed, written street directions to the locus (site). f. Provide a copy of a U.S.G.S. locus map indicating the general area of the project site. g. Provide a check for the Town of Barnstable portion of the required filing fee. (The portion payable to the Commonwealth, see 7. e. below) h. Provide any other documentation, photographs, architectural renderings or other supporting data prepared by professionals competent in the field which may be relevant to the application. 6.The site plan shall also show: a. All existing and proposed contours at 2-ft. minimum intervals (1-ft. preferred). b. Clear delineation of all existing and proposed structures and features. Building structures must be accurately dimensioned (fixed location) from property lines and wetland resource areas. Plans shall provide sufficient detail to show all potential wetland impacts, mitigation, compensatory areas, engineered structures, utilities, landscaping, etc. within the area of jurisdiction. On complicated sites, existing and proposed conditions must be shown on separate sheets. c. Locus inset map of the site clearly showing its location relative to surrounding public streets. d. All wetland resource area flags by individual flag number (matched to the field) to clearly identify all resource areas on or within 100 feet of the work area. The individual who performed the flagging and date of flagging shall be identified on the plan next to the resource line. e. Section views showing changes in grade, cuts and fills. 7.SUBMISSION OF THE COMPLETED APPLICATION WITH PLANS: a. Provide a signed Permission to Access Property, Form PA. The form must be signed by the property Owner, or legal representative and submitted prior to NOI being docketed and application advertised. Form PA is available at www.townofbarnstable.us/Conservation/. Do not send the abutter letter out until the form is submitted to the Conservation Division office. b. Email NOI application and all associated materials in PDF format to Kimberly.Cavanaugh@town.barnstable.ma.us AND Darcy.Karle@town.barnstable.ma.us . Do not include copies of checks. All attachments must be named with the hearing date (year first), type, name, address. Examples 20220301 NOI Smith 21 Main Street or 2022031 NOI Plan Smith 21 Main Street. c. Provide two (2) full NOI applications with folded plans (colored ink stamp) with signature/date to the Town of Barnstable Conservation Division Office for administrative use; □ d.Provide seven (7) additional copies of the NOI (with folded plans and all pertinent dataattached) to the Barnstable Conservation Division Office for distribution to, and review by,Conservation Commission members. Any supplementary documentation for administrativeand commission review should be submitted as soon as possible prior to the scheduled publichearing.*e.Mail one (I) copy of the complete NOi with plan(s) to the Massachusetts Department ofEnvironmental Protection (MassDEP) Southeast Regional Office, 20 Riverside Dr., Lakeville, MA02346. Send MassDEP portion of filing fee to: MA Department of Environmental Protection, Box4062, Boston, MA 02211.f.For roadway construction or repair projects, provide one electronic copy of the NOi and plans tothe Senior Project Manager Special Projects, c/o the Town of Barnstable Department of PublicWorks, 382 Falmouth Road, Hyannis, MA 02601.g.For coastal piers, dredging, coastal engineering structures or other coastal erosion controlprojects, provide two hard copies of the NOI and plans to the Shellfish Biologist, c/oTown of Barnstable Natural Resources, 1189 Phinney's Ln., Centerville, MA 02632. In_addition, email a (PDF) version to:I)shellfishNOI@town.barnstable.ma.us. (Email must be sent the same day as submissionto the Conservation Division); and 2)conservationprojects@town.barnstable.ma.ush.Also, for coastal piers, dredging, coastal engineering structures, provide two hard copiesof the NOI and plans to the Harbormaster, c/o Town of Barnstable Marine and EnvironmentalAffairs (MEA), 1189 Phinney's Ln., Centerville, MA 02632. In addition. email a (PDF) versionto:I)harbormaster@town.barnstable.ma.us. (Email must be sent the same day as submissionto the Conservation Division); and 2)conservati onproj ects@town. barnsta b le. ma. usNote: Please title the file for your NOI project as follows: a. Submission date, b. Last name of applicant, c.Map/parcel of property, e.g., 082316-Smith-076024. *Note: If a revised plan needs to be submitted prior to a hearing, please follow same instructions as 7. b. above (and submit to other entities as may be applicable). Plan revisions must be clearly noted and dated in the revision block. (The same individual who stamped the original plan must also stamp and sign the revised plan). 5 i}>-11 f ,z,,, Submitted this ___ , __ day of /f-'j//'}. in the year zvi, in accordance with the Townof Barnstable "Regulation Governing Minimum Submission Requirements for a Notice of Intent Application" by: (Print Name) 1. r CCMA r.Uf ;;i.-j1,, .-._ Owner / Applicant Cameron Larson Owner's Authorized Agent Approved: May 28. 1997 Revised: May 12, 2015 Signature Signature Revised: August 23, with minor rev. Sept. 6, 2016 Revised March 15, 2022 Chap 707 /rev. March 2022 Telephone Number Page 4 508-648-3957Telephone Number wpaform3.doc • rev. 6/18/2020 Page 1 of 9 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 3 – Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by MassDEP: MassDEP File Number Document Transaction Number Barnstable City/Town Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. Note: Before completing this form consult your local Conservation Commission regarding any municipal bylaw or ordinance. A. General Information 1.Project Location (Note: electronic filers will click on button to locate project site): 915 Craigville Beach Rd a. Street Address Barnstable b. City/Town 02632 c. Zip Code Latitude and Longitude: 41.63631"N d. Latitude 70.33674"W e. Longitude Parcel ID # 225001 f. Assessors Map/Plat Number g. Parcel /Lot Number 2.Applicant: a. First Name b. Last Name Christian Camp Meeting Association c. Organization 39 Prospect Ave d. Street Address Centerville e. City/Town MA f. State 02632 g. Zip Code h. Phone Number i. Fax Number j.Email Address 3.Property owner (required if different from applicant):Check if more than one owner a. First Name b. Last Name c. Organization d. Street Address e. City/Town f. State g. Zip Code h. Phone Number i. Fax Number j. Email address 4.Representative (if any): Cameron a. First Name Larson b. Last Name Environmental Consulting & Restoration, LLC c. Company PO Box 4012 d. Street Address Plymouth e. City/Town MA 02360 g. Zip Code 617-529-3792 h. Phone Number i. Fax Number f. State cameron@ecrwetlands.com j. Email address 5.Total WPA Fee Paid (from NOI Wetland Fee Transmittal Form): $500.00 a. Total Fee Paid $237.50 b. State Fee Paid $262.50 c. City/Town Fee Paid wpaform3.doc • rev. 6/18/2020 Page 2 of 9 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 3 – Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by MassDEP: MassDEP File Number Document Transaction Number Barnstable City/Town A. General Information (continued) 6.General Project Description: Proposed beach sand relocation project located at the Craigville Beach Association property off Craigville Beach Road. The proposed project includes relocating the accumulated beach sand from under and around the existing structures within the back shore beach to a portion of the beach seaward. For more information, please refer to the attached narrative. 7a. Project Type Checklist: (Limited Project Types see Section A. 7b.) 1. Single Family Home 2. Residential Subdivision 3. Commercial/Industrial 4. Dock/Pier 5. Utilities 6. Coastal engineering Structure 7. Agriculture (e.g., cranberries, forestry) 8. Transportation 9. Other 7b. Is any portion of the proposed activity eligible to be treated as a limited project (including Ecological Restoration Limited Project) subject to 310 CMR 10.24 (coastal) or 310 CMR 10.53 (inland)? 1. Yes No If yes, describe which limited project applies to this project. (See 310 CMR 10.24 and 10.53 for a complete list and description of limited project types) 2. Limited Project Type If the proposed activity is eligible to be treated as an Ecological Restoration Limited Project (310 CMR10.24(8), 310 CMR 10.53(4)), complete and attach Appendix A: Ecological Restoration Limited Project Checklist and Signed Certification. 8.Property recorded at the Registry of Deeds for: Barnstable a. County b. Certificate # (if registered land) 9086 c. Book 0011 d. Page Number B. Buffer Zone & Resource Area Impacts (temporary & permanent) 1. Buffer Zone Only – Check if the project is located only in the Buffer Zone of a Bordering Vegetated Wetland, Inland Bank, or Coastal Resource Area. 2. Inland Resource Areas (see 310 CMR 10.54-10.58; if not applicable, go to Section B.3, Coastal 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. wpaform3.doc • rev. 6/18/2020 Page 3 of 9 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 3 – Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by MassDEP: MassDEP File Number Document Transaction Number Barnstable City/Town B. Buffer Zone & Resource Area Impacts (temporary & permanent) (cont’d) For all projects affecting other Resource Areas, please attach a narrative explaining how the resource area was delineated. Resource Area Size of Proposed Alteration Proposed Replacement (if any) a. Bank 1. linear feet 2. linear feet b. Bordering Vegetated Wetland 1. square feet 2. square feet c. Land Under Waterbodies and Waterways 1. square feet 2. square feet 3. cubic yards dredged Resource Area Size of Proposed Alteration Proposed Replacement (if any) d. Bordering Land Subject to Flooding 1. square feet 2. square feet 3. cubic feet of flood storage lost 4. cubic feet replaced e. Isolated Land Subject to Flooding 1. square feet 2. cubic feet of flood storage lost 3. cubic feet replaced f. Riverfront Area 1. Name of Waterway (if available) - specify coastal or inland 2.Width of Riverfront Area (check one): 25 ft. - Designated Densely Developed Areas only 100 ft. - New agricultural projects only 200 ft. - All other projects 3.Total area of Riverfront Area on the site of the proposed project:square feet 4.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. 5.Has an alternatives analysis been done and is it attached to this NOI? Yes No 6.Was the lot where the activity is proposed created prior to August 1, 1996? Yes No 3. Coastal Resource Areas: (See 310 CMR 10.25-10.35) Note: for coastal riverfront areas, please complete Section B.2.f. above. wpaform3.doc • rev. 6/18/2020 Page 4 of 9 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 3 – Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by MassDEP: MassDEP File Number Document Transaction Number Barnstable City/Town B. Buffer Zone & Resource Area Impacts (temporary & permanent) (cont’d) 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 document transaction number (provided on your receipt page) with all supplementary information you submit to the Department. Resource Area Size of Proposed Alteration Proposed Replacement (if any) a. Designated Port Areas Indicate size under Land Under the Ocean, below b. Land Under the Ocean 1. square feet 2. cubic yards dredged c. Barrier Beach Indicate size under Coastal Beaches and/or Coastal Dunes below d. Coastal Beaches Approx. 60,000 sq. ft. 1. square feet 2. cubic yards beach nourishment e. Coastal Dunes 1. square feet 2. cubic yards dune nourishment Size of Proposed Alteration Proposed Replacement (if any) f.Coastal Banks 1. linear feet g.Rocky Intertidal Shores 1. square feet h. Salt Marshes 1. square feet 2. sq ft restoration, rehab., creation i.Land Under Salt Ponds 1. square feet 2. cubic yards dredged j. Land Containing Shellfish 1. square feet 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 l.Land Subject to Coastal Storm Flowage Approx. 60,000 sq. ft. 1. square feet 4. Restoration/Enhancement If the project is for the purpose of restoring or enhancing a wetland resource area in addition to the square footage that has been entered in Section B.2.b or B.3.h above, please enter the additional amount here. a. square feet of BVW b. square feet of Salt Marsh 5. Project Involves Stream Crossings a. number of new stream crossings b. number of replacement stream crossings wpaform3.doc • rev. 6/18/2020 Page 5 of 9 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 3 – Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by MassDEP: MassDEP File Number Document Transaction Number Barnstable City/Town C. Other Applicable Standards and Requirements This is a proposal for an Ecological Restoration Limited Project. Skip Section C and complete Appendix A: Ecological Restoration Limited Project Checklists – Required Actions (310 CMR 10.11). 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://maps.massgis.state.ma.us/PRI_EST_HAB/viewer.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 1 Rabbit Hill Road Westborough, MA 01581 August 2021 b. Date of map If yes, the project is also 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 C.1.c, and include requested materials with this Notice of Intent (NOI); OR complete Section C.2.f, if applicable. If MESA supplemental information is not included with the NOI, by completing Section 1 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). c.Submit Supplemental Information for Endangered Species Review∗ 1. Percentage/acreage of property to be altered: (a)within wetland Resource Area 1.37 acres percentage/acreage (b)outside Resource Area percentage/acreage 2. Assessor’s Map or right-of-way plan of site 2. 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 ∗∗ (a) Project description (including description of impacts outside of wetland resource area & buffer zone) (b) Photographs representative of the site ∗ Some projects not in Estimated Habitat may be located in Priority Habitat, and require NHESP review (see https://www.mass.gov/ma- endangered-species-act-mesa-regulatory-review). 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. wpaform3.doc • rev. 6/18/2020 Page 6 of 9 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 3 – Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by MassDEP: MassDEP File Number Document Transaction Number Barnstable City/Town C. Other Applicable Standards and Requirements (cont’d) (c) MESA filing fee (fee information available at https://www.mass.gov/how-to/how-to-file-for- a-mesa-project-review). Make check payable to “Commonwealth of Massachusetts - NHESP” and mail to NHESP at above address Projects altering 10 or more acres of land, also submit: (d) Vegetation cover type map of site (e) Project plans showing Priority & Estimated Habitat boundaries (f)OR Check One of the Following 1. Project is exempt from MESA review. Attach applicant letter indicating which MESA exemption applies. (See 321 CMR 10.14, https://www.mass.gov/service-details/exemptions-from-review-for-projectsactivities-in- priority-habitat; the NOI must still be sent to NHESP if the project is within estimated habitat pursuant to 310 CMR 10.37 and 10.59.) 2. Separate MESA review ongoing. a. NHESP Tracking #b. Date submitted to NHESP 3. Separate MESA review completed. Include copy of NHESP “no Take” determination or valid Conservation & Management Permit with approved plan. 3.For coastal projects only, is any portion of the proposed project located below the mean high water line or in a fish run? a. Not applicable – project is in inland resource area only b. Yes No If yes, include proof of mailing, hand delivery, or electronic delivery of NOI to either: South Shore - Cohasset to Rhode Island border, and the Cape & Islands: Division of Marine Fisheries - Southeast Marine Fisheries Station Attn: Environmental Reviewer 836 South Rodney French Blvd. New Bedford, MA 02744 Email: dmf.envreview-south@mass.gov North Shore - Hull to New Hampshire border: Division of Marine Fisheries - North Shore Office Attn: Environmental Reviewer 30 Emerson Avenue Gloucester, MA 01930 Email: dmf.envreview-north@mass.gov Also if yes, the project may require a Chapter 91 license. For coastal towns in the Northeast Region, please contact MassDEP’s Boston Office. For coastal towns in the Southeast Region, please contact MassDEP’s Southeast Regional Office. c. Is this an aquaculture project? d. Yes No If yes, include a copy of the Division of Marine Fisheries Certification Letter (M.G.L. c. 130, § 57). wpaform3.doc • rev. 6/18/2020 Page 7 of 9 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 3 – Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by MassDEP: MassDEP File Number Document Transaction Number Barnstable City/Town C. Other Applicable Standards and Requirements (cont’d) Online Users: Include your document transaction number (provided on your receipt page) with all supplementary information you submit to the Department. 4.Is any portion of the proposed project within an Area of Critical Environmental Concern (ACEC)? a. Yes No If yes, provide name of ACEC (see instructions to WPA Form 3 or MassDEP Website for ACEC locations). Note: electronic filers click on Website. b. ACEC 5.Is any portion of the proposed project within an area designated as an Outstanding Resource Water (ORW) as designated in the Massachusetts Surface Water Quality Standards, 314 CMR 4.00? a. Yes No 6.Is any portion of the site subject to a Wetlands Restriction Order under the Inland Wetlands Restriction Act (M.G.L. c. 131, § 40A) or the Coastal Wetlands Restriction Act (M.G.L. c. 130, § 105)? a. Yes No 7.Is this project subject to provisions of the MassDEP Stormwater Management Standards? a. Yes. Attach a copy of the Stormwater Report as required by the Stormwater Management Standards per 310 CMR 10.05(6)(k)-(q) and check if: 1. Applying for Low Impact Development (LID) site design credits (as described in Stormwater Management Handbook Vol. 2, Chapter 3) 2. A portion of the site constitutes redevelopment 3. Proprietary BMPs are included in the Stormwater Management System. b. No. Check why the project is exempt: 1. Single-family house 2. Emergency road repair 3. Small Residential Subdivision (less than or equal to 4 single-family houses or less than or equal to 4 units in multi-family housing project) with no discharge to Critical Areas. D. Additional Information This is a proposal for an Ecological Restoration Limited Project. Skip Section D and complete Appendix A: Ecological Restoration Notice of Intent – Minimum Required Documents (310 CMR 10.12). 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. wpaform3.doc • rev. 6/18/2020 Page 8 of 9 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 3 – Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by MassDEP: MassDEP File Number Document Transaction Number Barnstable City/Town D. Additional Information (cont’d) 3. Identify the method for BVW and other resource area boundary delineations (MassDEP BVW Field Data Form(s), Determination of Applicability, Order of Resource Area Delineation, etc.), and attach documentation of the methodology. 4. List the titles and dates for all plans and other materials submitted with this NOI. Conservation Plan Proposed Beach Sand Relocation Project a. Plan Title Envrionmental Consulting & Restoration b. Prepared By c.Signed and Stamped by August 4, 2022 d. Final Revision Date 1"=100' e. Scale f. Additional Plan or Document Title g. Date 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. 8. Attach NOI Wetland Fee Transmittal Form 9. Attach Stormwater Report, if needed. E. Fees 1.Fee Exempt: 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: 4268 2. Municipal Check Number 9/13/2022 3. Check date 4261 4. State Check Number 9/13/2022 5. Check date The Christian Camp Meeting Assoc. 6. Payor name on check: First Name 7. Payor name on check: Last Name � Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 3 -Notice of Intent Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 F.Signatures and Submittal Requirements 4 Provided by MassDEP: MassDEP File Number Document Transaction Number Barnstable City/Town 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 M.G.L. c. 131, § 40. Notice must be made by Certificate of Mailing or in writing by hand delivery or certified mail (return receipt requested) to all abutters within 100 feet of the property line of the project location. 1. Signature of ApplicantP ,1( 0.AA-L--Y"'=/ ,__ l-, cc,111+ 3. Signature of Property owi{er (if different) 5. Signature of Representative (if any) For Conservation Commission: 2.Date�­pt L. )<n-L4.Date ' 6. Date Two copies of the completed Notice of Intent (Form 3), including supporting plans and documents, two copies of the NOi Wetland Fee Transmittal Form, and the city/town fee payment, to the Conservation Commission by certified mail or hand delivery. For MassDEP: One copy of the completed Notice of Intent (Form 3), including supporting plans and documents, one copy of the NOi Wetland Fee Transmittal Form, and a copy of the state fee payment to the MassDEP Regional Office (see Instructions) by certified mail or hand delivery. Other: If the applicant has checked the "yes" box in any part of Section C, 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. 6/18/2020 Page 9 of 9 9/20/2022 noifeetf.doc • Wetland Fee Transmittal Form • rev. 10/11 Page 1 of 2 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands NOI Wetland Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. A.Applicant Information 1.Location of Project: 915 Craigville Beach Rd a. Street Address Centerville b. City/Town 4261 c.Check number $237.50 d.Fee amount 2.Applicant Mailing Address: a. First Name b. Last Name Christian Camp Meeting Association c. Organization 39 Prospect Ave d. Mailing Address Centerville e. City/Town MA f. State 02632 g. Zip Code h. Phone Number i. Fax Number j.Email Address 3.Property Owner (if different): a. First Name b. Last Name c. Organization d. Mailing Address e. City/Town f. State g. Zip Code h. Phone Number i. Fax Number j.Email Address To calculate filing fees, refer to the category fee list and examples in the instructions for filling out WPA Form 3 (Notice of Intent). B.Fees Fee should be calculated using the following process & worksheet. Please see Instructions before filling out worksheet. 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. noifeetf.doc • Wetland Fee Transmittal Form • rev. 10/11 Page 2 of 2 Massachusetts Department of Environmental Protection 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 of Activities Step 3/Individual Activity Fee Step 4/Subtotal Activity Fee Cat 2.) Beach Sand Relocation 1 $500.00 $500.00 Town Bylaw Fee (Ch. 237 Fee) $300.00 Step 5/Total Project Fee: $500.00 Step 6/Fee Payments: Total Project Fee: $500.00 a. Total Fee from Step 5 State share of filing Fee: $237.50 b. 1/2 Total Fee less $12.50 City/Town share of filling Fee: $262.50 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. To MassDEP 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.) Notice of Intent 915 Craigville Beach Rd, Centerville PROJECT NARRATIVE 1.Introduction This Notice of Intent (NOI) application has been submitted for the proposed beach sand relocation project at 915 Craigville Beach Road in Centerville (the site). The Town of Barnstable Assessors Department references the site as Parcel ID #225001. The proposed project includes relocating the accumulated beach sand from under the existing structures within the back shore beach to a portion of the beach seaward. The proposed project is located within a Barrier Beach/Coastal Beach and Land Subject to Coastal Storm Flowage. This application is being submitted in accordance with the Massachusetts Wetlands Protection Act and the Town of Barnstable Wetlands Protection Bylaw. 2.Site Description The site is located immediately south of Craigville Beach Road, bordered by the public access to Craigville Beach to the west, residential properties and Coville Beach to the east, and Centerville Harbor to the south. The site is home to the Craigville Beach Association (CBA), a member’s only beach club owned and operated by Christian Camp Meeting Association (CCMA). Gravel parking is located along Craigville Beach Road. The site consists of a main beach house with numerous storage sheds/bathhouses abutting directly east and west of the main beach house and interconnected by decking. A snack bar is located at the eastern end of the property. All structures are raised on pilings and/or concrete blocks above the barrier beach/coastal beach. Windblown sand from the beach has begun to collect and mound below the structures in many areas throughout the site. Environmental Consulting & Restoration, LLC (ECR) performed a review of the site on July 18, 2022. The intent of the site review was to classify all wetland resource areas on and near the site as well as document the existing conditions of the site. Wetland resource areas were reviewed in accordance with Massachusetts Department of Environmental Protection (DEP) regulations found at 310 CMR 10.00 as well as Chapter 237 of the Barnstable Town Bylaw. As a result of ECR’s wetland review at the site, ECR is able to confirm that the site contains the following wetland resource areas and areas of Conservation Commission jurisdiction: •FEMA Flood Zone VE •Barrier Beach/Coastal Beach •Coastal Dune •Land Under the Ocean Also review of the MassGIS wetlands database reveals the following: 1.The site is located within Estimated/Priority Habitat for Rare Species according to the Massachusetts Natural Heritage & Endangered Species Program (MaNHESP). The southern portion of the site is in both areas. 2.The site does not contain a Certified Vernal Pool according to the MaNHESP. 3.The site does not contain a U.S.G.S. mapped stream. 4.The site is not located within an Area of Critical Environmental Concern. Mapped Resource On or Within Proximity to Site Yes No Area of Critical Environmental Concern X NHESP Certified Vernal Pool X NHESP Potential Vernal Pool X NHESP Estimated Habitat of Rare Wildlife X NHESP Priority Habitat of Rare Species X DFW Cold Water Fisheries Resources X Outstanding Resource Waters X FEMA Flood Zones X Notice of Intent 915 Craigville Beach Rd, Centerville 3. Proposed Activities This NOI has been submitted to permit the proposed relocation of beach sand at the Craigville Beach Association property. As noted above, windblown sand from the beach has collected and mounded below the structures in many areas throughout the site. Historically, CCMA has managed this issue under a Determination issued by the Barnstable Conservation Commission in October 2005 (File #DA-05080). Recently, CCMA was notified by the Barnstable Conservation Staff that an NOI would be required to continue this work, prompting CCMA to submit this NOI. Relocating the windblown sand from under the structures to the recreation beach area is a way to recycle the sand in the form of nourishment to the resource area. CCMA has benefitted from this sand recycling in the past rather than nourish the beach with offsite sand or dredged material. The proposed project has been designed to minimize impacts to the site and will follow the methodology below: •Notification – Prior to any site work all appropriate local authorities shall be notified to include the Barnstable Conservation Commission as well as the MA Natural Heritage & Endangered Species Program. •Access – Equipment and machinery shall utilize the existing access along the eastern-most end of the property. The eastern end of the site includes gated access with an existing sandy path directly adjacent to the snack bar. This access abuts a small vegetated dune to the east that shall be avoided. At this time, the accessway is not proposed to be widened or altered in any way. •Sand Relocation – The windblown sand that has accumulated and mounded below the existing structures is proposed to be relocated seaward to the coastal beach. This work will require a small skid steer loader (Bobcat or similar) to excavate the sand adjacent and immediately under the structures. The sand shall be immediately transferred to the specified area seaward within the coastal beach. Laborers may be required to excavate sand further below the structures which will be completed by hand. The areas below the structures shall be excavated no further than the natural grade surrounding the structures where mounding has not occurred. Once the sand has been transferred to the coastal beach the recycled sand shall be graded flat. The applicant expects this work to be completed on an annual or biannual basis (once every two years) to maintain the use of the property and provide adequate recreational access Craigville Beach. 4.Summary The proposed project to relocate windblown sand at the Craigville Beach Association has been historically undertaken in accordance with a Determination issued by the Barnstable Conservation Commission in 2005. At this time, based on the requirement of Conservation Staff, the applicant is seeking approval to continue the work that has historically been untaken at the site under a new Order of Conditions. The project shall be overseen by an environmental monitor to ensure the methodology is followed and all wetland resource areas are adequately protected. The applicant understands that time-of-year restrictions may be required for this work and fully intends to comply with that restriction and any other conditions set forth in the anticipated Order of Conditions. CCMA 915 Craigville Beach Rd, Barnstable Site Photographs Photograph #1 – View looking west along the seaward side of the storage sheds/bath houses. Photograph #2 – View looking east along the seaward side of the storage sheds/bath houses. The main beach house can be seen with the flag pole. CCMA 915 Craigville Beach Rd, Barnstable Site Photographs Photograph #3 – View of the windblown sand that has accumulated under and around the structures. Photograph #4 – Another view of the windblown sand that has accumulated under and around the structures. CCMA 915 Craigville Beach Rd, Barnstable Site Photographs Photograph #5 – View across the coastal beach where the sand that has accumulated under and around the structures is proposed to be relocated. Photograph #6 – View of the existing beach access at the eastern-most end of the property. USGS SITE LOCUS MAP 915 Craigville Beach Road Centerville, Massachusetts Source: MassMapper N  SITE FEMA MAP 915 Craigville Beach Road Centerville, Massachusetts Map: 25001C0564J Eff: 07/16/2014 N  SITE Priority Habitat of Rare Species, Estimated Habitat of Rare Wildlife & Certified Vernal Pool Map 915 Craigville Beach Road Centerville, Massachusetts Source: MassMapper N  Site NOTICE OF INTENT ABUTTER NOTIFICATION LETTER DATE: RE: Upcoming Barnstable Conservation Commission Public Hearing To Whom It May Concern, As an abutter within 100 feet of a proposed project, please be advised that a NOTICE OF INTENT application has been filed with the Barnstable Conservation Commission. APPLICANT: PROJECT ADDRESS OR LOCATION: ASSESSOR’S MAP & PARCEL: MAP PARCEL PROJECT DESCRIPTION: ________________________________________________________ APPLICANT’S AGENT: PUBLIC HEARING: WILL BE HELD VIA ZOOM See agenda posting on Town Clerks website available at least 48 hours in advance of the meeting for details. DATE: / / TIME: P.M. Brad Holmes PO Box 4012 Plymouth, MA 02361 Christian Camp Meeting Association 915 Craigville Beach Road 225 001 Proposed beach sand relocation project. Existing sand under and around structures is proposed to be relocated seaward within the Coastal Beach. Commission, 367 Main Street, Hyannis (508-862-4093) NOTE: Plans and application describing the proposed activity are on file with the Conservation Conservation Notice of Intent (NOi) Abutter List for Subject Parcel 226137 Property owners within 100 feet of the perimeter of the subject parcel upon which work is proposed. Parcel ID 226015 226016 226017 226023 226044001 226050 226053 226054 Page 1of2 Owner1 Owner2 Address Line 1 GA VITI, JULIA G TR JGG CRAIGVILLE NOMINE TRUST 11 DROWNE PKWY GREENE, THOMAS M & STEPHANIE 22 BUTLER AVENUE REAL1Y 287 COMMONWEALTH M TRS TRUST AVE UNIT 3 KIRK, ELEANORE H S TR C/O KIRK, JAMES W 24 GRANVILLE BAKER WAY Address Line 2 GREENE, JOHN J & BARBARA L C/O NRG CONCEPTS, INC 165 MAIN ST, STE 307 PLONOWSKI, THADDEUS J & 23 DORSET LANE KATHLEEN FETAL REILLY, WILLIAM E JR 71 CHURCH STREET SHEA, KEVIN D & BLAKE, KIMBERLY 167 SALT MEADOW S ROAD DALESSANDRO, VINCENT A & DALESSANDRO FAMILY REV TRUST 1857 ATWOOD A VENUE CAROLE B TRS 2011 99 LAKE ELIZABETH LLC 28 SUMMERBELL A VE HERZOG, ELIZABETH HEIRS OF 61 LOUNSBURY PLACE FARQUHAR,DOUGLAS B& 1601 OLNEY-SANDY THERESE-FRANKLIN, ANN SPRING ROAD CRORY, ROBERT R & LAUREN C 39 THOMSON ROAD GATES, BARBARA H & CLARK R TRS GATES HEWITI FAMILY TRUST 8219 N FAIRWAY VIEW DRIVE Total Number of Abutters: 24 City State Zip RUMFORD RI 02916 BOSTON MA 02115 PLYMPTON MA 02367 MEDWAY MA 02053 MILL VALLEY CA 94941 SOUTH EASTON MA 02375 FAIRFIELD CT 06824 JOHNSTON RI 02919 CENTERVILLE MA 02632 KINGSTON NY 12401 SANDY SPRING MD 20860 WEST HARTFORD CT 06107 TUCSON AZ 85742 Report Generated On: 8/4/2022 3:03 PM This list by itself does NOT constitute a "Certified List of Abutters" and is provided only as an aid to the determination of abutters. If a Certified Abutter List is required, you must contact the Assessing Division tohave this list certified. Parcel ID Owner1 Owner2 Address Line 1 Address Line 2 City State Zip 226055 BROUILLARD, JOHN C & ELAINE F BROUILLARD LMNG TRUST 270 GREEN DUNES WEST HYANNIS PORT MA 02672 TRS DRIVE 226056 DELANEY, RYAN TR DELANEY FAMILY NOMINEE 41 LEDGEWOOD DRIVE COHASSET MA 02025 TRUST 226057 PARKE, AVIS-ANN S 135 LAKE ELIZABETH CENTERVILLE MA 02632 DRIVE 226065 WALTERS, GARY D & SUSAN B 128 SAYRE DRIVE PRINCETON NJ 08540 226066 MATTHIJSSEN, JUDITH E 8 SKINNER TRAIL CHESTER NJ 07930 226071 BARKSDALE, KENNETH P & LISA F 947 SPERRY WAY SYKESVILLE MD 21784 226098 CHRISTIAN CAMP MEETING ASSOC 39 PROSPECT A VE CENTERVILLE MA 02632 226136 LEE, CHRISTINA A TR CHRISTOS V & MENI E 17 IVEY ROAD BELMONT MA 02478 DAFNOULELIS IR TRS 226137 CHRISTIAN CAMP MEETING ASSOC 39 PROSPECT A VE CENTERVILLE MA 02632 226138 GA VITT, JULIA G TR JGG CRAIGVILLE NOMINEE TRUST 11 DROWNE PKWY RUMFORD RI 02916 226187 GRIFFIN, SUZANNE M PO BOX627 WEST HYANNISPORT MA 02672 Page 2 of2 Total Number of Abutters: 24 Report Generated On: 8/4/2022 3:03 PM This list by itself does NOT constitute a "Certified List of Abutters" and is provided only as an aid to the determination of abutters. If a Certified Abutter List is required, you must contact the Assessing Division to have this list certified. Town of Barnstable Conservation Commission 367 Main Street Hyannis Massachusetts 02601 Form PA Office: 508-862-4093 E-rnail: conservation@town.barnstable.ma.us FAX: 508-778-2412 Permission to Access Property Property owner's name(s): Christian Camp Meeting Association Applicant's (Representative's) Name(s)_________________ _ Project street address 915 Craigville Beach Rd Barnstable Assessor's Map & Parcel: Map 225001 Parcel ____ _ Applicant's Contact Phone Number: 6_1_7_ -_5_2_9_-3_7_ 9_2 __________ _ ACCESS TO PROPERTY PERMISSION As the Owner(s) of the above referenced property, I/we have been advised that under the provisions of the Massachusetts Wetlands Protection Act (MGL Ch 131, Section 40) and the Town of Barnstable General Ordinances (Chapter 237), the Barnstable Conservation Commission, its Agents or its designated staff are authorized, as a matter of law, to enter the outside areas of the property for the purpose of reviewing the existing conditions and the proposed work as described in my/our application (Notice of Intent or Request for Determination) to the Barnstable Conservation Commission. Where possible, notice will be provided to the applicant prior to the visit. Visits will occur during daylight hours on either weekdays or weekends as necessary for the Commission and its agent to examine said property. I understand that if attempts to contact me are unsuccessful, the Commissioner or its agent may proceed to inspect the outside areas of said property under this application. I/we confirm my/our understanding the purpose of this permission and I/we grant permission to . Commissioners, its agent, and its designated staff, to enter the outside areas of my/our property regarding this application for the period as described below: �. From the submission of the Application (Notice of Intent or Request for Determination) until the approval of the Notice of Intent Request or Request for Determination; and 2.From the issuance of the Order(s) of Conditions (approval for Notice of Intent) to the completion of the project and the final inspection by the Conservation staff to confirm the completion of the project. I have read the above and I understand and agree to allow inspections as described. Signature of property owner Date signed Representative's signature Date signed Adopted March 15, 2022, effective April 18, 2022. 9/21/2022 Cameron Larson Q:\Conservt\DEPFORMS\Form W.doc rev: 03 MAR 2009 Waiver Request WAIVER OF REQUIREMENT FOR HEARING WITHIN 21 DAYS I agree to waive the requirements of the MA Wetlands Protection Act MGL Ch. 131 Sec. 40 and the Town of Barnstable Code - Ch. 237 (Wetlands) for a hearing before the Conservation Commission within 21 days of receipt of my Notice of Intent or Request for Determination of Applicability application. Applicant name (please print): ___________________________________________ Signature of applicant or authorized agent: ___________________________________________ Date: ____________________ Town of Barnstable Conservation Commission 200 Main Street, Hyannis, MA 02601 E-mail: conservation@town.barnstable.ma.us Office: 508-862-4093 Fax: 508-778-2412 Form W Christian Camp Meeting Association 9/21/2022