HomeMy WebLinkAbout83-2029 - Extension PermitMassachusetts Department of E nvironmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 7 - Extension Permit for Orders of Conditions sE83-2029
Massachusetts Wetlands Protection Act M.G.L. c. 131, $40
Town of Yarmouth Wetland By-law, Chapter 143
Provided by DEP
DEP File Number:
A. General lnformation
lmportant:
When flling out
forms on the
computer, use
only the tab
key to move
your cursor -
do not use the
retum key.
Applicant:
Jacob Simmons
Name
Mailing Address
Mashpee MA 02649
City/Town
2. Property Owner (if different)
Zip Code
Name
Mailing Address
City/Town State Zip Code
B. Authorization
The Order of Conditions (or Extension Permit) issued to the applicant or property owner listed above on
811912015 lssued by Yarm
Conser
outh
Date
for work at Street Address Assessor'sl\4aplPlat Number Parcel/LotNumber
recorded at the Registry of Deeds for
Barnstable
County
1,276,831
Page
Certificate {if registered land)
N/Ais hereby extended until Date Date the Order was last extended (if applicable)
This date can be no more than 3 years from the expiration date of the Order of Conditions or the latest
extension. Only unexpired Orders of Conditions or Extension may be extended.
This Extension Permit must be signed by a majority of the Conservation Commission and a copy sent to
the applicant and the appropriate DEP Regional Office
(http:/iwww.mass ov/eea/aoencies/massdeo/ab ouVcontacts/f ind-the-massdeo-reoiona l-off ice-f or-vour-citv-or-
rvation Commission
14
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wpaformT doc . rev 5/29/2014
'17 Cape Drive, Unit 2
State
2 Channel Point Drive 009
t>
Massachusetts Department of Environmental Protection DEp Fite Number:Bureau of Resource Protection - Wetlands
WPA Form 7 - Extension Permit for Orders of Gonditions e!q3-202e
Massachusetts Wetlands Protection Act M.G.L. c. 131, $40 Provided bv DEP
Town of Yarmouth Wetland By-law, Chapter '143
G. Recording Confirmation
The applicant shall record this document in accordance with General Condition I of the Order of
Conditions (see below), complete the form attached to this Extension Permit, have it stamped by the
Registry of Deeds, and return it to the Conservation Commission.
Note: General Condition 8 of the Order of Conditions requires the applicant, prior to commencemenl of
work, to record the final Order (or in this case, the Extension Permit for the Order of Conditions) in the
Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of
the affected property. ln the case of recorded land, it shall be noted in the Registry's Granter lndex under
the name of the owner of the land upon which the proposed work is to be done. ln the case of registered
land, it shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the
proposed work is done.
Detach this page and submit it to the Conservation Commission prior to the expiration of the Order of
Conditions subject to this Extension Permit.
To:
Yelrng4h
Conservation Commission
Please be advised that the Extension Permit to the Order of Conditions for the project at
2 Channel Point Drive SE83-2029
DEP File Number
County
for
Property Owner
Date Book
lf recorded land the instrument number which identifies this transaction is
Page
lnstrument Number
lf registered land, the document number which identifies this transaction is:
Document Number
waalotmTi@. Gy 51291201 4
Signature of Applicant
\
Project Location
has been recorded at the Registry of Deeds of:
and has been noted in the chain of title of the affected property in accordance with General Condition 8 of
the original Order of Conditions on: