HomeMy WebLinkAbout83-540 - COC requestlmportant:
Vvhen lilling out
forms on the
computer, use
only the tab
key lo move
your cursor -
do not use lhe
retum key.
MassachusetG Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 8A - Request for Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131, $40
A. Project lnformation
1. This request is being made by
Michael Bernstein
Name
53 Con ressional Dr
Mailing Address
Yarmouth Port
City/Town State
sE-83-540
Proriaea ov oEP
oEP File Number:
Zip Code
AUG ,a 2018
RECETVED
o n serva ronommission
Applicanl
March 1 1985 sE-83-540
Dated
3. The project site is located at
53 Congressional D ve
DEP File Number
Yarmouth Port
Street Address
'103
City/Town
1'l
Upon completion
of the work
authorized in
an Order of
Conditions, the
property owner
must request a
Certificate of
Compliance
from the issuing
aulhority stating
that the work or
portion of the
work has been
satisfactorily
completed.
AssessoE Map/Plat Number Parc€Vlot Number
4. The final Order of Conditions was recorded at the Registry of Deeds for:
Property Owner (it differcnt)
Barnstable 3573 bb
County Book Page
Certificate (if registered land)
5. This request is for certification that (check one)
n the work regulated by the above-referenced Order of Conditions has been satisfactorily completed.
E the following portions of the work regulated by the above-referenced Order of Conditions have
been satisfactorily completed (use additional paper if necessary).
I the above-referenced Order of Conditions has lapsed and is therefore no longer valid, and the
work regulated by it was never started.
wpaform8a doc - rev. 5/2914
)
MA 0267 5
Phone Number
2. This request is in reference to work regulated by a final Order of Conditions issued to:
Ocean Sunset Real Estate & Construclion
,Affi
Massachusetts Departnent of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 8A - Request for Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131 , $40
DEP File Number
sE-83-540
Provided by DEP
A. Project lnformation (cont.)
6. Did the Order of Conditions for this project, or the portion of the project subject to this request, contain
an approval ofany plans stamped by a registered professional engineer, architect, landscape
architect, or land surveyor?
I Ves lfyes, attach a written statement by such a professional certifying substantial
compliance with the plans and describing what deviation, if any, exists from the plans
approved in the Order.
!No
B. Submittal Requirements
Requests for Certificates of Compliance should be directed to the issuing authority that issued the final
Order of Conditions (OOC). lf the project received an OOC from the Conservation Commission, submit
this request to thal Commission. lf the project was issued a Superseding Order of Conditions or was the
subject of an Adjudicatory Hearing Final Decision, submit this request to the appropriate DEP Regional
Offlce (see http://www.mass gov/eea/agencies/massdeplaballvEqlrtacts/find{he-massdep-regional-office-
for-yourcity-or-town. html).
wpafomaa da - r6v 5129/14