HomeMy WebLinkAbout83-1571 - COC requestMassachusetts 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
'l . This request is being made by
Michael Bernstein
Name
53 Congressional Drive
lmporlant:
\Men filling out
forms on lhe
compuler, use
only the tab
key to move
your cursor -
do not use the
return key.
Yarmouth C onse rvation
-rEgE-ftrE-D-
Commrssion
Mailing Address
Yarmouth Port
City/Town Slate
Phone Number
2. This request is in reference to work regulated by a final Order of Conditions issued to
Zip Code
Michael & Mary-Alyle B
Applicant
ernstein
November 28 2001
Dated
3. The project site is located at:
53 Congressional Drive
Upon completion
of the work
authorized in
an Order of
Conditions, the
property owner
must request a
Certificate of
Compliance
from the issuing
authority stating
that the work or
portion of the
work has been
satisfactorily
completed.
Slreet Address
103
Yarmouth Port
City/Town
11
Assessors Map/Plat Number Parceulot Number
4. The flnal Order of Conditions was recorded at the Registry of Deeds for:
D^l
Property Owner (il difierent)
Barnstable
County
176
Book Page
Cenilicate (if registered land)
5. This request is for certification that (check one)
E the work regulated by the above-referenced Order of Conditions has been satisfactorily completed
n the fottowing portions of the work regulated by the above-referenced Order of Conditions have
been satisfactorily completed (use additional paper if necessary).
X the above+eferenced Order of Conditions has lapsed and is therefore no longer valid, and the
work regulated by it was never started.
wp6fomEa (bc - rcv. 5129/14
DEP File Number:
sE-83-j!Z
Provided by DEP
MA 02675
AUG 27 2018
sE-83-1571
OeP fie NumOer
/e
14611
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 8A - Request for Gertificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131 , $40
A. Project Information (cont.)
6. Did the Order of Conditions for this pro.lect, or the portion of the proiect subJect to this request, contain
an approval ofany plans stamped by a registered professional engineer, archrtect, tandscape
architect, or land surveyor?
X Yes lf yes, 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.
n No
B. Submittal Requirements
Requests for Certificates of Compliance should be directed to the issuing authority that issued the flnal
Order of Conditions (OOC). lf the project received an OOC from the Conservation Commission, submit
this request to that Commission. lf the project was issued a Superseding Order of Conditions or was the
subject of an Adiudicatory Hearing Final Decision, submlt this request to the appropriate DEP Regional
Office (see http://www. mass.gov/eea/agencies/massdep/about/contacts/find-the-massdep-regional-office-
for-your-city-ortown. htm l).
*palo.m& cbc - @ 5/29/14
DEP File Number:
qE€3-1571
Provided by DEP