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Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 8A — Request for Certificate of Compliance
L i Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Town of Yarmouth Wetland By-law, Chapter 143
A. Project Information
Important:
When filling out
forms on the
computer, use
only the tab
key to move
your cursor -
do not use the
return key.
2
Upon completion
of the work 3.
authorized in
an Order of
Conditions, the
property owner
must request a
Certificate of 4.
Compliance
from the issuing
authority stating
that the work or
portion of the
work has been
satisfactorily
completed.
This request is being made by
Ronald J. Cadillac, PLS, RS
Name
P.O. Box 258
Mailing Address
West Yarmouth
City/Town
508-775-9700
MA
State
This request is in reference to work regulated by a final Order of Conditions issued to
John _& Carolyn_Kane
Applicant
2/11/19 SE83-2185
Dated DEP File Number
The project site is located at
23 Tanglewood Drive West Yarmouth
Street Address City/Town
30 93
Assessors Ma0PlatNumber -- Parcel/Lot Number
The final Order of Conditions was recorded at the Registry of Deeds for
Same
Property Owner (if different)
Barnstable 31859
County Book
Certificate (if registered land)
5. This request is for certification that (check one):
DEP File Number:
02673
Zip Code
107
Page
the work regulated by the above -referenced Order of Conditions has been satisfactorily completed.
❑ the following portions of the work regulated by the above -referenced Order of Conditions have
been satisfactorily completed (use additional paper if necessary).
❑ the above -referenced Order of Conditions has lapsed and is therefore no longer valid, and the
work regulated by it was never started.
wpziform - !
, 8a r�oc -- ray. 5129,14 Page I Of 2
Massachusetts Department of Environmental Protection
�z DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 8A — Request for Certificate of Compliance
Provided by DEP
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Town of Yarmouth Wetland By-law, Chapter 143
A. Project Information (cont.)
6. Did the Order of Conditions for this project, or the portion of the project subject to this request, contain
an approval of any plans stamped by a registered professional engineer, architect, landscape
architect, or land surveyor?
0 Yes If yes, attach a written statement by such a professional certifying substantial
compliance with the plans and describing what deviation, if any, exists from the pians
approved in the Order.
■
Requests for Certificates of Compliance should be directed to the issuing authority that issued the final
Order of Conditions (OOC). If the project received an OOC from the Conservation Commission, submit
this request to that Commission. If 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
Office (see http://wvvw,mass.govleea agencies/massdepfabouUcontacts/find-the-rnassoIep--rte
ci-'�'c)ui'-city-or-town.html).
wpaform8a.doc -- rev. 5/2 Page 2 of 2