HomeMy WebLinkAboutRequest for Certificate of ComplianceMassachusetts 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
Town of Yarmouth Wetland By-law, Chapter 143
A. Project Information
Important:
When filling out 1. This request is being made by:
forms on the Steven and Laurel Wilson
computer, use Name
only the tab 14 Elishas Pond Road
key to move
your cursor - Mailing Address
An not use the Yarmouth Port MA
return key. Cityrrown State
40--h 508-362-2270
Phone Number
2. This request is in reference to work regulated by a final Order of Conditions issued to:
Steven and Laurel Wilson
Applicant
3/16/77
Dated
The project site is located at:
14 Elishas Pond Road
Street Address
106
Assessors Map/Plat Number
Upon completion 3
of the work
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.
SE83-88
DEP File Number
Yarmouthport
Cityrrown
35
Parcel/Lot Number
The final Order of Conditions was recorded at the Registry of Deeds for:
Steven and Laurel Wilson
Property Owner (if different)
Barnstable
County
Certificate (if registered land)
5. This request is for certification that (check one):
197
Book
DEP File Number:
QFR3_RR
vroviaeo Dy uCr
02675
Zip Code
91
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❑ the above -referenced Order of Conditions has lapsed and is therefore no longer valid, and the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.
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Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 8A — Request for Certificate of Compliance sEss-ss
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?
® 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 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). 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://www mass gov/eea/agencies/massdep/about/contacts/find-the-massdep-regional-office-
for-you r -city -or -town. html).
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