HomeMy WebLinkAboutCOC request Yarmouth Conservation Commission • 1146 Route 28 • South Yarmouth, MA 02664-4492
Tel. (508)-398-2231 Ext. 1288 • Fax (508)-398-0836 • TTD# (508) 398-2231
Administrative Checklist
Certificate of Compliance
General Information:
All filings must be made on Town of Yarmouth forms.
All applications must be submitted two weeks prior to the next scheduled Conservation
Commission meeting. Refer to Meeting Schedule
Failure to follow the Administrative Checklist guidelines shall result in an Administrative
Incomplete Application and will not be advertised for a Public Hearing.
Contact the office if you need assistance. We will be happy to help guide you through the process.
Submitting an Application:
______ 1 original application with original signatures
______ 1 pdf of application, plan/sketch, and other supporting information emailed
to kgrant@yarmouth.ma.us
______ Statement from Engineer or stamped As-Built plan, refer to 310 CMR 10.05(9)(d)
______ Local filing fee – Refer to fee schedule, Check payable to “Town of Yarmouth”
DEPARTMENT
OF
CONSERVATION
x
x
x
x
wpaform8a.doc •• rev. 5/29/14 Page 1 of 2
Massachusetts 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
DEP File Number:
83-1524
Provided by DEP
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.
1. This request is being made by:
James Bloumbas
Name
2 Pebblebrook Road
Mailing Address
North Easton
City/Town
MA
State
02356
Zip Code
508-942-3343
Phone Number
2. This request is in reference to work regulated by a final Order of Conditions issued to:
Bosworth Associates
Applicant
8/23/2000
Dated
83-1524
DEP File Number
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.
3. The project site is located at:
194 Pawkannawkut Drive
Street Address
South Yarmouth
City/Town
19
Assessors Map/Plat Number
42.1.1
Parcel/Lot Number
4. The final Order of Conditions was recorded at the Registry of Deeds for:
Property Owner (if different)
Barnstable
County
34167
Book
146
Page
Certificate (if registered land)
5. This request is for certification that (check one):
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.
wpaform8a.doc •• rev. 5/29/14 Page 2 of 2
Massachusetts 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
DEP File Number:
83-1524
Provided by DEP
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-your-city-or-town.html).
Photo 1: View of the Site at 194 Pawkannawkut Drive. Looking south.
Photo 2:View of fill placed at Site. Looking northwest
Site Photographs
194 Pawkannawkut Drive
South Yarmouth, MA
December 2020
Page 1