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BARNSTABLE LAND COURT REGISTRY
Massachusetts Department of Environmental Protection
DEP Fife dumber:
Bureau of Resource Protection - Wetlands
WPA Form 7 — Extension Permit for Orders of Conditions SE083-2266
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
Town of Yarmouth Wetland By -Law, Chapter 143
A. General Information
1. Applicant:
Mark and Darlene Stoever
Name
66 Osgood Road
Mailing Address
Sterling
City/Town
2. Property Owner (if different):
Name
Mailing Address
City/Town
B. Authorization
MA
State
State
01564
Zip Code
Zip Code
The Order of Conditions (or Extension Permit) issued to the applicant or property owner listed above on:
3111 /2021
Date
Issued by:
for work at: 172 Blue Rock Road
Street Address
recorded at the Registry of Deeds for:
Barnstable
County
221906
Certificate (if registered land)
is hereby extended until
6/15/2027
Yarmouth
Conservation Commission
101 159
Assessor's Map/Plat Number
Book
Parcel/Lot Number
rays
Date Date the Order was last extended (if applicable)
This date can be no more than 3 years from the expiration date of the Order of Conditions or the latest
extension. Only unexpired Orders of Conditions or Extension may be extended.
This Extension Permit must be signed by a majority of the Conservation Commission and a copy sent to
the applicant and the appropriate DEP Regional Office (https://www.mass.gov/service-details/massdep-
regional-offices-by-community).
wpaform7.doc • rev, 312/2021 Page 1 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
DEP File Number:
WPA Form 7 — Extension Permit for Orders of Conditions sE083-2266
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
Town of Yarmouth Wetland By -Law, Chapter 143
B. Authorization (cunt.)
06/C� I zo2
Issue Date (mmlddlyyyy)
Cinnafi rren
Signatur
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Signature
Signature
Printed Name
Prep
Printe�Name
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PrintedbName 4
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Printed Name
Printed Name
wpaformTdoc • rev. 3/2/2021 Page 2 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
DEP File Number:
WPA Form 7 — Extension Permit for Orders of Conditions SE083-2266
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
Town of Yarmouth Wetland By -Law, Chapter 143
C. Recording Confirmation
The applicant shall record this document in accordance with General Condition 8 of the Order of
Conditions (see below), complete the form attached to this Extension Permit, have it stamped by the
Registry of Deeds, and return it to the Conservation Commission.
Note: General Condition 8 of the Order of Conditions requires the applicant, prior to commencement of
work, to record the final Order (or in this case, the Extension Permit for the Order of Conditions) in the
Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of
the affected property. In the case of recorded land, it shall be noted in the Registry's Granter Index under
the name of the owner of the land upon which the proposed work is to be done. In the case of registered
land, it shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the
proposed work is done.
Detach this page and submit it to the Conservation Commission prior to the expiration of the Order of
Conditions subject to this Extension Permit.
To:
Yarmouth
Commission
Please be advised that the Extension Permit to the Order of Conditions for the project at:
Project Location
has been recorded at the Registry of Deeds of:
Barnstable
County
for:
Property Owner
SE083-2270
DEP Fife Number
and has been noted in the chain of title of the affected property in accordance with General Condition 8 of
the original Order of Conditions on:
Date
Book
If recorded land the instrument number which identifies this transaction is:
Instrument N
If registered land, the document number which identifies this transaction is:
Document Number
Signature of Applicant
BARNSTABLE REGISTRY OF DEEDS
John F. Meade, Register
Page
wpaform7_doc • rev. 3/2/2021 Page 3 of 3