HomeMy WebLinkAboutEXT recordedDo•_=1:508s118 08-22-2024 1:19
BARNSTABLE LAND COURT REGISTRY
Massachusetts Department of Environmental Protection
DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 7 — Extension Permit for Orders of Conditions SE083-2299
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
Lill
Town of Yarmouth Wetland By -Law, Chapter 143
A. General Information
Important:
When filling out
1. Applicant:
forms on the
Baxter Nye Engineering and Surveyors
computer, use
Name
only the tab
key to move
1597 Falmouth Rd _
your cursor -
Mailing Address
do not use the
Centerville MA 02632
return key.
City/Town State Zip Code
2. Property Owner (if different):
Lisa and James Valone
-- — --
--
Name
��""�
205 Rice Rd
Mailing Address
Wayland MA 01778
City/Town State Zip Code
B. Authorization
The Order of Conditions (or Extension Permit) issued to the applicant or property owner listed above on:
t 0r0
9/28/2021 —_— Issued by: Yarmouth -
Date Conservation Commission
for work at: 63 Smiths Point Rd - 5 13
Street Address Assessor's Map/Plat Number Parcel/Lot Number
recorded at the Registry of Deeds for:
Barnstable
t
O
- --
County Book Page
223967
d
Certificate (if registered land)
4
9/28/2026
is hereby extended until: _
Date Date the Order was last extended (if applicable)
3
This date can be no more than 3 years from the expiration date of the Order of Conditions or the latest
vextension.
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-bv-community).
wpaform7.doc • rev. 3/2/2021 Page 1 of 3
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands
Lill
WPA Form 7 — Extension Permit for Orders of Conditions SE083-2299
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
Town of Yarmouth Wetland By -Law, Chapter 143
B. Authorization (cont.)
61,1 VZ6
Issue Date (mm/dd/yyyy)
Signatures: //�
f/ Ejn r
Signa u \ (� Printed Name v
Signature Printed Name
Sig ature Printed Name
Signature Printed Name
Signature Printed Name
Signature Printed Name
Signature Printed Name
Signature Printed Name
wpaform7.doc • rev. 3/2/2021 Page 2 of 3
Massachusetts Department of Environmental Protection DEP File Number:
- Bureau of Resource Protection - Wetlands
WPA Form 7 — Extension Permit for Orders of Conditions SE083-2299
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
Conservation Commission
Please be advised that the Extension Permit to the Order of Conditions for the project at:
_ _ SE083-2299
Project Location DEP File Number
has been recorded at the Registry of Deeds of:
Barnstable
County
for:
Property Owner
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 Number
If registered land, the document number which identifies this transaction is:
rdye
Document Number Doc= e 1 s 508 v 118 08-22-2024 1 : 19
BARNSTABLE LAND COURT REGISTRY
Signature of Applicant
wpaform7.doc • rev. 3/2/2021
BARNSTABLE REGISTRY OF DEEDS
John F. Meade, Register
Page 3 of 3