HomeMy WebLinkAboutRecorded Extension Permit for Order of Conditions - 1167 Great Island Road YarmouthDoc c 1 s 508 s 226 08-23-2024 2.037
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 SE083-2311
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
Town of Yarmouth Wetland By -Law, Chapter 143
A. General Information
Important:
When filling out
forms on the
computer, use
only the tab
key to move
your cursor -
do not use the
return key.
f�
Z
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,Y (gym IS extended untl . Date Date the Order was last extended (if applicable)
i q This date can be no more than 3 years from the expiration date of the Order of Conditions or the latest
0extension. Only unexpired Orders of Conditions or Extension may be extended.
!y 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).
Q 't
0
Hereby
1. Applicant:
John Griffen
Name
2 Hughes Place
Mailing Address
Bronxville
2. Property Owner (if different)
Name
Mailing Address
City/Town
B. Authorization
NY
State
10708
Zip Code
Zip Code
The Order of Conditions (or Extension Permit) issued to the applicant or property owner listed above on:
1
12/30/2021
Date
for work at:
Yarmouth
Conservation Commission
1167 Great Island Road 4
Street Address Assessor's Map/Plat Number
Issued by:
recorded at the Registry of Deeds for
Barnstable
County
225516
Certificate (if registered land)
12/30/2027
Book
Parcel/Lot Number
Page
wpaform] doc • rev. 3/2/2021 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 SE083-2311
Massachusetts Wetlands Protection Act M
Town of Yarmouth Wetland By -Law, Chap
B. Authorization (cont.)
-o Isne Date (mm/ddiyyyy)
Signatures:
Si
Signature
Signatur
Signature �s
Signature
Signature
Signature
Signature
. G. L. c. 131, §40 Provided by DEP
ter 143
N4��
Printed Name
Wv t J )3fir _ `h
Printed M.
Printed Name
Printed Name -� h
t.44�
Printed Name
Printed Name
Printed Name
Printed Name
wpaform7 doc • 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 SE083-2311
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:
SE083-2311
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:
Document Number
Signature of Applicant
6ARNSTABLE RFGISTRY OF DEEDS
John F. Meade, Register
Page
wpaform7 doc • rev 3/2/2021 Page 3 of 3