HomeMy WebLinkAboutCOC request J
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
L
WPA — Request for Certificate of Compliance SE-83-472 Form 8A p
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
A. Project Information
Important:
When filling out 1. This request is being made by:
forms on the BLH Environmental Consulting
computer, use Name
only the tab 47 Old Church Street
key to move
your cursor Mailing Address
do not use the Yarmouth Port _ MA 02675
return key. City/Town State Zip Code
508-362-3397
PA Phone Number
2. This request is in reference to work regulated by a final Order of Conditions issued to:
,/e"" A , Charles Tolley _
Applicant
April 26, 1984 SE-83-472
Dated DEP File Number
Upon completion
of the work 3. The project site is located at:
authorized in 15 Davidson Lane Yarmouth Port
an Order of Street Address City/Town
Conditions, the
property owner
must request a Assessors Map/Plat Number Parcel/Lot Number
Certificate of 4. The final Order of Conditions was recorded at the Registry of Deeds for:
Compliance
from the issuing Charles Tolley
authority stating Property Owner(if different)
that the work or Barnstable
portion of the
work has been County Book Page
satisfactorily #18812
completed. 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❑ the above-referenced Order of Conditions has lapsed and is therefore no longer valid, and the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 1 of 2
.._
-1MBureauassachuseofResoutts DeparrceProtetmentction of EnvironmentalWetlands Protection DEP File Number:
WPA Form 8A — Request for Certificate of Compliance SE-83-472
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 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-yo u r-city-or-tow n.htm l).
wpaform8a.doc»rev.529/14 Page 2 of 2
15 OuU ds,o., ( 0,,.e
0f'" i DEPARTMENT
k :g
OF
/ COMMUNITY
µ DEVELOPMENT tr; 44 -)1
>;3s cncIto�'°.9,'.,� TOWN OF Y A R M O U T H
CONSERVATION COMMISSION
Acknowledgment of Receipt
R L 1 l-
4_, c
I, - I 1 )1-- L\ J1— ) of(Name) (Business/Company)
have received the following document(s) via hand delivery on this
'rt ) day of ��\0 20 1 P at I._ 0 U pm/am.
• Original Plan to be Copied and Returned SE83 -
• Order of Conditions SE83 -
• Extension Permits SE83-
• Certificate of Compliance SE83- 3e, 47,2
• ORAD SE83-
• Determination of Applicability
(Street Address, Owners Name)
/
Sign t re ' - - `
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
Yarmouth Conservation Commission Voting Sheet
Address: 15 Davidson Ln.
Applicant: Tolley, C.
Date of Hearing: 2/1/2018
Owner:
Representative:
Project Description: Addition
Green Receipts: Complete
incomplete (explain)
Legal Ad $$: Paid
Not Paid (explain)
TYPE OF HEARING
Notice of Intent: Opening Request for Determination: Opening
Continued Continued
DEP File Number 5E83-472 Request to Amend an Order Opening
Continued
Certificate of Compliance: Opening Other:
Continued
DECISION: VOTES:
Notice of Intent: Request for Determination: For: Against:
Approved Neg. - _ Bishop Bishop
Durkin Durkin
Denied Pos. t _ Johnston Johnston
Lawrence Lawrence
Continued Continued Luttazi /7 Luttazi
Schlesinger Z Schlesinger
DISCUSSION: (approval ccu-iditions, denial esons, continuation reasons)