HomeMy WebLinkAboutCOC request 10.2.2025 L
1
)T Massachusetts Department of Environmental Protection
DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 8A — Request for Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 .mouth Co itdtk>���
Commission
Town of Yarmouth Wetland By-law, Chapter 143
A. Project Information OCT 02 2025
Important:
When filling out 1. This request is being made by: RECEIVED
forms on the Phil & Nance Carbone
computer, use Name
only the tab
key to move 6 Adrian Drive
your cursor Mailing Address
do not use the North Reading MA 01864-1.5.5.3
return key. City/Town State Zip Code
,,t978-500-1974
m Phone Number
frimA ,. 2. This request is in reference to work regulated by a final Order of Conditions issued to:
Phil & Nance Carbone
Applicant
3-17-2017 SE83-2104
Dated DEP File Number
Upon completion
of the work 3. The project site is located at:
authorized in 14 & 20 kingsbury Way Yarmouth Port
an Order of
Conditions,the Street Address City/Town
property owner 132 >f 4 # 1
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
authority stating Property Owner(if different)
that the work or
portion of the
work has been County Book Page
satisfactorily
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❑ the above-referenced Order of Conditions has lapsed and is therefore no longer valid, and the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
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number
'I L
WPA Form 8A -n Request for Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
Town of Yarmouth Wetland By-law, Chapter 143
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-you r-city-or-town.html).
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