34-002 (3) c Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
WPA Appendix A — DEP Regional Addresses
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Mail transmittal forms and DEP payments,payable to:
Commonwealth of Massachusetts
Department of Environmental Protection
Box 4062
Boston, MA 02211
DEP Western Region Adams Colrain Hampden Monroe Pittsfield Tynngham
436 Dwight Street Agawam Conway Hancock Montague Plainfield Wales
Alford Cummington Hatfield Monterey Richmond Ware
Suite 402 Amherst Dalton Hawley Montgomery Rowe Warwick
Springfield,MA 01103 Ashfield Deerfield Heath Monson Russell Washington
Phone:413-784-1100 Becket Easthampton Hinsdale Mount Washington Sandisfeld Wendell
Belchertown East Longmeadow Holland New Ashford Savoy Westfield
Fax:413-784-1149 Bernardston Egremont Holyoke New Marlborough Sheffield Westhampton
Blandford Erving Huntington New Salem Shelburne West Springfield
Brimfield Florida Lanesborough North Adams Shutesbury West Stockbridge
Buckland Gill Lee Northampton Southampton Whately
Charlemont Goshen Lenox Northfield South Hadley Wilbraham
Cheshire Granby Leverett Orange Southwick Williamsburg
Chester Granville Leyden Otis Springfield Williamstown
Chesterfield Great Barrington Longmeadow Palmer Stockbridge Windsor
Chicopee Greenfield Ludlow Pelham Sunderland Worthington
Clarksburg Hadley Middlefield Peru Tolland
DEP Central Region Acton Charlton Hopkinton Millbury Rutland Uxbridge
627 Main Street Ashburnham Clinton Hubbardston Millville Shirley Warren
Ashby Douglas Hudson New Braintree Shrewsbury Webster
Worcester,MA 01605 Athol Dudley Holliston Northborough Southborough Westborough
Phone: 508-792-7650 Auburn Dunstable Lancater Northbridge Southbridge West Boylston
Fax:508-792-7621 Ayer East Brookfield Leicester North Brookfield Spencer West Brookfield
Barre Fitchburg Leominster Oakham Sterling Westford
TDD: 508-767-2788 Bellingham Gardner Littleton Oxford Stow Westminster
Berlin Grafton Lunenburg Paxton Sturbridge Winchendon
Blackstone Groton Marlborough Pepperell Sutton Worcester
Bolton Harvard Maynard Petersham Templeton
Boxborough Hardwick Medway Phillipston Townsend
Boylston Holden Mendon Princeton Tyngsborough
Brookfield Hopedale Milford Royalston Upton
DEP Southeast Region Abington Dartmouth Freetown Mattapoisett Provincetown Tisbury
20 Riverside Drive Acushnet Dennis Gay Head Middleborough Raynham Truro
Attleboro Dighton Gosnold Nantucket Rehoboth Wareham
Lakeville,MA 02347 Avon Duxbury Halifax NewBedford Rochester Wellfleet
Phone: 508-946-2700 Barnstable Eastham Hanover North Attleborough Rockland West Bridgewater
Fax:508-947-6557 Berkley East Bridgewater Hanson Norton Sandwich Westport
Bourne Easton Harwich Norwell Scituate West Tisbury
TDD:508-946-2795 Brewster Edgartown Kingston Oak Bluffs Seekonk Whitman
Bridgewater Fairhaven Lakeville Orleans Sharon Wrentham
Brockton Fall River Mansfield Pembroke Somerset Yarmouth
Carver Falmouth Marion Plainville Stoughton
Chatham Foxborough Marshfield Plymouth Swansea
Chilmark Franklin Mashpee Plympton Taunton
DEP Northeast Region Amesbury Chelmsford Hingham Merrimac Quincy Wakefield
205 Lowell Street Andover Chelsea Holbrook Methuen Randolph Walpole
Arlington Cohasset Hull Middleton Reading Waltham
Wilmington,MA 01887 Ashland Concord Ipswich Millis Revere Watertown
Phone:978-661-7600 Bedford Danvers Lawrence Milton Rockport Wayland
Fax: 978-661-7615 Belmont Dedham Lexington Nahant Rowley Wellesley
Beverly Dover Lincoln Natick Salem Wenham
TDD:978-661-7679 Billerica Dracut Lowell Needham Salisbury West Newbury
Boston Essex Lynn Newbury Saugus Weston
Boxford Everett Lynnfield Newburyport Sherborn Westwood
Braintree Framingham Malden Newton Somerville Weymouth
Brookline Georgetown Manchester-By-The-Sea Norfolk Stoneham Wilmington
Burlington Gloucester Marblehead North Andover Sudbury Winchester
Cambridge Groveland Medfield North Reading Swampscott Winthrop
Canton Hamilton Medford Norwood Tewksbury Woburn
Carlisle Haverhill Melrose Peabody Topsfield
wpaform7.doc•Appendix A•rev.715/05 Page 1 of 1
Massachusetts Department of Environmental Protection
DEP File Number:
Bureau of Resource Protection -Wetlands
WPA Form 7 — Extension Permit for Orders of Conditions 246-484
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
C. Recording Confirmation (cont.)
To:
Northampton Conservation Commission
Conservation Commission
Please be advised that the Extension Permit to the Order of Conditions for the project at:
Turkey Hill Road 246-484
Project Location DEP File Number
has been recorded at the Registry of Deed of:
County
fo r:
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 Page
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
wpaform7.doc•rev.12/15/00 Page 3 of 3
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection -Wetlands
WPA Form 7 — Extension Permit for Orders of Conditions )&--qyq
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
B. Authorization (cont.)
This Order of Conditions Extension must be signed by a majority of the Conservation Commission
and a copy sent to the applicant and the appropriate DEP Regional Office.
Sin ures:
Notary Acknowledgement
Commonwealth of Massachusetts County of
On this Day 1) of
Month Year
Before me, the undersigned Notary Public, personally appeared
V tau&X
Name of Signf r
proved to me through satisfactory evidence of identification, which was/were
Description of evidence of identification
to be the person whose name is signed on the preceding or attached document, and acknowledged to
me that he/she signed it voluntarily for its stated purpose.
As member of �CitylTown Conservation Commission
� .
Signature f Nota Public �+� '_ ,,,
Printed Name of Notary Public ► \ '
14 Place notary seal and/or any stamp above
My Commission Expires(Date)
R y'p o,.
wpaformTdoc•rev.3/1/05 Page 2 of 3
Massachusetts Department of Environmental Protection J�
Bureau of Resource Protection -Wetlands DEP File Number:
WPA Form 7 — Extension Permit for Orders of Conditions 246-484
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
A. General Information
Important:
When filling out 1. Applicant:
forms on the Land Solutions for Valley Aggregates
computer, use Name
only the tab
key to move 2 Amherst Road
your cursor- Mailing Address
do not use the Sunderland MA 01375
return key. City/Town State Zip Code
2. Property Owner(if different):
Jedoron Realty, Inc.
Name
403 Papermill Road
Mailing Address
Westfield MA 01085
City/Town State Zip Code
B. Finding Information
The Order of Conditions (or Extension Permit) issued to the appliaontbr property owner listedt!above on:
June 27, 2001 and amended on June 13, 2002
Date
for work at:
Turkey Hill Road
Street Address I Assessod fiAaOlf'16f rpj*j` .3EC Lots Number
recorded at the Registry of Deeds for:
Hampshire 6728 89
County Book Page
Certificate(if registered land)
is hereby extended until:
June 24, 2006
Date
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.
Date the Order was last extended (if applicable):
NA
Date
Issued by:
Northampton Conservation Commission
Conservation Commission
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