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Certificate of Compliance - 246-591Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 8B - Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Number: 246 -591 Provided by DEP A. Project Information This Certificate of Compliance is issued to: John W. Ewing Name 297 Old Wilson Road Mailing Address Florence City/Town MA State 01062 Zip Code 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: 1020 Florence Road Name September 5, 2006 Dated 3. The project site is located at: 1020 Florence Road Street Address Northampton City/Town 44 116 246 -591 DEP File Number Assessors Map /Plat Number Parcel /Lot Number the final Order of Condition was recorded at the Registry of Deeds for: Property Owner (if different) Hampshire County 8924 Book 266 Page Certificate 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: Jan 3, 2014 Date wpafrmeb.doc • rev. 12/23/09 WPA Form 8B, Certificate of Compliance • Page 1 of 3 �i Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 8B - Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Numbe L/ Sc 1 Provided by DEP B. Certification Check all that apply: Complete Certification: It is hereby certified that the work regulated by the above - referenced Order of Conditions has been satisfactorily completed. ❑ Partial Certification: It is hereby certified that only the following portions of work regulated by the above - referenced Order of Conditions have been satisfactorily completed. The project areas or work subject to this partial certification that have been completed and are released from this Order are: ❑ Invalid Order of Conditions: It is hereby certified that the work regulated by the above - referenced Order of Conditions never commenced. The Order of Conditions has lapsed and is therefore no longer valid. No future work subject to regulation under the Wetlands Protection Act may commence without filing a new Notice of Intent and receiving a new Order of Conditions. [ Ongoing Conditions: The following conditions of the Order shall continue: (Include any conditions contained in the Final Order, such as maintenance or monitoring, that should continue for a longer period). Condition Numbers: 3 C. Authorization (/4kt Aga &iH Conservation Crriimission {Date of Issuance This Certifica e must be signed by a majority of the Conservation Co mission and a copy sent to he applicant and appropriate DEP Regional Office (See htto://www.mass.00video/about/reoion/findvour.htm). Signatures: wpafrmeb.boc • rev. 12/23/09 WPA Form 86, Certificate of Compliance • Page 2 of 3