Release 2 (1).doc
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 8A – Request for Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
DEP File Number:
246-591
Provided by DEP
A. Project Information
Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key.
1. This request is being made by:
Gregory C. Marotta and Kerry K. Marotta
Name
1006 Florence Road
Mailing Address
Northampton
City/Town
MA
State
01060
Zip Code
413-586-2294
Phone Number
2. This request is in reference to work regulated by a final Order of Conditions issued to:
John Ewing
Applicant
08/24/2006
Dated
246-591
DEP File Number
Upon completion of the work authorized in
an Order of Conditions, the property owner must request a Certificate of Compliance
from the issuing authority stating that the work or portion of the work has been satisfactorily completed.
3. The project site is located at:
1006 Florence Road
Street Address
Northampton
City/Town
44-134-001
Assessors Map/Plat Number
2
Parcel/Lot Number
4. The final Order of Conditions was recorded at the Registry of Deeds for:
John Ewing
Property Owner (if different)
Hampshire
County
8924
Book
266
Page
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the above-referenced Order of Conditions has lapsed and is therefore no longer valid, and the work regulated by it was never started.
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-your-city-or-town.html).