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Bikepath-Look Park Bikepath Extension OOC 01-24-08 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 7 – Extension Permit for Orders of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Number: 246-589 Provided by DEP A. General 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. Applicant: Wayne Feiden, City of Northampton Name 210 Main Street, City Hall Mailing Address Northampton City/Town MA State 01060 Zip Code 2. Property Owner (if different): City of Northampton Name Mailing Address City/Town State Zip Code B. Authorization The Order of Conditions (or Extension Permit) issued to the applicant or property owner listed above on: 08/17/2006 Date for work at: Look Memorial Park and former railroad ROW to Florence Street Street Address 10B; 16A Assessor’s Map/Plat Number 100;002 Parcel/Lot Number recorded at the Registry of Deeds for: Hampshire County 8314 Book 46 Page Certificate (if registered land) is hereby extended until: 01/24/2011 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): Date Issued by: Northampton Conservation Commission 01/24/2008 Date 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. Signatures: Notary Acknowledgement Commonwealth of Massachusetts County of On this Day of Month Year Before me, the undersigned Notary Public, personally appeared , Name of Signer 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 City/Town Conservation Commission Signature of Notary Public Printed Name of Notary Public Place notary seal and/or any stamp above My Commission Expires (Date) C. Recording Confirmation The applicant shall record this document in accordance with General Condition 8 of the Order of Conditions (see below), complete the form attached to this Extension Permit, have it stamped by the Registry of Deeds, and return it to the Conservation Commission. Note: General Condition 8 of the Order of Conditions requires the applicant, prior to commencement of work, to record the final Order (or in this case, the Extension Permit for the Order of Conditions) in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, it shall be noted in the Registry’s Granter Index under the name of the owner of the land upon which the proposed work is to be done. In the case of registered land, it shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done. Detach page 3 of Form 7 and submit it to the Conservation Commission prior to the expiration of the Order of Conditions subject to this Extension Permit. To: Conservation Commission Please be advised that the Extension Permit to the Order of Conditions for the project at: Project Location DEP File Number has been recorded at the Registry of Deeds of: County for: 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 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands 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 436 Dwight Street Suite 402 Springfield, MA 01103 Phone: 413-784-1100 Fax: 413-784-1149 Adams Agawam Alford Amherst Ashfield Becket Belchertown Bernardston Blandford Brimfield Buckland Charlemont Cheshire Chester Chesterfield Chicopee Clarksburg Colrain Conway Cummington Dalton Deerfield Easthampton East Longmeadow Egremont Erving Florida Gill Goshen Granby Granville Great Barrington Greenfield Hadley Hampden Hancock Hatfield Hawley Heath Hinsdale Holland Holyoke Huntington Lanesborough Lee Lenox Leverett Leyden Longmeadow Ludlow Middlefield Monroe Montague Monterey Montgomery Monson Mount Washington New Ashford New Marlborough New Salem North Adams Northampton Northfield Orange Otis Palmer Pelham Peru Pittsfield Plainfield Richmond Rowe Russell Sandisfield Savoy Sheffield Shelburne Shutesbury Southampton South Hadley Southwick Springfield Stockbridge Sunderland Tolland Tyringham Wales Ware Warwick Washington Wendell Westfield Westhampton West Springfield West Stockbridge Whately Wilbraham Williamsburg Williamstown Windsor Worthington DEP Central Region 627 Main Street Worcester, MA 01605 Phone: 508-792-7650 Fax: 508-792-7621 TDD: 508-767-2788 Acton Ashburnham Ashby Athol Auburn Ayer Barre Bellingham Berlin Blackstone Bolton Boxborough Boylston Brookfield Charlton Clinton Douglas Dudley Dunstable East Brookfield Fitchburg Gardner Grafton Groton Harvard Hardwick Holden Hopedale Hopkinton Hubbardston Hudson Holliston Lancaster Leicester Leominster Littleton Lunenburg Marlborough Maynard Medway Mendon Milford Millbury Millville New Braintree Northborough Northbridge North Brookfield Oakham Oxford Paxton Pepperell Petersham Phillipston Princeton Royalston Rutland Shirley Shrewsbury Southborough Southbridge Spencer Sterling Stow Sturbridge Sutton Templeton Townsend Tyngsborough Upton Uxbridge Warren Webster Westborough West Boylston West Brookfield Westford Westminster Winchendon Worcester DEP Southeast Region 20 Riverside Drive Lakeville, MA 02347 Phone: 508-946-2700 Fax: 508-947-6557 TDD: 508-946-2795 Abington Acushnet Attleboro Avon Barnstable Berkley Bourne Brewster Bridgewater Brockton Carver Chatham Chilmark Dartmouth Dennis Dighton Duxbury Eastham East Bridgewater Easton Edgartown Fairhaven Fall River Falmouth Foxborough Franklin Freetown Gay Head Gosnold Halifax Hanover Hanson Harwich Kingston Lakeville Mansfield Marion Marshfield Mashpee Mattapoisett Middleborough Nantucket New Bedford North Attleborough Norton Norwell Oak Bluffs Orleans Pembroke Plainville Plymouth Plympton Provincetown Raynham Rehoboth Rochester Rockland Sandwich Scituate Seekonk Sharon Somerset Stoughton Swansea Taunton Tisbury Truro Wareham Wellfleet West Bridgewater Westport West Tisbury Whitman Wrentham Yarmouth DEP Northeast Region 1 Winter Street Boston, MA 02108 Phone: 617-654-6500 Fax: 617-556-1049 TDD: 617-654-6868 Amesbury Andover Arlington Ashland Bedford Belmont Beverly Billerica Boston Boxford Braintree Brookline Burlington Cambridge Canton Carlisle Chelmsford Chelsea Cohasset Concord Danvers Dedham Dover Dracut Essex Everett Framingham Georgetown Gloucester Groveland Hamilton Haverhill Hingham Holbrook Hull Ipswich Lawrence Lexington Lincoln Lowell Lynn Lynnfield Malden Manchester-By-The-Sea Marblehead Medfield Medford Melrose Merrimac Methuen Middleton Millis Milton Nahant Natick Needham Newbury Newburyport Newton Norfolk North Andover North Reading Norwood Peabody Quincy Randolph Reading Revere Rockport Rowley Salem Salisbury Saugus Sherborn Somerville Stoneham Sudbury Swampscott Tewksbury Topsfield Wakefield Walpole Waltham Watertown Wayland Wellesley Wenham West Newbury Weston Westwood Weymouth Wilmington Winchester Winthrop Woburn