36-199 Request Partial Cert of Compliance.pdf
wpaform8a.doc •• rev. 7/13/04 Page 1 of 2
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 - 621
Provided by DEP
A. Project Information
Important:
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1. This request is being made by:
Sandra E. Pinkham
Name
348 Westhampton Road
Mailing Address
Northampton (Florence)
City/Town
MA
State
01062
Zip Code
413-584-2675 (NeJame & Kling Law Offices)
Phone Number
2. This request is in reference to work regulated by a final Order of Conditions issued to:
Sandra Pinkham
Applicant
9/11/2008
Dated
246-621
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:
348 Westhampton Road
Street Address
Florence (Northampton)
City/Town
36 - 199 - 001
Assessors Map/Plat Number
Lot 1, Plan Book 220, Page 57
Parcel/Lot Number
4. The final Order of Conditions was recorded at the Registry of Deeds for:
Sandra Pinkham
Property Owner (if different)
Hampshire
County
9639
Book
208
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).
Requesting a Partial Certificate of Compliance for 348 Westhampton Road, Florence
(Northampton), Massachusetts, Assessors' Lot 36 - 199 - 001, Lot 1 at Plan Book 220, Page 57. None of
the work covered by the Order of Conditions is within this parcel. Instead, all of the work covered by said
Order of Conditions was to take place and has taken place on Lot 2, Plan Book 220, Page 57, now
Assessors' Lot 36 - 408 - 001.
the above-referenced Order of Conditions has lapsed and is therefore no longer valid, and the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. 7/13/04 Page 2 of 2
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 - 621
Provided by DEP
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/dep/about/region/findyour.htm).