Extension Request - Timeline Waiver.pdfWAIVER/EXTENSION REQUEST
Please complete this form, sign at the bottom and return email to the address indicated above
Date:
I, hereby waive the time period requirement for a public
Name of Applicant or Representative
hearing / meeting following receipt of my filing of;
□Notice of Intent
□Request for Determination of Applicability
□Other _________________________________
by the Northampton Conservation Commission under Massachusetts General Laws, Ch. 131, sec. 40 and
its Regulations, and/or Northampton Wetlands Ordinance, C 337 of the Northampton Code.
The request was submitted on:for work at:
Date Filed Location / Address of where work will be done
I am the: Applicant
Applicant’s Representative Property Owner
_________________________________
(Signature)
_________________________________ (Date)
Scott K. Daggett
x
October 19, 2023 182 Mt. Tom Road
x
Scott K. Daggett
October 19, 2023