35-264 (3) Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
� DEP File Number:
WPA Form 8B — Certificate of Compliance
� 246-556
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
D. Recording Confirmation
The applicant is responsible for ensuring that this Certificate of Compliance is recorded in the Registry of
Deeds or the Land Court for the district in which the land is located.
Detach on dotted line and submit to the Conservation Commission.
To:
Conservation Commission
Please be advised that the Certificate of Compliance 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 on:
Date Book Page
If recorded land, the instrument number which identifies this transaction is:
If registered land, the document number which identifies this transaction is:
Document Number
Signature of Applicant
wpaform 8b.doc•rev.7/13/04 Page 4 of 4
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance
� 246-556
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
C. Authorisation (cont.)
Notary Acknowledgement
Commonwealth of Massachusetts County of �' "fa
On this H Of i�C�`d,r'.�erg jic ,
Day Month Year
before me, the undersigned Notary Public, personally appeared
Name of Docu nt 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 j`'" m� ll`� Conservation Commission
City/Town
c
Signature of Notary Public
Printed ame of Notary Public
My C m ssio
O• Z,
Place notary seal and/or any stamp above �` N•'
Signature of
46
e*�9211.ts
1#04110114.1.
wpaform 8b.doc•rev.7/13/04 Page 3 of 4
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
B. Certification (cont.)
❑ 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 The Order of Conditions has lapsed and is therefore no
longer valid.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:
C. Authorization
Issued by:
a
Conservation Commission. Dat of 1 "uance
This Certificate must be signed by a majority of the Conservation Commission and a copy sent to the
applicant and appropriate DEP Regional Office (See Attachment).
Signatures �p
LLI
V V
i
a
wpaform 8b.doc•rev.7/13/04 Page 2 of 4
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance 246-556
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
A. Project Information
Important:
When filling out 1. This Certificate of Compliance is issued to:
forms on the Wright Builders
computer, use Name
only the tab
key to move 48 Bates Street
your cursor- Mailing Address
do not use the Northampton MA 01060
return key. City/Town State Zip Code
Q2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to:
Anita and James Durfer
Name
02/18/2005 246-556
Dated DEP File Number
3. The project site is located at:
49 West Parsons Lane Northampton
Street Address City/Town
35 264
Assessors Map/Plat Number Parcel/Lot Number
the final Order of Condition was recorded at the Registry of Deeds for:
Anita and James Durfer
Property Owner(if different)
Hampshire 5802 301
County Book Page
Certificate
4. A site inspection was made in the presence of the applica htallc�nt"� a' ons
,..,,� LLB' `_,._._=.:�___,_-_ -
07/19/2005 r
Date -
r."
� l
;J 1
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:
wpaform 8b.doc•rev.7/13104 Page 1 of 4