18-012 (2) i
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance
� 246-531
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.12/15/00 Page 3 of 3
i
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance
246-531
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therefore no longer valid.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:
#39 and #42
C. Authorization
Issued by:
Northampton Conservation Commission November 1 2004
Conservation Commission Date of Issuance
This Certificate must be signed by a major f the Conservation Commission and a copy sent to the
applicant and appropria EP Regiona ce (See Appendix A).
Signature :
On This Twenty Eighth Da Of October, 2004 PERSON '
Y 9 Y t Q •••' .
before me personally appeared Y „ ¢
the above-named It � r ti w
to me known to be the person described in and who executed the foregoing instrume
acknowledged that he/she executed the same as his/her free act and deed.
September 4, 2009
�Notarybic'
My commission expires
wpaform 8b.doc•rev.12/15/00 Page 2 of 3
A
Massachusetts Department of Environmental Protection
Ilk Bureau of Resource Protection - Wetlands DEP File Number:
LI) WPA Form 8B — Certificate of Compliance 246-531
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 Lane Construction Corporation
computer, use Name
only the tab
key to move P.O. Box 491
your cursor- Mailing Address
do not use the Westfield MA 01086
return key. City/Town State Zip Code
2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to:
A If Lane Construction Corporation
Name
October 20, 2003 246-531
Dated DEP File Number
3. The project site is located at:
Damon Road Northampton
Street Address City/Town
_18 12
Assessors Map/Plat Number Parcel/Lot Number
the final Order of Condition was recorded at the Registry of Deeds for:
Property Owner(if different)
Hampshire 7594 16
County Book Page
Certificate
4. A site inspection was made in the presence of the applicant, or the applicant's agent, on:
October 28, 2004
Date
B. Certification
Check all that apply:
DEPT n> !''l'.nf'v INSPE(.[IONS
&0
® Complete Certification: It is hereby certified that the work regulated by the above-re erenced
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.12/15/00 Page 1 of 3