wpafrm8a 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:
64-647
Provided by DEP A. Project 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. This request is being made by: Jamey Steadman
Name
Mailing Address
City/Town
State
Zip Code
Phone Number 2. This request is in reference to work regulated by a final Order of Conditions issued to: Kenneth G. Steadman
Applicant 5/30/18
Dated 64-647
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: 8 Martin Lane (f.k.a. 6-8 Dell Street)
Street Address Salem
City/Town Map 14
Assessors Map/Plat Number Lot 144
Parcel/Lot Number 4. The final Order of Conditions was recorded at the Registry of Deeds for: Kenneth G. Steadman
Property Owner (if different) Essex (South)
County
Book
Page
80815
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).
the above-referenced Order of Conditions has lapsed and is therefore no longer valid, and the work regulated by it was never started. 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/eea/agencies/massdep/about/contacts/find-the-massdep-regional-office-for-your-city-or-town.html).
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