HomeMy WebLinkAboutMiscellaneous - 0 FOREST STREET r
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 7 — Extension Permit for Orders of Conditions
242-1121
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
A. General Information
Important:
When filling out 1. Applicant:
forms on the James Hartigan
computer, use Name
only the tab
key to move 36 Spring Street
your cursor- Mailing Address
do not use the Danvers MA. 01923
return key. City/Town State Zip Code
,Q 2. Property Owner(if different):
Name
etwn
Mailing Address
City/Town State Zip Code
B. Authorization
The Order of Conditions (or Extension Permit) issued to the applicant or property owner listed above on:
April 30, 2002
Date
for work at:
0 Forest Street Map 105D Parcel 22
Street Address Assessor's Map/Plat Number Parcel/Lot Number
recorded at the Registry of Deeds for:
Essex North 2801 339
County Book Page
Certificate(if registered land)
is hereby extended until:
April 30, 2007
Date
This date can be no more than 3 years from the expiration date of the Order of Conditions or the latest
extension. Only unexpired Orders of Conditions or Extension may be extended.
Date the Order was last extended (if applicable): April 30, 2006
Date
Issued by:
North Andover
1
46
Conservation Commission Date
wpaformTdoc•rev.3/1/05
Page 1 of 3
Massachusetts Department of Environmental Protection DEP File Number:
�— Bureau of Resource Protection - Wetlands
WPA Form 7 — Extension Permit for Orders of Conditions 242-1121
\ Provided by DEP
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Authorization (cont.)
This Order of Conditions Extensionapastbe signed by a majority of the Conservation Commission
and a copy sent to the applic and the appropriate DEP Regional Office.
Signatures: +
Notary Acknowledgement
Commonwealth of Massachusetts County of Essex North
�.�-� -
On this Day of Mo th Year
Before me, the
undersigned Notary Public, personally appeared
�
cn,
Name of Signer
proved to me through satisfactory evidence of identification,which was/were
Massachusetts License
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 North Andover Conservation Commission
City/Town
14:DONNA M.WEDGESignature of Notary PublicNOTARY PUBLIC D Z2 ZA G' .�1>NWEALTH OF MASSACHUSETTS Printed Name of Notary Public
mm.Expires Aug.7,2009
Place notary seal and/or any stamp above My Commission xpires(Date)
wpaformTdoc•rev.3/1/05 Page 2 of 3
Massachusetts Department of Environmental Protection DEP File Number:
�- Bureau of Resource Protection Wetlands
WPA Form 7 — Extension Permit for Orders of Conditions 242-1121
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
C. Recording Confirmation
The applicant shall record this document in accordance with General Condition 8 of the Order of
Conditions (see below), complete the form attached to this Extension Permit, have it stamped by the
Registry of Deeds, and return it to the Conservation Commission.
Note: General Condition 8 of the Order of Conditions requires the applicant, prior to commencement of
work, to record the final Order(or in this case, the Extension Permit for the Order of Conditions) in the
Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of
the affected property. In the case of recorded land, it shall be noted in the Registry's Granter Index under
the name of the owner of the land upon which the proposed work is to be done. In the case of registered
land, it shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the
proposed work is done.
Detach page 3 of Form 7 and submit it to the Conservation Commission prior to the expiration of the
Order of Conditions subject to this Extension Permit.
To:
North Andover
Conservation Commission
Please be advised that the Extension Permit to the Order of Conditions for the project at:
0 Forest Street 242-1121
Project Location DEP r=ile Number
has been recorded at the Registry of Deeds of:
Essex North
County
for:
Property Owner
and has been noted in the chain of title of the affected property in accordance with General Condition 8 of
the original Order of Conditions on:
Date Book Page
If recorded land the instrument number which identifies this transaction is:
Instrument Number
If registered land, the document number which identifies this transaction is:
Document Number
Signature of Applicant
wpaformTdoc•rev,311105 Page 3 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
DEP Regional Addresses
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
L1Mail transmittal forms and DEP payments,payable to:
Commonwealth of Massachusetts
Department of Environmental Protection
Box 4062
Boston, MA 02211
DEP Western Region Adams Colrain Hampden Monroe Pittsfield Tyringham
436 Dwight Street Agawam Conway Hancock Montague Plainfield Wales
Alford Cummington Hatfield Monterey Richmond Ware
Suite 402 Amherst Dalton Hawley Montgomery Rowe Warwick
Springfield, MA 01103 Ashfield Deerfield Heath Monson Russel Washington
Phone:413 784-1100 Becket Easthampton Hinsdale Mount Washington Sandisfield Wendell
Belchertown East Longmeadow Holland New Ashford Savoy Westfield
Fax:413-784-1149 Bernardston Egremont Holyoke New Marlborough Sheffield Westhampton
Blandford Erving Huntington New Salem Shelburne West Springfield
Brimfield Florida Lanesborough North Adams Shutesbury West Stockbridge
Buckland Gill Lee Northampton Southampton whately
Charlemont Goshen Lenox Northfield South Hadley Wilbraham
Cheshire Granby Leverett Orange Southwick Williamsburg
Chester Granville Leyden Otis Springfield Williamstown
Chesterfield Great Barrington Longmeadow Palmer Stockbridge Windsor
Chicopee Greenfield Ludlow Pelham Sunderland Worthington
Clarksburg Hadley Middlefield Peru Tolland
DEP Central Region Acton Charlton Hopkinton Millbury Rutland Uxbridge
627 Main Street Ashburnham Clinton Hubbardston Millville Shirley Warren
Ashby Douglas Hudson New Braintree Shrewsbury Webster
Worcester,MA 01605 Athol Dudley Holliston Northborough Southborough Westborough
Phone: 508-792-7650 Auburn Dunstable Lancaster Northbridge Southbridge West Boylston
Fax: 508-792-7621 Ayer East Brookfield Leicester North Brookfield Spencer West Brookfield
Barre Fitchburg Leominster Oakham Sterling Westford
TDD:508-767-2788 Bellingham Gardner Littleton Oxford Stow Westminster
Berlin Grafton Lunenburg Paxton Sturbridge Winchendon
Blackstone Groton Marlborough Pepperell Sutton Worcester
Bolton Harvard Maynard Petersham Templeton
Boxborough Hardwick Medway Phillipston Townsend
Boylston Holden Mendon Princeton Tyngsborough
Brookfield Hopedale Milford Royalston Upton
DEP Southeast Region Abington Dartmouth Freetown Mattapoisett Provincetown Tisbury
20 Riverside Drive Acushnet Dennis Gay Head Middleborough Raynham Truro
Attleboro Dighton Gosnold Nantucket Rehoboth Wareham
Lakeville, MA 02347 Avon Duxbury Halifax New Bedford Rochester Welifleet
Phone: 508-946-2700 Barnstable Eastham Hanover North Attleborough Rockland West Bridgewater
Fax:508-947-6557 Berkley East Bridgewater Hanson Norton Sandwich Westport
Bourne Easton Harwich Norwell Scituate West Tisbury
TDD:508-946-2795 Brewster Edgartown Kingston Oak Bluffs Seekonk Whitman
Bridgewater Fairhaven Lakeville Orleans Sharon Wrentham
Brockton Fall River Mansfield Pembroke Somerset Yarmouth
Carver Falmouth Marion Plainville Stoughton
Chatham Foxborough Marshfield Plymouth Swansea
Chilmark Franklin Mashpee Plympton Taunton
DEP Northeast Region Amesbury Chelmsford Hingham Merrimac Quincy Wakefield
1 Winter Street Andover Chelsea Holbrook Methuen Randolph Walpole
Arlington Cohasset Hull Middleton Reading Waltham
Boston, MA 02108 Ashland Concord Ipswich Millis Revere Watertown
Phone:617-654-6500 Bedford Danvers Lawrence Milton Rockport Wayland
Fax: 617-556-1049 Belmont Dedham Lexington Nahant Rowley Wellesley
Beverly Dover Lincoln Natick Salem Wenham
TDD:617-654-6868 Billerica Dracut Lowell Needham Salisbury West Newbury
Boston Essex Lynn Newbury Saugus Weston
Boxford Everett Lynnfield Newburyport Sherborn Westwood
Braintree Framingham Maiden Newton Somerville Weymouth
Brookline Georgetown Manchester-By-The-Sea Norfolk Stoneham Wilmington
Burlington Gloucester Marblehead North Andover Sudbury Winchester
Cambridge Groveland Medfield North Reading Swampscott Winthrop
Canton Hamilton Medford Norwood Tewksbury Woburn
Carlisle Haverhill Melrose Peabody Topsfield
i
l
wpaform7.doc•DEP Addresses•rev.4/10/06 Page 1 of 1
Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 7 — Extension Permit for Orders of Conditions 242-1121
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
A. General Information
Important:
When filling out 1. Applicant:
forms on the James Hartigan
computer, use
only the tab Name
key to move 36 Spring Street
your cursor- Mailing Address
do not use the Danvers MA. 01923
return key. City/Town State Zip Code
2. Property Owner(if different):
Name
,earn
Mailing Address
City/Town State Zip Code
B. Authorization
The Order of Conditions(or Extension Permit) issued to the applicant or property owner listed above on:
April 30, 2002
Date
for work at:
0 Forest Street Map 105D Parcel 22
Street Address Assessor's Map/Plat Number Parcel/Lot Number
recorded at the Registry of Deeds for:
Essex North T�w�•en� At al?
County Book Page
Certificate(if registered land)
is hereby extended until:
April 30, 2006
Date
This date can be no more than 3 years from the expiration date of the Order of Conditions or the latest
extension. Only unexpired Orders of Conditions or Extension may be extended.
Date the Order was last extended (if applicable): None
Date
Issued by:
North Andover t11.2 60's
Conservation Commission Date—�
wpaformTdoc•rev.3/1/05 Page 1 of 3
Massachusetts Department of Environmental Protection
DEP File Number:
--- Bureau of Resource Protection - Wetlands
WPA Form 7 — Extension Permit for Orders of Conditions 242-1121
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
B. Authorization (cont.)
This Order of Conditions Ext ust be signed by a majority of the Conservation Commission
and a copy sent tothea icant and the appropriate DEP Regional Office.
Signatures:
Notary Acknowledgement
Commonwealth of Massachusetts County of Essex North
�7 -F� log r ' �D05
On this Day of Montif Year
Before me, the undersigned Notary Public, personally appeared
Sco -.-�, fil4sse-
Name of Signer
proved to me through satisfactory evidence of identification, which was/were
Massachusetts License
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 North Andover Conservation Commission
City town
DONNA M.WEDGE Signature of Notary Public
OF�EM N� C� ����
P4Cwm Aug7.2=
Printed Name of Notary Public
Place notary seal and/or any stamp above -2Q0
My Commi ion E Aires(Date)
wpafcrm7.doc•rev.3/1/05 Page 2 of 3
Massachusetts Department of Environmental Protection
DEP File Number:
Bureau of Resource Protection - Wetlands
WPA Form 7 - Extension Permit for Orders of Conditions 242-1121
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
C. Recording Confirmation
The applicant shall record this document in accordance with General Condition 8 of the Order of
Conditions (see below), complete the form attached to this Extension Permit, have it stamped by the
Registry of Deeds, and return it to the Conservation Commission.
Note: General Condition 8 of the Order of Conditions requires the applicant, prior to commencement of
work, to record the final Order(or in this case, the Extension Permit for the Order of Conditions) in the
Registry of Deeds or the Land Court for the district in which the land is located,within the chain of title of
the affected property. In the case of recorded land, it shall be noted in the Registry's Granter Index under
the name of the owner of the land upon which the proposed work is to be done. In the case of registered
land, it shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the
proposed work is done.
Detach page 3 of Form 7 and submit it to the Conservation Commission prior to the expiration of the
Order of Conditions subject to this Extension Permit.
To:
North Andover
Conservation Commission
Please be advised that the Extension Permit to the Order of Conditions for the project at:
0 Forest Street 242-1121
Project Location DEP File Number
has been recorded at the Registry of Deeds of:
_Essex North
County
for:
Property Owner
and has been noted in the chain of title of the affected property in accordance with General Condition 8 of
the original Order of Conditions on:
Date Book Page
If recorded land the instrument number which identifies this transaction is:
Instrument Number
If registered land, the document number which identifies this transaction is:
Document Number
Signature of Applicant
wpaformTdoc•rev.3/1105 Page 3 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
DEP Regional Addresses
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Mail transmittal forms and DEP payments,payable to:
Commonwealth of Massachusetts
Department of Environmental Protection
Box 4062
Boston, MA 02211
DEP Western Region Adams Colrain Hampden Monroe Pittsfield Tyringham
436 Dwight Street Agawam Conway Hancock Montague Plainfield Wales
Alford Cummington Hatfield Monterey Richmond Ware
Suite 402 Amherst Dalton Hawley Montgomery Rowe Warwick
Springfield,MA 01103 Ashfield Deerfield Heath Monson Russell Washington
Phone:413-784-1100 Becket Easthampton Hinsdale Mount Washington Sandisfield Wendell
Belchertown East Longmeadow Holland New Ashford Savoy Westfield
Fax:413-784-1149 Bernardston Egremont Holyoke New Marlborough Sheffield Westhampton
Blandford Erving Huntington New Salem Shelburne West Springfield
Brimfield Florida Lanesborough North Adams Shutesbury West Stockbridge
Buckland Gill LeeNorthampton Southampton Whately
Charlemont Goshen Lenox Northfield South Hadley Wilbraham
Cheshire Granby Leverett Orange Southwick Williamsburg,
Chester Granville Leyden Otis Springfield Williamstown
Chestemeld Great Barrington Longmeadow Palmer Stockbridge Windsor
Chicopee Greenfield Ludlow Pelham Sunderland Worthington
Clarksburg Hadley Middlefield Peru Tolland
DEP Central Region Acton Chariton Hopkinton Millbury Rutland Uxbridge
627 Main Street Ashburnham Clinton Hubbardston Millville Shirley Warren
Ashby Douglas Hudson New Braintree Shrewsbury Webster
Worcester,MA 01605 Athol Dudley Holliston Northborough Southborough Westborough
Phone:508-792-7650 Auburn Dunstable Lancaster Northbridge Southbridge West Boylston
Fax:508-792-7621 Ayer East Brookfield Leicester North Brookfield Spencer West Brookfield
Barre Fitchburg Leominster Oakham Sterling Westford
TDD:508-767-2788 Bellingham Gardner Littleton Oxford Stow Westminster
Berlin Grafton Lunenburg Paxton Sturbridge Wmchendon
Blackstone Groton Marlborough Pepperell Sutton Worcester
Bolton Harvard Maynard Petersham Templeton
Boxborough Hardwick Medway Phillipston Townsend
Boylston Holden Mendon Princeton Tyngsborough
Brookfield Hopedale Milford Royalston Upton
DEP Southeast Region Abington Dartmouth Freetown Mattapoiselt Provincetown Tisbury
20 Riverside Drive Acushnet Dennis Gay Head Middleborough Raynham Truro
Attleboro Dighton Gosnold Nantucket Rehoboth Wareham
Lakeville,MA 02347 Avon Duxbury Halifax New Bedford Rochester Wellfleet
Phone:508-946-2700 Barnstable Eastham Hanover North Attleborough Rockland West Bridgewater
Fax:508-947-6557 Berkley East Bridgewater Hanson Norton Sandwich Westport
Bourne Easton Harwich Norwell Scituate West Tisbury
TDD:508-946-2795 Brewster Edgartown Kingston Oak Bluffs Seekonk Whitman
Bridgewater Fairhaven Lakeville Orleans Sharon Wrentham
Brockton Fall River Mansfield Pembroke Somerset Yarmouth
Carver Falmouth Marion Plainville Stoughton
Chatham Foxborough Marshfield Plymouth Swansea
Chilmark Franklin Mashpee Plympton Taunton
DEP Northeast Region Amesbury Chelmsford Hingham Merrimac Quincy Wakefield
1 Winter Street Andover Chelsea Holbrook Methuen Randolph Walpole
Arlington Cohasset Hull Middleton Reading Waltham
Boston,MA 02108 Ashland Concord Ipswich Millis Revere Watertown
Phone:617-654-6500 Bedford Danvers Lawrence Milton Rockport Wayland
Fax; 617-5561049 Belmont Dedham Lexington Nahant Rowley Wellesley
Beverly Dover Lincoln Natick Salem Wenham
TDD:617-654-6868 Billerica Dracut Lowell Needham Salisbury West Newbury
Boston Essex Lynn Newbury Saugus Weston
Boxford Everett Lynnfield Newburyport Sherborn Westwood
Braintree Framingham Malden Newton Somerville Weymouth
Brookline Georgetown Manchester-By-The-Sea Norfolk Stoneham Wilmington
Burlington Gloucester Marblehead North Andover Sudbury Winchester
Cambridge Groveland Medfield North Reading Swampscott Winthrop
Canton Hamilton Medford Norwood Tewksbury Woburn
Carlisle Haverhill Melrose Peabody Topsfield
wpaform7.doc-DEP Addresses-rev.4!4!05 Page f of 1