HomeMy WebLinkAboutMiscellaneous - 32 STONEWEDGE CIRCLE 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, 40 242-1438
Provided by DEP
A. Project Information
Important:
When filling out 1• This Certificate of Compliance is issued to:
forms on the Norbert Johnson
computer, use Name
only the tab
key to move 32 Stonewedge Circle
your cursor- Mailing Address
do not use the North Andover MA 01845
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:
1 10 Norbert Johnson
Name
August 15, 2008 242-1438
Dated DEP File Number
3. The project site is located at:
32 Stonewedge Cirle
Street Address City/Town
Map 1068 Parcel 163
Assessors Map/Plat Number Parcel/Lot Number
the final Order of Condition was recorded at the Registry of Deeds for:
Property Owner(if different)
Essex North 11298 135
County Book Page
Certificate
4. A site inspection was made in the presence of the applicant, or the applicant's agent, on:
2/9/09
Date
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.7/13/04 Page 1 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, 40 242-1438
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 The Order of Conditions has lapsed and is therefore no
longer valid.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:
47
C. Authorization
Issued by:
North.Andover /� D
Conservation Commission Date of Isduance
This Certificate must be signed by a majority of the Conservation Commission and y s nt to the
applicant and appropriate DEP Regional Office (See Attachment).
Signatures: Y l'
}
wpatorm 8b.doc•rev.7113/04 Page 2 of 4
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number.
r WPA Form 8B — Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 242-1438
Provided by DEP
C. Authorization (cont.)
Notary Acknowledgement
Commonwealth of Massachusetts County of Essex North
On this F-111- � 1,
Day �f Month �— Year
before me, the undersigned Notary Public, personally appeared
Name of Document 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
Signature of Notary Public
DONNEWEDGE
-,�J �
NOTARY Printed Name of NotaryPublic
COMMo� rrsMYComm 9
*8"- 9>) c?
MyCommission E ires(Date)
Place notary seal and/or any stamp above Signature of Notary Public
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, §40 242-1438
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:
North Andover
Conservation Commission
Please be advised that the Certificate of Compliance for the project at:
32 Stonewed e Circle 242-1438
Project Location DEP File Number
Has been recorded at the Registry of Deeds of:
Essex North
County
for:
Norbert Johnson
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:
1
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 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 Tynngham
436 Dwight Street Agawam Conway Hancock Montague Plainfield Wales
Suite 402 Alford Cummington Hatfield Monterey Richmond Ware
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 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 Ashbumham Clinton Hubbardston Millville Shirley Warren
Ashby Douglas Hudson New Braintree Shrewsbury Webster
Worcester, MA 01608 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
Boxhnrough 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 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: 617-556-1049 Belmont Dedham Lexington Nahant Rowley Wellesley
Beverly Dover Lincoln Natick Salem Wenham
TDD:617-574-6868 Billerica Dracut Lowell Needham Salisbury West Newbury
Boston Essex Lynn Newbury Saugus Weston
Boxford Everett Lynnfield Newburyport Sherbom 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
wpaform8b.doc•DEP Addresses•rev.1/26/09- Page.1 of 1
r
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 - Order of Conditions 242-1438
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. General Information
Important: North Andover
When filling 1. From: Conservation Commission
out forms on
the computer, 2. This issuance is for(check one): a. ® Order of Conditions b. ❑ Amended Order of Conditions
use only the
tab key to 3. To: Applicant:
move your
cursor-do not Norbert Johnson
use the return a. First Name b.Last Name
-
key.
c.Organization
ran 32 Stonewedge Circle
d.Mailing Address
North Andover MA 01845
e. City/Town f.State g.Zip Code
4. Property Owner(if different from applicant):
Same
a. First Name b. Last Name
c.Organization
d. Mailing Address
e. City/Town f.State g.Zip Code
5. Project Location:
32 Stonewedge Circle North Andover
a. Street Address b.City/Town
Map 1068 Parcel 163
c.Assessors Map/Plat Number d.Parcel/Lot Number
Latitude and Longitude, if known: 42D-38'-08"N 72D-56'-33"W
e,Latitude f. Longitude
6. Property recorded at the Registry of Deeds for(attach additional information if more than one parcel):
Essex North
a. County b.Certificate Number(if registered land)
8026 228
c. Book d. Page
7/10/08 8/13/08 8/15/08
7. Dates: a.Date Notice of Intent Filed b.Date Public Hearing Closed c.Date of Issuance
s. Final Approved Plans and Other Documents (attach additional plan or document references as
needed):
Site Plan
a. Plan Title
Eugene T. Sullivan Consulting Engineers Inc. Eugene T. Sullivan, P. E.
b. Prepared By c.Signed and Stamped by
July 1, 2008 V =20'
d. Final Revision Date e.Scale
f.Additional Plan or Document Title g.Date
wpaform5.doc• rev.2/27/08 Page 1 of 10
r
Massachusetts Department of Environmental Protection
�- Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 Order of Conditions 242-1438
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Findings
1. Findings pursuant to the Massachusetts Wetlands Protection Act:
Following the review of the above-referenced Notice of Intent and based on the information provided
in this application and presented at the public hearing, this Commission finds that the areas in which
work is proposed is significant to the following interests of the Wetlands Protection Act. Check all that
apply:
a. ® Public Water Supply b. ❑ Land Containing Shellfish c. ® Prevention of Pollution
Protection of Wildlife
d. ® Private Wafer Supply e. ❑ Fisheries f. Habitat
g. ® Groundwater Supply h. ® Storm Damage Prevention i. ® Flood Control
2. This Commission hereby finds the project, as proposed, is:(check one of the following boxes)
Approved subject to:
a. ® the following conditions which are necessary in accordance with the performance standards set
forth in the wetlands regulations.This Commission orders that all work shall be performed in
accordance with the Notice of Intent referenced above, the following General Conditions, and any
other special conditions attached to this Order. To the extent that the following conditions modify or
differ from the plans, specifications, or other proposals submitted with the Notice of Intent, these
conditions shall control.
Denied because:
b. ❑ the proposed work cannot be conditioned to meet the performance standards set forth in the
wetland regulations. Therefore, work on this project may not go forward unless and until a new Notice
of Intent is submitted which provides measures which are adequate to protect these interests,and a
final Order of Conditions is issued.A description of the performance standards which the
proposed work cannot meet is attached to this Order.
c. ❑ the information submitted by the applicant is not sufficient to describe the site, the work, or the
effect of the work on the interests identified in the Wetlands Protection Act. Therefore, work on this
project may not go forward unless and until a revised Notice of Intent is submitted which provides
sufficient information and includes measures which are adequate to protect the Act's interests, and a
final Order of Conditions is issued. A description of the specific information which is lacking and
why it is necessary is attached to this Order as per 310 CMR 10.05(6)(c).
Inland Resource Area Impacts: Check all that apply below. (For Approvals Only)
3. ❑ Buffer Zone Impacts: Shortest distance between limit of project disturbance and
wetland boundary(if available) a.linear feet
Resource Area Proposed Permitted Proposed Permitted
Alteration Alteration Replacement Replacement
4. ❑ Bank a.linear feet b.linear feet c.linear feet d.linear feet
5. ❑ Bordering Vegetated
Wetland a.square feet b.square feet c.square feet d.square feet
6. ❑ Land Under W aterbodies a.square feet b.square feet c.square feet d.square feet
and Waterways
e.dy dredged f.c/y dredged
wpaform5.doc• rev.2/27/08 Page 2 of 10
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
�\ WPA Form 5 - Order of Conditions 242-1438
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Findings (cont.)
Resource Area Proposed Permitted Proposed Permitted
Alteration Alteration Replacement Replacement
7. ❑ Bordering Land
Subject to Flooding a.square feet b.square feet c.square feet d.square feet
Cubic Feet Flood Storage
e.cubic feet f.cubic feet g.cubic.feet h.cubic feet
8. ❑ Isolated Land Subject
to Flooding a.square feet b.square feet
Cubic Feet Flood Storage c.cubic feet d.cubic feet e.cubic feet f.cubic feet
9. ❑ Riverfront area a.total sq.feet b.total sq.feet
Sq ft within 100 ft c.square feet d.squarer feet e.square feet f.square feet
Sq ft between 100-200 ft square feet h.square feet i.square feet
g. q q q J.square feet
Coastal Resource Area Impacts: Check all that apply below. (for Approvals Only)
10. ❑ Designated Port Areas Indicate size under Land Under the Ocean, below
11. ❑ Land Under the Ocean a.square feet b.square feet
c.cly dredged d.c/y dredged
12. ❑ Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes below
13. ❑ Coastal Beaches a.square feet b.square feet c.c/y nourishmt. d.c/y nourishmt.
14. ❑ Coastal Dunes a.square feet b,square feet c.c/y nourishmt. d.c/y nourishmt.
15. ❑ Coastal Banks a.linear feet b.linear feet
16. ❑ Rocky Intertidal Shores a.square feet b.square feet
17. ❑ Salt Marshes a.square feet b.square feet c.square feet d.square feet.
18. ❑ Land Under Salt Ponds a.square feet b.square feet
c.c/y dredged d.c/y dredged
19. ❑ Land Containing
Shellfish a.square feet b.square feet c.square feet d.square feet
20. ❑ Fish Runs Indicate size under Coastal Banks, inland Bank, Land Under the
Ocean, and/or inland Land Under Waterbodies and Waterways,
above
a.c/y dredged b.cly dredged
21. ❑ Land Subject to Coastal
Storm Flowage a.square feet b.square feet
wpaform5.doc• rev.2/27/08 Page 3 of 10
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
i\
WPA Form 5 - Order of Conditions 242-1438
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. General Conditions Under Massachusetts Wetlands Protection Act
(only applicable to approved projects)
1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory
measures, shall be-deemed cause to revoke or modify this Order.
2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any
injury to private property or invasion of private rights.
3. This Order does not relieve the permittee or any other person of the necessity of complying with all
other applicable federal, state, or local statutes, ordinances, bylaws, or regulations.
4. The work authorized hereunder shall be completed within three years from the date of this Order
unless either of the following apply:
a. the work is a maintenance dredging project as provided for in the Act; or
b. the time for completion has been extended to a specified date more than three years, but less
than five years, from the date of issuance. If this Order is intended to be valid for more than three
years, the extension date and the special circumstances warranting the extended time period are
set forth as a special condition in this Order.
5. This Order may be extended by the issuing authority for one or more periods of up to three years each
upon application to the issuing authority at least 30 days prior to the expiration date of the Order.
6. Any fill used in connection with this project shall be clean fill. Any fill shall contain no trash, refuse,
rubbish, or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard,
pipe, tires, ashes, refrigerators, motor vehicles, or parts of any of the foregoing.
7. This Order is not final until all administrative appeal periods from this Order have elapsed, or if such
an appeal has been taken, until all proceedings before the Department have been completed.
8. No work shall be undertaken until the Order has become final and then has been recorded 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, the Final Order shall also be noted in the
Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to
be done. In the case of the registered land, the Final Order shall also be noted on the Land Court
Certificate of Title of the owner of the land upon which the proposed work is done. The recording
information shall be submitted to this Conservation Commission on the form at the end of this Order,
which form must be stamped by the Registry of Deeds, prior to the commencement of work.
9. A sign shall be displayed at the site not less then two square feet or more than three square feet in
size bearing the words,
"Massachusetts Department of Environmental Protection" [or, "MassDEP"]
"File Number
242-1438 "
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Page 4 of 10
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 Order of Conditions 242-1438
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. General Conditions Under Massachusetts Wetlands Protection Act
10. Where the Department of Environmental Protection is requested to issue a Superseding Order, the
Conservation Commission shall be a party to all agency proceedings and hearings before MassDEP.
11. Upon completion of the work described herein, the applicant shall submit a Request for Certificate of
Compliance(WPA Form 8A)to the Conservation Commission.
12. The work shall conform to the plans and special conditions referenced in this order.
13. Any change to the plans identified in Condition#12 above shall require the applicant to inquire of the
Conservation Commission in writing whether the change is significant enough to require the filing of a
new Notice of Intent.
14. The Agent or members of the Conservation Commission and the Department of Environmental
Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours
to evaluate compliance with the conditions stated in this Order, and may require the submittal of any
data deemed necessary by the Conservation Commission or Department for that evaluation.
15. This Order of Conditions shall apply to any successor in interest or successor in control of the property
subject to this Order and to any contractor or other person performing work conditioned by this Order.
16. Prior to the start of work, and if the project involves work adjacent to a Bordering Vegetated Wetland,
the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden
stakes or flagging. Once in place, the wetland boundary markers shall be maintained until a Certificate
of Compliance has been issued by the Conservation Commission.
17. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully
stabilized with vegetation or other means. At no time shall sediments be deposited in a wetland or
water body. During construction, the applicant or his/her designee shall inspect the erosion controls
on a daily basis and shall remove accumulated sediments as needed. The applicant shall immediately
control any erosion problems that occur at the site and shall also immediately notify the Conservation
Commission, which reserves the right to require additional erosion and/or damage prevention controls
it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of
work line has been approved by this Order.
18. The work associated with this Order is (1)® is not(2)❑ subject to the Massachusetts
Stormwater Policy Standards. If the work is subject to the Stormwater Policy,the following
conditions apply to this work and are incorporated into this Order:
a) No work, including site preparation, land disturbance, construction and redevelopment, shall
commence unless and until the construction period pollution prevention and erosion and
sedimentation control plan required by Stormwater Standard 8 is approved in writing by the issuing
authority. Until the site is fully stabilized, construction period erosion, sedimentation and pollution
control measures and best management practices(BMPs)shall be implemented in accordance with
the construction period pollution prevention and erosion and sedimentation control plan, and if
applicable, the Stormwater Pollution Plan required by the National Discharge Elimination System
Construction General Permit.
wpaform5.doc• rev.2/27/08 Page 5 of 10
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 - Order of Conditions 242-1438
--
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. General Conditions Under Massachusetts Wetlands Protection Act (cont.)
b) No stormwater runoff may be discharged to the post-construction stormwater BMPs until written
approval is received from the issuing authority. To request written approval, the following must be
submitted: illicit discharge compliance statement required by Stormwater Standard 10 and as-built
plans signed and stamped by a registered professional engineer certifying the site is fully stabilized;
all construction period stormwater BMPs and any illicit discharges to the stormwater management
system have been removed; and all post-construction stormwater BMPs were installed in accordance
with the plans(including all planting plans)approved by the issuing authority, and have been
inspected to ensure they are not damaged and will function properly.
c) Prior to requesting a Certificate of Compliance, the responsible party(defined in General
Condition 18(e))shall submit to the issuing authority an Operation and Maintenance(O & M)
Compliance Statement for the Stormwater BMPs.This Statement shall identify the responsible party
for implementing the Operation and Maintenance Plan and also state that: 1. "Future responsible
parties shall be notified in writing of their continuing legal responsibility to operate and maintain the
stormwater management BMPs and implement the Pollution Prevention Plan; and 2. The Operation
and Maintenance Plan for the stormwater BMPs is complete and will be implemented upon receipt of
the Certificate."
d) Post-construction pollution prevention and source control shall be implemented in accordance
with the long-term pollution prevention plan section of the approved Stormwater Report and, if
applicable, the Stormwater Pollution Prevention Plan required by the National Discharge Elimination
System Multi-Sector General Permit.
e) Unless and until another party accepts responsibility, the issuing authority shall presume that the
responsible party for maintaining each BMP is the landowner of the property on which the BMP is
located. To overcome this presumption, the landowner of the property must submit to the issuing
authority a legally binding agreement acceptable to the issuing authority evidencing that another entity
has accepted responsibility for maintaining the BMP,and that the proposed responsible party shall be
treated as a permittee for purposes of implementing the requirements of Conditions 18(f)through
18(k)with respect to that BMP. Any failure of the proposed responsible party to implement the
requirements of Conditions 18(f)through 18(k)with respect to that BMP shall be a violation of the
Order of Conditions or Certificate of Compliance. In the case of stormwater BMPs that are serving
more than one lot, the legally binding agreement shall also identify the lots that will be serviced by the
stormwater BMPs. A plan and easement deed that grants the responsible party access to perform the
required operation and maintenance must be submitted along with the legally binding agreement.
f) The responsible party shall operate and maintain all stormwater BMPs in accordance with the
design plans, the Operation and Maintenance Plan section of the approved Stormwater Report, and
the Massachusetts Stormwater Handbook.
g) The responsible party shall:
1. Maintain an operation and maintenance log for the last three years including inspections,
repairs, replacement and disposal (for disposal the log shall indicate the type of material and
the disposal location);
p o n),
2. Make this log available to MassDEP and the Conservation Commission upon request; and
3. Allow members and agents of the MassDEP and the Conservation Commission to enter and
inspect the premises to evaluate and ensure that the responsible party complies with the
Operation and Maintenance requirements for each BMP set forth in the Operations and
Maintenance Plan approved by the issuing authority.
h) All sediments or other contaminants removed from stormwater BMPs shall be disposed of in
accordance with all applicable federal, state, and local laws and regulations.
i) Illicit discharges to the stormwater management system as defined in 310 CMR 10.04 are
prohibited.
wpaform5.doc• rev.2/27/08 Page 6 of 10
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 Order of Conditions 242-1438
1 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. General Conditions Under Massachusetts Wetlands Protection Act (cont.)
j) The stormwater management system approved in the Final Order of Conditions shall not be
changed without the prior written approval of the issuing authority. Areas designated as qualifying
pervious areas for purpose of the Low Impact Site Design Credit shall not be altered without the prior
written approval of the issuing authority.
k) Access for maintenance of stormwater BMPs shall not be obstructed or blocked. Any fencing
constructed around stormwater BMPs shall include access gates. Fence(s)shall be at least six inches
above grade to allow for wildlife passage.
Special Conditions(if you need more space for additional conditions, please attach a text document):
D. Findings Under Municipal Wetlands Bylaw or Ordinance
1. Is a municipal wetlands bylaw or ordinance applicable? ® Yes ❑ No
2. The North Andover hereby finds (check one that applies):
Conservation Commission
a. ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal
ordinance or bylaw specifically:
1.Municipal Ordinance or Bylaw 2.Citation
Therefore, work on this project may not go forward unless and until a revised Notice of Intent is
submitted which provides measures which are adequate to meet these standards, and a final
Order of Conditions is issued.
b. ® that the following additional conditions are necessary to comply with a municipal ordinance or
bylaw:
North Andover Wetland Protection Bylaw Chapter 178
1.Municipal Ordinance or Bylaw 2.Citation
3. The Commission orders that all work shall be performed in accordance with the following conditions
and with the Notice of Intent referenced above. To the extent that the following conditions modify or
differ from the plans, specifications, or other proposals submitted with the Notice of Intent, the
conditions shall control
The special conditions relating to municipal ordinance or bylaw are as follows(if you need more space
for additional conditions, attach a text document):
See attached
wpaform5.doc• rev.2/27108 Page 7 of 10
DEP FILE #242 - 1438
Therefore, the North Andover Conservation Commission(hereafter the"NACC")hereby
finds that the following conditions are necessary, in accordance with the Performance
Standards set forth in the State Regulations, the local ByLaw and Regulations, to protect
those interests noted above. The NACC orders that all work shall be performed in
accordance with said conditions and with the Notice of Intent referenced below. To the
extent that the followingconditions modify or differ from the plans,specifications or other
proposals submitted with the Notice of Intent,the conditions shall control.
GENERAL CONDITIONS
1. The proposed work includes: the expansion of an existing deck(previously removed)on
hand dug sonotube footings with associated stairways within the Buffer Zone to a
Bordering Vegetated Wetland (BVW)but outside the 25 foot No-Disturbance Zone and 50
foot No-Build Zone. Ail construction is proposed over maintained lawn area and is sixty-
eight(68)feet from the delineated resource areas at its closest point.
2. The work shall conform to the following (except as noted in the remainder of this
document where revisions may be required):
Notice of Intent filed by: Norbert Johnson
32 Stonewedge Circle
North Andover, MA 01845
Dated: July 2, 2008
Site Plans prepared by: Eugene T.Sullivan Jr. PE
Eugene T. Sullivan, Inc.
Consulting Engineers
31 Sheridan Road
Wilmington, MA 01887
Other Record Documents: Letter from Division of Fisheries &Wildlife
Thomas W. French,Ph.D
Re: NHE,SP Tracking No. 08-25107
Dated:July 18,2008
3. The term "Applicant" as used in this Order of Conditions shall refer to the owner, any
successor in interest or successor in control of the property referenced in the Notice of
Intent, supporting documents and this Order of Conditions. The NACC shall be notified
in writing within 30 days of all transfers of title of any portion of property that takes
place prior to the issuance of a Certificate of Compliance.
4. The conditions of this decision shall apply to, and be binding upon, the applicant, owner,
its employees and all successors and assigns in interest or control. These obligations
shall
�
be expressed in covenants in all deeds to succeeding owners of portions of the property.
CAWinword\OOC\boi1er1Am 1 NACC 8/14/2008
DEP FILE #242- 1438
5. Failure to comply with all conditions stated herein, and with all related statutes and other
regulatory measures, shall be deemed cause to revoke or modify this Order.
6. This Order does not grant any property rights or any exclusive privileges;it does not
authorize any injury to private property or invasion of property rights. However, the
NACC, agent of the NACC or the Department of Environmental Protection (DEP)
reserves the right to enter and inspect the property at all reasonable times until a
Certificate of Compliance is issued, to evaluate compliance with this Order of Conditions,
the Act(310 CMR 10.00), the North Andover Wetland ByLaw and Regulations, and may
require any information, measurements, photographs, observations, and/or materials, or
may require the submittal of any data or information deemed necessary by the NACC for
that evaluation. Further,work shall be halted on the site if the NACC, agent or DEP
determines that any of the work is not in compliance with this Order of Conditions.
Work shall not resume until the NACC is satisfied that the work will comply and has so
notified the applicant in writing.
7. This Order does not relieve the permittee or any other person of the necessity of
complying with all other applicable federal,state or local statutes, ordinances, by-laws or
regulations.
8. The work authorized hereunder shall be completed within three years from the date of
this order.
9. This Order may be extended by the issuing authority for one but not more than two
periods of up to one year each upon application to the issuing authority at least this.
days (30) prior to the expiration date of the Order (Refer to Section VIII (B)(p.33) of the
North Andover Wetland Regulations).
10.The NACC reserves the right to amend this Order of Conditions after a legally advertised
public hearing if plans or circumstances are changed or if new conditions or information
so warrant.
11.Where the Department of Environmental Protection(DEP)is requested to make a
determination and to issue a Superseding Order,the Conservation Commission shall be a
party to all agency proceedings and hearings before the Department
12. The following wetland resource areas are affected by the proposed work: Buffer Zone to
Bordering Vegetated Wetland (BVW). These resource areas are significant to the interests
of the Act and Town ByLaw as noted above and therein. The applicant has not attempted
to overcome the presumption of significance of these resource areas to the identified
interests.
13.The NACC agrees with the applicant's delineation of the wetland resource areas on the
site as shown on the plans dated referenced herein.
CAWinword\OOClboilerl.doc 2 NACC 8/14/2008
DEP FILE #242 - 1438
14. The NACC finds that the intensive use of the upland areas and buffer zone proposed on
this site will cause further alteration of the wetland resource areas. In order to prevent
any alteration of wetland resource areas a hygnty five foot(25') No-Disturbance Zone and
a fifty foot(50') No-Construction Zone shall be established from the edge of the adjacent
wetland resource area.The Conservation Administrator and/or other agents of the
NACC do not have the authority to waive these setbacks as established under the local
bylaw. No disturbance of existing grade, soils or vegetation is permitted in the No-
Disturbance zone. (See Section III(D) &Appendix G of the local Regulations).
15.This document shall be included in all construction contracts,subcontracts, and
specifications dealing with the work proposed and shall supersede any conflicting
contract requirements. The applicant shall assure that all contractors, subcontractors, and
other personnel performing the permitting work are fully aware of the permits terms and
conditions. Thereafter, the contractor will be held jointly liable for any violation of this
Order resulting from failure to comply with its conditions.
16. The owners of the project and their successors in title agree that the Order does not in
itself impose upon the Town any responsibility to maintain the proposed drainage
system and that said Town shall not be liable for any damage in the event of failure. By
acceptance of this Order, the owners agree to indemnify and hold harmless to the Town
and its residents for any damage attributable to alterations undertaken on this property
pursuant to the Order. Issuance of these Conditions does not in any way imply or certify
that the site or downstream areas will not be subject to flooding, storm damage or any
other foam of water damage. Maintenance of the drainage system, if accepted by the
Town as part of a public way, becomes the responsibility of the Town.
17. Issuance of these Conditions does not in any way imply or certify that the site or
downstream areas will not be subject to flooding, storm damage or any other form of
water damage.
PRIOR TO CONSTRUCTION
18. No work shall be undertaken until all administrative appeal periods from this Order
have elapsed or, if such an appeal has been filed, until all proceedings before the
Department or Court have been completed.
19. This Order shall be recorded by the applicant at the Registry of Deeds immediately after
the expiration of all appeal periods. No work shall be undertaken until the Final Order
has been recorded 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, the Final Order shall also be noted in the Registry's Grantor 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, the Final Order shall also be noted on the Land Court Certificate of Title
of the owner of the land upon which the proposed work is to be done. The recording
information shall be submitted to the North Andover Conservation Commission on the
CAWinword\00C\boi1er1.doc 3 NACC 8/14/2008
DEP FILE #242 - 1438
form at the end of this Order prior to commencement of the work. Any Order not
recorded by the applicant before work commences may be recorded by the NACC at the
applicant's expense.
20. A sign shall be displayed at the site not less than two square feet or more than three
square feet in size bearing the words "Massachusetts DEP, File Number 242-2438."
21.Any changes in the submitted plans caused by the applicant, another Board's decision or
resulting from this Order of Conditions must be submitted to the NACC for approval
prior to implementation. If the NACC finds said changes to be significant, the NACC
will call for another public hearing (at the expense of the applicant). Within 21 days of the
close of said public hearing the NACC will issue an amended or new Order of
Conditions. Any errors found in the plans or information submitted by the applicant shall
be considered as changes. No work shall begin on a project until written approval has
been granted by the NACC.
22. It is the responsibility of the applicant, owner, and/or successor(s)to ensure that all
conditions of this Order of Conditions are complied with. The project engineer and
contractors are to be provided with a copy of this Order of Conditions and referenced
documents before commencement of construction.
23. Prior to any work commencing on-site,the applicant shall submit to the NACC for
approval, a detailed sequence of construction,including the construction of compensation
and retention areas, installation of sedimentation/erosion control devices and re-
vegetation to be completed before other work begins on-site.
24.Wetland flagging shall be checked prior to start of construction and shall be re-
established where missing. All wetland flagging shall remain visible and enumerated
per the approved plan(s) throughout the life of the project and until a Certificate of
Compliance is issued so that erosion control measures can be properly placed and
wetland impacts can be monitored. The proposed limit of work shall be shall be clearly
marked with erosion controls or temporary fencing and shall be confirmed by the NACC.
Such barriers shall be checked and replaced as necessary and shall be maintained until all
construction is complete. Workers should be informed that no use of machinery, storage
of machinery or materials, stockpiling of soil, or construction activity is to occur beyond
this line at any time.
25. A row of staked hay bales shall be placed in the southeastern corner of the yard between
the construction area and wetland. The erosion control barrier will be properly installed
and its location inspected and approved by the NACC or its agent prior to the start of
construction and shall remain intact until all disturbed areas have been permanently
stabilized to prevent erosion. All erosion prevention and sedimentation protection
measures found necessary during construction shall be implemented at the direction of
the NACC or its agent. The NACC reserves the right to impose additional conditions on
portions of this project to mitigate any impacts which could result from site erosion, or
any noticeable degradation of surface water quality discharging from the site. For
CAWinword\OOC\boilerl.doc 4 NACC 8/14/2008
DEP FILE #242- 1438
example, installation of erosion control measures may be required in areas not shown on
the plan(s) referenced in this Order of Conditions. Should such installation be required
by the NACC, they shall be installed within 48 hours of the Commission's request.
26. The applicant shall have on hand at the start of any soil disturbance, removal or
stockpiling, a minimum of 3 hay bales and sufficient stakes for staking these bales(or an
equivalent amount of silt fence, 1 hay bale to equal 3 feet of fence). Said bales shall be
used only for the control of emergency erosion problems and shall not be used for the
normal control of erosion.
27.A check payable to the Town of North Andover shall be provided in the$500 which shall
be in all respects satisfactory to Town Counsel, Town Treasurer, and the NACC, and shall
be posted with the North Andover Town Treasurer through the NACC before
commencement of work. Said deposit of money shall be conditioned on the completion
of all conditions hereof, shall be signed by a party or parties satisfactory to the NACC,
and Town Counsel,and shall be released after completion of the project, provided that
provisions, satisfactory to the NACC,have been made for performance of any conditions
which are of continuing nature. The applicant may propose a monetary release schedule
keyed to completion of specific portions of the project for the NACC's review and
approval. This condition is issued under the authority of the local ByLaw.
28. The applicant shall be responsible for placing signs on each parcel, where there is more
than one (1) lot, designating the applicable lot number as depicted on the plans approved
and referenced herein.
29. "Protected Wetland Resource Area" markers already installed on the property shall
remain posted and be replaced as necessary in perpetuity.
30.The applicant and/or the legal owner of that portion of land upon which these Orders of
Conditions have been placed shall provide to the NACC prior to transferring, or
assigning any portion of said land to another party, subject to said Orders of Conditions,
the"Compliance Certification Form Affidavit"attached via"Appendix A" signed under
the pains and penalties of perjury,stating that said applicant and/or owner has read
these Orders of Conditions and is in compliance with each and every condition. This
document shall apply to each of the conditions referenced herein and shall be provided to
the Conservation Department at least five(5)business days prior to the closing of said
land transaction.
31. Once these above mentioned pre-construction requirements are complete, the applicant
shall contact the Conservation Office prior to site preparation or construction and shall
arrange an on-site conference with an NACC representative, the contractor, and the
applicant to ensure that all of the Conditions of this Order are understood. This Order
shall be included in all construction contracts, subcontracts, and specifications dealing
with the work proposed and shall supersede any conflicting contract requirements. The
applicant shall assure that all contractors, subcontractors and other personnel performing
the permitted work are fully aware of the permit's terms and conditions. Thereafter, the
CAWinword\OOC\boilerl.doc 5 NACC 8/14/2008
DEP FILE #242 - 1438
contractor will be held jointly liable for any violation of this Order of Conditions
resulting from failure to comply with ifs conditions. The applicant or contractor shall
notify the NACC in writing of the identity of the on-site construction supervisor hired to
coordinate construction and to ensure compliance with this Order. A reasonable period
of time shall be provided as notice of the pre-construction meeting (e.g. 72 hours).
DURING CONSTRUMON
32. Upon beginning work, the applicant shall submit written progress reports every month
detailing what work has been done in or near resource areas, and what work is
anticipated to be done over the next period. This will update the construction sequence.
33. Approved de-watering activities anticipated at the roadway entrance location shall be
supervised and witnessed by the designated erosion control monitor. This designee must
be on-site while work specific to the roadway retaining wall installation is occurring and
until this section is complete. De-watering activities shall be conductedd as shown on the
approved plans and shall be monitored daily by the erosion control monitor to ensure
that sediment laden water is appropriately settled prior to discharge toward the wetland
resource areas. No discharge of water is allowed directly into an area subject to
jurisdiction of the Wetlands Protection Act and/or the North Andover Wetland ByLaw.
If emergency de-watering requirements arise, the applicant shall submit a contingency
plan to the Commission for approval which provides for the pumped water to be
contained in a settling basin,to reduce turbidity prior to discharge into a resource area.
34.Any fill used in connection with this project shall be clean fill, containing no trash, refuse,
rubbish or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper,
cardboard, pipe, tires, ashes,refrigerators, motor vehicles or parts on any of the
foregoing.
35. No exposed area shall remain unfinished for more than thirty (30) days, unless approved
by the NACC.
36. No re-grading in the buffer zone shall have a slope steeper than 2:1 (horizontal: vertical).
Slopes of steeper grade shall be rip-rapped to provide permanent stabilization.
37.There shall be no stockpiling of soil or other materials within fifty (50)feet of any
resource area.
38.Washings from concrete trucks, or surplus concrete,shall not be directed to, any drainage
system, or wetland resource area.
39.All waste generated by, or associated with, the construction activity shall be contained
within the limit of work, and away from any wetland resource area. There shall be no
burying of spent construction materials or disposal of waste on the site by any other
means. The applicant shall maintain dumpsters (or other suitable means) at the site for
CAWinword\000boilerl.doc 6 NACC 8/14/2008
DEP FILE #242 - 1438
the storage and removal of such spent construction materials off-site. However, no trash
dumpsters will be allowed within 50' of areas subject to protection under the Act or local
ByLaw.
40. Accepted engineering and construction standards and procedures shall be followed in
the completion of the project.
41. During and after work on this project, there shall be no discharge or spillage of fuel, or
other pollutants into any wetland resource area. If there is a spill or discharge of any
pollutant during any phase of construction the NACC shall be notified by the applicant
within one (1) business day. No construction vehicles are to be stored within 100 feet of
wetland resource areas, and no vehicle refueling, equipment lubrication, or maintenance
is to be done within 100 feet of a resource area.
AFTER CONSTRUCTION
42. No underground storage of fuel oils shall be allowed on any lot within one-hundred
(100) feet of any wetland resource area. This condition shall survive this Order of
Conditions and shall run with the title of the property. This condition is issued under the
authority of the Town's Wetland protection ByLaw.
43.Fertilizers utilized for landscaping and lawn care shall be slow release, low-nitrogen
types (< 5%), and shall not be used within 25 feet of a resource area. Pesticides and
herbicides shall not be used within 100 feet of a wetland resource area. This condition
shall survive this Order of Conditions and shall run with the title of the property. This
condition is issued under the authority of the Town`s Wetland Protection ByLaw and
shall remain in perpetuity.
44. Upon completion of construction and grading, all disturbed areas located outside
resource areas shall be stabilized permanently against erosion. This shall be done by
loaming and seeding according to NRCS standards. Stabilization will be considered
complete once full vegetative cover has been achieved.
45. Upon approved site stabilization by Conservation staff, the erosion controls shall be
removed and properly disposed of and all exposed unvegetated areas shall be seeded.
46. Upon completion of the project the applicant shall submit the following to the
Conservation Commission as part of a request for a Certificate of Compliance:
a. WPA Form 8A-"'Request for a Certificate of Compliance."
b. A letter from the applicant requesting a Certificate of Compliance.
c. The name and address of the current landowner.
d. Signed statements from the individual property owners shall be submitted with
the request for a Certificate of Compliance indicating that they read and
understood the recorded Order of Conditions prior to purchasing their property.
CAWinwor&000lboilerl.doc 7 NACC 8/14/2008
DEP FILE #242 - 1438
e. The name and address of the individual/trust or corporation to whom the
compliance is to be granted.
f. The street address and assessor's map/parcel number for the project.
g. The DEP file number.
h. A written statement from a Registered Professional Civil Engineer(and/or
Registered Professional Land Surveyor) of the Commonwealth certifying that the
work has been conducted as shown on the plan(s) and documents referenced
above, and as conditioned by the Commission.
i. An"As-Built" plan prepared and signed and stamped by a Registered Professional
Civil Engineer(and/or Registered Professional Land Surveyor) of the
Commonwealth,for the public record. This plan will include(as appropriate):
➢ "As-Built' post-development elevations of all drainage&stormwater
management structures constructed within 100 feet of any wetland resource
area. NOTE: If portions of the stormwater systems exist partially within
the Buffer Zone than the entire structure must be depicted to accurately
verify compliance.
➢ "As-Buil' post-development elevations and grades of all filled or altered
wetland resource areas including the encompassing buffer zone which is
regulated as a resource area under the local Wetland Protection Bylaw.
➢ Distances from structures to wetland resource areas. Structures include (but
are not limited to) septic systems, additions, fences, sheds, stone walls,
pools, retaining walls, subsurface utilities and decks.
➢ A line showing the limit of work and the extent of existing erosion control
devices. "Work" includes a_X disturbance of soils or vegetation.
➢ Location of all subsurface utilities entering the property.
47.The following special conditions shall survive the issuance of a Certificate of Compliance
(COC) for this project:
➢ 25' No-Disturbance Zone and a 50' No-Construction Zone shall be
established from the edge of adjacent wetland resource areas except in those
locations approved under DEP #242-1438. Future work within 100' of
existing wetland resource areas will require a separate filing with the
NACC(refer to Section XI(page 18) of the Regulations for performance
standards within these zones)The Conservation Administrator and/or
other agents of the NACC do not have the authority to waive these setbacks
as established under the local ByLaw;
➢ Resource Area Markers (Condition#29);
CAWinword\OOClbailerl.doc 8 NACC 8!14/2008
DEP FILE #242 - 1438
➢ Discharge or spillage of pollutants (Condition #41);
➢ Prohibition of underground fuels (Condition #42);
➢ Limitations on the use of fertilizers, herbicides,and pesticides (Conditions
#43);
CAWinword\000boilerl-doe 9 NACC 8/14/2008
Massachusetts Department of Environmental Protection
- Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 - Order of Conditions 242-1438
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
E. Issuance
This Order is valid for three years, unless otherwise specified.as a special
condition pursuant to General Conditions#4, from the date of issuance. 1.Date of Issuance
Please indicate the number of members who will sign this form: q
This Order must be signed by a majority of the Conservation Commission. 2.Number of signers
The Order must be mailed by certified mail (return receipt requested)or hand delivered to the applicant. A
copy also must be mailed or hand delivered at the same time to the appropriate Department of
Environmental Protection Regional Office, if not filing electronically, and the property owner, if different
from applicant.
Signatures:
�^1
ZIP
`J
L
No a?Acknowledgement
Commonwealth of Massachusetts County of Essex North
On this fti of
Day Month Year
Before,me, the undersigned Notary Public, 5ef91J F 1�126 DDlQy
personally appeared Name of Document 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
--�
CUMMONNI KTNcy�sETTS ARY PUBLIC
Signature of Notary Public
ndy Ccrrxtts Aug.7,209
_-- Printed NV71-
f Notary Public
Place notary seal and/or any stamp above �
My Commission Lpires(Date)
This Order is issued to the applicant as follows:
❑ by hand delivery on D-Iby certified mail,/return receipt requested, on
Pb �'/��
Date Date
wpaform5.doc• rev.2/27108 Page 8 of 10
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 - Order of Conditions 242-1438
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
F. Appeals
The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject
to this Order, or any ten residents of the city or town in which such land is located, are hereby notified of
their right to request the appropriate MassDEP Regional Office to issue a Superseding Order of
Conditions. The request must be made by certified mail or hand delivery to the Department, with the
appropriate filing fee and a completed Request of Departmental Action Fee Transmittal Form, as provided
in 310 CMR 10.03(7)within ten business days from the date of issuance of this Order. A copy of the
request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission
and to the applicant, if he/she is not the appellant.Any appellants seeking to appeal the Department's
Superseding Order associated with this appeal will be required to demonstrate prior participation in the review
of this project. Previous participation in the permit proceeding means the submission of written information
to the Conservation Commission prior to the close of the public hearing, requesting a Superseding Order
or Determination, or providing written information to the Department prior to issuance of a Superseding
Order or Determination.
The request shall state clearly and concisely the objections to the Order which is being appealed and how
the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands
Protection Act(M.G.L. c. 131, §40), and is inconsistent with the wetlands regulations(310 CMR 10.00).
To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts
Wetlands Protection Act or regulations,the Department has no appellate jurisdiction.
Section G, Recording Information is available on the following page.
wpaform5.doc• rev.2/27/08 Page 9 of 10
Massachusetts Department of Environmental Protection
�-- Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 - Order of Conditions 242-1438
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
G. Recording Information
This Order of Conditions must be recorded 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, the
Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land
subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court
Certificate of Title of the owner of the land subject to the Order of Conditions.The recording information on
this page shall be submitted to the Conservation Commission listed below.
North Andover
Conservation Commission
Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission.
--------------------------------------------------------------------------------------------------------------------------
To:
North Andover
Conservation Commission
Please be advised that the Order of Conditions for the Project at:
32 Stonewedge Circle 242-1438
Project Location MassDEP File Number
Has been recorded at the Registry of Deeds of:
Essex North
County Book Page
for:
Property Owner
and has been noted in the chain of title of the affected property in:
Book Page
In accordance with the Order of Conditions issued on:
Date
If recorded land, the instrument number identifying this transaction is:
Instrument Number
If registered land, the document number identifying this transaction is:
Document Number
Signature of Applicant
wpaform5.doc• rev.2/27/08 Page 10 of 10
DEP MILE #242- 1438
APPENDIX A-AFFIDAVIT
1, on oath do hereby depose and state:
(authorized agent applicant and/or current owner)
(PLEASE CHECK AT LEAST ONE BLOCK)
1. I am the of
(position with applicant) (applicant name or company name)
the applicant upon whom Order of Conditions
have been placed upon by (DEP or NACC number)
the North Andover Conservation Commission.
&/or
2. I am the of
(position with owner) (owner name)
the owner upon whose land Order of Conditions -
have been placed up by (DEP or NACC number)
the North Andover Conservation Commission.
3. I hereby affirm and acknowledge that I have received said Order of Conditions
arid have read the same and understand each
(DEP File#) and every condition which has been set forth
in said Order of Conditions.
4. I hereby affirm and acknowledge that on this day of 19
I inspected said property together with any and all improvements which have
been made to the same and hereby certify that each and every condition set
forth in Order of Conditions are presently in compliance.
(DEP File#)
5. I hereby affirm and acknowledge that this document will be relied upon by the
North Andover Conservation Commission as well as any potential buyers of
said property which is subject to said Order of Conditions
(DEP File#)
Signed under the pains and penalties of perjury this day of 19
(Signature-authorized agent of applicant or owner)
C:\Winword\00C\boi1er1.d6c 10 NACC 8/142008