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Home My WebLink AboutMiscellaneous - 50 BRIDLE PATH Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance 242-1171 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 Peter&Caroline O' Neil computer, use Name only the tab key to move 50 Bridle Path your cursor- Mailing Address do not use the North Andover _ MA. 01845 return key. City/Town State Zip Code f� 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: Peter&Caroline O' Neil Name e November 22, 2002 242-1171 Dated DEP File Number 3. The project site is located at: 50 Bridle Path North Andover Street Address City/Town Map 103 Parcel 114 Assessors Map/Plat Number Parcel/Lot Number the final Order of Condition was recorded at the Registry of Deeds for: Same Property Owner(if different) Essex North 6317 65 County Book Page Certificate 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: 12/8/05 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.7/13104 Page 1 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: i WPA Form 8B — Certificate of Compliance 242-1171 1 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 The Order of Conditions has lapsed and is therefore no longer valid.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: 64 C. Authorization Issued by: North Andover Conservation Commission Date of tisuangI5 This Certificate must be signed,,by`t majority of the Conservation Commission and a copy sent to the applicant and appropriate DJ`P R nal Office(See Attachment). n Signatures: d r wpaform Bb.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 242-1171 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP C. Authorization (cont.) Notary Acknowledgement Commonwealth of Massachusetts County of Essex North a 9 li 1 On this Day Of '9't; Month Year before me, the undersigned Notary Public,personally appeared 4-'r� ' H&C, S 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 Cityrrown �IrA Signature of Notary Public _ DONNA M.WEDGE 4 'i) /l // /tJFDG u "'tE NOTARY PUBLIC Printed Name of Notary Public COh1MONWEALTH OF MASSACHUSEM my Comm.Expires Aug.7,2009 kh My Co issionxpires(Date) Place notary seal and/or any stamp above Sig1mature of Notary Pubic wpaform 8b.doc•rev.7113104 Page 3 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance 242-1171 \ 131 40 Wetlands Protection Act M.G.L. C. Provided b DEP Massachusetts Wetla ds P c , § P y 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: 242-1171 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 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 g 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 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 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 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 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.12/12/05 Page 1 of 1 Town of North Andover F `x�4an a•�d 7f Office of the Conservation Department Community Development and Services Division 04 . s + r� 27 Charles Street Ic►wsE� Julie Parrino North Andover,Massachusetts 01845 Telephone(978)688-9530 Conservation Administrator Fax(978)688-9542 September 25, 2003 Peter O'Neil 50 Bridle Path North Andover, MA 01845 Re: Modification,50 Bridle Path Road 242-1171 Dear Mr. O'Neil: At the September 24,2003 Conservation Commission pubic meeting,the Commission voted to issue a modification for your project located at 50 Bridle Path. The modification was for regrading activities,construction of a retaining wall and construction of several steps. Your modification request also including the proposal to divert stormwater from the driveway into the existing infiltration pipe. As discussed at the hearing,prior to installation of the drainage system at the end of the driveway,specific details on the particular structure must be submitted to the Conservation Department. The Commission also expressed concern over the construction sequencing of the grading and wall activities, as activities will be in close proximity to wetland resource areas. Daily erosion control monitoring will be required during fill placement activities. Prior to grading and drainage improvement activities,the Conservation Department must be notified to schedule an on-site meeting. If you have any question7pse1 free to contact me. s� Sincerely, 0 arrino,Cons ation Administrator BOARD OFAPPEALS 688-9541 BUR DING 088-9545 CONSERVATION 688-9530 HEALTH 688-9544 PLANNING 688-9535 Z Ya 1171 Town of North Andover of NOR7lf Office of the Conservation Department ? Community Development and Services Division *ro y Heidi Griffin Division Director *-°� =• '' �' Griffin, recX14 'wsToo 27 Charles Street ss.►cr+cs� North Andover,Massachusetts 01845 Telephone(978)688-9530 Julie Parrino Conservation Administrator Fax(978)688-9542 Modification to Order of Conditions The NORTH ANDOVER CONSERVATION COMMISSION agreed to accept Applicant: D Xu as a odificatio to the Order of Conditions issued ' File 242- />7/ ated and recorded in Book# and page I sue by RTH ANDOVER CONSERVATION COMMISSION: i On this of _before me personally appeared Scott Masse to me day month/yr known to be the person described in and who executed the foregoing instrument and acknowledged that he/she executed the same as his/her free act and deed. Notary Public V My Cqf=ission Expires 's office showing o Deeds must be submitted to this A receipt from the Lawrence Registry f D d g that this Modification has been recorded and referenced to the book and page numbers. BOARD OF APPEALS 688-9541 BUILDINQ 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 f-1 7- tC 11 'A b--1, I0`;'I CL R,'J 1 -P VC i J- 1 H U L- 1003 JUN -Q P 2: 4 8 TO: Town of North Andover Planning Department 27 Charles Street North Andover,MA 01845 Phone: (978) 688-9535 Fax: (978) 688-9542 Please be advised that I wish to withdraw my amfication from the Planning Board for property located at: STREET: TOWN: A) 10 NAME OF PEMR: SIGNED: Pet' ion;r or`Mtit'ioner's fepresen�Oive PLANNING BOARD: oard or Planning Board Agent) By my above signature I hereby a the following: 1. That the vote is with or without prejudice. 2. That future submittals will require a new application. 3. That any new application will require a complete filing with applicable fees under the current regulations. RECEIVED Town of North Andover Office of the Planning Department JUN 1 0 2003Community Development and Services Division 27 Charles Street *�-�,;;;o�:•�' NC�l�"i=ii A�dDC;V�`.f� 'SsacHusEt� PLANNING DEPARTMENT North Andover, Massachusetts 01845 Planning Director. hft://www.townofnorthandover-com p (978) 688-9535 J.Justin Woods iwoods@townofnorthandover.com F (978) 688-9542 June 4, 2003 Peter&Caroline O'Neil 50 Bridle Path - No Andover,MA 01845 t1;n RE: 50 Bridle Path Waiver of Watershed Special Permit -0 �" ' ' Assessor's Map 103,Lot 114 n� Dear Mr. &Mrs. O'Neil: co On Tuesday,June 3,2003,the Planning Board voted on the following motion: Angles motion to grant a waiver per Section 4.136(8)of the Zoning Bylaw,last amended December 2002,to Peter&Caroline O'Neil to convert an eldsting three-season porch to living space at 50 Bridle Path,as approved by the Conservation Commission on November 22,2002. 2°d by White Discussion:None. Motion carries 4-0. The Board found that the project met the conditions of Section 4.136(8)of the Zoning Bylaw,and accordingly,you must agree in writing that: 1) The Town Planner can perform a minimum of two inspections during the construction process to ensure proper erosion control is established during construction;AND 2) The Town Planner can stop construction if the proper erosion control is not in place. Kindly sign this form in the space provided below to acknowledge acceptance of these two conditions and an original copy to o''ffice. 17/,/wIl/. eter O'Ne' Caroline O'Neil Thank you in advance for `our prompt return of the signed copy and please feel free to call me if you have any additional questions. Sincerel , c ?imn'!oodSity Development Dir. Health Administrator Applicant M CD Conservation Administrator Planning Board Engineer ' � r Director ofPublic Works Police Chief Assessor r_j Building Commissioner Fire Chief Clerk w BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Town of Orth Andover o Na or„ Office of the lanning Department GA Community Devel pment and Services Division « = 4� Charles Street =`""" 'bys,,r.o North An over, Massachusetts 01845 Planning Director. h : townofnorthandover.com p (978) 688-9535 J.Justin Woods iwoodsGt wnofnorthandover.com F (978) 688-9542 June 4, 2003 Peter& Caroline O'Neil 50 Bridle Path No Andover,MA 01845 ' RE: 50 Bridle Path Waiver of Watershed Special Permit z° e Assessor's Map 103,Lot 114 .� Dear Mr. &Mrs. O'Neil: N ` r - On Tuesday,June 3,2003,the Planning Board voted on the following motion: Angles motion to grant a waiver per Section 4.136(8)of the Zoning Bylaw,last amended December 2002,to Peter&Caroline O'Neil to convert an existing three-season porch to living space at 50 Bridle Path,as approved by the Conservation Commission on November 22,2002. tad by White. Discussion:None. Motion carries 4-0. The Board found that the project met the conditions of Section 4.136(8)of the Zoning Bylaw,and accordingly,you must agree in writing that: 1) The Town Planner can perform a minimum of two inspections during the construction process to ensure proper erosion control is established during construction;AND 2) The Town Planner can stop construction if the proper erosion control is not in place. Kindly sign this form in the space provided below to acknowledge acceptance of these two conditions and return an original copy to my office. Peter O'Neil Caroline O'Neil Thank you in advance for your prompt return of the signed copy and please feel free to call me if you have any additional questions. Sincerely, sin Woods ommunity Development Dir. Health Administrator Applicant Conservation Administrator Planning Board Engineer Director of Public Works Police Chief Assessor Building Commissioner Fire Chief CIerk BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 5 Order of Conditions 242-1171 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP A. General Information Important: When filling From: out forms on North Andover Conservation Commission the computer, Conservation Commission use only the tab key to This issuance if for(check one): move your cursor- do ® Order of Conditions not use the return key. ❑ Amended Order of Conditions To: Applicant: Property Owner(if different from applicant): Peter O'Neil ern Name Name 50 Bridle Path Mailing Address Mailing Address North Andover MA 01845 City/Town State Zip Code City/rown State Zip Code 1. Project Location: 50 Bridle Path North Andover Street Address City/Town Map 103 Lot 114 Assessors Map/Plat Number Parcel/Lot Number 2. Property recorded at the Registry of Deeds for: Essex South 6317 65 County Book Page Certificate(if registered land) 3. Dates: 8/30/02 1 z,A-9- Date Notice of Intent Filed Date ubli Hearing Closed Date of Puance/ 4. Final Approved Plans and Other Documents (attach additional plan references as needed): Planof Land in North Andover, Mass prepared for Peter&Carolyn O'Neil, 50 Bridle 9/09/02, lat rev. Path 11/04/02 Restoration and Mitigation Plan 10/22/02 Title Date Notice of Intent, dated 9/24/02& Revised Project Narrative dated 10/9/02 Title Date 5. Final Plans and Documents Signed and Stamped by: Dennis G. Quintal, P.E. and Daniel L. Johnson, P.L.S. of Plaistow Consultants Professional Land Surveyors 6. Total Fee: $50 + $50 local, Total =$100 (from Appendix B:Wetland Fee Transmittal Form) Wpaform5.doc•rev.12/15/00 Page 1 of 7 Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions 242-1171 'LlProvided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Findings 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: Public Water Supply ❑ Land Containing Shellfish Prevention of Pollution ® Private Water Supply ❑ Fisheries ® Protection of Wildlife Habitat ® Groundwater Supply ® Storm Damage Prevention Z Flood Control Furthermore,this Commission hereby finds the project,as proposed,is:(check one of the following boxes) Approved subject to: ® the following conditions which are necessary, in accordance with the performance standards set forth in the wetlands regulations, to protect those interests checked above.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: ❑ the proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations to protect those interests checked above. 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. ❑ 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). General Conditions (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. W paform5.doc•rev.12/15/00 Page 2 of 7 Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands WPA Form 5 -- Order of Conditions 242-1171 LL7) il Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP B. Findings (cont.) 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 forthasa 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, "MA DEP"] "File Number 242-1171 " 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 DEP. 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. Wpaform5.doc•rev.12/15/00 Page 3 of 7 LlMassachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection -Wetlands WPA Form 5 - Order of Conditions 242-1171 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP B. Findings (cont.) 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 to 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. Findings as to municipal bylaw or ordinance Furthermore, the North Andover Conservation hereby finds (check one that applies): Commission ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw specifically: Municipal Ordinance or Bylaw 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. ® that the following additional conditions are necessary to comply with a municipal ordinance or bylaw, specifically: Chapter 178 of the Code of North Andover Municipal Ordinance or Bylaw Citation The Commission orders that all work shall be performed in accordance with the said additional 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. wpatorm5.doc•rev.12/15/00 Page 4 of 7 242-1171 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, r 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 following conditions modify or differ from the Manss, cations or other proposals submitted with the Notice of Intent, the conditions shall control. GENERAL CONDITIONS 18. 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. 19. 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. 20. 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. 21. The work authorized hereunder shall be completed within three years from the date of this order. 22. This Order may be extended by the issuing authority for one or more periods of up to one year each upon application to the issuing authority at least thirty days (30) prior to the expiration date of the Order {Refer to Section VIII ( )B (P.33)of the North Andover Ketland Regulations). Order of Conditions242-1171 1 NACC 11/22/02 242-1171 23.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. 24. 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. 25.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. 26. 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. 27.The proposed work includes: Conversion and expansion of a three- season deck to all-season living space.Activities will include relocation and replacement of support pilings. Infiltration of roof runoff from the new addition and rear facade of the existing house will be directed to an infiltration pipe. Buffer zone enhancement plantings are proposed under this project Work will be conducted in the buffer zone to bordering vegetated wetland located in the Watershed Protection District 28. 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: Peter&O'Neill 50 Bridle Path North Andover, MA 01845 Dated September 24,2002 Restoration&Mitigation Plan: Restoration and Mitigation Plan to accompany a Notice of Intent Request for Waiver,50 Bridle Path, North Andover,MA,prepared by Seekamp Environmental Consulting, dated October 22, 2002 Site Plan Prepared by: Plaistow Consultants,Professional Land Consultants, 22 Smith Corner Road, Plaistow, NH 03865 Order of Conditions242-1171 2 NACC 11/22/02 242-1171 Entitled: Plan of Land in North Andover, MA, Prepared for Peter&Carolyn O'Neill, 50 Bridle Path, Dated 9/9/02, Revised through 11/04/02 29. The following wetland resource areas are affected by the proposed work: buffer zone to bordering vegetated wetland located in the Watershed Protection District.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 theseresource areas to the identified interests. 30. The NACC agrees with the applicant`s delineation of the wetland resource areas on the site as shown on the plans dated referenced herein 31.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. 32. 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 twenty five foot(251 No-Disturbance Zone and a fifty foot(50`) No-Construction Zone shall be established from the edge of the adjacent wetland resource area (except in areas previously disturbed as shown on the approved site pians). Proposed buffer mitigation areas must be maintained in perpetuity as No-Disturbance 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. 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). 33. The owners of the project and their successors in title, in the event they proceed to alter areas subject to the Commission`s jurisdiction under the order, 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 Order of Conditions242-1171 3 NACC 11/22/02 242-1171 to flooding, storm damage or any other form 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. 34. 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 35. 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. 36. 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 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. 37. 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'"DEP 242-1171". 38. 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. The proposed project may be still under review by g P P other local or stage boards or agencies. This may result in changes to the project plans or wetland impacts.If any such changes occur a revised plan and an explanation of the revisions shall be submitted to the NACC for Order of Conditions242-1171 4 NACC 11/22102 242-1171 review and approval prior to the start of construction. No work shall begin on a project until written approval has been granted by the NACC. 39. 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. 40. Prior to any work commencing on-site, the applicant shall submit to the NACC for approval, a detailedsequenceof 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. 41. 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 stakes or flags and shall be confirmed by the NACC Such markers 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. All flags used:for the above purposes shall be of a color different from other flagging used on the site. 42. A row of staked hay bales backed by trenched siltation fence shall be placed between all construction areas and wetlands and in areas displayed on the site plans. The erosion control barrier will be properly installed and placed as shown on the plans approved and referenced herein and shall be inspected and approved by the NACC 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. 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 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 Order of Conditions242-1171 5 NACC 11/22/02 242-1171 43. The applicant shall have on hand at the start of any soil disturbance, removal or stockpiling, a minimum of 20 hay bales and sufficient stakes for staking these bales(or an equivalent amount of silt 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 44. Prior to construction, the applicant shall permanently mark the edge of the approved No-Disturbance Zone with signs or markers spaced evenly every 25 feet incorporating the following text: "Protected Wetland Resource Area" (for sale at the Conservation Department). This will designate their sensitivity and assure no further inadvertent encroachment into the wetland. These permanent markers are subject to review and approval by the NACC. The applicant shall instruct all agents to explain these markers to buyers/lessees/landscapers and all persons taking over the property from the applicant. 45. A check payable to the Town of North Andover shall be provided in the amount of$4400,(2,000 for construction activities;$2400 for buffer zone enhancement activities,$3.00 per sI. of mitigation area(3.00 x 800 s.f= 2400)) 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 NACCs review and approval. This condition is issued under the authority of the local ByLaw. 46. The applicant shall designate a Wetland Scientist as an "Erosion Control Monitor" to oversee any emergency placement of controls and regular inspection or replacement of sedimentation control devices. The name and phone number of the erosion control monitor must be provided to the NACC in the event that this person has to be contacted, due to an emergency at the site, during any 24-hour period,including weekends. This person shall be given the authority to stop construction for erosion control purposes. The erosion control monitor will be required to inspect all such devices and oversee cleaning and the proper disposal of waste products. Cleaning shall include removal of any entrapped silt. At least once during each week in which construction activities occurs on-site and for as long thereafter as ground remains unstabilized, the applicant shall submit a written report from the"Erosion Control Monitor" to the NACC certifying that; to the best Order of Conditions242-1171 6 NACC 11/22/02 242-1171 of lis/her knowledge and belief based on a careful site inspection, all work is being performed in compliance with this Order of Conditions and that approved setbacks are being adhered to. The erosion control monitor must visually inspect all sedimentation/erosion control measures and assume responsibility for their maintenance on a weekly basis and that they are functioning as intended. In addition, all wetland resource areas must be visually inspected for siltation, turbidity, and/or other water quality impacts. 47. The applicant and/or the legal owner of that portion of land upon which these Orders of Conditions have been placed shallprovidetg 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. 48. 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,the engineer,wetland scientist 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 permifs terms and conditions. Thereafter, the contractor will be held jointly liable for any violation of this Order of Conditions resulting from failure to comply with its 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 CONSTRUCTION 49. 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. Order of Conditions242-1171 7 NACC 11/22/02 242-1171 50. No exposed area shall remain unfinished for more than thirty (30) days, unless approved by the NACC. 51. No re-grading in the buffer zone shall have a slope steeper than 2:1 (horizontal: vertical). Slopes Pte'of steeper grade shall be rip-rapped to provide permanent stabilization. 52. There shall be no stockpiling of sod or other materials within twenty-five(25) feet of any resource area. 53. Washings from concrete trucks, or surplus concrete, shall not be directed to, any drainage system, or wetland resource area. 54. All waste generated by, or associated with, the construction activity shall be contained within the construction area, 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 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. 55. Accepted engineering and construction standards and procedures shall be followed in the completion of the project 56. Buffer zone restoration plantings must be conducted in accordance with the approved Restoration and Mitigation Plan. Planting activities must be supervised by the designated Erosion Control Monitor. The restoration areas must be monitored for two growing seasons by a qualified wetland scientist and monitoring reports must be submitted to the Conservation Commission in the spring and fall of each of the monitored growing seasons. 57. 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. Order of Conditions242-1171 8 NACC 11/22/02 242-1171 AFTER CONSTRUCTION 58. 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. 59. 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- 60. erpetuity60. The current property owners and future property owners are responsible for cleaning,maintaining,repairing and replacing the infiltration pipe approved on the property. 61. Upon completion of construction and grading, all disturbed areas located outside resource areas shall be stabilized permanently against erosion. This shall be done either by loaming and seeding according to SCS standards. Stabilization will be considered complete once vegetative cover has been achieved. 62. Upon completion of work and stabilization of the site,erosion controls must be removed and disposed of properly. 63. 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. 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. Order of Conditions242-1171 9 NACC 11/22/02 242-1171 h. A written statement from a qualified wetland scientist certifying that the mitigation plantings were conducted in accordance to the approved plan i. A written statement from a Registered Professional Civil Engineer 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 j. An"As-Buil' plan prepared and signed and stamped by a Registered Professional Civil Engineer of the Commonwealth, for the public record. This plan will include: ➢ "As-Built" 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. ➢ "As-Built" locations of drainage and infiltration structures including invert and outlet elevations. ➢ 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--y disturbance of soils or vegetation ➢ Location of all subsurface utilities entering the property. 64. 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 areas previously disturbed as approved under this filing).Future work within 100' of existing wetland resource areas or within the 200 Riverfront Area 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; ➢ Discharge or spillage of pollutants; Condition#57 Order of Conditions242-1171 10 NACC 11/22/02 242-1171 ➢ Prohibition of underground fuels; Condition #58 ➢ Limitations on the use of fertilizers, herbicides, and pesticides; Condition#59 ➢ Cleaning, maintenance, repair and replacement of the infiltration pipe;Condition #60 Order of Conditions242-1171 11 NACC 11/22/02 Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions 242-1171 LIProvided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Findings (cont.) Additional conditions relating to municipal ordinance or bylaw: See Attached This Order is valid for three years, unless otherwise specified as a special condition pursuant to General Conditions#4, from the date of 7;nce. Date IT This Order must be signed by a majority of the Conservation Commission.The Order must be mailed by certified mail (return receipt requested)or han delivered to the applicant. A copy also must be mailed or hand delivered at the same time to the ropriate Department of Environmental Protection Regional Office (see Appendix A) d the pr ert wrier(if different from applicant). Sigat res: 4 t On Of C.C. Day Month an Year before me p nally appeared to me known to be the person described in and who executed the foregoing instrument and acknowledged that he/she executed the same as his/her free act and deed. No a Public My Gommissi4 Expires This Order is issued to the applicant as follows: ❑ by hand delivery on [-tSy certfi mail, return receipt requested, on fl ZZ d Date Date Wpaform5.doc•rev.12/15/00 Page 5 of 7 Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions 242-1171 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP C. 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 DEP 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 Appendix E: 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 timebesent by certified mail or hand-delivery-to the Conservation Commission and to the applicant, if he/she is not the appellant. 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. D. 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 Page 7 of Form 5 shall be submitted to the Conservation Commission listed below. North Andover Conservation Commission Conservation Commission Wpaform5.doc•rev.12/15/00 Page 6 of 7 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP Fife Number: WPA Form 5 - Order of Conditions 242-1171 Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 D. Recording Information (cont.) Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission. -------------------------------------------------------------------------------------------------------------------------- To: Conservation Commission Please be advised that the Order of Conditions for the Project at: Project Location DEP File Number Has been recorded at the Registry of Deeds of: 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.12/15/00 Page 7 of 7 242-1171 APPENDIX A-AFFIDAVIT I, on oath do hereby depose and state: (authorized agent applicant and/or current owner) (PLEASE CHECKAT 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. AVor 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 and 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 14 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) Order of Conditions242-1171 12 NACC 11/22/02 Massachusetts Department of Environmental Protection -- Bureau of Resource Protection - Wetlands WPA Appendix E — Request for Departmental Action Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. Request Information Important: When filling 1. Person or-party making request(if appropriate, name the citizen group's representative): out forms on the computer, Name use only the tab key to Mailing Address move your cursor-do Cityfrown State Zip Code not use the return key. Phone Number Fax Number(if applicable) VQ Project Location �I Mailing Address rtman City/Town State Zip Code 2. Applicant(as shown on Notice of Intent(Form 3), Abbreviated Notice of Resource Area Delineation (Form 4A); or Request for Determination of Applicability(Form 1)): Name Mailing Address City/Town State Zip Code Phone Number Fax Number(if applicable) 3. DEP File Number: B. Instructions 1. When the Departmental action request is for(check one): ❑ Superseding Order of Conditions ❑ Superseding Determination of Applicability ❑ Superseding Order of Resource Area Delineation Send this form and check or money order for$50.00, payable to the Commonwealth of Massachusetts to: Department of Environmental Protection Box 4062 Boston, MA 02211 wpaform6.doc•Appendix E-rev.11/6/02 Pagel of 2 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Appendix E — Request for Departmental Action Fee Transmittal Form Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Instructions (cont.) 2. On a separate sheet attached to this form, state clearly and concisely the objections to the Determination or Order which is being appealed.To the extent that the Determination or Order is based on a municipal bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. 3. Send a copy of this form and a copy of the check or money order with the Request for a Superseding Determination or Order by certified mail or hand delivery to the appropriate DEP Regional Office_(see Appendix A). 4. 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. wpaform5.doc•Appendix E•rev.11/6/02 Page 2 of 2 Town of North Andover Planning Board Application for Watershed Special Permit Please type or print clearly. 1. Petitioner: E- Petitioner's Address: 6-0 Qrtdle 66 A),()rfh Telephone number: 2. Owners of the Land: -,f-r-e,.--' 0 1 'N- �� Address: 0 r-twep PGL YID /V®,. .b V If Number of years of ownership: 3. Year lot was created: 4. Is the lot currently on septic or sewer? cJ If on sewer,please provide date the sewer connection was completed: -;W00 5. Description of Proposed Project:60Y/✓-e4dtr) -I1I 1 —.f-eaiJ v/ s "'XJ(�.S'r �b .f �A ! t .rax 'Ic 1tv► GKd-. 6. Description of Premises: f K I f-hr7 4 h,p Uf fj, —,CJ7-0 ; F' ccs f enact 1. e.r a Ise C � � 54,f f;17 - 1 h 7. Address of Property Being Affected Zoning District Y Assessors: Map: 103 Lot# !/ Registry of Deeds: Book#: / Page#: 8. Existing Lot: / Lot Area(Sq.Ft) BuildingHeight Street Frontage: _ Side Setbacks: 3 / Front Setback: �-/ ��` Rear Setback:_ Floor Area Ratio: "z' �,_S'`jo Lot Coverage: 9. Proposed Lot(if applicable): Lot Area(Sq.Ft) Building Height _ F Street Frontage: Side Setbacks: Front Setback: Rear Setback:'" Floor Area Ratio: Lot Coverage:- v>c 0 y 6 10. Required Lot(as required by Zoning Bylaw): 1 Lot Area(Sq.Ft) Building Height SY Street.Frontage: �— Side Setbacks: Front Setback: O Rear Setback: O Floor Area Ratio: Lot Coverage: 11. Existing Building(if applicab • Ground Floor(Sq.Ft.) ` N/0 #of Floors: Total S .Ft. Height: Use: ;/ r/7 Type of Construction 4J U 0 Gt, �Gre� �t.- C,e►�t�,Gr�e -art tom_. 12. Proposed Building: ?17407 Ground Floor(Sq.Ft.) #of Floor • Total S .Ft. Height: G✓ Use:-^ Type of Construction Q V 13. Has there been a previoud application for a Special Permit from the Planning Board on these premises? JjO If so,when and for what type of construction? R_ 14. Section of ZQQ Bylaw that Special Permit Is Being Requested_ 7 15. Petitioner and Landowner signature(s): Every application for Special Permit shall be made on this form which is the official form of the Planning Board. Every application shall be filed with the Town Clerk's office. It shall be the responsibility of the petitioner to furnish all supporting documentation with this application. The dated copy of this application received by the Town Clerk or Planning Office does not absolve the applicant from this responsibility. The petitioner shall be responsible for all expenses for filing and legal notification. Failure to comply with application requirements,as cited herein and in the Planning Board Rules and Regulations may result in a dismissal by the Planning B oard of this application as inc te. Petitioner's Signature- e. or type name here: e F Gt✓ L Owner's Signature: r Print or type name here: r 16. / Please list title of plans and documents you will be attaching tothisapplication. (,;1:i.�'t''l l.-� ? : �LCQ��'�" �-�.�yl�,�,G�;� �2.�Gt✓hx/ ✓/�'r '"GG t tom. �J T/�?� rtj ��•h>;t' �?� �n,t�•t- G�.,,�t /2.t�f u,�s-� -/-ten 4J�xc�-�j '� /o a�O�- L� .S�l,�,Gin� �1�d +'"�� -� (,�-�71nG� s7nt• , Y14^ ,!'_�-n 9 ),l ,c)oiA vv-v7