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310 CMR 10-99 DEF File Not. - 5
Form 8 (To be provided by DEP)
Gryn:own &or- ndoVEP,
�+ ¢ Appticam /17 a.rb ip d
commonwealth
of Massachusetts PARTIAL
Certificate of Compliance
Massachuset�tssWetlan¢s protection Act, G.L. c. 131, 540
From Issuing Authority
,COLL
&hZLTo V, 7rnu. "r <Y L • S t
1? ' D _
(Nam (address.) Al, n0 ,
Date of Issuance TLA-I(A
This certificate i iss ed for work regulated by an order of Conditions issued
to /� dated A_
and issued by the
1. It is hereby certified that the work regulated by the above-referenced
order of Conditions has been satisfactorily completed.
2 . It is hereby certified that only the following portions of the work
regulated by the above-referenced order of conditions have been
satisfactorily completed: (if the Certificate of Compliance does not
include the entire project, specify what portions are included.)
k,0� /, --# 8¢ 04SWe-J
m er e f la e C,
3 . F7 It is hereby certified that the work regulated by the above-referenced
order of Conditions was never commenced. The order of Conditions has
lapsed and is therefore no longer valid. No future work subject to
-regulation under the Ac} may be commenced without filing a new Notice
of Intent and receiving a new order of Conditions.
.(Leave . . . . .
Space Blank)
4. ❑ This certificate shall be recorded in the Registry of Deeds or the land Court for the district in
which the land is located. The Order was originally recorded on (date)
at the Registry of Book_. Page
5. Q The following conditions of the Order shall continue: (Set forth any conditions contained in the
Final Order, such as maintenance or monitoring, which are to continue for a longer period.)
Issued by North Andover Con5Azvation Commission
Signatures) `
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I
When issued by the Conservation Commision this Certificate must be signed by`a majority of is members.
On thisy� -�
_ � _ day of . 19 1 922 before me
personally appeared , to me known to be the
person described in and who executed the foregoing instr9ment'aA acknowledged that heishe executed
the same as his/her free act and deed.
Public My c mmissfon expir s
Detach on dotted line and submit to the
....................................................................................................................................................................................................
70 NACC Issuing Authonty
Please be advised mat the Certificate of Cornpi.ance for the protect at.
File Numoer 242 has beenrecoroedattheRegistryot Deeds, Northern Essex
and has been noted in the chain of title of:ne affected orocerty on t O
it reczrceo tanc.:^•e instrument numue(:vntcn toenaaes trns:ransacaon is
a registered iand.:ne eecument number wnich identities tuts transaction is
3-gnature
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