HomeMy WebLinkAboutTOWN OF NORTH ANDOVER (5) a
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:P
WPA Form 8B — Certificate of Compliance
242-1160
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
Ll
A. Project Information
Important:
When filling out 1. This Certificate of Compliance is issued to:
forms on the R. M. Pacella, Inc.
computer, use Name
only the tab
key to move3 Madison Street
your cursor- Mailing Address
do not use the Plainville MA. 02762
return key. City/Town State Zip Code
2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to:
' Town of North Andover
Name
� 8/27102 242-1160
Dated DEP File Number
3. The project site is located at:
Osgood Street, Great Pond Road, Mableridge&Abbott St. North Andover
Street Address City/Town
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
County Book Page
N/A
Certificate
4. A site inspection was made in the presence of the applicant, or the applicant's agent, on:
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 Bb.doc•rev.12/15/00 Page 1 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance
242-1160
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therefore no longer valid.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:
66
C. Authorization
Issued by:
North Andover 3 hisLos
Conservation Commission Date Issu rice
This Certificate must be signed by a majority of the Conservation Commission and opy sent to the
applicant and appropriate DEP Regional Office(See Appendix A).
Sign res:
On Q kh Of Hard o'ZtI�IJ�
Day / Month and Year
before me personally 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.
Notary P&c Y L Y-1PPOLITO My commission expires
WNotary Public
Commonweahh of Maumhusetts
My Commission Expires
June 7,2007
wpaform 8b.doc-rev.12115/00 Page 2 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance
242-1160
Massachusetts Wetlands Protection Act LlM.G.L. c. 131, §40 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:
242-1160
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.12/15/00 Page 3 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands
WPA Appendix A — DEP Regional Addresses
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
Mail transmittal forms and DEP payments,payable to:
Commonwealth of Massachusetts
Department of Environmental Protection
Box 4062
Boston, MA 02211
DEP Western Region Adams Colrain Hampden Monroe Pittsfield Tyringham
436 Dwight Street Agawam Conway Hancock Montague Plainfield Wales
Alford Cummington Hatfield Monterey Richmond Ware
Suite 402 Amherst Dalton Hawley Montgomery Rowe Warwick
Springfield,MA 01103 Ashfield Deerfield Heath Monson Russell Washington
Phone:413-784-1100 Becket Easthampton Hinsdale Mount Washington Sandisfield Wendell
Belchertown East Longmeadow Holland New Ashford Savoy Westfield
Fax:413-784-1149 Bernardston Egremont Holyoke New Marlborough Sheffield Westhampton
Blandford Erving Huntington New Salem Shelburne West Springfield
Brimfield Florida Lanesborough North Adams Shutesbury West Stockbridge
Buckland Gill Lee Northampton Southampton Whately
Charlemont Goshen Lenox Northfield South Hadley Wilbraham
Cheshire Granby Leverelt Orange Southwick Williamsburg
Chester Granville Leyden Otis Springfield Williamstown
Chesterfield Great Barrington Longmeadow Palmer Stockbridge Windsor
Chicopee Greenfield Ludlow Pelham Sunderland Worthington
Clarksburg Hadley Middlefield Peru Tolland
DEP Central Region Acton Charlton Hopkinton Millbury Rutland Uxbridge
627 Main Street Ashburnham Clinton Hubbardston Millville Shirley Warren
Ashby Douglas Hudson New Braintree Shrewsbury Webster
Worcester,MA 01605 Athol Dudley Holliston Northborough Southborough Westborough
Phone:508-792-7650 Auburn Dunstable Lancater Northbridge Southbridge West Boylston
Fax:508-792-7621 Ayer East Brookfield Leicester North Brookfield Spencer West Brookfield
Barre Fitchburg Leominster Oakham Sterling Westford
TDO: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 NewBedford 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
205 Lowell Street Andover Chelsea Holbrook Methuen Randolph Walpole
Arlington Cohasset Hull Middleton Reading Waltham
Wilmington,MA 01887 Ashland Concord Ipswich Millis Revere Watertown
Phone:978-661-7600 Bedford Danvers Lawrence Milton Rockport Wayland
Fax: 978-661-7615 Belmont Dedham Lexington Nahant Rowley Wellesley
Beverly Dover Lincoln Natick Salem Wenham
TDD:978-661-7679 Billerica Dracut Lowell Needham Salisbury West Newbury
Boston Essex Lynn Newbury Saugus Weston
Boxford Everett Lynnfield Newburyport Sherborn Westwood
Braintree Framingham Malden Newton Somerville Weymouth
Brookline Georgetown Manchester-By-The-Sea Norfolk Stoneham Wilmington
Burlington Gloucester Marblehead North Andover Sudbury Winchester
Cambridge Groveland Medfield North Reading Swampscott Winthrop
Canton Hamilton Medford Norwood Tewksbury Woburn
Carlisle Haverhill Melrose Peabody Topsfield
wpaform8b.doc•Appendix A•rev.3/9/05 Page 1 of 1