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HomeMy WebLinkAboutKEY LIME INC i Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP File"umber: WPA Form 7 — Extension Permit for Orders of Conditions 242-1337 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP A. General Information Important: When filling out 1. Applicant: forms on the Key Lime, InC. computer, use Name only the tab key to move 6 Herpatica Drive your cursor- Mailing Address do not use the North Andover MA 01845 return key. City/Town State Zip Code 2. Property Owner(if different): Same Name ,enan Mailing Address City/Town State Zip Code B. Authorization The Order of Conditions(or Extension Permit) issued to the applicant or property owner listed above on: January 11, 2006 Date for work at: Old Salem Village, Salem Turnpike,Route 114 Map 1078 Parcel 16&73 Street Address Assessor's Map/Plat Number ParceVLot Number recorded at the Registry of Deeds for: Essex North 11396 123 County Book Page Certificate(if registered land) is hereby extended until`. January 11, 2011 Date This date can be no more than 3 years from the expiration date of the Order of Conditions or the latest extension. Only unexpired Orders of Conditions or Extension may be extended. Date the Order was last extended(if applicable): January 11, 2010 Date Issued by: North Andover Conservation Commission Date wpaform7.doc•rev.1/07 Page 1 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 7 — Extension Permit for Orders of Conditions 242-1337 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP B. Authorization cont. This Order of Conditions Extension must be signed by a majority of the Conservation Commission and a copy sent to the applicant and the appropriate DEP Regional Office (see htt ://www.mass. ov/de /about/re ion/find our.htm p a o a � ?. Signatures: <T Notary Acknowledgement Commonwealth of Massachusetts County of Essex North On this 1114-4 3dN 4+�' ca?fi)to Day of Month Year Before me, the undersigned Notary Public, personally appeared John Mabon, Name of Signer proved to me through satisfactory evidence of identification, which was/were Massachusetts License Description of evidence of identification to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he/she signed it voluntarily for its stated purpose. As member of North Andover Conservation Commission City/Town =# WNNA?M.WEDGEPIlBUCSignature of Notary Public iNASSACIg13ETfSJ*I5,2QI6 -b4l?Alf M AL8U e Bog Printed Name of Notary Public Place notary seal and/or any stamp above My Co missio Expires(Date) wpaform7.doc•rev.1107 Page 2 of 3 f i �a :8N Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 7 — Extension Permit for Orders of Conditions 242-1337 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP C. Recording Confirmation The applicant shall record this document in accordance with General Condition 8 of the Order of Conditions (see below), complete the form attached to this Extension Permit, have it stamped by the Registry of Deeds, and return it to the Conservation Commission. Note: General Condition 8 of the Order of Conditions requires the applicant, prior to commencement of work, to record the final Order(or in this case, the Extension Permit for the Order of Conditions) in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, it shall be noted in the Registry's Granter Index under the name of the owner of the land upon which the proposed work is to be done. In the case of registered land, it shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done. Detach page 3 of Form 7 and submit it to the Conservation Commission prior to the expiration of the Order of Conditions subject to this Extension Permit. To: North Andover Conservation Commission Please be advised that the Extension Permit to the Order of Conditions for the project at: Old Salem Village, Salem Turnpike, Route 114 242-1337 Project Location DEP File Number has been recorded at the Registry of Deeds of: Essex North County fora Key Lime, Inc. Property Owner and has been noted in the chain of title of the affected property in accordance with General Condition 8 of the original Order of Conditions on: Date Book Page If recorded land the instrument number which identifies this transaction is: Instrument Number If registered land, the document number which identifies this transaction is: Document Number Signature of Applicant wpaform7.doc•rev.1/07 Page 3 of 3 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 7 — Extension Permit for Orders of Conditions 242-1337 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP A. General Information Important: When filling out 1. Applicant: forms on the Key Lime, Inc. computer, use Name only the tab key to move 1538 Turnpike Street your cursor- Mailing Address do not use the North Andover MA 01845 return key. City/Town State Zip Code Q2. Property Owner(if different): Same Name rerun Mailing Address City/Town State Zip Code B. Authorization The Order of Conditions (or Extension Permit) issued to the applicant or property owner listed above on: January 11, 2006 Date for work at: Old Salem Village, Salem Turnpike, Route 114 Map 1078 Parcel 16 &73 Street Address Assessor's Map/Plat Number Parcel/Lot Number recorded at the Registry of Deeds for: Essex North 10118 281 County Book Page Certificate(if registered land) is hereby extended until: January 11, 2010 Date This date can be no more than 3 years from the expiration date of the Order of Conditions or the latest extension. Only unexpired Orders of Conditions or Extension may be extended. Date the Order was last extended (if applicable): Date Issued by: North Andover 12/4/08 Conservation Commission Date wpaformZdoc•rev.1/07 Page 1 of r ` Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP File Number: WPA Form 7 - Extension Permit for Orders of Conditions 242-1337 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP B. Authorization (cont.) This Order of Conditions Extension must be signed by a majority of the Conservation Commission and a copy sent to the applicant and the appropriate DEP Regional Office (see http://w\A,w.mass.gov/dep/about/region/findyour.htm). Signatures: fF�,X � 1r / �N Notary Acknowledgement Commonwealth of Massachusetts County of Essex North On this '3 �`t of Dam e y'Lne Day Month Year Before me, the undersigned Notary Public, personally appeared Name of Signer proved to me through satisfactory evidence of identification, which was/were Massachusetts License Description of evidence of identification to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he/she signed it voluntarily for its stated purpose. As member of North Andover Conservation Commission Cityrrown DONNA M.WEDGE NOTARY PUBLIC Signature of Notary Public10, `:-EACTH OF MASSACHUSETTS ;mm.Expires Aug.7,2009 Printed Name of Notary Public Place notary seal and/or any stamp above My Com issi n Expires(Date) wpaform7.doc•rev.1/07 Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wetlands DEP File Number: WPA Form 7 — Extension Permit for Orders of Conditions 242-1337 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP C. Recording Confirmation The applicant shall record this document in accordance with General Condition 8 of the Order of Conditions (see below), complete the form attached to this Extension Permit, have it stamped by the Registry of Deeds, and return it to the Conservation Commission. Note: General Condition 8 of the Order of Conditions requires the applicant, prior to commencement of work, to record the final Order(or in this case, the Extension Permit for the Order of Conditions) in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, it shall be noted in the Registry's Granter Index under the name of the owner of the land upon which the proposed work is to be done. In the case of registered land, it shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done. Detach page 3 of Form 7 and submit it to the Conservation Commission prior to the expiration of the Order of Conditions subject to this Extension Permit. To: North Andover Conservation Commission Please be advised that the Extension Permit to the Order of Conditions for the project at: Old Salem Village, Salem Turnpike, Route 114 242-1337 Project Location DEP File Number has been recorded at the Registry of Deeds of: Essex North County for: Key Lime, Inc. Property Owner and has been noted in the chain of title of the affected property in accordance with General Condition 8 of the original Order of Conditions on: Date Book Page If recorded land the instrument number which identifies this transaction is: Instrument Number If registered land, the document number which identifies this transaction is: Document Number Signature of Applicant wpaform7.doc•rev.1/07 Page 3 of 3