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Home My WebLink AboutMiscellaneous - 10 COMMERCE WAY 4/30/2018 (5).� �. 4 0 3�e �° Massachusetts Department of Environmental Protection ILIBureau of Resource Protection - Wetlands WPA Form 8B — Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Number: 7d7 -11A) rroviaea oy ucr 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 A. Project Information Important: When filling out 1. This Certificate of Compliance is issued to: forms on the Vincent Grasso computer, use Name only the tab key to move 10 Commerce Way your cursor - Mailing Address do not use the North Andover MA. 01845 return key. Cityrrown State Zip Code 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: Vincent Grasso Name March 17, 2003 242-1162 Dated DEP File Number 3. The project site is located at: 10 Commerce Way North Andover Street Address Cityrrown Map 35 Parcel 15 & 45 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 8732 amended 9054 279,206 County Book Page Certificate 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: 12/8/06 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 .1 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance 242-1162 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: 77 C. Authorization Issued by: Thi: app Sigr North Andover Conservation Commission Q Date of I suan e wpaform 8b.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 242-1162 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP C. Authorization (cont.) Notary Acknowledgement Commonwealth of Massachusetts County of On this Day Essex North Of 2)e c.-ewl, be✓ a 1906 Month Year before me, the undersigned Notary Public, personally appeared Name of Document 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 City/Town Place notary seal and/or any stamp above Conservation Commission 6e., -;w 4 ignature of Notary Public D62a d M Allcd &I --- Printed Name of Notary Public ? b/0000'? My Commi ion xpires (Date) Sign ture of Notary Public JIF wpafoan 8b.doc • rev. 7/13/04 Page 3 of 4 t; DONNA M. WEDGE NOTARY Pusuc COMMONWEALTH OF MASSACHUSETTS M Comm. Ex i Y pies Aug. 7, 2009 North Andover City/Town Place notary seal and/or any stamp above Conservation Commission 6e., -;w 4 ignature of Notary Public D62a d M Allcd &I --- Printed Name of Notary Public ? b/0000'? My Commi ion xpires (Date) Sign ture of Notary Public JIF wpafoan 8b.doc • rev. 7/13/04 Page 3 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: Ll' WPA Form 8B — Certificate of Compliance 242-1162 Massachusetts Wetlands Protection Act M.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: 242-1162 Project Location DEP File Number Has been recorded at the Registry of Deeds of: for: County Property Owner and has been noted in the chain of title of the affected property on: Date Book 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 Page wpaform 8b.doc • rev. 7113104 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 Acton Charlton Hopkinton DEP Western Region Adams Colrain Hampden Monroe Pittsfield Tyringham 436 Dwight Street Agawam Conway Hancock Montague Plainfield Wales Douglas 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 Spencer Belchertown East Longmeadow Holland New Ashford Savoy Westfield Fax: 413-784-1149 Bemardston Egremonl Holyoke New Marlborough Sheffield Westhampton Littleton Blandford Erving Huntington New Salem Shelburne West Springfield Grafton Brimfield Florida Lanesborough North Adams Shutesbury West Stockbridge Blackstone Buckland Gill Lee Northampton Southampton Whately Charlemont Goshen Lenox Northfield South Hadley Wilbraham Cheshire Granby Leverett Orange Southwick Williamsburg Townsend Chester Granville Leyden Otis Springfield Williamstown Princeton Chesterfield Great Barrington Longmeadow Palmer Stockbridge Windsor Milford Chicopee Greenfield Ludlow Pelham Sunderland Worthington Chelsea 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 Fax: 508-947 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 DEP Northeast Region Brookfield Hopedale Milford Royalston Upton Wakefield 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 6557 Berkley East Bridgewater Hanson Norton Sandwich Westport Fax: 508-947 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 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 • DEP Addresses • rev. 12/4/06 Page 1 of 1 i LidMassachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands 01n,e-'ik, WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. VAIQ - A. General Information From: North Andover 1. Conservation Commission DEP File Number: 242-1162 2. This issuance is for (check one): ❑ Order of Conditions ® Amended Order of Conditions 3. To: Applicant: Vincent a. First Name 10 Commerce l d. Mailing Address North Andover Grasso b. Last Name e. City/Town 4. Property Owner (if different from applicant): a. First Name b. Last Name d. Mailing Address e. City/Town 5. Project Location: 10 Commerce Way a. Street Address Map 35 c. Assessors Map/Plat Number Latitude and Longitude, if known (note: c. Company MA. 01845 f. State g. Zip Code c. Company f. State g. Zip Code North Andover b. City/Town Parcel 15 & 45 d. Parcel/Lot Number electronic filers will click for GIS locator): e. Latitude f. Longitude 6. Property recorded at the Registry of Deeds for (attach additional information if more than one parcel): Essex North 8 a. County 6318 c. Book nn+oma• 7/31/02 2/26/03 b. Certificate (if registered land) 215 d. Page 3/17/03 a. uate Notice of intent I-ueo D. Date vuwic hearing c;ioseo C. Date of Issuance Final Approved Plans and Other Documents (attach additional plan or document references as needed): Proposed Car Wash Facility Permit Site Plan & Stormwater Management Plan (see attached for additional amended plan) Hancock Engineering Associates James R. Comeau ( see attached for b. Prepared By Amendment plan) 2/19/03 (see attached for amendment plan date) 1" = 20' d. Final Revision Date e. Scale (See original Order) f. Additional Plan or Document Title g. Date W It 250 U. TotalPA Fee Paid a. Total Fee Paid b. State Fee Paid c. City/Town Fee Paid wpaform5.doc • rev. 8/10/04 Page 1 of 8 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 B. Findings 1. Findings pursuant to the Massachusetts Wetlands Protection Act: DEP File Number: 242-1162 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 d. ® Private Water Supply e. ❑ Fisheries f. ® Protection of Wildlife 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: ® 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: ❑ 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. ❑ 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) Resource Area Proposed Alteration 3. ❑ Bank a. linear feet 4. ❑ Bordering Vegetated Wetland a. square feet 5. ❑ Land Under a. square feet Waterbodies and Waterways e. cu.yd dredged Permitted Proposed Permitted Alteration Replacement Replacement D. unear Leet c. linear Leet a. linear teet b. square feet c. square feet d. square feet b. square feet c. square feet d. square feet f. cu.yd dredged wpaform5.doe • rev. 8/2/04 Page 2 of 8 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Number: 242-1162 Indicate size under Coastal Beaches and/or Coastal Dunes below B. Findings (cont.) ❑ Proposed Permitted Proposed Permitted Resource Area Alteration Alteration Replacement Replacement 6. ❑ Bordering Land Subject to Flooding a. square feet b. square feet c. square feet d. square feet Cubic Feet Flood a. square feet b. square feet c. c/y nourishmt. d. c/y nourishmt Storage e. cubic feet f. cubic feet g. cubic feet h. cubic feet 7. ❑ Isolated Land Subject a. linear feet b. linear feet to Flooding a. square feet b. square feet ❑ Cubic Feet Flood Storage c. cubic feet d. cubic feet e. cubic feet f. cubic feet 8. ❑ Riverfront area a. total sq. feet b. total sq. feet a. square feet b. square feet Sq ft within 100 ft c. square feet d. square feet ❑ Sq ft between 100-200 ft e. square feet f. square feet a. square feet b. square feet c. square feet d. square feet Coastal Resource Area Impacts: Check all that apply below. (For Approvals Only) s. ❑ Designated Port Indicate size under Land Under the Ocean, below Areas 1o. ❑ Land Under the Ocean a. square feet b. square feet a. square feet b. square feet c. cu.yd dredged d. cu.yd dredged 11. ❑ Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes below 12. ❑ Coastal Beaches a. square feet b. square feet c. c/y nourishmt. d. c/y nourishmt. 13. ❑ Coastal Dunes a. square feet b. square feet c. c/y nourishmt. d. c/y nourishmt 14. ❑ Coastal Banks a. linear feet b. linear feet 15. ❑ Rocky Intertidal Shores a. square feet b. square feet 16. ❑ Salt Marshes a. square feet b. square feet c. square feet d. square feet 17. ❑ Land Under Salt Ponds a. square feet b. square feet c. cu.yd dredged d. cu.yd dredged 18. ❑ Land Containing Shellfish a. square feet b. square feet c. square feet d. square feet 19. ❑ Fish Runs Indicate size under Coastal Banks, inland Bank, Land Under the Ocean, and/or inland Land Under Waterbodies and Waterways, above a. cu.yd dredged b. cu.yd dredged 20. ❑ Land Subject to Coastal Storm Flowage a. square feet b. square feet wpaform5.doc • rev. 8/2104 Page 3 of 8 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Number: 242-1162 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. 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, WA DEP"] "File Number 242-1162 wpaform5.doc • rev. 8/2/04 Page 4 of 8 If you need more space for additional conditions, select box to attach a text document Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Number: 242-1162 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 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. 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. Special Conditions: See attached wpaform5.doc • rev. 8/2/04 Page 5 of 8 AMENDMENT -10 COMMERCE WAY - 242-1162 At the meeting of August 4, 2004, The North Andover Conservation Commission (NACC) voted unanimously to amend the Order of Conditions for 10 Commerce Way (242-1162) to accept the additional (note that the amended plan submitted was not the approved record plan and shall be used as record in reference to the installation of the transformer pad and associated utility connections only and shall not be used in replacement of the previously approved record plan) plan as referenced below showing the approved location of the new transformer pad and associated utilities. Condition #28 of the Order of Conditions shall be amended to include the following additional record plan for the installation of the transformer pad and associated utilities only. Site Plans prepared by: Hancock Engineering Associates 235 Newbury Street Danvers, MA 01923 Entitled: Proposed Car Wash Facility Permit Site Plan 10 Commerce Way North Andover, MA Dated 5/21/04; last revised 7/21/04 Stamped & Signed by Richard F. Doherty, P.E. Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 DEP File Number: 242-1162 D. Findings Under Municipal Wetlands Bylaw or Ordinance 1. Furthermore, the North Andover hereby finds (check one that applies): Conservation Commission 2. ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw specifically: a. Municipal Ordinance or Bylaw b. 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. 3. ® that the following additional conditions are necessary to comply with a municipal ordinance or bylaw: North Andover Wetland Protection Bylaw Chapter 178 a. Municipal Ordinance or Bylaw b. Citation 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. If you need more space for additional conditions, select box to attach a text document c. The special conditions relating to municipal ordinance or bylaw are as follows: See attached 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. X to D 1. Datd of i suance Please indicate the number of members who will sign this form: 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 electrically (s ' Appendix A), and the property owner, if different from applicant. I r Signatures: wpaform5.doc - rev. 8/2104 Page 6 of 8 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 E. Issuance (cont.) Notary Acknowledgement Commonwealth of Massachusetts County of On this Day Essex North DEP File Number: 242-1162 of A+—go() y Month J Year Before me, the undersigned Notary Public, personally appeared S(0+4- 1rA S S'e Name of Document Signer proved to me through satisfactory evidence of identification, which was/were 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. North Andover Conservation Commission As member of City/Town Place notary seal and/or any stamp above This Order is issued to the applicant as follows ❑ by hand delivery on nth. JSiatureof Notary Public 7)1wit1_i /,Y - y Prin ed Name of Notary Public DONNA M. WEDGE NOTARY PUBUC My Comm r p�spug.7 20M Q(by certified mail, return receipt requested, on 8 /o oN Date 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 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 time be sent 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 Actor regulations, the Department has no appellate jurisdiction. Page 7 of 8 wpeform5.doc • rev. 8/2104 LL11Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 G. Recording Information DEP File Number: 242-1162 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 this form 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: Project Location DEP File Number Has been recorded at the Registry of Deeds of: for: County Book Page 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 Page 8 of 8 wpaform5.doc • rev. WIN