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L7Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 8B — Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
DEP File Number:
WO-1Onl
ivv U uy ver
Street Address
Map 107D
Assessors Map/Plat Number
City/Town
Parcel 14
Parcel/Lot Number
the final Order of Condition was recorded at the Registry of Deeds for:
Property Owner (if different)
Essex North
County
Certificate
8624
Book
4. A site inspection was made in the presence of the applicant, or the applicant's agent, on:
6/23/09
nate
B. Certification
uy.
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
computer,
Eugene P. Willis
use
Name
only the tab
key to move
76 Boston Hill Road
your cursor -
Mailing Address
do not use the
North Andover
MA 01845
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:
Same
Name
June 26, 2003
242-1203
Dated
DEP File Number
3. The project site is located at:
10 Stiles Street
North Andover
Street Address
Map 107D
Assessors Map/Plat Number
City/Town
Parcel 14
Parcel/Lot Number
the final Order of Condition was recorded at the Registry of Deeds for:
Property Owner (if different)
Essex North
County
Certificate
8624
Book
4. A site inspection was made in the presence of the applicant, or the applicant's agent, on:
6/23/09
nate
B. Certification
uy.
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
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance
242-1203
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:
71
C. Authorization
Issued by:
North Andover
Conservation Commission
This Certificate must be signed by a majority of th
applicant and appropriate DEP Regional Office (IS
Signatures: 110 �( / r"" �-�
wpaform 8b.doc • rev. 7/13/04
k S -16L?
Dat of !ss ance
Page 2 of 4
LI(Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 8B — Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. Authorization (cont.)
Notary Acknowledgement
Commonwealth of Massachusetts County of
On this
Day
Essex North
Of
Month
before me, the undersigned Notary Public, personally appeared
Name of Document Signer
proved to me through satisfactory evidence of identification, which was/were
Massachusetts License
Description of evidence of identification
Year
DEP File Number:
242-1 2ni
rroviaea Dy utr
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
DONNA M. WEDGE
NOTARY PUBUC
COIAAIONWm UPI=
OF MASSACHUSETTS
My ComPI= Aug. 7, 2009
North Andover
City/Town
Place notary seal and/or any stamp above
Conservation Commission
Siature of Notary Public 7�
Printed Name of Notary Public
O" *7� GO
My Commissio xpires (Date)
Signature of Notary Public
wpaform 8b.doc • rev. 7/13/04
Page 3 of 4
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance L1
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 242-1203
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:
10 Stiles Street 242-1203
Project Location DEP File Number
Has been recorded at the Registry of Deeds of:
Essex North
County
fo r:
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. 7/13/04 Page 4 of 4
ILIMassachusetts 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
A g y
Agawam Conwayancock
Shirley
Montague
Plainfield
Wales
Suite 402
Alford Cummington
Amherst Dalton
Hatfield
Monterey
Richmond
Ware
Springfield, MA 01103
Ashfield Deerfield
Hawley
Heath
Montgomery
Monson
Rowe
Warwick
Phone: 413-784-1100
Becket Easthampton
Hinsdale
Mount Washington
Russell
Sandisfield
Washington
Wendell
Fax: 413-784-1149
Belchertown East Longmeadow
Holland
New Ashford
Savoy
Westfield
Sterling
Bemardston Egremont
Blandford Erving
Holyoke
Huntington
New Marlborough
Sheffield
Westhampton
Oxford
Paxton
Brimfield Florida
Lanesborough
New Salem
North Adams
Shelburne
Shutesbury
West Springfield
West Stockbridge
Marlborough
Buckland Gill
Lee
Northampton
Southampton
Whately
Harvard
Charlemont Goshen
Cheshire Granby
Lenox
Leverett
Northfield
Orange
South Hadley
Wilbraham
Boxborough
Chester Granville
Leyden
Otis
Southwick
Springfield
Williamsburg
Williamstown
Chesterfield Great Barrington
Longmeadow
Palmer
Stockbridge
Windsor
Winthrop
Chicopee Greenfield
Clarksburg Hadley
Ludlow
Middlefield
Pelham
Sunderland
Worthington
Upton
Woburn
Peru
Tolland
DEP Central Region
Acton
Charlton
Hopkinton
Millbury
Rutland
Uxbridge
627 Main Street
Ashbumham
Clinton
Hubbardston
Millville
Shirley
Warren
Worcester, MA 01608
Ashby
Athol
Douglas
Hudson
New Braintree
Shrewsbury
Webster
Phone: 508-792-7650
Auburn
Dudley
Dunstable
Holliston
Lancaster
Northborough
Northbridge
Southborough
Southbridge
Westborough
Fax: 508-792-7621
Ayer
East Brookfield
Leicester
North Brookfield
Spencer
West Boylston
West Brookfield
TDD: 508-767-2788
Barre
Bellingham
Fitchburg
Gardner
Leominster
Oakham
Sterling
Westford
Berlin
Grafton
Littleton
Lunenburg
Oxford
Paxton
Stow
Sturbridge
Westminster
Winchendon
Blackstone
Groton
Marlborough
Pepperell
Sutton
Worcester
Bolton
Harvard
Maynard
Petersham
Templeton
Yarmouth
Boxborough
Hardwick
Medwav
Phillipston
Townsend
Wilmington
Winchester
Boylston
Holden
Mendon
Princeton
Tyngsborough
Winthrop
Brookfield
Hopedale
Milford
Royalston
Upton
Woburn
DEP Southeast Region
Abington
Dartmouth
Freetown
Mattapoiselt
Provincetown
Tisbury
20 Riverside Drive
Acushnet
Dennis
Gay Head
Middleborough
Raynham
Truro
Lakeville, MA 02347
Attleboro
Avon
Dighton
Gosnold
Nantucket
Rehoboth
Wareham
Phone: 508-946-2700
Barnstable
Duxbury
Eastham
Halifax
Hanover
New Bedford
Rochester
Wellfleet
Fax: 508-947-6557
Berkley
East Bridgewater
Hanson
North Attleborough
Norton
Rockland
Sandwich
West Bridgewater
TDD: 508-946-2795
Bourne
Easton
Harwich
Norwell
Scituate
Westport
West Tisbury
Brewster
Edgartown
Kingston
Oak Bluffs
Seekonk
Whitman
Bridgewater
Fairhaven
Lakeville
Orleans
Sharon
Wrentham
Brockton
Carver
Fall River
Mansfield
Pembroke
Somerset
Yarmouth
Burlington
Falmouth
Marion
Plainville
Stoughton
Wilmington
Winchester
Chatham
Foxborough
Marshfield
Plymouth
Swansea
Winthrop
Chilmark
Franklin
Mashpee
Plympton
Taunton
Woburn
DEP Northeast Reg ion
Amesbury
Chelmsford
Hingham
9
Merrimac
Quincy
Wakefield
1 Winter Street
Andover
Chelsea
Holbrook
Methuen
Randolph
Walpole
P
Boston, MA 02108
Arlington
Ashland
Cohasset
Hull
Middleton
Reading
Waltham
Phone: 617-654-6500
Bedford
Concord
Danvers
Ipswich
Lawrence
Millis
Milton
Revere
Watertown
Fax: 617-556-1049
Belmont
Dedham
Lexington
Nahant
Rockport
Rowley
Wayland
Wellesley
TDD: 617-574-6868
Beverly
Billerica
Dover
Lincoln
Natick
Salem
Wenham
Boston
Dracut
Essex
Lowell
Lynn
Needham
Salisbury
West Newbury
Boxford
Everett
Lynnfield
Newbury
Newburyport
Saugus
Sherbom
Weston
Westwood
Braintree
Brookline
Framingham
Georgetown
Malden
Manchester -By -The -Sea
Newton
Norfolk
Somerville
Weymouth
Burlington
Gloucester
Marblehead
North Andover
Stoneham
Sudbury
Wilmington
Winchester
Cambridge
Canton
Groveland
Medfield
North Reading
Swampscott
Winthrop
Carlisle
Hamilton
Haverhill
Medford
Melrose
Norwood
Tewksbury
Woburn
Peabody
Topsfield
wpaform8b.doc • DEP Addresses • rev. 6/12/09
Page 1 of 1