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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
A. Project Information
1. This Certificate of Compliance is issued to:
Kellem & Kellem
Name
100 Recreation Park Drive
DEP File Number:
picot
242-683
Provided by DEP
Mailing Address
Hingham MA 02043
City/Town State Zip Code
2. This Certificate of Compliance -is issued for work regulated by a final Order of
Conditions issued to:
Summer Street Realtv Trust
3.
Name
27, 1994
242-683
Dated DEP File Number
The project site is located at:
15 Weyland Circle (Lot 9A) North Andover
Street Address City/Town
Map 65 Parcel 234
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
4007 241
Book Page
Certificate
4. A site inspection was made in the presence of the applicant, or the applicant's agent,
on:
6/7/10
Date
wpafrm8b.doe • rev. 12/23/09 0
WPA Form 8B, Certificate of Compliance • Page 1 of 3
ILIMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands
WPA Form 8B P�ertificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Certification
Check all that apply:
DEP File Number:
PC. vC
242-683
Provided by.DEP
❑ 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:
PCOC for 15 Weyland Circle (Lot 9A) only.
❑ 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Conditions has lapsed and is therefore no longer valid.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:
45
C. Authorization
Issued by: /
North Andover C1 b
Conservation Commission Date of Is uance
This Certificate must be signed by a majority of the Conservation Commission and a
copy sent to the applicant and appropriate DEP Regional Office (See
hftp://www.mass.gov/dep/about/region/findvour.htm).
Signatures:
wpafrm8b.doc • rev. 12/23/09
WPA Form 8B, Certificate of Compliance • Page 2 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
z;A to
Lil WPA Form 8B L'Certificate of Compliance PC 06
242-683
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:
15 Weyland Circle (Lot 9A) 242-683
Project Location DEP File Number
Has been recorded at the Registry of Deeds of:
County
for:
North
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
wpafrm8b.doc - rev. 12/23/09
WPA Form 8B, Certificate of Compliance - Page 3 of 3