HomeMy WebLinkAboutMiscellaneous - 154 MAIN STREET 4/30/2018 (3) '�
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Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 - Order of Conditions 242-1441
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
A. General Information
Important: North Andover
When filling 1. F. Conservation Commission
out forms on
the computer, 2. This issuance is for(check one): a. ® Order of Conditions b. ❑ Amended Order of Conditions
use only the
tab key to 3. To: Applicant:
move your
cursor-do not Tina Daigle
use the return a. First Name b. Last Name
key. CB Richard Ellis Global Corporate
c.Organization
Q 1075 Main Street
d.Mailing Address
Waltham MA 02451
e.City/Town f.State g.Zip Code
4. Property Owner(if different from applicant):
a. First Name b. Last Name
Bank of America Attn: Corporate Real Estate Assessments
c.Organization
101 N. Tryon Street
d. Mailing Address
Charlotte NC 28255
e.City/Town f.State g.Zip Code
5. Project Location:
154 Main Street North Andover
a. Street Address b.City/Town
Map 41 Parcel 33
c.Assessors Map/Plat Number d. Parcel/Lot Number
Latitude and Longitude, if known: 42D-42'-08" 71 D-07'-47"
e. Latitude f. Longitude
6. Property recorded at the Registry of Deeds for(attach additional information if more than one parcel):
Essex North
a.County b.Certificate Number(if registered land)
797 495
c. Book d. Page
9/25/08 10/22/08 11/7/08
7. Dates: a. Date Notice of Intent Filed b. Date Public Hearing Closed c.Date of Issuance
8. Final Approved Plans and Other Documents (attach additional plan or document references as
needed):
Exsiting Conditions Plan, Site Plan
a. Plan Title
Cavanaro Consulting Brendan P. Sullivan, R. P. L. S.
b. Prepared By c.Signed and Stamped by
9/11/08 and revised 10/7/08 & 10/21/08 1" =20'
d. Final Revision Date e. Scale
f.Additional Plan or Document Title g. Date
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Page 1 of 10
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands MassDEP File Number:
WPA Form 5 - Order of Conditions 242-1441
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Findings
1. Findings pursuant to the Massachusetts Wetlands Protection Act:
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:
a. ® 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:
b. ❑ 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.
C. ❑ 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)
3. ❑ Buffer Zone Impacts: Shortest distance between limit of project disturbance and
wetland boundary (if available) a. linear feet
Resource Area Proposed Permitted Proposed Permitted
Alteration Alteration Replacement Replacement
4. ❑ Bank a. linear feet b. linear feet c. linear feet d. linear feet
5. ❑ Bordering Vegetated
Wetland a.square feet b.square feet c.square feet d.square feet
6. ElLand Under Waterbodies a.square feet b.square feet c.square feet d.square feet
and Waterways
e.c/y dredged fc/y dredged
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Page 2 of 10
LlMassachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 - Order of Conditions 242-1441
I Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Findings (cont.)
Resource Area Proposed Permitted Proposed Permitted
Alteration Alteration Replacement Replacement
7. ❑ Bordering Land
Subject to Flooding a.square feet b.square feet c.square feet d.square feet
Cubic Feet Flood Storage e.cubic feet f.cubic feet g.cubic feet h.cubic feet
8. ❑ Isolated Land Subject
to Flooding a.square feet b.square feet
Cubic Feet Flood Storage c. cubic feet d.cubic feet e.cubic feet f.cubic feet
9. ❑ Riverfront area a.total sq.feet b.total sq.feet
Sq ft within 100 ft
c.square feet d.square feet e.square feet f.square feet
Sq ft between 100-200 ft g.square feet h.square feet i.square(feet
q j.square feet
Coastal Resource Area Impacts: Check all that apply below. (For Approvals Only)
1o. ❑ Designated Port Areas Indicate size under Land Under the Ocean, below
11. ❑ Land Under the Ocean a.square feet b.square feet
c.c/y dredged d.c/y dredged
12. ❑ Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes below
13. ❑ Coastal Beaches a.square feet b.square feet c.c/y nourishmt. d.c/y nourishmt.
14. ❑ Coastal Dunes a.square feet b.square feet c.c/y nourishmt. d.c/y nourishmt.
15. ❑ Coastal Banks a. linear feet b.linear feet
16. ❑ Rocky Intertidal Shores a.square feet b.square feet
17. ❑ Salt Marshes
a.square feet b.square feet c.square feet d.square feet
18. ❑ Land Under Salt Ponds a.square feet b.square feet
c.c/y dredged d.c/y dredged
19. El Land Containing
Shellfish a.square feet b.square feet c.square feet d.square feet
20. ❑ Fish Runs Indicate size under Coastal Banks, inland Bank, Land Under the
Ocean, and/or inland Land Under Waterbodies and Waterways,
above
a.c/y dredged b.c/y dredged
21. El Subject to Coastal
Storm Flowage a.square feet b.square feet
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Page 3 of 10
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 - Order of Conditions 242-1441
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
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.
8. 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, "MassDEP")
"File Number
242-1441 "
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Page 4 of 10
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 - Order of Conditions 242-1441
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
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 MassDEP.
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.
18. The work associated with this Order is (i)® is not(2)❑subject to the Massachusetts
Stormwater Policy Standards. If the work is subject to the Stormwater Policy,the following
conditions apply to this work and are incorporated into this Order:
a) No work, including site preparation, land disturbance, construction and redevelopment, shall
commence unless and until the construction period pollution prevention and erosion and
sedimentation control plan required by Stormwater Standard 8 is approved in writing by the issuing
authority. Until the site is fully stabilized, construction period erosion, sedimentation and pollution
control measures and best management practices (BMPs) shall be implemented in accordance with
the construction period pollution prevention and erosion and sedimentation control plan, and if
applicable, the Stormwater Pollution Plan required by the National Discharge Elimination System
Construction General Permit.
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Page 5 of 10
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 - Order of Conditions 242-1441
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. General Conditions Under Massachusetts Wetlands Protection Act (cont.)
b) No stormwater runoff may be discharged to the post-construction stormwater BMPs until written
approval is received from the issuing authority. To request written approval, the following must be
submitted: illicit discharge compliance statement required by Stormwater Standard 10 and as-built
plans signed and stamped by a registered professional engineer certifying the site is fully stabilized;
all construction period stormwater BMPs and any illicit discharges to the stormwater management
system have been removed; and all post-construction stormwater BMPs were installed in accordance
with the plans (including all planting plans) approved by the issuing authority, and have been
inspected to ensure they are not damaged and will function properly.
c) Prior to requesting a Certificate of Compliance, the responsible party (defined in General
Condition 18(e))shall submit to the issuing authority an Operation and Maintenance (O & M)
Compliance Statement for the Stormwater BMPs. This Statement shall identify the responsible party
for implementing the Operation and Maintenance Plan and also state that: 1. "Future responsible
parties shall be notified in writing of their continuing legal responsibility to operate and maintain the
stormwater management BMPs and implement the Pollution Prevention Plan; and 2. The Operation
and Maintenance Plan for the stormwater BMPs is complete and will be implemented upon receipt of
the Certificate."
d) Post-construction pollution prevention and source control shall be implemented in accordance
with the long-term pollution prevention plan section of the approved Stormwater Report and, if
applicable, the Stormwater Pollution Prevention Plan required by the National Discharge Elimination
System Multi-Sector General Permit.
e) Unless and until another party accepts responsibility, the issuing authority shall presume that the
responsible party for maintaining each BMP is the landowner of the property on which the BMP is
located. To overcome this presumption, the landowner of the property must submit to the issuing
authority a legally binding agreement acceptable to the issuing authority evidencing that another entity
has accepted responsibility for maintaining the BMP, and that the proposed responsible party shall be
treated as a permittee for purposes of implementing the requirements of Conditions 18(f) through
18(k)with respect to that BMP. Any failure of the proposed responsible party to implement the
requirements of Conditions 18(f)through 18(k)with respect to that BMP shall be a violation of the
Order of Conditions or Certificate of Compliance. In the case of stormwater BMPs that are serving
more than one lot, the legally binding agreement shall also identify the lots that will be serviced by the
stormwater BMPs. A plan and easement deed that grants the responsible party access to perform the
required operation and maintenance must be submitted along with the legally binding agreement.
f) The responsible party shall operate and maintain all stormwater BMPs in accordance with the
design plans, the Operation and Maintenance Plan section of the approved Stormwater Report, and
the Massachusetts Stormwater Handbook.
g) The responsible party shall:
1. Maintain an operation and maintenance log for the last three years including inspections,
repairs, replacement and disposal (for disposal the log shall indicate the type of material and
the disposal location);
2. Make this log available to MassDEP and the Conservation Commission upon request; and
3. Allow members and agents of the MassDEP and the Conservation Commission to enter and
inspect the premises to evaluate and ensure that the responsible party complies with the
Operation and Maintenance requirements for each BMP set forth in the Operations and
Maintenance Plan approved by the issuing authority.
h) All sediments or other contaminants removed from stormwater BMPs shall be disposed of in
accordance with all applicable federal, state, and local laws and regulations.
i) Illicit discharges to the stormwater management system as defined in 310 CMR 10.04 are
prohibited.
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Page 6 of 10
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 - Order of Conditions 242-1441
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
C. General Conditions Under Massachusetts Wetlands Protection Act (cont.)
j) The stormwater management system approved in the Final Order of Conditions shall not be
changed without the prior written approval of the issuing authority. Areas designated as qualifying
pervious areas for purpose of the Low Impact Site Design Credit shall not be altered without the prior
written approval of the issuing authority.
k) Access for maintenance of stormwater BMPs shall not be obstructed or blocked. Any fencing
constructed around stormwater BMPs shall include access gates. Fence(s) shall be at least six inches
above grade to allow for wildlife passage.
Special Conditions (if you need more space for additional conditions, please attach a text document):
D. Findings Under Municipal Wetlands Bylaw or Ordinance
1. Is a municipal wetlands bylaw or ordinance applicable? ® Yes ❑ No
2. The North Andover hereby finds (check one that applies):
Conservation Commission
a. ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal
ordinance or bylaw specifically:
1. Municipal Ordinance or Bylaw 2. 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.
b. ® that the following additional conditions are necessary to comply with a municipal ordinance or
bylaw:
North Andover Wetland Protection Bylaw Chapter 178
1.Municipal Ordinance or Bylaw 2. Citation
s. 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.
The special conditions relating to municipal ordinance or bylaw are as follows (if you need more space
for additional conditions, attach a text document):
See attached
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DEP FILE#242- 1441
Therefore, the North Andover Conservation Commission(hereafter the"NACC") hereby
finds that the following conditions are necessary, in accordance with the Performance
i
Standards set forth in the State Regulations, the local ByLaw and Regulations, to protect
those interests noted above. The NACC orders that all work shall be performed in
accordance with said conditions and with the Notice of Intent referenced below. 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.
GENERAL CONDITIONS
19. The proposed work includes: Reconstruction and expansion of an existing parking
lot,including the removal of the former drive-thru aisle and installation of a concrete
retaining wall. Reconstruction also includes the installation of a deep sump catch
basin,filtration chamber and recharge units. Slope and buffer-zone restoration are
also approved.
20. The work shall conform to the following (except as noted in the remainder of this
document where revisions may be required):
Notice of Intent filed by: Cavanaro Consulting, Inc.
687 Main Street
Norwell, MA 02061
Received:September 25, 2008
Site Plans prepared by: Cavanaro Consulting
687 Main Street
P.O. Box 5175
Norwell, MA 02061
Dated: 9/11/08 and revised 10/07/08 & 10/21/07
Sheets 1 -4
Report prepared by: Michael Joyce
Cavanaro Consulting, Inc.
Operation& Maintenance
Plan prepared by: Cavanaro Consulting, Inc.
687 Main Street
Norwell, MA 02061
21. The termA licant' as used in this Order der of Conditions shall refer to the owner, any
successor in interest or successor in control of the property referenced in the Notice of
Intent, supporting documents and this Order ofConditions.
The NACC shall be
notified in writing within 30 days of all transfers of title of any portion of property
that takes place prior to the issuance of a Certificate of Compliance.
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DEP FILE #242- 1441
22. The conditions of this decision shall apply to, and be binding upon, the applicant,
owner,its employees and all successors and assigns in interest or control. These
obligations shall be expressed in covenants in all deeds to succeeding owners of
portions of the property.
23. 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.
24. This Order does not grant any property rights or any exclusive privileges;it does not
authorize any injury to private property or invasion of property rights. However, the
NACC, agent of the NACC or the Department of Environmental Protection (DEP)
reserves the right to enter and inspect the property at all reasonable times until a
Certificate of Compliance is issued, to evaluate compliance with this Order of
Conditions, the Act(310 CMR 10.00), the North Andover Wetland ByLaw and
Regulations, and may require any information, measurements, photographs,
observations, and/or materials, or may require the submittal of any data or
information deemed necessary by the NACC for that evaluation. Further, work shall
be halted on the site if the NACC, agent or DEP determines that any of the work is not
in compliance with this Order of Conditions. Work shall not resume until the NACC
is satisfied that the work will comply and has so notified the applicant in writing.
25.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, by-laws
or regulations.
26. The work authorized hereunder shall be completed within three years from the date
of this order.
27. This Order may be extended by the issuing authority for one but not more than two
periods of up to one year each upon application to the issuing authority at least thir
days (30) prior to the expiration date of the Order (Refer to Section 8.3)(p.37)of the
North Andover Wetland Regulations).
28.The NACC reserves the right to amend this Order of Conditions after a legally
advertised public hearing if plans or circumstances are changed or if new conditions
or information so warrant.
29.Where the Department of Environmental Protection(DEP)is requested to make a
determination and to issue a Superseding Order, the Conservation Commission shall
be a party to all agency proceedings and hearings before the Department
30. The following wetland resource area is affected by the proposed work: Buffer Zone to
Bordering Vegetated Wetland (BVW). This resource area is significant to the interests
of the Act and Town ByLaw as noted above and therein. The applicant has not
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DEP FILE #242- 1441
attempted to overcome the presumption of significance of these resource areas to the
identified interests.
31. The NACC agrees with the applicant's delineation of the wetland resource areas on
the site as shown on the plans dated referenced herein.
32. The NACC finds that the intensive use of the upland areas and buffer zone proposed
on this site will cause further alteration of the wetland resource areas. In order to
prevent any alteration of wetland resource areas a twenty five foot(25') No-
Disturbance Zone and a fifty foot NY) No-Construction Zone shall be established
from the edge of the adjacent wetland resource area. The Conservation Administrator
and/or other agents of the NACC do not have the authority to waive these setbacks as
established under the local bylaw. No disturbance of existing grade, soils or
vegetation is permitted in the No-Disturbance zone with the exception of the
approved buffer zone cleanup and restoration as depicted on the herein referenced
Landscape Plan(sheet 3 of 4). (See Section 3.4 &Appendix F of the local Regulations).
33. This document shall be included in all construction contracts, subcontracts, and
specifications dealing with the work proposed and shall supersede any conflicting
contract requirements. The applicant shall assure that all contractors, subcontractors,
and other personnel performing the permitting work are fully aware of the permits
terms and conditions. Thereafter, the contractor will be held jointly liable for any
violation of this Order resulting from failure to comply with its conditions.
34. The owners of the project and their successors in title agree that the Order does not in
itself impose upon the Town any responsibility to maintain the proposed drainage
system and that said Town shall not be liable for any damage in the event of failure.
By acceptance of this Order, the owners agree to indemnify and hold harmless to the
Town and its residents for any damage attributable to alterations undertaken on this
property pursuant to the Order. Issuance of these Conditions does not in any way
imply or certify that the site or downstream areas will not be subject to flooding,
storm damage or any other form of water damage. Maintenance of the drainage
system, if accepted by the Town as part of a public way, becomes the responsibility of
the Town
35. Issuance of these Conditions does not in any way imply or certify that the site or
downstream areas will not be subject to flooding, storm damage or any other form of
water damage.
PRIOR TO CONSTRUCTION
36. No work shall be undertaken until all administrative appeal periods from this Order
have elapsed or, if such an appeal has been filed, until all proceedings before the
Department or Court have been completed.
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DEP FILE#242- 1441
37. This Order shall be recorded by the applicant at the Registry of Deeds immediately
after the expiration of all appeal periods. No work shall be undertaken until the Final
Order 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 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 to be
done. The recording information shall be submitted to the North Andover
Conservation Commission on the form at the end of this Order prior to
commencement of the work. Any Order not recorded by the applicant before work
commences may be recorded by the NACC at the applicant's expense.
38. A signhall
s be displayed at the site not less than two square feet or more than three
square feet in size bearing the words"Massachusetts DEP, File Number 242-1441."
39. Any changes in the submitted plans caused by the applicant, another Board's decision
or resulting from this Order of Conditions must be submitted to the NACC for
approval prior to implementation. If the NACC finds said changes to be significant,
the NACC will call for another public hearing(at the expense of the applicant). Within
21 days of the close of said public hearing the NACC will issue an amended or new
Order of Conditions. Any errors found in the plans or information submitted by the
applicant shall be considered as changes. No work shall begin on a project until
written approval 1-Las been granted by the NACC.
40. It is the responsibility of the applicant, owner, and/or successor(s) to ensure that all
conditions of this Order of Conditions are complied with. The project engineer and
contractors are to be provided with a copy of this Order of Conditions and referenced
documents before commencement of construction.
41. Prior to any work commencing on-site, the applicant shall submit to the NACC for
approval, a detailed sequence of construction(in addition to that provided on Sheet 4
of the approved plans), including the construction of restoration areas and retention
areas, installation of sedimentation/erosion control devices, and re-vegetation to be
completed before other work begins on-site.
42. Prior to any work commencing on-site, the applicant shall submit detailed drawings
of the proposed retaining wall and proposed connections to existing walls to be
designed by a structural engineer. roved Drawings must be a NACC or its
PP b3'
agent prior to the start of construction.
43. Wetland flagging shall be checked prior to start of construction and shall be re-
established where missing. All wetland flagging shall remain visible and enumerated
per the approved plan(s) throughout the life of the project and until a Certificate of
Compliance is issued so that erosion control measures can be properly placed and
wetland impacts can be monitored. The proposed limit of work shall be shall be
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DEP FILE#242- 1441
clearly marked with erosion controls or temporary fencing and shall be confirmed by
the NACC. Such barriers shall be checked and replaced as necessary and shall be
maintained until all construction is complete. Workers should be informed that no
use of machinery, storage of machinery or materials, stockpiling of soil, or
construction activity is to occur beyond this line at any time.
44. A row of staked hay bales backed by trenched siltation fence shall be placed between
all construction areas and wetlands. Due to steep slope conditions on the site,
secondary erosion control, a silt sack(tube type siltation barrier), shall be installed
down gradient of the hay bale and silt fence. The erosion control barriers will be
properly installed and placed as shown on the plans approved and referenced herein
and shall be inspected and approved by the NACC or its agent prior to the start of
construction and shall remain intact until all disturbed areas have been permanently
stabilized to prevent erosion. All erosion prevention and sedimentation protection
measures found necessary during construction shall be implemented at the direction
of the NACC or its agent. The NACC reserves the right to impose additional
conditions on portions of this project to mitigate any impacts which could result from
site erosion, or any noticeable degradation of surface water quality discharging from
the site. For example, installation of erosion control measures may be required in
areas not shown on the plan(s)referenced in this Order of Conditions. Should such
installation be required by the NACC, they shall be installed within 48 hours of the
Commission's request.
45. The applicant shall have on hand at the start of any soil disturbance,removal or
stockpiling, a minimum of 15 hay bales and sufficient stakes for staking these bales (or
an equivalent amount of silt fence, 1 hay bale to equal 3 feet of fence). Said bales shall
be used only for the control of emergency erosion problems and shall not be used for
the normal control of erosion.
46. A check payable to the Town of North Andover shall be provided in the amount of
$3,000 which shall be in all respects satisfactory to Town Counsel, Town Treasurer,
and the NACC, and shall be posted with the North Andover Town Treasurer through
the NACC before commencement of work. Said deposit of money shall be
conditioned on the completion of all conditions hereof, shall be signed by a party or
parties satisfactory to the NACC, and Town Counsel, and shall be released after
completion of the project; provided that provisions, satisfactory to the NACC, have
been made for performance of any conditions which are of continuing nature. The
applicant may propose a monetary release schedule keyed to completion of specific
portions of the project for the NACC's review and approval. This condition is issued
under the authority of the local ByLaw.
47. The applicant shall be responsible for placing signs on each parcel, where there is
more than one(1) lot, designating the applicable lot number as depicted on the plans
approved and referenced herein
48. The applicant shall designate a Wetland Scientist(or other environmental professional
as approved by the NACC or its agent) as an"Erosion Control Monitor" to oversee
CAWinword100C1boilerl.doc 5 NACC 11/6/2008
DEP FILE#242- 1441
any emergency placement of controls and regular inspection or replacement of
sedimentation control devices. The name and phone number of the erosion control
monitor must be provided to the NACC in the event that this person has to be
contacted, due to an emergency at the site, during any 24-hour period, including
weekends. Proof of the retained monitor must be submitted to the Conservation
Department on letterhead by the retained consulting firm. This person shall be given
the authority to stop construction for erosion control purposes. The erosion control
monitor will be required to inspect all such devices and oversee cleaning and the
proper disposal of waste products. Cleaning shall include removal of any entrapped
silt At least once during each week in which construction activities occurs on-site and
for as long thereafter as ground remains unstabilized, the applicant shall submit a
written report from the"Erosion Control Monitor" to the NACC certifying that, to the
best of his/her knowledge and belief based on a careful site inspection, all work is
being performed in compliance with this Order of Conditions and that approved
setbacks are being adhered to. The erosion control monitor must visually inspect all
sedimentation/erosion control measures and assume responsibility for their
maintenance on a weekly basis and that they are functioning as intended. In addition,
all wetland resource areas must be visually inspected for siltation, turbidity, and/or
other water quality impacts.
49. Prior to construction, the applicant shall permanently mark the edge of the"25' No-
Disturbance Zone" with four (4) signs or markers spaced evenly every 25 feet
incorporating the following text "Protected Wetland Resource Area". This will
designate their sensitivity and assure no further inadvertent encroachment into the
wetland. These permanent markers are subject to review and approval by the NACC.
The applicant shall instruct all agents to explain these markers to
buyers/lessees/landscapers and all persons taking over the property from the
applicant These markers shall remain posted and be replaced as necessary in
perpetuity.
50. The applicant and/or the legal owner of that portion of land upon which these Orders
of Conditions have been placed shall provide to the NACC prior to transferring, or
assigning any portion of said land to another party, subject to said Orders of
Conditions, the"Compliance Certification Form Affidavit' attached via"Appendix
A" signed under the pains and penalties of perjury, stating that said applicant and/or
owner has read these Orders of Conditions and is in compliance with each and every
condition. This document shall apply to each of the conditions referenced herein and
shall be provided to the Conservation Department at least five(5) business days prior
to the closing of said land transaction.
51.Once these above mentioned pre-construction requirements are complete, the
applicant shall contact the Conservation Office prior to site preparation or
construction and shall arrange an on-site conference with an NACC representative,
the environmental monitor, the contractor, the engineer, and the applicant to ensure
that all of the Conditions of this Order are understood. This Order shall be included
in all construction contracts, subcontracts, and specifications dealing with the work
CAWinv"d\00C\boilerl.doc 6 NACC 11/6/2008
DEP FILE#242- 1441
proposed and shall supersede any conflicting contract requirements. The applicant
shall assure that all contractors, subcontractors and other personnel performing the
permitted work are fully aware of the permit's terms and conditions. Thereafter, the
contractor will be held jointly liable for any violation of this Order of Conditions
resulting from failure to comply with its conditions. The applicant or contractor shall
notify the NACC in writing of the identity of the on-site construction supervisor hired
to coordinate construction and to ensure compliance with this Order. A reasonable
period of time shall be provided as notice of the pre-construction meeting (e.g. 72
hours).
STORMWATER MANAGEMENT CONDITIONS
52. All construction and post-construction stormwater management shall be conducted in
accordance with supporting documents submitted with the Notice of Intent:, the
Department of Environmental Protection Stormwater Management Policy and as
approved by the NACC in this Order of Conditions.
53. All stormwater best management practices shall be maintained as specified in the
Operation and Maintenance Plan submitted with the Notice of Intent and
incorporated in the Order of Conditions. Evidence of maintenance of the stormwater
management system shall be provided to the NACC on an annual basis by a
Registered Professional Civil Engineer. The first report shall be submitted to the
NACC one year after the first stormwater structure goes on-line and annual reports
must continue to be submitted in perpetuity. Maintenance bills submitted by cleaning
contractors (catch basins,stormcepters,etc.)shall be submitted with annual
engineering reports.
M.There shall be no increase in the post development discharges from the storm
drainage system or any other changes in post development conditions that alter the
post development watershed boundaries as currently depicted in the Notice of Intent
and approved by this Order of Conditions, unless specifically approved in writing by
the Commission
55. Water quality in down gradient BVW's shall not differ significantly following
completion of the project from the pre-development conditions. There shall be no
sedimentation into wetlands or water bodies from discharge pipes or surface runoff
leaving the site.
56. The applicants, owners, and their successors and assignees, shall maintain all culverts,
collections basins, traps, outlet structures, subsurface storage areas, and other
elements of the drainage system, unless put into an easement to the Town of North
Andover, in order to avoid blockages and siltation which might cause failure of the
system and/or detrimental impacts to on-sine or off-sine resource areas, and shall
maintain the integrity of vegetative cover on the site.
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DEP FILE#242- 1441
DURING CONSTRUCTION
57. IMPORTANT: Immediately upon completion of the retaining wall, and prior to
further construction activities associated with the site, the applicant shall complete a
plan prepared by a Registered Professional Land Surveyor of the Commonwealth
(R.P.L.S.)which accurately depicts the wall location and it's proximity to wetland
resource areas as approved under this Order of Conditions. Said plan shall be
submitted to the Conservation Administrator for approval. [Failure to comply may
result in a stop work order for the site.]
58. Upon beginning work, the applicant shall submit written progress weekly reports
detailing what work has been done in or near resource areas, and what work is
anticipated to be done over the next period. This will update the construction
sequence.
59. The Erosion Control Monitor shall be on site during and or following a major storm
event of 1 inch of rain or greater to ensure that soils remain stable, erosion controls are
adequate and secure, and that all BM7s are adequately functioning.
60. Installation of a fence along the southern property boundary and outside of the 25-
foot No Disturbance Zone is permitted.
61.All catch basins shall contain oil/gasoline traps, and it shall be a continuing condition
of this order, even after a Certificate of Compliance is issued, that the oil/gasoline
traps in the catch basins be maintained. All catch basins shall be free of all
accumulated silt and debris before a Compliance is issued and the owner or his/her
agent shall so specify in the request for Compliance.
62. No de-watering activities are approved under this Order of Conditions. If emergency
de-watering requirements arise, the applicant shall submit a contingency plan to the
Commission for approval,which provides for the pumped water to be contained in a
settling basin, to reduce turbidity prior to discharge into a resource area.
63. Any fill used in connection with this project shall be clean fill,containing 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 on any
of the foregoing.
64. No exposed.area shall remain unfinished for more than thirty (30) days, unless
approved by the NACC.
65. No re-grading in the buffer zone shall have a slope steeper than 2:1 (horizontal:
vertical). Slopes of steeper grade shall be rip-rapped to provide permanent
stabilization.
CAWinw0rd\000\boi1er1.doc 8 NACC 11/6/2008
DEP FELE #242 - 1441
66. There shall be no stockpiling of soil or other materials within fifty (50) feet of any
resource area.
67. Washings from concrete trucks, or surplus concrete, shall not be directed to, any
drainage system, or wetland resource area.
68. All waste generated by, or associated with, the construction activity shall be contained
within the limit of work, and away from any wetland resource area. There shall be no
burying of spent construction materials or disposal of waste on the site by any other
means. The applicant shall maintain dumpsters (or other suitable means) at the site
for the storage and removal of such spent construction materials oft-site. However, no
trash dumpsters will be allowed within 50' of areas subject to protection under the Act
or local ByLaw.
69.Accepted engineering and construction standards and procedures shall be followed in
the completion of the project.
70. During and after work on this project, there shall be no discharge or spillage of fuel,
or other pollutants into any wetland resource area. If there is a spill or discharge of
any pollutant during any phase of construction the NACC shall be notified by the
applicant within one(1) business day. No construction vehicles are to be stored
within 100 feet of wetland resource areas, and no vehicle refueling,equipment
lubrication or maintenance is to be done within 100 feet of a resource area.
71. All restoration and slope stabilization plantings shall be protected from deer browse
for a period of 2 years.
Nam
AFTER CONSTRUCTION
72. No underground storage of fuel oils shall be allowed on any lot within one-hundred
(100)feet of any wetland resource area. This condition shall survive this Order of
Conditions and shall run with the title of the property. This condition is issued under
the authority of the Town's Wetland protection ByLaw.
73. Fertilizers utilized for landscaping and lawn care shall be slow release, low-nitrogen
types (<5%), and shall not be used within 25 feet of a resource area. Pesticides and
herbicides shall not be used within 100 feet of a wetland resource area. This condition
shall survive this Order of Conditions and shall run with the title of the property.
This condition is issued under the authority of the Town's Wetland Protection ByLaw
and shall remain in perpetuity.
74. No road salt, sodium chloride, or other de-icing chemicals shall be used on paved
surfaces, and any arrangement for snow removal shall so stipulate due to the
importance of the site and wetlands. Permanent signs designating"No-Salt Zone"
and "No-Snow Stockpiling Zones" shall be displayed in prominent locations.
CAWinwoW\00Cfti1er1,doc 9 NACC 11/6/2008
DEP FILE #242- 1441
75. Upon completion of construction and grading, all disturbed areas located outside
resource areas shall be stabilized permanently against erosion. This shall be done by
loaming and seeding according to NRCS standards. Stabilization will be considered
complete once full vegetative cover has been achieved.
76. Upon approved site stabilization by Conservation staff, the erosion controls shall be
removed and properly disposed of and all exposed unvegetated areas shall be seeded.
77. A qualified wetland scientist shall monitor the restoration areas for two full growing
seasons following construction of said restoration areas. Yearly progress reports and
photographs shall be prepared and submitted to the Conservation Department that
describe the survivability, health and vigor of the restoration areas. Reports shall be
submitted by November 15 of each year. If at the end of the two growing seasons,
overall success of restoration activities is not achieved, the NACC reserves the right to
require additional mitigation measures.
78. Upon completion of the project the applicant shall submit the following to the
Conservation Commission as part of a request for a Certificate of Compliance:
a. WPA Form 8A-"Request for a Certificate of Compliance."
b. A letter from the applicant requesting a Certificate of Compliance.
c. The name and address of the current landowner.
d. The name and address of the individual/trust or corporation to whom the
compliance is to be granted.
e. The street address and assessor's map/parcel number for the project.
f. The DEP file number.
g. A written statement from a Registered Professional Civil Engineer(and/or
Registered Professional Land Surveyor) of the Commonwealth certifying that the
work has been conducted as shown on
the plan(s) and documents referenced
above, and as conditioned by the Commission.
h. An"As-Built' plan prepared and signed and stamped by a Registered Professional
Civil Engineer (and/or Registered Professional Land Surveyor) of the
Commonwealth,for the public record. This plan will include:
➢ "As-Built" post-development elevations of all drainage& stormwater
management structures constructed within 100 feet of any wetland resource
area. NOTE: If portions of the stormwater systems exist partially within
the Buffer Zone than the entire structure must be depicted to accurately
verify compliance.
➢ "As-Built" post-development elevations and grades of all filled or altered
wetland resource areas including the encompassing buffer zone which is
regulated as a resource area under the local Wetland Protection Bylaw.
CAWinwotdd\OOC\boilerl.doc 10 NACC 11/6/2008
DEP FILE#242- 1441
➢ Distances from structures to wetland resource areas. Structures include(but
are not limited to) septic systems, additions, fences, sheds, stone walls,
pools, retaining walls, subsurface utilities and decks.
➢ A line showing the limit of work and the extent of existing erosion control
devices. "Work" includes Apy disturbance of soils or vegetation.
➢ Location of all subsurface utilities entering the property.
78. The following special conditions shall survive the issuance of a Certificate of
Compliance(COC)for this project:
➢ 25' No-Disturbance Zone and a 50' No-Construction Zone shall be
established from the edge of adjacent wetland resource areas except in those
locations approved under DEP#242-1441. Future work within 100' of
existing wetland resource areas will require a separate filing with the
NACC. The Conservation Administrator and/or other agents of the NACC
do not have the authority to waive these setbacks as established under the
local ByLaw;
Resource Area Markers (Condition#49);
A Maintenance of catch basins (Condition #61);
➢ Discharge or spillage of pollutants (Condition #70);
➢ Prohibition of underground fuels (Condition #72);
➢ Limitations on the use of fertilizers, herbicides, road salts, de-icing
compounds and pesticides (Conditions #73 & 74).
➢ The attached "Stormwater Operations and Management Plan", including
Best Management Practices. No additional filings will be required to
conduct maintenance of the above referenced system and plan. Evidence of
maintenance of the stormwater management system shall be provided to
the NACC on an annual basis in perpetuity(Condition#53).
CAWinword\00C\boilerl.dm 11 NACC 11/6/2008
I
Stormwater Operation and Maintenance Plan and Illicit Discharge
Statement
Proposed Reconstruction and Expansion to the Existing Parking
Area for Bank of America
154 Main Street, North Andover, MA 01845
Stormwater Management System's Owner: Bank of America
System Owner's Address: 154 Main Street, North Andover, MA 01845
Party responsible for Operations and Maintenance:Bank of America
It is most important for a drainage system to be maintained in order for it to work properly. The
following is an Operation and Maintenance plan to'upkeep the existing non-structural and
structural best performance practices as outlined in the Massachusetts Department of
Environmental Protection's Stormwater Management Policy.
Operation and Maintenance Plan During Construction:
Sediment and.Erosion Control
A silt fence shall be installed along a section of the proposed work as shown in the Notice of
Intent Plan submitted to the Conservation Commission. Catch basins shall be protected from
siltation via the use of haybales.
Infiltration Bed
Per MA DEP Stormwater Guidelines the following work shall be done to stabilize the site prior to
installing the subsurface structures:
Do not allow runoff from any disturbed areas on the site to flow to the
subsurface structures.
Rope off the area where the subsurface structures are to be placed.
Accomplish any required excavation with equipment placed just outside the
area. If the size of the area intended for exfiltration is too large to
accommodate this approach, use trucks with low-pressure tires to minimize
compaction. Do not allow any other vehicles within the area to be excavated.
Keep the area above and immediately surrounding the subsurface system
roped off to all construction vehicles until the final top surface is installed.
At no time shall the area for the infiltration system be used as a temporary
sediment basin. Stockpiles shall be placed away from the subsurface
infiltration system and sedimentation fences shall be placed around the
perimeter of the infiltration area to prevent the accumulation of sediment within
the native soils.
Operation and Maintenance Plan After Construction:
Deep Sump Catch Basin Cleaning
Inspect or clean deep sump basins at least four times per year and at the end of the foliage and
snow removal seasons. Sediments must also be removed four times per year or whenever the
depth of the deposits is greater than or equal to one half the depth from the bottom to the invert
of the lowest pipe in the basin. Vacuum trucks are preferable in the removal of the sediment.
All catch basins shall be cleaned and inspected in late winter or early spring after the snow
melts. Inspections should include the frame and grate, pipe, and structure itself for damage
and/or repair.
Stormfilter Unit:
Inspect and clean inlets as necessary after every major storm. At a minimum, inspect the oil grit
separator monthly and clean it out twice per year. Polluted water or sediments removed from
the oil/grit separator shall be disposed of in accordance with all applicable local, state and
federal laws and regulations.
Subsurface Infiltration System:
t
Inspect inlets at least twice a year. Remove any debris or sediment that may be clogging the
system.
Pipes and Drainage Manhole
Inspect or clean the drainage manhole at least twice per year. In addition to inspecting the drain
manhole, all pipe inlets and outlets shall be inspected to ensure that they are free of all
obstructions and that all required hoods are intact.
Parking Lot Sweeping
The parking lot area shall be swept a minimum of 2 times peryear.
Illicit Discharges:
At no time will the owner or any other individual utilize the stormwater management system for
any purpose other than its intended use. The stormwater management system as shown on the
attached site plan at no time shall receive discharges other than stormwater, this includes
"water water discharges and discharges of stormwater contaminated by contact with process
wastes, raw materials, raw materials, toxicollutants hazardous substances,s, oil or grease."
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands MassDEP File Number:
WPA Form 5 - Order of Conditions 242-1441
1 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
E. Issuance
This Order is valid for three years, unless otherwise specified as a special 11)71,0�
condition pursuant to General Conditions#4, from the date of issuance. 1. Date of issuance
sThisPlease indicate the number of members who will sign this form: 1-5-
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 electronicall , and the property owner, if different
from applicant.
Signatures: � / !.
r
Notary Acknowledgement
Commonwealth of Massachusetts County of Essex North
On this S-A4Aavembeh Daae
Day of Month Year
Before me, the undersigned Notary Public, S A,) /yf bolJ
personally appeared Name of Document 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
City/Town Conservation Commission
le
DONNA M.WED:HE0TTJS
' ', ;�_.•_ NOTARY PUBLIC
F' COMMONWEALTH OF IAASSAC
My Comm.Expires Aug. Signature of Notary Public
Printed Name of Notary Public
Place notary seal and/or any stamp above --ply
My Commissio Expires( ate)
This Order is issued to the applicant as follows:
❑ by hand delivery on Zby certified mail, return requested,receipt re
p q , on
Date
Date
wpaform5.doc• rev.2/27/08
Page 8 of 10
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands MassDEP File Number:
WPA Form 5 - Order of Conditions 242-1441
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
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 MassDEP 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 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. Any appellants seeking to appeal the Department's
Superseding Order associated with this appeal will be required to demonstrate prior participation in the review
of this project. Previous participation in the permit proceeding means the submission of written information
to the Conservation Commission prior to the close of the public hearing, requesting a Superseding Order
or Determination, or providing written information to the Department prior to issuance of a Superseding
Order or Determination.
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 Act or regulations, the Department has no appellate jurisdiction.
Section G. Recording Information is available on the following page.
wpaform5.doc• rev.2127108
Page 9 of 10
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands MassDEP File Number:
I
WPA Form 5 - Order of Conditions 242-1441
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
G. Recording Information
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
this page 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:
154 Main Street 242-1441
Project Location MassDEP File Number
Has been recorded at the Registry of Deeds of:
Essex North
County Book Page
for:
Property Owner
and has been noted in the chain of title of the affected property in:
Book Page
9
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
wpaform5.doc• rev.2/27/08
Page 10 of 10
DEP FILE#242- 1441
APPENDIX A -AFFIDAVIT
I, on oath do hereby depose and state:
(authorized agent applicant and(or cement owner)
(PLEASE CHECK AT LEAST ONE BLOCK)
1. I am the of
(position with applicant) (applicant name or company name)
the applicant upon whom Order of Conditions
have been placed upon by (DEP or NACC number)
the North Andover Conservation Commission.
fir/or
2. 1 am the of
(position with owner) (owner name)
the owner upon whose land Order of Conditions
have been placed up by (DEP or NACC number)
the North Andover Conservation Commission.
3. I hereby affirm and acknowledge that I have received said Order of Conditions
and have read the same and understand each
(DEP File#) and every condition which has been set forth
in said Order of Conditions.
4. I hereby affirm and acknowledge that on this day of 19
I inspected said property together with any and all improvements which have
been made to the same and hereby certify that each and every condition set
forth in Order of Conditions are presently in compliance.
(DEP File#)
5. I hereby affirm and acknowledge that this document will be relied upon by the
North Andover Conservation Commission as well as any potential buyers of
saidproperty which is subject to said Order of Conditions
(DEP File#
Signed under the pains and penalties of perjury this day of 19
(Signature-authorized agent of applicant or owner
C:\Winword\00C\boi1er1.doc 12 NACC 11/6/2008