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Home My WebLink AboutMiscellaneous - 17 WILDWOOD CIRCLE 4/30/2018 (4)Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance 242-1213 LI) Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 1 Provided by DEP A. Project Information Important: When filling out 1. This Certificate of Compliance is issued to: forms on the Paula Klipfel computer, use Name only the tab key to move 17 Wildwood Circle your cursor - Mailing Address do not use the North Andover MA 01845 return key. Cityfrown State Zip Code r� 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: Paula Klipfel Name r October 22, 2003 242-1213 Dated DEP File Number 3. The project site is located at: 17 Wildwood Circle North Andover Street Address City/Town Map 105D Parcel 64 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 8409 259 County Book Page Certificate 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: 9/8/09 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. 7/13104 Page 1 of 4 fA Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance 242-1213 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 The Order of Conditions has lapsed and is therefore no longer valid.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: C. Authorization Issued by: North Andover Conservation Commission lel -sc be Dat of Issu nce 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 Attachment). Signatures: .V / )w � GL wpaform 8b.doc • rev. 7/13/04 Page 2 of 4 I ,k Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 242-1213 LI( 3 Provided by DEP C. Authorization (cont.) Notary Acknowledgement Commonwealth of Massachusetts County of Essex North On this C%G T �,�,� d 00c? Day Of Month Year before me, the undersigned Notary Public, personally appeared John Mabon, 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 Conservation Commission Cityfrown --\\'-- Ft WEDGE = u - Place notary seal and/or any stamp abol- Signature of Notary Public 10 Prined Name of Notary Public 7 My Commission Ex ares (Daher) Signature of Notary Public wpaform Bb.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 Li Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 242-1213 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: 17 Wildwood Circle 242-1213 Project Location DEP File Number Has been recorded at the Registry of Deeds of: for: Essex North t;ounty Paula Klipfel 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 4 L 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 Chariton Hopkinton DEP Western Region Adams Colrain Hampden Monroe Pittsfield Tyringham 436 Dwight Street Agawam Conway Hancock Montague Plainfield Wales Suite 402 Alford Cummington Hatfield Monterey Richmond Ware 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 Fax: 413-784-1149 Belchertown East Longmeadow Holland New Ashford Savoy Westfield Oakham Bernardston Egremont 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 Chademont Goshen Lenox Northfield South Hadley Wilbraham Cheshire Granby Levereft 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 Dartmouth Clarksburg Hadley Middlefield Peru Tolland 20 Riverside Drive DEP Central Region Acton Chariton Hopkinton Millbury Rutland Uxbridge 627 Main Street Ashbumham Clinton Hubbardston Millville Shirley Warren Worcester, MA 01608 Ashby Athol Douglas Hudson New Braintree Shrewsbury Webster 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 TDD: 508-767-2788 Barre Fitchburg Leominster Oakham Sterling Westford 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 Brookfield Hopedale Milford Royalston Upton DEP Southeast Region Abington Dartmouth Freetown Mattapoisett Provincetown Tisbury 20 Riverside Drive Acushnet Dennis Gay Head Middleborough Raynham Truro Lakeville, MA 02347 Attleboro Dighton Gosnold Nantucket Rehoboth Wareham Avon Duxbury Halifax New Bedford Rochester Wellfleel Phone: 508-946-2700 Barnstable Eastham Hanover North Aftleborough Rockland West Bridgewater Fax: 508-947-6557 Berkley East Bridgewater Hanson Norton Sandwich Westport TDD: 508-946-2795 Bourne Easton Harwich Norwell Scituate West Tisbury 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 Boston, MA 02108 Arlington Cohasset Hull Middleton Reading Waltham 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 TDD: 617-574-6868 Beverly Dover Lincoln Natick Salem Wenham Billerica Dracut Lowell Needham Salisbury West Newbury Boston Essex Lynn Newbury Saugus Weston Boxford Everett Lynnfield Newburyport Sherbom 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. 10/2/09 Page 1 of 1