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Home My WebLink AboutMiscellaneous - 227 BERRY STREET 4/30/2018 (3) 227 BERRY STREET % 21C/ O&D-0051-0005.0 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Num WPA Form 8B — Certificate of Compliance 242-941 t Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by D A. Project Information Important: When filling out 1. This Certificate of Compliance is issued to: forms on the John Brunette computer, use Name only the tab key to move 227 Berry Street your cursor- Mailing Address do not use the North Andover MA. 01845 return key. City/Town State Zip Code rse 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to.- John o:John Brunette Name 10/4/02 (Final Order) 242-941 Dated DEP File Number 3. The project site is located at: 227 Berry Street North Andover , Street Address City/Town Map 106D Lot 51 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 7879 178 County Book Page N/A Certificate 4. A site inspecltion was made in the presence of the applicant, or the applicant's agent, on: 11/14/03 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 worth subject to this partial certification that have been completed and are released from this Order are: wpaform 8b.doc•rev.12/15/00 _ Page 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: L11 WPA Form 8B — Certificate of Compliance 242-941 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 The Order of Conditions has lapsed and is therefore no longer valid.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: / 64 J C. Authorization Issued by: North Andover Conservation Commission Date of Issuance This Certificate must be signed by a majority of the Conservation Commission an copy- ent to the applicant and appropriate DEP Regional Office (See Appendix A). Sig atures: On _ Of Day Month a6d Year before me personally appeared veu to me known to be the person described in and who executed the foregoing instrument and acknowledged that he/she executed }the .same as his/her free act and deed. Notary Pubic My commission eApires wpaform 8b.doc•rev.12/15/00 - Page 2 of 3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form .8B — Certificate of Compliance 242-941 1 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: 242-941 Project Location DEP File Number ' 1 Has been recorded at the Registry of Deeds of: County for: 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 wpaform 8b.doc•rev.12/15/00 Page 3 of 3 y Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Appendix A — 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 DEP Western Region Adams Colrain Hampden Monroe Pittsfield Tyringham 436 Dwight Street Agawam Conway Hancock Montague Plainfield Wales 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 Belchertown East Longmeadow Holland New Ashford Savoy Westfield Fax:413-784-1149 Bernardston Egremonl Holyoke New Marlborough Sheffield Westhampton Blandford Erving Huntington New Salem Shelburne West Springfield Brimfield Florida Lanesborough North Adams Shutesbury West Stockbridge Buckland Gill Lee Northampton Southampton Whately Charlemont Goshen Lenox Northfield South Hadley Wilbraham Cheshire Granby Leverett Orange Southwick Williamsburg Chester Granville Leyden Otis Springfield Williamstown Chesterfield Great Barrington Longmeadow Palmer Stockbridge Windsor Chicopee Greenfield Ludlow Pelham Sunderland Worthington Clarksburg Hadley Middlefield Peru Tolland DEP Central Region Acton Charlton Hopkinton Millbury Rutland Uxbridge 627 Main Street Ashburnham Clinton Hubbardston Millville Shirley Warren Ashby Douglas Hudson New Braintree Shrewsbury Webster Worcester,MA 01605 Athol Dudley Holliston Northborough Southborough Westborough f Phone:508-792-7650 Auburn Dunstable Lancater Northbridge Southbridge West Boylston Fax: 508-792-7621 Ayer East Brookfield Leicester North Brookfield Spencer West Brookfield 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 Brookfield Hopedale Milford Royalston Upton 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 NewBedford Rochester Wellfleet Phone:508-946-2700 Barnstable Eastham Hanover North Attleborough Rockland West Bridgewater Fax:508-947-6557 Berkley East Bridgewater Hanson Norton Sandwich Westport 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 205 Lowell Street Andover Chelsea Holbrook Methuen Randolph Walpole Arlington Cohasset Hull Middleton Reading Waltham Wilmington, MA 01887 Ashland Concord Ipswich Millis Revere Watertown Phone:978-661-7600 Bedford Danvers Lawrence Milton Rockport Wayland Fax: 978-661-7615 Belmont Dedham Lexington Nahant Rowley Wellesley Beverly Dover Lincoln Natick Salem Wenham TDD:978-661-7679 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•Appendix A•rev.11/17/03 Page 1 of 1 NUMBER FEE BHP-2003-0119 COMMONWEALTH OF MASSACHUSETTS North Andover Board of Health BRUNETTE, JOHN A& CELIA A BRUNETTE ------------------------------------------------------------------------------------------------------------------------------ NAME 227 BERRY STREET ----------------------------------------------------------------------------- ADDRESS IS HEREBY GRANTED A PERMIT Well Construction This permit is granted in conformity with the Statutes and ordinances relating thereto,and expires---------------------------- ---unless sooner suspended or revoked. ----------------------------------------------------------------- June 10,2003 --------------------------------- ---------------------------- Board ------------------------------------------------------------- 0 -- Health L ----------------------------------------------------------------- NUMBER FEE BHP-2003-0119 COMMONWEALTH OF MASSACHUSETTS North Andover Board of Health BRUNETTE, JOHN A& CELIA A BRUNETTE ----------------------------------------------------------- ----------------- -------------------------- NAME 227 BERRY STREET ---------------------------------------------- ADDRESS IS HEREBY GRANTED A PERMIT Well Construction This permit is granted in conformity with the Statutes and ordinances relating thereto,and expires-----------------------------------------------__--unless sooner suspended or revoked. ----------------------------------------------------------------- June 10,2003 --------------------------------------------------------------- Board -------------- ------------------------------------------- of --- ------------------------------------------- Health Massachusetts Department of Environmental Management 112787 Office of Water Resources TYPE OR PRINT ONLY Well Completion Report 1. WELL LOCATION GPS OPTIONAL. LATITUDE LONGITUDE Address at Well Location: X27 / r'h Property Owner: S�ti�► Q CL Subdivision Name: Mailing Address: fi City/Town: N- Ando Lte►- M4 City/Town: 414 Or- I"C, D��T r Assessors Map Assessors Lot#: NOTE: Assessors Map and Lot# mandatory if no street address available Board of Health permit obtained: Yes [F' Not Required ❑ Permit Number 01 Q W Date Issued 3 �0 3 2 WORK PERFORMED 3. PROPOSED USE 4.DRILLING METHOD 95 New Well ❑ Abandon 57Domestic ❑ Irrigation ❑ Pable ❑ Auger ❑ Deepen ❑ Recondition ❑ Monitoring ❑ Municipal RrAir Hammer ❑ Direct Push &b"Re lace ❑ Other ❑ Industrial ❑ Other ❑ Mud Rotary ❑ Other 5. WELL LOG W Unconsolidated Consolidated 6.SCIS SKETCH(use mend landmarks with distances) W Permeability E2 Q From (ft) To (ft) High Low `� �` m Other Rock Type p _ - If-- 360' cfific ---� Ili ' Uiv 7. WELL CONSTRUCTION 8.CASING Total Depth Drilled f From (ft) To (ft) Casing Type and Material Size O.D. (in) Well Seal Type - r Date Drilling Complete i� b 'f 1'!� _P/lc Yvi 13 j0 3 9. SCREEN From (ft) To (ft) Slot Size Screen Type and Material Screen Diameter 10. FILTER PACK/GROUT/ABANDONMENT MATERIAL 11.ADDITIONAL WELL INFORMATION From (ft) To (ft) Material Description Purpose Developed? ❑ Yes C`- 0 Fracture Enhancement? ❑ Yes [tNo Method Disinfected? P�es ❑ No 12.WELL TEST DATA(PRODUCTION WELLS) 13. STATIC WATER LEVEL(ALL WELLS) Yield Time Pumped Drawdown to Time Recovery to Depth Below Date Method (GPM) (hrs & min) (Ft. BGS) (hrs& min) (Ft. BGS) Date Measured Ground Surface (FT) S ly'd? /lily s 14. PERMANENT PUMP(IF AVAILABLE) %NAWADDRESS OF PUMP INSTALLATION COMPANY Pump Description Horsepower r S OAS Pump Intake Depth (ft) Nominal Pump Capacity (gpm) 16. COMMENTS 17. WELL DRILLER'S STATEMENT This well was drilled and/or abandoned under my supervision, according to applicable rules and regulations, and this report is completeandcorrect to the best of my knowledge. Driller: C�/Yti r b"`{(, Supervising Driller Signature: f/- Registration 1 1 /13 1 Firm: a vy G W G6 Date: r�r O� Rig Permit#: 1 13 .3 NOTE: Well Completion Reports must be filed by the registered well driller within 30 days of well completion. BOARD OF HEALTH COPY. . _