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Home My WebLink AboutMiscellaneous - 453 FOREST STREET 4/30/2018 (3) yS3 2es'7 (16r B) Lai Asrxe Road P f L1Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance PC a G Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 242-441 Provided by DEP A. Project Information Important: When filling out 1. This Certificate of Compliance is issued to: forms on the Jennifer Herald computer, use only the tab Name key to move 453 Forest Street your cursor- Mailing Address do not use the North Andover MA. 01845 return key. Cityfrown State Zip Code 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: Litha Flynn, Trustee of Long Pasture Realty Trust Name 3/25/96 242-441 Dated DEP File Number 3. The project site is located at: 453 Forest Street(Lot 8 Long Pasture Road) North Andover , Street Address Cityfrown Map 106A Lot 268 Assessors Map/Plat Number Parcel/Lot Number the final Order of Condition was recorded at the Registry of Deeds for: Long Pasture Realty Trust Property Owner(if different) Essex North 4471 171 County Book Page N/A Certificate 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: 12/12/03 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 work subject to this partial certification that have been completed and are released from this Order are: PCOC Lot 8 wpaform 8b.doc•rev.12/15/00 Page 1 of 3 Massachusetts Department of Environmental Protection 1 Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance 242-441 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 The Order of Conditions has lapsed and is therefore no longer valid.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 Date of Issuance This Certificate must be sig by a majority of the Conservation Commission and a c py sent to the applicant and appropriat EP Regional Office.(See Appendix A). Signatures: V171 On Of 4 � Day Month and Year before me personally appeared 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. N tary PubicMy ocmy mmission expires wpaform 8b.doc•rev.12/15/00 Page 2 of 3 y Massachusetts Department of Environmental�ronmental Protection � Bureau of Resource Protection - Wetlands DEP File Number: 1 WPA Form 8B — Certificate of Compliance \ Massachusetts Wetlands Protection Act M.G.L. c. 131, 40 242-441 Provided by DEP I 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 o: North Andover Conservation Commission Please be advised that the Certificate of Compliance for the project at: 242-441 Project Location DEP File Number � I 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 LlMassachusetts 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 ! Agawam Conway Hancock Montague Plainfield 436 Dwight Street Alford Cummington Hatfield Monterey Richmond Wares Suite 402 Amherst •Dalton Hawley Montgomery Rowe Warwick Springfield,MA 01103 Ashfield Deerfield Heath Monson Russell Washington Phone:413-784-1100Bec et Easthampton Hinsdale Mount Washington Sandisfield Wendell Belchertown East Longmeadow Holland New Ashford Savoy Westfield Fax:413-784-1149 Bernardston Egremont 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 Asnburnnam Clinton Hubbardston Millville Shirley Warren Ashby Douglas Hudson New Braintree Shrewsbury Webster Worcester,MA 01605 Athol Dudley Holliston Northborough Southborough Westborough 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 Royalslon 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 I i DEP i Northeast Region Amesbury Chelmsford Hingham Merrimac g g 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 Wenharn TDD:978-661-7679 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•Appendix A•rev.12/9/03 - Page 1 of 1 Commonwealth of Massachusetts _ i City/Town of NORTH ANDOVER MASSACHUS T System Pumping Record h ` ?,Qio Form 4 TOWN Or NORTH ANDOVER DEP has provided this form for use by local Boards of Health. The System be submitted to the local Board of Health or other approving authority. A. Facility Information Important: When filling out 1. System Location: forms on the (Vas C)ftt computer,use only the tab key Address to move your ( ) cursor-do not Ci /town C use the return ty State Zip Code key. 2. System Owner: Nemd Name Address(if different from location) Cityrrown State Zip Code Telephone Number B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) 1;2/Septic Tank ❑ Tight Tank ❑ Other(describe): 4. Effluent Tee Filter present? ❑ Yes ❑ No If yes,was it cleaned? ❑ Yes ❑ No 5. Condition of System: zhXX c 6. stem Pumped By: e Vehicle License Number ompany 6E I 7. Location yKhere contents w re dispose X11 Sig ature of Hauler %te http://www.mass.gov/deptwater/approvals/t5forms.htm#inspect t5form4.doca 06/03 System Pumping Record•Page 1 of 1 No Andover J&S Development dba 1600 Osgood St Stewart's Septic Building 20 Suite 2-36 Andover Septic No. Andover, Ma 01845 58 South Kimball Street + Bradford, MA 01835 II VED HAY 18-2012 TOWN OF NORTH ANDOVER Date Name & Address Gallons Comments L HEALTH DEPARTMENT 5-Apr Andriolo 37 Birch Lane 1500 Good Sullivan 47 Boxford St 750 Good 6-Apr Saplenza 40 Sterling Ave 1500 Heavy bottom 9-Apr Disalvo 400 Winter St 1500 Good 10-Apr Sarano 265 Hay meadow Rd 1500 Xxxsolids 12-Apr Lind 575 Winter 3s4,-' 1500 Good 16-Apr Distefano W&Raleigh Tavern Lane 1000 HG Walsh 58 Paddock Lane 1500 Good 18-Apr Schrader 35 Woodberry Lane 1000 Good Ahlhdm 48 Hawkins Lane 1000 Good 19-Apr Barrett 235 Candel Stick Rd 1500 Good 20-Apr Harold 453 Forest St 1500 Good Duffy 67 Shirwood Dr 1500 Good Zoll 333 raeligh Tavern Lane 1500 Good 23-Apr Haffeners Car wash 564 Chickering Rd 2000 red tank 25-Apr Valle 58 Evergreen Dr 1000 Good 27-Apr Lucas 39 deer meadow Rd 1500 Good 30-Apr Meaney 745 Foster St 1000 Good I