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Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands DEP File Number:
Ll WPA Form 8B P'tertificate of Compliance
242-266
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
A. Project Information
Important:
When filling out 1. This Certificate of Compliance is issued to:
forms on the
computer, use Wanda J. Peters Title Resource Group
only the tab key Name
to move your 3001 Leadenhall Road
cursor-do not
use the return Mailing Address
key. Mount Laurel NJ 08054
City/Town State Zip Code
r� 2. This Certificate of Compliance is issued for work regulated by a final Order of
Conditions issued to:
V., Inc.
Na
'eh0" Namee '
May 22, 1985 242-266
Dated DEP File Number
3. The project site is located at:
65 Campion Road (Lot 15) North Andover
Street Address City/Town
Map 62 Parcel 92
Assessors Map/Plat Number Parcel/Lot Number
the final Order of Condition was recorded at the Registry of Deeds for:
G. P. V., Inc.
Property Owner(if different)
Essex North 1810 145
County Book Page
Certificate
4. A site inspection was made in the presence of the applicant, or the applicant's agent,
on:
2/22/12
Date
wpafrm8b.doc•rev.12/23/09 WPA Form 8B,Certificate of Compliance•Page 1 of 3
I
Massachusetts Department of Environmental Protection
Bureau of Resource P otection -Wetlands DEP File Number:
WPA Form 8B ��Cfertificate of Compliance 42-266
242-266
Ll Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
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 for 65 Campion Road (Lot 15) only.
❑ Invalid Order of Conditions: It is hereby certified that the work regulated by the
above-referenced Order of Conditions never commenced. The Order of
Conditions has lapsed and is therefore no longer valid. No future work subject to
regulation under the Wetlands Protection Act may commence without filing a new
Notice of Intent and receiving a new Order of Conditions.
❑ Ongoing Conditions: The following conditions of the Order shall continue:
(Include any conditions contained in the Final Order, such as maintenance or
monitoring, that should continue for a longer period).
Condition Numbers:
C. Authorization
Issued by:
North Andover Q/.9:3 J'Q
Conservation Commission Date of Issuance
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
http://www.mass.gov/der)/about/region/findyour.htm).
Signatures:
AA
wpafrm8b.doc•rev.12/23/09 WPA Form 8B,Certificate of Compliance•Page 2 of 3
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Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands DEP File Number:
WPA Form 8B �'�ei tificate of Compliance /42-266
242-266
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:
65 Campion Road (Lot 15) 242-266
Project Location DEP File Number
Has been recorded at the Registry of Deeds of:
Essex North
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:
i
i
If registered land, the document number which identifies this transaction is:
Document Number
Signature of Applicant
wpafrm8b.doc•rev.12/23/09 WPA Form 8B,Certificate of Compliance•Page 3 of 3