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Home My WebLink AboutMiscellaneous - 701 FOREST STREET 4/30/2018 (3)Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. VQ �nrn Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands WPA Form 8B — Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 A. Project Information 1. This Certificate of Compliance is issued to: David Martin Name 701 Forest Street Mailing Address North Andover City/Town MA State DEP File Number: 7d7-1771 rrumeu uy Liar n 1 Rdr, uN wuc 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: David Martin Name November 3, 2003 Dated 3. The project site is located at: 701 Forest Street 242-1221 DEP File Number North Andover Street Address City/Town Map 105D Lot 17 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 County Instrument #13708 Certificate Book 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: March 4, 2005 Date B. Certification Check all that apply: Page ® 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. 7/13/04 Page 1 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance 242-1221 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 The Order of Conditions has lapsed and is therefore no longer valid.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. 5/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: 31, 59, 60, & 61 . C. Authorization Issued by: North Andover Conservation Commission a8 0 Date Issu nce This Certificate must be signed by Jo 'ty of the Conservation Commission and a copy sent to the applicant and appropriate DEP egional Office (See Attachment). Signatures: G wpaform 8b.doc - rev. 7/13/04 Page 2 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance 242-1221 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP C. Authorization (cont.) Notary Acknowledgement Commonwealth of Massachusetts County of Nv- a? -�' /' I -!Q0 0S On this Day Of Month / Year before me, the undersigned Notary Public, personally appeared Name of Document Signer proved to me through satisfactory evidence of identification, which was/were 1"14 zl°cehs e 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 /L)ao- i Ak'dove Conservation Commission Cityrro" Place notary seal and/or any stamp above Si nature of Notary Public DONNA M. WEDGE NOTARY PUBLIC COMMONWEALTH OF MASSACHUSETTS My Com b+� VniraA nature of Notary Public wpaform 8b.doo • rev. 7/13104 Page 3 of 4 J Massachusetts Department of Environmental Protection ILIBureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance 242-1221 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: Conservation Commission Please be advised that the Certificate of Compliance for the project at: Project Location DEP File Number Has been recorded at the Registry of Deeds of: for: County 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. 7113104 Page 4 of 4 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 DEP Western Region Adams Colrain Hampden Monroe Pittsfield Tyringham 436 Dtnri ht Street 9 '�un'hhanm Conway Hubbardston Montague �►ague Plainfield Wales Alford Cummington Hatfield Monterey Richmond Wee Suite 402 Amherst Da@on Hawley Montgomery Rowe Warwick Springfield, MA 01103 Ashfield Deerfield Heath Monson Russel 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 Egremont Holyoke New Marlborough Sheffield Westhampton Blandford Erving Huntington New Salem Shelburne West Springfield Brimfield Florida Larimborough North Adams Shutesbury West Stockbridge Buckland Gill Lee Northtempton Southampton Whatey Chademord Goshen Lenox Northfield South Hadley Wilbraham Cheshire Granby Leverett Orange SaAhwidk Williamsburg Chester Grenville Leyden Otis Springfield Williamstown Chesterfield Great Barrington Longmeadow Palmer Stockbridge Windsor Chicopee Greenfield Ludlow Pelham Sunderland Worthington Clarksburg Hadley Middlefield Peru Tolland DEP Centra) Region Acton Charlton Hopkinton Millbury Rutland Uxbridge 627 Main Street '�un'hhanm Clinton Hubbardston Milhrille Shirley War m, Ashby Dough Hudson New Braintree . Shrewsbury Webster Worcester, MA 01608 Athol Dudley Holliston Northborough Southborough Westborough Phone: 508-792-7650 Auburn Dunstable Lancaster Northbridge Southbridge West Boylston Fax: 508-792-7621 Ayer Fit Brookfield ield Leicester North Brookfield Sp West Brodffield Barre Fitchburg Leominster oakhan Sterling Westford TDD: 508-767-2788 Bellingham Gardner Littleton oxford Stow Westminster Bertin Grafton Lunenburg Paxton Sturbridge Wirnchendon Blackstone Groton Marhbaough Pepperell Sutton Worcester Bolton Harvard Maynard Petersham Templeton Weymouth Boxborough Hardwick Medway Ph illipston Townsend Almington Boylston Holden Mardon Princeton Tyrgsborough Winchester Brookfield Hopedale Mittord Royalston Upton Winthrop DEP Southeast Region Abingt- Dartnnouth Freetown Mattapoisett Previnostown Tisbrry 20 Riverside Drive ick' Dennis Gay plead Middleborough Raynhern Truro Attleboro Dighton Gosrald Nantucket Rehoboth Wareham Lakeville, MA 02347 Avon Duxbury Halifax New Bedford Rochester Welneet Phone: 508-946-2700 Barnstable Eastham Hanover Nath Attleborough Rolland West Bridgewater Fax: 508-947$557 tee' East Bridgewater Hansen Norton SandwichWestport Wellesley Bourne Easton Harwich Natick Salem Wenham TDD: 508-946-2795 Brewster Edgertown lKi nen Bluffs se ork Whitman Bridgewater Fairhaven Lakeville Orleans Sharon Wrentham Brockton Fall River Mansfield Pembroke Somerset Yarmouth Cave Falmouth Marion Plainville Stoughton Weymouth Chatham Foxborough Marshfield Plymouth Swansea Almington Chilmark Franklin Mast"a Plimpton Taunton Winchester DEP Northeast Region Amesbury Chelmsford Hingham Merrimac Quincy Wakefield 1 Winter Street Andover Chelsea Holbrook Meftxm Randolph Walpole Arlington Cchasset Hull Middleton Reading Welham Boston, MA 02108 Ashtand Concord Ipswich Millis Revere Watertown Phone: 617-654-6500 ead►ord Danvers Milton Rock;W Wayland Fax: 617-556-1049 Belmont Dedham Lexington Nahant Rowley Wellesley Beverly Dover Lincoln Natick Salem Wenham TDD: 617-574-6868 Billerica Dracut Lowell Needham Salsbury West Newbury Boston Essex Lynch Newbury Saugus Weston Boxford Everett Lynnleld Newburyport Sherbom Westwood Braintree Framingham Malden Newton Somerville Weymouth Brookline Georgetown Manchester -By -The -Sea Norfolk Stoneham Almington Burlington Gloucester Marblehead North Andover Sukbuay Winchester Cambridge Groveled Medfield North Reading Swampscott Winthrop Canton Hamilton Medford Norwood Tewkabuy Woburn Carlisle Haverhill Melrose Peabody Topsheld wpaform8b.doc • DEP Addresses • rev. 3/9/05 Page 1 of 1