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Home My WebLink AboutMiscellaneous - 725 BOXFORD 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. raS r� 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: Joseph & Suzanne Pelich Name 725 Boxford Street Mailing Address North Andover MA. DEP File Number: 242-837 Provided by DEP 01845 City/Town State Zip Code 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: Jeff Simmons Name 12/6/1996 Dated 242-837 DEP File Number 3. The project site is located at: 725 Boxford Street _ North Andover Street Address City/Town Map 105A Parcel 6 Assessors Map/Plat Number Parcel/Lot Number the final Order of Condition was recorded at the Registry of Deeds for: Jeff Simmons Property Owner (if different) Essex North Instrument # 1143 County Book Page Certificate 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: 11/10/05 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. 7113104 Page 1 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance 242-837 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 The Order of Conditions has lapsed and is therefore no longer valid.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: 48 C. Authorization Issued by: North Andover Conservation Commission 1116 AS Date of lss46nce This Certificate must be signed by a majority of the Conservation Commission and copy sent to the applicant and appropriate DEP Regional Office (See Attachment). Signat es: wpaform 8b.doc - rev. 7113I04 Page 2 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance 242-837 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP C. Authorization (cont.) Notary Acknowledgement Commonwealth of Massachusetts County of I� On this Day Essex North Of / 10 A? (- a 924,s 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 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 City/Town Place notary seal and/or any stamp above Conservation Commission Signature of Notary Public Printed Name of Notary Public ,� / 76JI My Commission xpires (Date) Si , ature of Notary Public wpaform Bb.doc • rev. 7/13/04 Page 3 of 4 . DONNA M. WEDGE NOTARY PUBLIC COMMONWEALTH OF MASSACHUSETTS tfy Comm. Expires Aug. 7, 2009 North Andover City/Town Place notary seal and/or any stamp above Conservation Commission Signature of Notary Public Printed Name of Notary Public ,� / 76JI My Commission xpires (Date) Si , ature 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 242-837 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: Project Location DEP File Number 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. 7/13/04 Page 4 of 4 L1Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands 1 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 Wales 436 Dwight Street 9 Alford Cummington Hatfield Monterey Richmond Ware Suite 402 Amherst Dalton Hawley Montgomery Rowe Warwick Springfield, MA 01103 Ashfield Deerfield Heath Monson Russell Washington Becket Easthampton Hinsdale Mount Washington Sandisfield Wendell Phone: 413-784-1100 Belcherlown East Longmeadow Hclland New Ashford Savoy Westfield Fax: 413-784-1149 Bemardston Egremom 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 Levereft Orange Southwick Williamsburg Chester Granville Leyden Otis Springfield Williamstown DEP Southeast Region Chesterfield Great Barrington Longmeadow Palmer Stockbridge Windsor Chicopee Greenfield Ludlow Pelham Sunderland Worthington 20 Riverside Drive Clarksburg Hadley Middlefield Peru Tolland Wareham DEP Central Region Acton Charlton Hopkinton Millbury Rutland Uxbridge Ashburnham Clinton Hubbardston Millville Shirley Warren 627 Main Street Ashby Douglas Hudson New Braintree Shrewsbury Webster Worcester, MA 01608 Athol Dudley Holliston Northbcrough Southborough Westborough Phone: 508-792-7650 Auburn Dunstable Lancaster Northbridge Southbridge West Boylston Ayer East Brookfield Leicester North Brookfield Spencer West Brookfield Fax: 508-792-7621 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 Weymouth Boxborough Hardwick Medway Phillipston Townsend Wilmington Boylston Holden Mendon Princeton Tyngsborough Winchester Brookfield Hopedale Milford Royalston Upton Winthrop DEP Southeast Region Abington Dartmouth Freetown Mattapoisett Provincetown Tisbury Acushnet Dennis Gay Head Middleborough Raynham Truro 20 Riverside Drive Attleboro Dighton Gosnold Nantucket Rehoboth Wareham Lakeville, MA 02347 Avon Duxbury Halifax New Bedford Rochester Wellfleet Phone: 508-946-2700 Barnstable Eastham Harover North Attleborough Rockland West Bridgewater Berkley East Bridgewater Hanson Norton Sandwich Westport Fax: 508-947-6557 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 Fcxborough Marshfield Plymouth Swansea Chilmark Franklin Mashpee Plympton Taunton DEP Northeast Region Amesbury Chelmsford Hingham Merrimac Quincy Wakefield Andover Chelsea Holbrook Methuen Randolph Walpole 1 Winter Street Arlington Cohasset Hull Middleton Reading Waltham Boston, MA 02108 Ashland Concord Ipswich Millis Revere Watertown Phone: 617-65 4-6500 Bedford Danvers Lawrence Milton Rockport Wayland Belmont Dedham Lexington Nahant Rowley Wellesley Fax: 617-556-10494-65 Beverly Dover Lincoln Natick Salem Wenham TDD: 617-574-6868 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 • DEP Addresses • rev. 11/14105 Page 1 of 1