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Home My WebLink AboutMiscellaneous - 9 INGALLS STREET 4/30/2018 (3)e LllMassachusetts 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 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. Q A. Project Information 1. This Certificate of Compliance is issued to: David Delaney 5kic, r�Kp-- DEP File Number: 242-1201 rrovioea Dy utr Name 9 Ingalls Street Mailing Address North Andover MA. 01845 City/Town State Zip Code 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: David Delaney Name 5/30/03 242-1201 Dated DEP File Number 3. The project site is located at: 9 Ingalls Street North Andover Street Address City/Town Map 1068 Parcel 51 Assessors Map/Plat Number Parcel/Lot Number the final Order of Condition was recorded at the Registry of Deeds for: David Delaney Property Owner (if different) Essex North Instrument # 31859 County Book Page N/A Certificate 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: 10/7/04 Date B. Certification Check all that apply: wpaform 8b.doc • rev. 12/15/00 ® 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: Page 1 of 3 N Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: Lki WPA Form 8B — Certificate of Compliance 242-1201 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 The Order of Conditions has lapsed and is therefore no longer valid.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: 69 C. Authorization Issued by: North Andover [4 V-0 VK Conservation Commission Date of Issuance This Certificate must be signed by a majority of the Conservation Commission a copy sent to the applicant and appropriate DEP Regional Office (See Appendix A). Sigqures: Day Month and Year before me personally appeared SGS 1 ! NG 5se, 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. "W� No ry.PubicMy commis wpaform 8b.doc • rev. 12/15/00 -M�11PAW faE �b��Alq 2of3 r N Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 242-1201 Provided 1 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: 242-1201 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: wpaform 8b.doc • rev. 12/15/00 Document Number Signature of Applicant Page 3 of 3 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 Worcester, MA 01605 Afford 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 TDD: 508-946-2795 Belchertown East Longmeadow Holland New Ashford Savoy Westfield Fax: 413-784-1149 Bernardslon 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 Ashbumham Clinton Hubbardston Millville Shirley Warren Worcester, MA 01605 Ashby Athol Douglas Dudley Hudson New Braintree Shrewsbury Webster Phone: 978-661-7600 Avon Duxbury 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 TDD: 508-946-2795 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 Winchester Boxborough Hardwick Medway Phillipston Townsend Winthrop Boylston Holden Mendon Princeton Tyngsborough Woburn Brookfield Hopedale Milford Royalston Upton DEP Southeast Region Abington Dartmouth Freetown Mattapoisett Provincetown Tisbury 20 Riverside Drive Acushnet Dennis Gay Head Middleborough Raynham Truro Lakeville, MA 02347 Attleboro Dighton Gosnold Nantucket Rehoboth Wareham Phone: 978-661-7600 Avon Duxbury Halifax NewBedford Rochester Wellfteet Phone: 508-946-2700 Barnstable Eastham Hanover North Attleborough Rockland West Bridgewater Fax: 508-947-6557 Berkley East Bridgewater Hanson Norton Sandwich Westport TDD: 508-946-2795 Bourne Easton Harwich Norwell Scituate West Tisbury 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 Winchester Chatham Foxborough Marshfield Plymouth Swansea Winthrop Chilmark Franklin Mashpee Plympton Taunton Woburn DEP Northeast Region Amesbury Chelmsford Hingham Merrimac Quincy Wakefield 205 Lowell Street Andover Chelsea Holbrook Methuen Randolph Walpole Wilmington, MA 01887 Arlington Ashland Cohasset Concord Hull Ipswich Middleton Millis Reading Waltham Phone: 978-661-7600 Bedford Danvers Lawrence Milton Revere Rockport Watertown Wayland Fax: 978-661-7615 Belmont Dedham Lexington Nahant Rowley Wellesley TDD: 978-661-7679 Beverly Billerica Dover Dracut Lincoln Lowell Natick Needham Salem Salisbury Wenham 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. 10/12/04 Page 1 of 1