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Home My WebLink AboutMiscellaneous - 934 SALEM STREET 4/30/2018 (3).--7 / � f - Ll'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 Important: When filling out forms on the computer, use only the tab key to move your cursor - do not use the return key. n� A. Project Information 1. This Certificate of Compliance is issued to: William rrahtrPP 2. Name 934 Salem Street Mailing Address North Andover CityfTown MA. State DEP File Number: 242-1113 Provided by DEP 01845 Zip Code This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: William Crabtree Name 1,)il mi 242-1113 Dated 3. The project site is located at: 934 Salem Street Street Address Map 65 Assessors Map/Plat Number DEP File Number North Andover City[Town Parcel 72 Parcel/Lot Number the final Order of Condition was recorded at the Registry of Deeds for: Willinm Cxahtree Property Owner (if different) Essex North County Certificate 77 Book 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: 1 n/R/ns Date B. Certification 297 Page 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: Page 1 of 4 wpaform 8b.doc • rev. 7/13/04 '0 % Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: Li WPA Form 8B — Certificate of Compliance 242-1113 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 The Order of Conditions has lapsed and is therefore no longer valid.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: 65 C. Authorization Issued by: North Andover Conservation Commission This Certificate must be signed by a majority of the Conservation Commission and applicant and appropriate DEP Regiopal Office (See Attachment). / Signatures: /% 103 16, Date of fssuaAce sent to the wpaform 8b.doc • rev. 7/13104 Page 2 of 4 Of, 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 C. Authorization (cont.) Notary Acknowledgement Commonwealth of Massachusetts County of Essex North On this Day I Of DEP File Number: 242-1113 Provided by DEP c o2LOo ` Month Year before me,, the undersigned Notary Public, personally appeared cJG.GTthhG S.S'-- 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 DONNA M. WEDGE NOTARY PUBLIC COMMONWEALTH OF MASSACHUSETTS My Comm ExpUes 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 My Commission Ex fres (Date) %i(. ,i/e,e4--� Sig ture of Notary Public wpaform 8b.doc - rev. 7/13/04 Page 3 of 4 r Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance 242-1113 Ll' 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: 242-1113 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 436 Dwight Street Agawam Conway Hancock Montague Plainfield Wales Suite 402 Alford Cummington Hatfield Monterey Richmond Ware Springfield, MA 01103 Amherst Ashfield Dalton Deerfield Hawley Heath Montgomery Monson Rowe Russell Warwick Washington Phone: 413-784-1100 Becket Easthampton Hinsdale Mount Washington Sandisfield Wendell Fax: 413-784-1149 Belchertown East Longmeadow Holland New Ashford Savoy Westfield TDD: 508-767-2788 Bemardston 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 Whalely 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 DEP Southeast Region Chicopee Greenfield Ludlow Pelham Sunderland Worthington 20 Riverside Drive Clarksburg Hadley Middlefield Peru Tolland Truro DEP Central Region Acton Charlton Hopkinton Millbury Rutland Uxbridge 627 Main Street Ashbumham Clinton Hubbardston Millville Shirley Warren Worcester, MA 01608 Ashby Douglas Hudson New Braintree Shrewsbury Webster Athol Dudley Holliston Northborough Southborough Westborough Phone: 508-792-7650 Auburn Dunstable Lancaster Northbridge Southbridge West Boylston Fax: 508-792-7621 Ayer East Brookfield Leicester North Brookfield Spencer West Brookfield TDD: 508-767-2788 Barre Fitchburg Leominster Oakham Sterling Westford 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 Phillipslon Townsend Boylston Holden Mendon Princeton Tyngsborough Brookfield Hopedale Milford Royalston Upton DEP Southeast Region Abington Dartmouth Freetown Maltapoisett Provincetown Tisbury 20 Riverside Drive Acushnet Dennis Gay Head Middleborough Raynham Truro Lakeville, MA 02347 Attleboro Dighton Gosnold Nantucket Rehoboth Wareham Avon Duxbury Halifax New Bedford 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 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 Chatham Foxborough Marshfield Plymouth Swansea Chilmark Franklin Mashpee Plympton Taunton DEP Northeast Region Amesbury Chelmsford Hingham Merrimac Quincy Wakefield 1 Winter Street Andover Chelsea Holbrook Methuen Randolph Walpole Boston, MA 02108 Arlington Cohasset Hull Middleton Reading Waltham Phone: 617-654-6500 Ashland Bedford Concord Danvers Ipswich Lawrence Millis Milton Revere Rockport Watertown Wayland Fax: 617-556-1049 Belmont Dedham Lexington Nahant Rowley Wellesley TDD: 617-574-6868 Beverly Dover Lincoln Natick Salem Wenham 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. 10/6/05 Page 1 of 1