HomeMy WebLinkAboutMiscellaneous - 990 FOREST STREET 4/30/2018 (6)pl
310 CMR 10.99
Form 8
Coa=omweal th
of Massachusetts
Lot 2A Forest Street (#990)
DEP File No_ 242-736
(To be provided by CE?)
Ci ty/T0, ,, North Andover
Applicant Colonial Village Development
Certificate of Compliance
Massachusetts Wetlands Protection Act, C.L. c. 131, §40
From North Andover Conservation Commission (NACC) Issuing Authority
William Barrett 4 Roach Circle
To Colonial Village Development No. Reading MA 01864
(Name). (Address)
Date of Issuance- August 8, 1996
This Certificate is issued for work regulated by an Oder of Conditions issued
to Colonial Village Development dated March 21, 1995
and issued by the NACC
1. Dxxx It is hereby certified that the work regulated by the above -
referenced Order.of Conditions has beer_ sat_sfactorily Completed.
2. ❑ It is hereby certified that only the following portions of the. -work
regulated by the above -referenced Order of Conditions have been
satisfactorily completed: (If the Certificate of Compliance does noz
include the entire project, specify what portions are included.)
3. ❑ It is hereby certified that the work regulated by the above -
referenced Order of Conditions was never commenced. The Order of
Conditions has lapsed and is therefore no longer valid... No future
work subject to regulation under the Act may be commenced without
filing a new Notice of Intent and receiving a new Order of
Conditions.
.................................................................
(Leave Space Blank)
Effective 11/10/89 - 9-1_
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance
242-1323
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
3. The project site is located at:
990 Forest Street
Street Address
Map 105D
Assessors Map/Plat Number
North Andover
City/Town
Parcel 2 (Lot 2A)
Parcel/Lot Number
the final Order of Condition was recorded at the Registry of Deeds for:
Property Owner (if different)
Essex North
County
Certificate
9824
Book
4. A site inspection was made in the presence of the applicant, or the applicant's agent, on:
5/21/07
Date
B. Certification
Check all that apply:
18
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 Bb.doc • rev. 7/13/04 Page 1 of 4
A. Project Information
Important:
When filling out
1. This Certificate of Compliance is issued to:
forms on the
Michael Foraste'
computer, use
Name
only the tab
key to move
990 Forest Street
your cursor -
Mailing Address
do not use the
North Andover
MA. 01845
return key.
City/Town
State Zip Code
2. This Certificate of Compliance is issued for work regulated
by a final Order of Conditions issued to:
Michael Foraste'
Name
July 29, 2005
242-1323
Dated
DEP File Number
3. The project site is located at:
990 Forest Street
Street Address
Map 105D
Assessors Map/Plat Number
North Andover
City/Town
Parcel 2 (Lot 2A)
Parcel/Lot Number
the final Order of Condition was recorded at the Registry of Deeds for:
Property Owner (if different)
Essex North
County
Certificate
9824
Book
4. A site inspection was made in the presence of the applicant, or the applicant's agent, on:
5/21/07
Date
B. Certification
Check all that apply:
18
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 Bb.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
242-1323
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 ma ority of the Conservation Commission and
applicant and appropriate DEP Region Office (See Attachment). /
Signaturesi
say
Date f Iss ance
sent to the
wpaform 8b.doc • rev. 7/13/04 Page 2 of 4
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
L'�ki WPA Form 8B — Certificate of Compliance
242-1323
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
C. Authorization (cont.)
Notary Acknowledgement
Commonwealth of Massachusetts County of Essex North
w foo
On this P3 rj
Of
Day 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
DONNA M. WEDGE
NOTARY PUBLIC
F•,
"'!Oi:YdEALTH OF MASGGCf'd'fETTS
;Cor. m. Expires Aub �'J9
Place notary seal and/or any stamp above
Conservation Commission
Signature of Notary Public
J),-)-'24& 12 lie 9
Printed Name of Notary Public
' 7 aoa q
My Commission,Expires (Date)
/'
69vi�-rte_ 2J G
Si ature of Notary Public
wpaform 6b.doc • rev. 7/13/04 Page 3 of 4
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
L� i WPA Form 8B — Certificate of Compliance
242-1323
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:
242-1323
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
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:
Amesbury
Chelmsford
Hingham
Merrimac
Commonwealth of
Massachusetts
1 Winter Street
Andover
Chelsea
Holbrook
Methuen
Department of Environmental Protection
Walpole
Arlington
Cohasset
Box 4062
Middleton
Reading
Waltham
Boston, MA 02108
Ashland
Concord
Boston, MA 02211
Millis
Revere
Watertown
Phone: 617-654-6500
Bedford
DEP Western Region
Adams
Colrain
Hampden
Monroe
Pittsfield
Tyringham
436 Dwi ht Street
g
Agawam
Conway
Hancock
Montague
Plainfield
Wales
Suite 402
Alford
Amherst
Cummington
Dalton
Hatfield
Hawley
Monterey
Montgomery
Richmond
Rowe
Ware
Warwick
Springfield, MA 01103
Ashfield
Deerfield
Heath
Monson
Russell
Washington
Phone: 413-784-1100
Becket
Easthampton
Hinsdale
Mount Washington
Sandisfield
Wendell
Everett
Belchertown
East Longmeadow
Holland
New Ashford
Savoy
Westfield
Fax: 413-784-1149
Bemardston
Egremont
Holyoke
New Marlborough
Sheffield
Westhampton
Georgetown
Blandford
Erving
Huntington
New Salem
Shelburne
West Springfield
Gloucester
Brimfield
Florida
Lanesborough
North Adams
Shulesbury
West Stockbridge
Groveland
Buckland
Gill
Lee
Northampton
Southampton
Whately
Hamilton
Charlemont
Goshen
Lenox
Northfield
South Hadley
Wilbraham
Haverhill
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
Ashby
Douglas
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
East Brookfield
Leicester
North Brookfield
Spencer
West Brookfield
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
Boxborough
Hardwick
Medway
Phillipston
Townsend
Boylston
Holden
Mendon
Princeton
Tyngsborough
Brookfield
Hopedale
Milford
Royalston
Upton
DEP Southeast Region
Abington
Dartmouth
Freetown
Mattapoisett
Provincetown
Tisbury
20 Riverside Drive
Acushnet
Dennis
Gay Head
Middleborough
Raynham
Truro
Attleboro
Dighton
Gosnold
Nantucket
Rehoboth
Wareham
Lakeville, MA 02347
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
Boume
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
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
Arlington
Cohasset
Hull
Middleton
Reading
Waltham
Boston, MA 02108
Ashland
Concord
Ipswich
Millis
Revere
Watertown
Phone: 617-654-6500
Bedford
Danvers
Lawrence
Millon
Rockport
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
Salisbury
West Newbury
Boston
Essex
Lynn
Newbury
Saugus
Weston
Boxford
Everett
Lynnfield
Newburyport
Sherbom
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
wpaformBb.doc • DEP Addresses • rev. 5/14/07 Page 1 of 1
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 5 - Order of Conditions 242-1323
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Ab�,eeV,41-e4
wpaform5.doc - rev. 311/05 Page 1 of 9
A. General Information
Important:North
Andover
When filling
From: 1. Conservation Commission
out forms on
the computer,
2. This issuance is for (check one): ® Order
of Conditions ❑ Amended Order of Conditions
use only the
tab key to
3. To: Applicant:
move your
cursor - do not
Michael Foraste
use the return
a. First Name b. Last Name
c. Company
key.
990 Forest Street
d. Mailing Address
"
North Andover
MA. 01845
e. City/Town
f. State g. Zip Code
4. Property Owner (if different from applicant):
Same
a. First Name b. Last Name
c. Company
d. Mailing Address
e. City/Town
f. State g. Zip Code
5. Project Location:
990 Forest Street
North Andover
a. Street Address
b. City/Town
Map 105D
Parcel 2 (let aA�
c. Assessors Map/Plat Number
d. Parcel/Lot Number
Latitude and Longitude, if known (note:
electronic filers will click for GIS locator):
e. Latitude f. Longitude
6. Property recorded at the Registry of Deeds for (attach additional information if more than one parcel):
Essex North
a. County
b. Certificate (if registered land)
4395
241
c. Book
d. Page
7/1/05
7. Dates: a. Date Notice of Intent Filed
b. Date Public Hearing Closed c. Date of Issuance
8. Final Approved Plans and Other Documents (attach additional plan or document references as
needed):
Permit Site Plan for 940 E.-"+
a. Plan Title
Hancock Associates
John Gilbert Dick, IR,t..S.
b. Prepared By
c. Signed and Stamped by
6/23/05
1" = 20'
d. Final Revision Date
e. Scale
f. Additional Plan or Document Title
g. Date
$ 215.00
$ 42.50 $ 172.50
9. Total WPA Fee Paid:
a. Total Fee Paid
b. State Fee Paid c. City/Town Fee Paid
wpaform5.doc - rev. 311/05 Page 1 of 9
t
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands revs a
WPA Form 5 - Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Findings
1. Findings pursuant to the Massachusetts Wetlands Protection Act:
DEP File Number:
242-1323
Following the review of the above -referenced Notice of Intent and based on the information provided
in this application and presented at the public hearing, this Commission finds that the areas in which
work is proposed is significant to the following interests of the Wetlands Protection Act. Check all that
apply:
a. ® Public Water Supply b. ❑ Land Containing Shellfish c. ® Prevention of Pollution
d. ® Private Water Supply e. ❑ Fisheries f. ® Protection of Wildlife
Habitat
g. ® Groundwater Supply h. ® Storm Damage Prevention i. ® Flood Control
2. This Commission hereby finds the project, as proposed, is: (check one of the following boxes)
Approved subject to:
® the following conditions which are necessary in accordance with the performance standards set forth
in the wetlands regulations. This Commission orders that all work shall be performed in accordance
with the Notice of Intent referenced above, the following General Conditions, and any other special
conditions attached to this Order. To the extent that the following conditions modify or differ from the
plans, specifications, or other proposals submitted with the Notice of Intent, these conditions shall
control.
Denied because:
❑ the proposed work cannot be conditioned to meet the performance standards set forth in the wetland
regulations. Therefore, work on this project may not go forward unless and until a new Notice of Intent is
submitted which provides measures which are adequate to protect these interests, and a final Order of
Conditions is issued. A description of the performance standards which the proposed work cannot
meet is attached to this Order.
❑ the information submitted by the applicant is not sufficient to describe the site, the work, or the effect
of the work on the interests identified in the Wetlands Protection Act. Therefore, work on this project may
not go forward unless and until a revised Notice of Intent is submitted which provides sufficient information
and includes measures which are adequate to protect the Act's interests, and a final Order of Conditions
is issued. A description of the specific information which is lacking and why it is necessary is
attached to this Order as per 310 CMR 10.05(6)(c).
Inland Resource Area Impacts: Check all that apply below. (For Approvals Only)
wpaform5.doc • rev. 3/1/05
❑ Buffer Zone Impacts: Shortest distance between limit of project disturbance and
wetland boundary (if available) linear feet
Resource Area Proposed Permitted Proposed Permitted
Alteration Alteration Replacement Replacement
3. ❑ Bank
a. linear feet
4. ❑ Bordering Vegetated
Wetland a. square feet
5. ❑ Land Under a. square feet
Waterbodies and
Waterways
e. cu.yd dredged
D. nnear reet c. nnear Leet a. unear Leet
b. square feet c. square feet d. square feet
b. square feet c. square feet d. square feet
T. cu.ya areagea
Page 2 of 9
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 5 - Order of Conditions 242-1323
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
B. Findings (cont.)
Proposed
Permitted
Proposed
Permitted
Resource Area
Alteration
Alteration
Replacement
Replacement
6. ❑ Bordering Land
Subject to Flooding
a. square feet
b. square feet
c. square feet
d. square feet
Cubic Feet Flood
Storage
e. cubic feet
f. cubic feet
g. cubic feet
h. cubic feet
7. ❑ Isolated Land Subject
to Flooding
a. square feet
b. square feet
Cubic Feet Flood
Storage
c. cubic feet
d. cubic feet
e. cubic feet
f. cubic feet
8. ❑ Riverfront area
a. total sq. feet
b. total sq. feet
Sq ft within 100 ft
c. square feet
d. square feet
e. square feet
f. square feet
Sq ft between 100-200 ft
e. square feet
f. square feet
e. square feet
f. square feet
Coastal Resource Area Impacts:
Check all that apply below. (For Approvals
Only)
9. ❑ Designated Port
Indicate size under Land Under the Ocean, below
Areas
1o. ❑ Land Under the
Ocean
a. square feet
b. square feet
11. ❑ Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes below
12. ❑ Coastal Beaches a. square feet b. square feet c. c/y nourishmt. d. Gy nourishmt.
13. ❑ Coastal Dunes a. square feet b. square feet c. c/y nourishmt. d. c/y nourishmt
14. ❑ Coastal Banks a. linear feet b. linear feet
15. ❑ Rocky Intertidal
Shores a. square feet b. square feet
16. ❑ Salt Marshes a. square feet b. square feet c. square feet d. square feet
17. ❑ Land Under Salt
Ponds a. square feet b. square feet
c. cu.yd dredged d. cu.yd dredged
18. ❑ Land Containing
Shellfish a. square feet b. square feet c. square feet d. square feet
19. ❑ Fish Runs Indicate size under Coastal Banks, inland Bank, Land Under the
Ocean, and/or inland Land Under Waterbodies and Waterways,
above
20. ❑ Land Subject to
Coastal Storm Flowage
a. square feet
b. cu.yd dredged
wpaform5.doc • rev. 3/1105 Pape 3 of 9
LL11Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands AIbre-vi-&I F-�
WPA Form 5 - Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
DEP File Number:
242-1323
C. General Conditions Under Massachusetts Wetlands Protection Act
(only applicable to approved projects)
1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory
measures, shall be deemed cause to revoke or modify this Order.
2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any
injury to private property or invasion of private rights.
3. This Order does not relieve the permittee or any other person of the necessity of complying with all
other applicable federal, state, or local statutes, ordinances, bylaws, or regulations.
4. The work authorized hereunder shall be completed within three years from the date of this Order
unless either of the following apply:
a. the work is a maintenance dredging project as provided for in the Act; or
b. the time for completion has been extended to a specified date more than three years, but less
than five years, from the date of issuance. If this Order is intended to be valid for more than three
years, the extension date and the special circumstances warranting the extended time period are
set forth as a special condition in this Order.
5. This Order may be extended by the issuing authority for one or more periods of up to three years each
upon application to the issuing authority at least 30 days prior to the expiration date of the Order.
6. Any fill used in connection with this project shall be clean fill. Any fill shall contain no trash, refuse,
rubbish, or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard,
pipe, tires, ashes, refrigerators, motor vehicles, or parts of any of the foregoing.
7. This Order is not final until all administrative appeal periods from this Order have elapsed, or if such
an appeal has been taken, until all proceedings before the Department have been completed.
8. No work shall be undertaken until the Order has become final and then has been recorded in the
Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title
of the affected property. In the case of recorded land, the Final Order shall also be noted in the
Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to
be done. In the case of the registered land, the Final Order shall also be noted on the Land Court
Certificate of Title of the owner of the land upon which the proposed work is done. The recording
information shall be submitted to this Conservation Commission on the form at the end of this Order,
which form must be stamped by the Registry of Deeds, prior to the commencement of work.
9. A sign shall be displayed at the site not less then two square feet or more than three square feet in
size bearing the words,
"Massachusetts Department of Environmental Protection" [or, WA DEP"]
"File Number 242-1323 "
wpaform5.doc - rev. 3/1/05 Page 4 of 9
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands A b bre► I'.�e�
WPA Form '5 - Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
DEP File Number:
242-1323
C. General Conditions Under Massachusetts Wetlands Protection Act
10. Where the Department of Environmental Protection is requested to issue a Superseding Order, the
Conservation Commission shall be a party to all agency proceedings and hearings before DEP.
11. Upon completion of the work described herein, the applicant shall submit a Request for Certificate of
Compliance (WPA Form 8A) to the Conservation Commission.
12. The work shall conform to the plans and special conditions referenced in this order.
13. Any change to the plans identified in Condition #12 above shall require the applicant to inquire of the
Conservation Commission in writing whether the change is significant enough to require the filing of a
new Notice of Intent.
14. The Agent or members of the Conservation Commission and the Department of Environmental
Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours
to evaluate compliance with the conditions stated in this Order, and may require the submittal of any
data deemed necessary by the Conservation Commission or Department for that evaluation.
15. This Order of Conditions shall apply to any successor in interest or successor in control of the
property subject to this Order and to any contractor or other person performing work conditioned by
this Order.
16. Prior to the start of work, and if the project involves work adjacent to a Bordering Vegetated Wetland,
the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden
stakes or flagging. Once in place, the wetland boundary markers shall be maintained until a Certificate
of Compliance has been issued by the Conservation Commission.
17. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully
stabilized with vegetation or other means. At no time shall sediments be deposited in a wetland or
water body. During construction, the applicant or his/her designee shall inspect the erosion controls
on a daily basis and shall remove accumulated sediments as needed. The applicant shall immediately
control any erosion problems that occur at the site and shall also immediately notify the Conservation
Commission, which reserves the right to require additional erosion and/or damage prevention controls
it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of
work line has been approved by this Order.
18. All work associated with this Order is required to comply with the Massachusetts Stormwater Policy
Standards.
If you need more
space for
additional
conditions,
select box to
attach a text
document
Special Conditions:
See attached
wpaform5.doc • rev. 3/1/05 Pape 5 of 9
Massachusetts Department of Environmental Prot e tion
Bureau of Resource Protection - Wetlands Xb""a-J
Ll : d
WPA Form 5 - Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
DEP File Number:
242-1323
D. Findings Under Municipal Wetlands Bylaw or Ordinance
1. Is a municipal wetlands bylaw or ordinance applicable? ® Yes ❑ No
2. The North Andover hereby finds (check one that applies):
Conservation Commission
3. ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal
ordinance or bylaw specifically:
a. Municipal Ordinance or Bylaw b. Citation
Therefore, work on this project may not go forward unless and until a revised Notice of Intent is
submitted which provides measures which are adequate to meet these standards, and a final Order of
Conditions is issued.
4. ® that the following additional conditions are necessary to comply with a municipal ordinance or
bylaw:
North Andover Wetland Protection Bylaw Chapter 178
a. Municipal Ordinance or Bylaw b. Citation
The Commission orders that all work shall be performed in accordance with the following conditions
and with the Notice of Intent referenced above. To the extent that the following conditions modify or
differ from the plans, specifications, or other proposals submitted with the Notice of Intent, the
conditions shall control.
If you need more c. The special conditions relating to municipal ordinance or bylaw are as follows:
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DEP FILE # 242 -1323
Therefore, the North Andover Conservation Commission (hereafter the "NACU) hereby
finds that the following conditions are necessary, in accordance with the Performance
Standards set forth in the State Regulations, the local Bylaw and Regulations, to protect those
interests noted above. The NACC orders that all work shall be performed in accordance with
said conditions and with the Abbreviated Notice of Intent referenced below. To the extent
that the following conditions modify or differ from the plans, specifications or other
proposals submitted with the Notice of Intent, the conditions should control.
GENERAL CONDITIONS
18. Failure to comply with all conditions stated herein, and with all related statutes and other
regulatory measures, shall be deemed cause to revoke or modify this Order.
19. This Order does not grant any property rights or any exclusive privileges; it does not
authorize any injury to private property or invasion of property rights. However, the
NACC, agent of the NACC or the Department of Environmental Protection (DEP)
reserves the right to enter and inspect the property at all reasonable times until a
Certificate of Compliance is issued, to evaluate compliance with this Order of Conditions,
the Act (310 CMR 10.00), the North Andover Wetland Bylaw and Regulations, and may
require any information, measurements, photographs, observations, and/or materials, or
may require the submittal of any data or information deemed necessary by the NACC for
that evaluation. Further, work shall be halted on the site if the NACC, agent or DEP
determines that any of the work is not in compliance with this Order of Conditions.
Work shall not resume until the NACC is satisfied that the work will comply and has so
notified the applicant in writing.
20. This Order does not relieve the permittee or any other person of the necessity of
complying with all other applicable federal, state or local statutes, ordinances, by-laws or
regulations.
21. The work authorized hereunder shall be completed within three years from the date of
this order.
22. This Order may be extended by the issuing authority for one or more periods of -up to one
year each upon application to the issuing authority at least thirty days (30) prior to the
expiration date of the Order (Refer to Section 8.3 (p.37) of the North Andover Wetland
Regulations).
23. The NACC reserves the right to amend this Order of Conditions after a legally advertised
public hearing if plans or circumstances are changed or if new conditions or information
so warrant.
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DEP FILE # 242 -1323
24. Where the Department of Environmental Protection (DEP) is requested to make a
determination and to issue a Superseding Order, the Conservation Commission shall be a
party to all agency proceedings and hearings before the Department.
25. This Order of Conditions is issued under File No. 242-1323.
26. The conditions of this decision shall apply to, and be binding upon, the applicant, owner,
its employees and all successors and assigns in interest or control. These obligations shall
be expressed in covenants in all deeds to succeeding owners of portions of the property.
27. The term "Applicant" as used in this Order of Conditions shall refer to the owner, any
successor in interest or successor in control of the property referenced in the Notice of
Intent, supporting documents and this Order of Conditions. The NACC shall be notified
in writing within 30 days of all transfers of title of any portion of property that takes place
prior to the issuance of a Certificate of Compliance.
28. The proposed work includes: The construction of a 16'x22' deck to an existing single-
family dwelling within the Buffer Zone to Bordering Vegetated Wetlands (BVW).
29. The work shall conform to the following (except as noted in the remainder of this
document where revisions may be required):
Abbreviated Notice of Intent filed by:
Site Plans and ANOI prepared by:
Michael Foraste (Applicant)
990 Forest Street
North Andover, MA 01845
Hancock Associates, entitled,
"Permit Site Plan for 990 Forest Street",
dated June 23, 2005. Stamped & signed by
John Gilbert Dick, R.L.S.
30. The following wetland resource areas are affected by the proposed work: Buffer Zone to
Bordering Vegetated Wetlands (BVW). These resource areas are significant to the
interests of the Act and Town Bylaw as noted above and therein. The applicant has not
attempted to overcome the presumption of significance of these resource areas to the
identified interests.
31. The NACC agrees with the applicant's delineation of the wetland resource areas on the
site as shown on the plans dated referenced herein.
32. The NACC finds that the intensive use of the upland areas, Buffer Zone, and Riverfront
Resource Area proposed on this site will cause further alteration of the wetland resource
areas. In order to prevent any alteration of wetland resource areas a twenty-five foot
(25') No -Disturbance Zone and a fifty -foot (50') No -Construction Zone shall be
established from the edge of the adjacent wetland resource area (BVW). The
Conservation Administrator and/or other agents of the NACC do not have the authority
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DEP FILE # 242 -1323
to waive these setbacks as established under the local bylaw. No disturbance of existing
grade, soils or vegetation is permitted in the No -Disturbance zone. (See Section 3.4 &
Appendix F of the local Regulations).
33. There shall be no increase in the post development discharges from the storm drainage
system or any other changes in post development conditions that alter the post
development watershed boundaries as currently depicted in the Abbreviated Notice of
Intent and approved by this Order of Conditions, unless specifically approved in writing
by the Commission.
34. This document shall be included in all construction contracts, subcontracts, and
specifications dealing with the work proposed and shall supersede any conflicting
contract requirements. The applicant shall assure that all contractors, subcontractors, and
other personnel performing the permitting work are fully aware of the permits terms and
conditions. Thereafter, the contractor will be held jointly liable for any violation of this
Order resulting from failure to comply with its conditions.
35. The owners of the project and their successors in title, in the event they proceed to alter
areas subject to the Commissions jurisdiction under the order; agree that the Order does
not in itself impose upon the Town any responsibility to maintain the proposed drainage
system and that said Town shall not be liable for any damage in the event of failure. By
acceptance of this Order, the owners agree to indemnify and hold harmless to the Town
and its residents for any damage attributable to alterations undertaken on this property
pursuant to the Order. Issuance of these Conditions does not in any way imply or certify
that the site or downstream areas will not be subject to flooding, storm damage or any
other form of water damage.
36. Issuance of these Conditions does not in any way imply or certify that the site or
downstream areas will not be subject to flooding, storm damage or any other form of
water damage.
PRIOR TO CONSTRUCTION
37. No work shall be undertaken until all administrative appeal periods from this Order have
elapsed or, if such an appeal has been filed, until all proceedings before the Department
or Court have been completed.
38. This Order shall be recorded by the applicant at the Registry of Deeds immediately after
the expiration of all appeal periods. No work shall be undertaken until the Final Order
has been recorded in the Registry of Deeds or the Land Court for the district in which the
land is located, within the chain of title of the affected property. In the case of recorded
land, the Final Order shall also be noted in the Registry's Grantor Index under the name
of the owner of the land upon which the proposed work is to be done. In the case of
registered land, the Final Order shall also be noted on the Land Court Certificate of Title
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DEP FILE # 242 -1323
of the owner of the land upon which the proposed work is to be done. The recording
information shall be submitted to the North Andover Conservation Commission on the
form at the end of this Order prior to commencement of the work. Any Order not
recorded by the applicant before work commences may be recorded by the NACC at
the applicant's expense.
39. A sign shall be displayed at the site not less than two square feet or more than three
square feet in size bearing the words "Massachusetts DEP, File Number 242-1323."
40. Any changes in the submitted plans caused by the applicant, another Board's decision
or resulting from this Order of Conditions must be submitted to the NACC for
approval prior to implementation. If the NACC finds said changes to be significant, the
NACC will call for another public hearing (at the expense of the applicant). Within 21
days of the close of said public hearing the NACC will issue an amended or new Order of
Conditions. Any errors found in the plans or information submitted by the applicant shall
be considered as changes. The proposed project may be still under review by other local
or state boards or agencies. This may result in changes to the project plans or wetland
impacts. If any such changes occur a revised plan and an explanation of the revisions shall
be submitted to the NACC for review and approval prior to the start of construction. No
work shall begin on a project until written approval has been granted by the NACC.
41. It is the responsibility of the applicant, owner, and/or successor(s) to ensure that all
conditions of this Order of Conditions are complied with. The project engineer and
contractors are to be provided with a copy of this Order of Conditions and referenced
documents before commencement of construction.
42. Prior to any work commencing on-site, the applicant shall submit to the NACC for
approval, a detailed sequence of construction, including the construction of
compensation and retention areas, installation of sedimentation/ erosion control devices
and re -vegetation to be completed before other work begins on-site..
43. Wetland flagging shall be checked prior to start of construction and shall be re-
established where missing. All wetland flagging shall remain visible and enumerated
per the approved plan(s) throughout the life of the project and until a Certificate of
Compliance is issued so that erosion control measures can be properly placed and
wetland impacts can be monitored. The proposed limit of work shall be shall be clearly
marked with stakes or flags and shall be confirmed by the NACC. Such markers shall be
checked and replaced as necessary and shall be maintained until all construction is
complete. Workers should be informed that no use of machinery, storage of machinery or
materials, stockpiling of soil, or construction activity is to occur beyond this line at any
time. All flags used for the above purposes shall be of a color different from other
flagging used on the site.
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DEP FILE # 242 -1323
44. Since the deck sonotubes will be hand dug, erosion controls are not required. However,
the NACC reserves the right to impose the use of erosion control (hay bales & silt
fence) if the site exhibits erosion, or any noticeable degradation of surface water
quality discharging from the site. Should the erosion control be required by the NACC
or the Conservation Department, they shall be installed within 48 hours of the request.
The erosion control barrier will be properly installed (trenched 4 - 6 -inches into the
ground, backed by double -staked hay bales) and shall be inspected and approved by
the Conservation Department. These temporary erosion control measures shall remain
intact until all disturbed areas have been permanently stabilized to prevent erosion.
All erosion prevention and sedimentation protection measures found necessary during
construction shall be implemented at the direction of the Department or the NACC.
45. A check payable to the Town of North Andover shall be provided in the amount of
$500, which shall be in all respects satisfactory to Town Counsel, Town Treasurer, and the
NACC, and shall be posted with the North Andover Town Treasurer through the NACC
before commencement of work. Said deposit of money shall be conditioned on the
completion of all conditions hereof, shall be signed by a party or parties satisfactory to the
NACC, and Town Counsel, and shall be released after completion of the project, provided
that provisions, satisfactory to the NACC, have been made for performance of any
conditions which are of continuing nature. The applicant may propose a monetary
release schedule keyed to completion of specific portions of the project for the NACC's
review and approval. This condition is issued under the authority of the local Bylaw.
46. Prior to construction, the applicant shall permanently mark the edge of the 25' no -
disturbance zone or existing tree line with six (6) markers evenly spaced every 25 -feet
incorporating the following text: "Protected Wetland Resource Area". This will
designate their sensitivity and assure no further inadvertent encroachment into the
wetland. These markers can be purchased at the Conservation Department for $2.00 per
marker. These permanent markers are subject to review and approval by the NACC.
The applicant shall instruct all agents to explain these markers to
buyers/lessees/landscapers and all persons taking over the property from the applicant.
47. 'The applicant and/or the legal owner of that portion of land upon which these Orders of
Conditions have been placed shall provide to the NACC prior to transferring, or
assigning any portion of said land to another party, subject to said Orders of
Conditions, the "Compliance Certification Form Affidavit" attached via "Appendix A"
signed under the pains and penalties of perjury, stating that said applicant and/or
owner has read these Orders of Conditions and is in compliance with each and every
condition. This document shall apply to each of the conditions referenced herein and
shall be provided to the Conservation Department at least five (5) business days prior to
the closing of said land transaction.
IS. Once these above mentioned pre -construction requirements are complete, the applicant
shall contact the Conservation Office prior to site preparation or construction and shall
arrange an on-site conference with an NACC representative, the contractor, the
engineer, wetland scientist and the applicant to ensure that all of the Conditions of this
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DEP FILE # 242 -1323
Order are understood. This Order shall be included in all construction contracts,
subcontracts, and specifications dealing with the work proposed and shall supersede any
conflicting contract requirements. The applicant shall assure that all contractors,
subcontractors and other personnel performing the permitted work are fully aware of the
permit's terms and conditions. Thereafter, the contractor will be held jointly liable for any
violation of this Order of Conditions resulting from failure to comply with its conditions.
The applicant or contractor shall notify the NACC in writing of the identity of the on-site
construction supervisor hired to coordinate construction and to ensure compliance with
this Order. A reasonable period of time shall be provided as notice of the pre -
construction meeting (e.g. 72 hours).
11 DURING CONSTRUCTION
49. Accepted engineering and construction standards and procedures shall be followed in the
completion of the project.
50. There shall be no increase in the post development discharges from the storm drainage
system or any other changes in post development conditions that alter the post
development watershed boundaries as currently depicted in the Abbreviated Notice of
Intentand approved by this Order of Conditions, unless specifically approved in writing
by the Commission.
51. Water quality of the adjacent BVW shall not differ significantly following completion of
the project from the pre -development conditions. There shall be no sedimentation into
wetlands or water bodies from discharge pipes or surface runoff leaving the site.
52. Any fill used in connection with this project shall be clean fill, containing no trash, refuse,
rubbish or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper,
cardboard, pipe, tires, ashes, refrigerators, motor vehicles or parts on any of the
foregoing.
53. No exposed area shall remain unfinished for more than thirty (30) days, unless approved
by the NACC. If soils are left to idle greater than thirty days, all areas shall be seeded
with rye seed to provide immediate stabilization.
54. The contractor will take all steps necessary to control dust onsite so that adverse effects on
adjacent resource areas and / or habitat do not occur.
55. No re -grading in the buffer zone shall have a slope steeper than 2:1 (horizontal: vertical).
Slopes of steeper grade shall be rip -rapped or biodegradable erosion controls to provide
permanent stabilization.
56. There shall be no stockpiling of soil or other materials within fifty (50) feet of any resource
area.
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DEP FILE # 242 -1323
57. Washings from concrete trucks, or surplus concrete, shall not be directed to, any drainage
system, or wetland resource area.
58. All waste generated by, or associated with, the construction activity shall be contained
within the construction area, and away from any wetland resource area. There shall be no
burying of spent construction materials or disposal of waste on the site by any other
means. The applicant shall maintain dumpsters (or other suitable means) at the site for
the storage and removal of such spent construction materials off-site. However, no trash
dumpsters will be allowed within 50' of areas subject to protection under the Act or
local Bylaw.
59. During and after work on this project, there shall be no discharge or spillage of fuel, or
other pollutants into any wetland resource area.. If there is a spill or discharge of any
pollutant during any phase of construction the NACC shall be notified by the applicant
within one (1) business day. No construction vehicles are to be stored within 100 feet of
wetland resource areas, and no vehicle refueling, equipment lubrication, or maintenance
is to be done within 100 feet of a resource area.
11 AFTER CONSTRUCTION �;J]
60. No underground storage of fuel oils shall be allowed on any lot within one hundred (100)
feet of any wetland resource area. This condition shall survive this Order of Conditions
and shall run with the title of the property. This condition is issued under the authority
of the Towns Wetland protection Bylaw.
61. Fertilizers utilized for landscaping and lawn care shall be slow release, low -nitrogen types
(< 5%), and shall not be used within 25 feet of a resource area. Pesticides and herbicides
shall not be used within 100 feet of a wetland resource area. This condition shall survive
this Order of Conditions and shall run with the title of the property. This condition is
issued under the authority of the Towns Wetland Protection Bylaw and shall remain in
perpetuity.
62. Upon completion of construction and grading, all disturbed areas located outside
resource areas shall be stabilized permanently against erosion. This shall be done either
by loaming and seeding according to SCS standards. If the latter course is chosen,
stabilization will be considered complete once vegetative cover has been achieved.
63. Upon approved site stabilization by Conservation staff, the erosion controls shall be
removed and properly disposed of and all exposed unvegetated areas shall be seeded.
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64. Upon completion of the project the applicant shall submit the following to the
Conservation Commission as part of a request for a Certificate of Compliance:
a. WPA Form 8A - "Request for a Certificate of Compliance."
b. A letter from the applicant requesting a Certificate of Compliance.
c. The name and address of the current landowner.
d. Signed statements from the individual property owners shall be submitted with
the request for a Certificate of Compliance indicating that they read and
understood the recorded Order of Conditions prior to purchasing their property.
e. The name and address of the individual/ trust or corporation to whom the
compliance is to be granted.
f. The street address and assessor's map/ parcel number for the project.
g. The DEP file number.
h. A written statement from a Registered Professional Civil Engineer (and/or
Registered Professional Land Surveyor) of the Commonwealth certifying that the
work has been conducted as shown on the plan(s) and documents referenced
above, and as conditioned by the Commission.
i. An "As -Built" plan prepared and signed and stamped by a Registered Professional
Civil Engineer (and/or Registered Professional Land Surveyor) of the
Commonwealth, for the public record. This plan will include:
➢ "As -Built" post -development elevations and grades of all filled or altered
wetland resource areas including the encompassing buffer zone, which is
regulated as a resource area under the local Wetland Protection Bylaw.
➢ Distances from structures to wetland resource areas. Structures include (but
are not limited to) septic systems, additions, fences, sheds, stonewalls, pools,
retaining walls, subsurface utilities and decks.
➢ A line showing the limit of work and the extent of existing erosion control
devices. "Work" includes my disturbance of soils or vegetation.
➢ Location of all subsurface utilities entering the property.
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DEP FILE # 242 -1323
65. The following special conditions shall survive the issuance of a Certificate of Compliance
(COC) for this project:
➢ 25' No -Disturbance Zone, a 50' No -Construction Zone shall be established
from the edge of adjacent wetland resource areas. Future work within 100'
of existing wetland resource areas will require a separate filing with the
NACC (refer to Section XI (page 18) of the Regulations for performance
standards within these zones) The Conservation Administrator and/or
other agents of the NACC do not have the authority to waive these setbacks
as established under the local Bylaw (Condition # 32);
➢ Discharge or spillage of pollutants (Condition #59);
➢ Prohibition of underground fuels (Condition #60);
➢ Limitations on the use of fertilizers, herbicides, and pesticides (Condition
#61).
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DEP FILE # 242 -1323
I,
APPENDIX A - AFFIDAVIT
(authorized agent of applicant and / or owner)
1) I am the
on oath do hereby depose and state:
(PLEASE CHECK AT LEAST ONE BLOCK)
(position with applicant)
of
the applicant upon whom the Order of Conditions
(applicants name)
(DEP or NACC File #)
have been
placed upon by the North Andover Conservation Commission (NACC).
and / or
2) I am the of
(position with owner)
the owner upon whose land Order of Conditions
placed upon by the NACC.
(owner)
(DEP or NACC File #)
have been
♦ I hereby affirm and acknowledge that I have received said Order of Conditions and
have read the same and understand each and every condition, which has been set
forth in said Order of Conditions.
♦ I hereby affirm and acknowledge that on this day of
.20____, I inspected said property together with any and
all improvements, which have been made to the same and hereby certify that each
and every condition set forth in the Order of Conditions are presently in
compliance.
♦ I hereby affirm and acknowledge that this document will be relied upon by the
NACC, as well as any potential buyers of said property, which is subject to the
Order of Conditions.
Signed under the pain and penalties of perjury this day of
20
(Authorized agent of applicant or owner)
C:\Winword\OOC\990ForestStreet.doc 10 NACC 7/26/2005
Massachusetts Department of Environmental Pro ection
Bureau of Resource Protection - Wetlands b b re-v;aAc j
WPA Form 5 - Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
E. Issuance
DEP File Number:
242-1323
This Order is valid for three years, unless otherwise specified as a special 7 195
condition pursuant to General Conditions #4, from the date of issuance. 1. Date Issuailice
Please indicate the number of members who will sign this form: .5,
This Order must be signed by a majority of the Conservation Commission. 2. Number of signers
The Order must be mailed by certified mail (return receipt requested) or hand delivered to the applicant. A
copy also must be mailed or hand delive ed at the same time to the appropriate Department of
Environmental Protection Regional ce, if not filing electronically, and the property owner, if different
from applicant. /f
Signatures:
Notary Acknowledgement
Commonwealth of Massachusetts County of
On this7 -F%
Day
Before me, the undersigned Notary Public,
personally appeared
Essex North
of t,` I o�ilJO.S
Month Year
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.
North Andover C0 nservation Commission
As member of
Dawki
J• co��CHUESETIS
i f ty CORM Eow Aug. 7, 2009
Place notary seal and/or any stamp above
City/Town
This Order is issued to the applicant as follows:
R(by hand delivery o7742/,05S
Date
8-�►�c, �2 Gf�'
Signature of Notary Public
DvHnw fil• 4/6-0 G&'
Printed Name of Nptary Public
P/-7/9,009
My Commission'Expires (Date)
Date
Dy certified mail, return receipt requested, on
wpaform5.doc • rev. 311105 Page 7 of 9
L1Massachusetts Department of Environmental Protection i
Bureau of Resource Protection - Wetlands A b b -P-\) ,
1 WPA Form 5 - Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
F. Appeals
DEP File Number:
242-1323
The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject
to this Order, or any ten residents of the city or town in which such land is located, are hereby notified of
their right to request the appropriate DEP Regional Office to issue a Superseding Order of Conditions.
The request must be made by certified mail or hand delivery to the Department, with the appropriate filing
fee and a completed Request of Departmental Action Fee Transmittal Form, as provided in 310 CMR
10.03(7) within ten business days from the date of issuance of this Order. A copy of the request shall at
the same time be sent by certified mail or hand delivery to the Conservation Commission and to the
applicant, if he/she is not the appellant. Any appellants seeking to appeal the Department's Superseding
Order associated with this appeal will be required to demonstrate prior participation in the review of this project.
Previous participation in the permit proceeding means the submission of written information to the
Conservation Commission prior to the close of the public hearing, requesting a Superseding Order or
Determination, or providing written information to the Department prior to issuance of a Superseding Order
or Determination.
The request shall state clearly and concisely the objections to the Order which is being appealed and how
the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands
Protection Act, (M.G.L. c. 131, § 40) and is inconsistent with the wetlands regulations (310 CMR 10.00).
To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts
Wetlands Protection Act or regulations, the Department has no appellate jurisdiction.
Section G, Recording Information is available on the following page.
wpaform5.doc • rev. 3/1/05 Page 8 of 9
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands yeu�a
Ll :11) 1
WPA Form 5 - Order of Conditions
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
G. Recording Information
DEP File Number:
242-1323
This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in
which the land is located, within the chain of title of the affected property. In the case of recorded land, the
Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land
subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court
Certificate of Title of the owner of the land subject to the Order of Conditions. The recording information
on Page 7 of this form shall be submitted to the Conservation Commission listed below.
North Andover
Conservation Commission
Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission.
---------------------------------------------------------------------------------------------------------------------------
To:
North Andover
Conservation Commission
Please be advised that the Order of Conditions for the Project at:
Project Location
Has been recorded at the Registry of Deeds of:
County
for:
Property Owner
242-1323
DEP File Number
Book Page
and has been noted in the chain of title of the affected property in:
Book
In accordance with the Order of Conditions issued on:
Date
Page
If recorded land, the instrument number identifying this transaction is:
Instrument Number
If registered land, the document number identifying this transaction is:
Document Number
Signature of Applicant
Page 9 of 9
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