Loading...
HomeMy WebLinkAbout- Permits #242-1765 - 2053 SALEM STREET 10/2/2019 4 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 242-1765 WPA Form 5 — Order of Conditions MassDEP File# Ll Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 oDEP Transaction# J North Andover Cityl-rown A. General Information Please note: North Andover this form has 1. From: been modified Conservation Commission With added 2. This issuance is for space to a.ZOrder of Conditions b. E] Amended Order of Conditions accommodate (check one): the Registry of Deeds 3. To: Appficant: Requirements Cleon & Jane Richards ..........-........... a. First Name b. Last Name Important: When filling out forms on c.Organization the 2051 Salem Street computer, d.Mailing Address use only the tab key to North Andover ............ MA 01845 move your e.City/Town f.State g,Zip Code cursor-do not use the 4. Property Owner(if different from applicant): return key. rob a. First Name b. Last Name .......... c.Organization d.Mailing Address ................ .. ......... e,City/Town f.State g.Zip Code 5,. Project Location: 2051 & 2053 Salem Street North Andover a.Street Address b.City/Town Map 108-A Lots 1 & 18 c.Assessors MapIPlat Number d. Parcel/Lot Number - Latitude and Longitude, if known: 42d63m5691 s 71d04m8668s d.Latitude e. Longitude wpaform5.doc« rev.611 612 01 5 Page 1 of 12 4 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 242-1765 WPA Form 5 — Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# L11 - North Andover City/Town A. General Information (cont) 6. Property recorded at the Registry of Deeds for(attach additional information if more than one parcel): Northern Essex a.County b.Certificate Number(if registered land) 15590 .154 c.Book d.Page 7. Dates: July 3112019 September 11, 2019 October 2, 2019 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): Buffer Zone Disturbance & Restoration Plan, Sheet 1 of 2 a. Plan Title Ranger Engineering A_PeAsi !1, LLC Benjamin C. Osgood, Jr. b. Prepared By c.Signed and Stamped by September 11,- 201'9............... 1 11=20' d!. Final Revision date e.Scale Buffer Zone Disturbance& Restoration Plan, Sheet 2 of 2 09-11-19 f.Additional Plan or Document Title g. Date B. Findings 1. Findings pursuant to the Massachusetts Wetlands Protection Act: 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(the Act), Check all that apply: a. 0 Public Water Supply b. Land Containing Shellfish C' E Prevention of Pollution CIL 0 Private Water Supply e. Fisheries f. 0 Protection of Wildlife Habitat Groundwater Supply lh. Storm Damage Prevention i. E Flood Control 2. This Commission hereby finds the project, as proposed, is: (check one of the following boxes) Approved subject to: a. M 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. wpaformS.doc rev.611 612 01 5 Page,2 of 12 4 Massachusetts Department mf Environmental Protection Provided u;Massoep 242-l705 Bureau 0f Resource Protection - Wetlands Ll 5 _ K*eumDEPFRe# ����� FormFormOrderofConditions Massachusetts Wetlands Protection Act M.G.L. o. 131, §40 *nEP Transaction# North Andover Q�Tonn B. Findings (cont.) Denied because: b. E7 the proposed work cannot be conditioned to meet the performance standards set forth in the v«e1Uamd 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 the interests of the Act, and a final Order of Conditions is issued. A description of the performance standards which the proposed work cannot meet is attached tothis Order. v� Fl the information submitted by the applicant is not sufficient to describe the site, the work, or the effect of the work oo the inbaneo[m identified in the Wetlands Protection Act. Therefore, work oo this project meynotOofonwardun|euaondumt|| arev|uedNctioeof Intent is submitted which provides sufficient information and Kno1mdoe 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 |e lacking and why |t1s necessary |o attached to this Order as per31Q CKDR 10-05(6)(n). a. n Buffer Zone Impacts: Shortest distance between limit nfproject _____ disturbance and the Yvot|ond resource area specified |� 31O <�yN�� 1O.O2(1)(a) m�|�nomr�=v� Inland Resource Area Impacts: Check all that apply below. (For Approvals Only) Resource Area Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 4. �� ------------ ----------- �� Bank u. linear feet b.linear�et —u—||n ear hae-------t d. linear feet 5. Bordering 740 1525 tmzommmre Vegetated Welland a,square feet b.square feet c.square feet d.square feet 6. Land Under VVaberbodKam and o.square feet *.square feet c.square feet V.square feet Waterways a.clydmdgad [ctydredged 7. [l Bordering Land Subject to Flooding a.nq«ama feet b.square feet c.square feet d.aquupa feet Cubic Feet Flood Storage ---------- ------------ ------------ --------- e.cubic feet [cubic feet g.cubic feet h.cubic feet 8. n Isolated Land Subject toFlooding a.square feet V.square feet Cubic Feet Flood Storage ------------ --------- --------- -����������� c.cubic feet feet e.cubic feet C cubic feet g 0 308 B�3V0 ��|ve�rontAveo ��----- � ���� m.m�|mq.�et b.total sq.feet 8qM within iQUft -����������' ------------ --------- --------- c.square feet d.square feet a.square feet i square feet Sqft between 18Q- 9, 300 9,390 8,390 9�90 200ft g.square feet h.s,qoumfeot Lwquare feet ].nquare feet 4 Massachusetts Department of Environmental Protection Provided by Mass[DEP: Bureau of Resource Protection - Wetlands 242-1765 WPA Form 5 — Order of Conditions MassDEP File# ----------- ILI Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# J North Andover City/Town B. Findings (cont.) Coastal Resource Area Impacts: Check all that apply below. (For Approvals Only) Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement la. F1 Designated Port Indicate size under Land Under the Ocean, below Areas 11, n Land Under the Ocean a.square feet b.square feet c.cly dredged d.cly dredged 12. El Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes below 13. El Coastal Beaches cu yd cu yd a.square feet b.square feet G.nourishment d. nourishment 14. El Coastal Dunes cu yd cu yd a.square feet b.square feet r—nourishment d. nourishment 15. El Coastal Banks a. linear feet b.linear feet 16, F1 Rocky Intertidal Shores a.square feet b.square feet 17. [:1 Salt Marshes a.square feet b.square feet c.square feet d.square feet 18. El Land Under Salt Ponds a.square feet b.square feet c.cly dredged d.cly dredged % F] Land Containing Shellfish a.square feet b.square feet c.square feet d.square feet 20. [-1 Fish Runs Indicate size under Coastal Banks, Inland Bank, Land Under the Ocean, and/or inland Land Under Waterbodies and Waterways, above a.cly dredged b.cly dredged 21. El Land Subject to Coastal Storm a.square feet b.square feet Flowage 22. F 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 g.square feet h.square feet L square feet j.square feet wpaform5.doc- rev.611612015 Page 4 of 12 4 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 242-1765 -- WPA Form 5 — Order of Conditions MassDEP File# ILI Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction,# North Andover Cityrrown B. Findings (cont.) #23. If the 21 F-1 Restoration/En hance men It project is for the purpose of restoring or enhancing a a.square feet of BVW b,square feet of salt marsh Welland resource area 24. El Stream Crossing(s): in addition to the square footage that a.number of new stream crossings b. number of replacement stream crossings has been C. General Conditions Under Massachusetts Wetlands Protection Act entered in Section B.5.c (BVVV)or The following conditions are only applicable to Approved projects. B.1 Tc(Salt Marsh)above, 1. Failure to comply with all conditions stated herein, and with all related statutes and other please enter the add itanal regulatory measures, shall be deemed cause to revoke or modify this Order. amount here. 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. c. If the work is for a Test Project, this Order of Conditions shall be valid for no more than one year. 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. An Order of Conditions for a Test Project may be extended for one additional year only upon written application by the applicant, subject to the provisions of 310, CMR 10.05(1 1)(f). 6. If this Order constitutes an Amended Order of Conditions, this Amended Order of Conditions does not extend the issuance date of the original Final Order of Conditions and the Order will expire on unless extended in writing by the Department. 7. 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. vipaform5,doc rev.611 612 01 5 Page 5 of 12 4 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 242-1765 WPA Form 5 — Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act MG.L. c. 131, §40 eDEP Transaction# North Andover City/Town C. General Conditions Under Massachusetts Wetlands Protection Act 8. 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. 9. 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 Finial 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 the 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. 10. 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, "MassDEP"] "File Number 242-1765 _" 11. 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 MassDEP. 112, Upon completion of the work described herein, the applicant shall submit a Request for Certificate of Compliance (WPA Form 8A) to the Conservation Commission. 13. The work shall conform to the plans and special conditions referenced in this order. 14. Any change to the plans identified in Condition#13 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. 15. 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. 16. 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. Nvpaform5.doc- rev.6116/2015 Page 6 of 12 4 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection, - Wetlands 242-1765 WPA Form 5 — Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# North Andover City/Town C. General Conditions Under Massachusetts Wetlands Protection Act (cont.) 17. 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. 18. 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 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. 19. The work associated with this Order(the"Project") (1) ❑ is subject to the Massachusetts Stormwater Standards (2) is NOT subject to the Massachusetts Stormwater Standards If the work is subject to the Stormwater Standards, then the project is subject to the following conditions: a) All work, including site preparation, land disturbance, construction and redevelopment, shall be implemented in accordance with the construction period pollution prevention and erosion and sedimentation control plan and, if applicable, the Stormwater Pollution Prevention Plan required by the National Pollution Discharge Elimination System Construction General Permit as required by Stormwater Condition 8. Construction period erosion, sedimentation and pollution control measures and best management practices (BMPs) shall remain in place until the site is fully stabilized. b) No stormwater runoff may be discharged to the post-construction stormwater BMPs unless and until a Registered Professional Engineer provides a Certification that: i. all construction period BMPs have been removed or will be removed by a date certain specified in the Certification. For any construction period BMPs intended to be converted to post construction operation for stormwater attenuation, recharge, and/or treatment, the conversion is allowed by the MassDEP Stormwater Handbook BMP specifications and that the BMP has been properly cleaned or prepared for post construction operation, including removal of all construction period sediment trapped in inlet and outlet control structures; fi. as-built final construction BMP plans are included, signed and stamped by a Registered Professional Engineer, certifying the site is fully stabilized; ifi. any illicit discharges to the stormwater management system have been removed, as per the requirements of Stormwater Standard 10; Nvpaforrn5.doc- rev.611612016 Page 7 of 12 4 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 242-1765 WPA Form 5 — Order of Conditions MassDEP Ffle# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# LIJ North Andover cityrrown C. General Conditions Under Massachusetts Wetlands Protection Act (cont.) iv. all post-construction:stormwater BMPs are installed in accordance with the plans (including all planting plans) approved by the issuing authority, and have been inspected to ensure that they are not damaged and that they are in proper working condition; v. any vegetation associated with post-construction BMPs is suitably established to withstand erosion. c) The landowner is responsible for BMP maintenance until the issuing authority is notified that another party has legally assumed responsibility for BMP maintenance, Prior to requesting a Certificate of Compliance, or Partial Certificate of Compliance, the responsible party(defined in General Condition 18(e)) shall execute and submit to the issuing authority an Operation and Maintenance Compliance Statement("O&M Statement) for the Stormwater BMPs identifying the party responsible for implementing the stormwater BMP Operation and Maintenance Plan ("O&M Plan") and certifying the following: i.) the O&M Plan is complete and will be implemented upon receipt of the Certificate of Compliance, and ii.) the future responsible parties shall be notified in writing of their ongoing legal responsibility to operate and maintain the stormwater management BMPs and implement the Stormwater Pollution Prevention Plan. d) Post-construction pollution prevention and source control shall be implemented in accordance with the long-term pollution prevention plan section of the approved Stormwater Report and, if applicable, the Stormwater Pollution Prevention Plan required by the National Pollution Discharge Elimination System Multi-Sector General Permit. e) Unless and until another party accepts responsibility, the landowner, or owner of any drainage easement, assumes responsibility for maintaining each BMP. To overcome this presumption, the landowner of the property must submit to the issuing authority a legally binding agreement of record, acceptable to the issuing authority, evidencing that another entity has accepted responsibility for maintaining the BMP, and that the proposed responsible party shall be treated as a permittee for purposes of implementing the requirements of Conditions 18(f) through 18(k)with respect to that BMP. Any failure of the proposed responsible party to implement the requirements of Conditions 18(f) through 18(k) with respect to that BMP shall be a violation of the Order of Conditions or Certificate of Compliance. in the case of stormwater BMPs that are serving more than one lot, the legally binding agreement shall also identify the lots that will be serviced by the stormwater BMPs. A plan and easement deed that grants the responsible party access to perform the required operation and maintenance must be submitted along with the legally binding agreement. f) The responsible party shall operate and maintain all stormwater BMPs in accordance with the design plans, the O&M Plan, and the requirements of the Massachusetts Stormwater Handbook. wpaform5.doc^ rev.6/16/2015 Page 8 of 12 4 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands .242-175 -6 WPA Form 5 — Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Tran�saction# ILI North Andover CityrFown C. General Conditions Under Massachusetts Wetlands Protection Act (cont.) g) The responsible party shall: 1. Maintain an operation and maintenance log for the last three (3) consecutive calendar years of inspections, repairs, maintenance and/or replacement of the stormwater management system or any part thereof, and disposal (for disposal the log shalt indicate the type of material and the disposal location); 2. Make the maintenance log available to MassDEP and the Conservation Commission ("Commission") upon request; and 3. Allow members and agents of the Mas,sDEP and the Commission to enter and inspect the site to evaluate and ensure that the responsible party is in compliance with the requirements for each BMP established in the O&M Plan approved by the issuing authority. h) All sediment or other contaminants removed from stormwater BMPs shall be disposed of in accordance with all applicable federal, state, and local laws and regulations. i) Illicit discharges to the stormwater management system as defined in 310 CMR 10,04 are prohibited. j) The stormwater management system approved in the Order of Conditions shall not be changed without the prior written approval of the issuing authority. k) Areas designated as qualifying pervious areas for the purpose of the Low Impact Site Design Credit(as defined in the MassDEP Stormwater Handbook, Volume 3, Chapter 1, Low Impact Development Site Design Credits) shall not be altered without the prior written approval of the issuing authority. 1) Access for maintenance, repair, and/or replacement of BMPs shall not be withheld. Any fencing constructed around stormwater BMPs shall include access gates,and shall be at least six inches above grade to allow for wildlife passage. Special Conditions (if you need more space for additional conditions, please attach a text document): ........... ........... 20. For Test Projects subject to 310 CMR 10.05(11), the applicant shall also implement the monitoring plan and the restoration plan submitted with the Notice of Intent. If the conservation commission or Department determines that the Test Project threatens the public health, safety or the environment, the applicant shall implement the removal plan submitted with the Notice of Intent or modify the project as directed by the conservation commission or the Department. wpaformS,doc• rev,6116/2015 Page 9 of 12 4 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection - Wetlands 242-1765 WPA Form 5 — Carder of Conditions MassDEP File# Ll ..............Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# J North Andover Cityrrown D. Findings Under Municipal Wetlands Bylaw or Ordinance i. Is a municipal wetlands bylaw or ordinance applicable? a Yes [:] No Z The North Andover hereby finds (check one that applies): Conservation Commission a. 0 that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw, specifically: 1.Municipal Ordinance or Bylaw 2.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. b. 0 that the following additional conditions are necessary to comply with a municipal ordinance or bylaw: North Andover Wetlands Protection Bylaw& Regulations Chap. 190 T.Wunici"Pal Ordinance. -or Bylaw et. seq. 3. 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. The special conditions relating to municipal ordinance or bylaw are as follows (if you need more space for additional conditions, attach a text document): North Andover Conservation Commission Findings & Special Conditions..(see.attached) ...... ..... wpaform5.doc- rev.6116/2015 Page 10 of 12 4 Massachusetts Department of Environmental Protection Provided by MassIDEP: Bureau of Resource Protection - Wetlands 242-1765 WPA Form 5 — Order of Conditions MassDEP File# Ll Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction,# North Andover City/Town E. Signatures This Order is valid for three years, unless otherwise specified as a special --- condition pursuant to General Conditions#4,from the date of issuance. 1. Date of Issuance Please indicate the number of members who will sign this form. - a This Order must be signed by a majority of the Conservation Commission. 2.Numb&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 delivered at the same time to the appropriate Department of Environmental Protection Regional Office, if not filing electronically, and the property owner, if different from applicant. Signatures- ......... 9- A El by hand delivery on by certified mail, return receipt requested, on , () Date Date F. Appeals 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 MassDEP 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 for 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 providing written information to the Department prior to issuance of a Superseding Order. 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 10.0,0). 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. wpaform5,doc• rev,6/1612015 Page 11 cf 12 4 Massachusetts Department of Environmental Protection Provided by MmonDEr: Bureau 0fResource PrOtectiOO - WetlGDds 243-1785 ��oumepp|�# ����� � � Order � m� °�~�~ ��n v� Form � �� "���u�� ��u '��D���K�U��ns Massachusetts Wetlands Protection Act M.G.L. c. 131' 040 eDep Transaction# North Andover City/Town G. Recording Information Prior to commencement of work, this Order of Conditions must be recorded in the Registry of Deeds ur the Land Court for the district in which the land ls located, within the chain cf 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 0o the Order of Conditions. The recording information on this page 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. _______________________ ____ _ ___________ _ ________ __ _ ________ |o! North Andover Conservation Commission Please be advised that the Order ufConditions for the Project at: 2051 &2053 Salem Street 242-1765 Project Location x0seooEP File Number Has been recorded at the Registry of Deeds of: Northern Essex County Book Page C|eoo & Jane Richards fol. Property Owner and has been noted in the chain of title of the affected property in: 15590 154 Bank Page In accordance with the Order ofConditions issued on: 10'O2-1A nnve 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 ufApplicant "p"mrmzu""^ ,ev.6116M/5 Page/oof 12 DEP FILE 9 242 - 1765 Therefore, the North Andover Conservation Commission (hereafter the "NACC") 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 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 shall control. "ALCONDITIONS �FGENER Mi 20. The proposed work includes: The Notice of Intent is in response to an Enforcement Order issued by the NACC for unauthorized tree removal within BVW, 100-Foot Buffer Zone and 200-Foot Riverfront Area. The NOI sought and this Order of Conditions approves, the after-the-fact permitting for tree removal undertaken as well as additional proposed tree removal,restorative tree and shrub replanting and re- seeding of disturbed soils. Cut trunks/limbs shall be removed from the area and disposed of off-site, and cut stumps shall remain undisturbed. The BVW shall receive a native New England seed wetmix and the uplands shall receive a native New England logging road seed mix. Work to take place within Bordering Vegetated Wetland, 200-Foot Riverfront Area and 100-Foot Buffer Zone. "Note: the approved plans listed below depicts a proposed stone construction entrance and area of proposed septic system - these activities are NOT approved under this Order and must be reviewed under a separate application with the Commission, "Note: The existing shed located within the 50-Foot No Build Zone at 2053 Salem Street will be removed from this zone under a separate Enforcement Order issued by the Commission. The final as-built plan for this Order of Conditions shall reflect the shed's,new location. 21. The work shall conform to the following (except as noted in the remainder of this document where revisions may be required): Notice of Intent filed by: Cleon and Jane Richards 2051/2053 Salem Street North Andover,MA 01845 Site Plans prepared by: Ranger Engineering& Design,LLC "Buffer Zone Disturbance and Restoration Platt" Sheet I of 2 Signed and Stamped by Benjamin C. Osgood,Jr. PE Scale 1"=20' -Final Revision Dated September 11,2019 "Buffer Zone Disturbance and Restoration Plait" Sheet 2 of 2 Signed and Stamped by Benjamin C. Osgood,Jr. PE Scale 1"=50' -Final Revision Dated September 11,2019 205 P &1 2053 Salan Suvc� FM 11111 Fflk°U242-A 76i Hndirq.ls& Spccia CinldifiomN i Pa2e V of V 2 DEP FILE #242 - 1765 Letter Prepared by: Massachusetts Division of Fisheries &Wildlife (MESA review) Dated August 6, 2019- signed by Everose Schluter 22. 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. 23. 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. 24. 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. 25. 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. 26. 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. 27. The work authorized hereunder shall be completed within three years from the date of this order. 28. This Order may be extended by the issuing authority for one but not more than two periods of up to one year each upon application to the issuing authority at least fllia days (30) prior to the expiration date of the Order (Refer to Section 83) of the Nortli Andover Wetland RegWations). 29. '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. 205 V &r"05. 3 Salem SpTod p:)N'Fk Q-1112 �765 NACC IFincxtoq!!"'^ "'upcch:l('olafifions h. DEP FILE 9 242 - 1765 30. 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. 31. Any future project which proposes a wetland crossing in order to access certain portions of the property will not be qualified as a limited project roadway under 310 CMR 10.53(e). 32. The following wetland resource areas are affected by the proposed work: Bordering Vegetated Wetland (BVW), 200-Foot Riverfront Area (between 100 and 200 feet), 100- Foot Buffer Zone to 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. 33. The NACC agrees with the applicant's delineation of the wetland resource areas on the site as shown on the plans, dated referenced herein, 34. The NACC finds that the intensive use of the upland areas and buffer zone 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. 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. No disturbance of existing grade, soils or vegetation is permitted in the No-Disturbance zone, (See Section 3.4 &Appendix F of the local Regulatims). 35. 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. 36. The owners of the project and their successors in title 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 20,')8 &2053 Sakm Sheel DEP Fik,82,42-1765 NAC( F Kati diigs&Spe6a� ("onkfidons Pa,ge 3 o F 2 DEP FILE #242 - 1765 damage or any other form of water damage. Maintenance of the drainage systern, if accepted by the Town as part of a public way, becomes the responsibility of the Town. 37. The NACC finds the applicant's proposal for 1,525 sq. f t. of BVW restoration replanting and 9,390 square feet of Riverfront restoration replanting to be adequate and provides sufficient mitigation for the proposed removal of three additional trees in the 25-Foot No Disturbance Zone. 38. 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 39. 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. 40. 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 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 con-unencement of the work. Any Order not recorded by the applicant before work conunences may be recorded by the NACC at the applicant's expense. 4L A sign, visible from the public right of way, shall be displayed at the site not less than two square feet or more than three square feet in site bearing the words "'MassachLisetts DEP, File Number 242-1765." 42. No changes to the approved plan shall be implemented in the field until written approval has been granted by the NACC. 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. 2051 209 S4&m S�rcc F)H`FHc Y242--V765 NACC Ftimfin Uondii�tm� 4 of d 2 DEP FILE #242 - 1765 43. 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. 44. 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. 45. 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 property placed and wetland impacts can be monitored. The proposed limit of work shall be shall be clearly marked with erosion controls or temporary fencing and shall be confirmed by the NACC. Such barriers 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. 46. A row of 12" minimum Filtrexx compost FilterSoxx or equivalent shall be placed between all construction areas and wetlands. The erosion control barrier will be properly staked and installed and placed as shown on the plans approved and referenced herein and shall be inspected and approved by the NACC or its agent prior to the start of construction and 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 NACC or its agent. The NACC reserves the right to impose additional conditions on portions of this project to mitigate any impacts which could result from site erosion, or any noticeable degradation of surface water quality discharging from the site. For example, installation of erosion control measures may be required in areas not shown on the plan(s) referenced in this Order of Conditions. Should such installation be required by the NACC, they shall be installed within 48 hours of the Commission`s request. 47. The applicant shall have on hand at the start of any restoration planting work, removal or stockpiling, a minimum of 25 hay bales or equivalent length of Filtersoxx and sufficient stakes for staking these bales (or an equivalent amount of silt fence, 1 hay bale to equal 3 feet of fence). Said bales shall be used only for the control of emergency erosion problems and shall not be used for the normal control of erosion. 205 Q 8,r 2053 S,Am St vvl Dlk P File 112,42 N 765 N,,V'(' Fmmfings 'spu6all('ow'fifimv, Pmno 5 of�2 DEP FILE 4 242 - 1765 48. A check payable to the'Town of North Andover shall be provided in the amount of $10,000 (ten thousand dollars), 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 NACCs review and approval. This condition is issued under the authority of the local Bylaw. 49. The applicant shall designate a Wetland Scientist (or other environmental professional as approved by the NACC or its agent) as an "Erosion Control Monitor" to oversee any emergency placement of controls and regular inspection or replacement of sedimentation control devices, The name and phone number of the erosion control monitor must be provided to the NACC in the event that this person has to be contacted, due to an emergency at the site, during any 24-hour period, including weekends. Proof of the retained monitor must be submitted to the Conservation Department on letterhead by the retained consulting firm. This person shall be given the authority to stop work for erosion control purposes and require remedy of any problems. The Environmental Professional will immediately notify the Conservation agent of any matter that requires attention by the Commission or the agent. The, erosion control monitor will be required to inspect all such devices and oversee cleaning and the proper disposal of waste products. Cleaning shall include removal of any entrapped silt. 50. At least once during each week in which construction activities occurs on-site and for as long thereafter as ground remains unstabilized, the applicant shall submit a written report with photographs from the "Erosion Control Monitor" to the NACC certifying that, to the best of his/her knowledge and belief based on a careful site inspection, all work is being performed in compliance with this Order of Conditions and that approved setbacks are being adhered to, The erosion control monitor must visually inspect all sedimentation/erosion control measures and assume responsibility for their maintenance on a weekly basis and that they are functioning as intended, In addition, all wetland resource areas must be visually inspected for siltation, turbidity, and/or other water quality impacts. The Erosion Control Monitor shall be on site during and/or following a major storm event of 1/2" inch of rain or greater (24 hour event) to ensure that soils remain stable, and erosion controls are adequate and secure 51. After restoration planting/seeding and before the issuance of a Certificate of Compliance, the applicant shall permanently mark the edge of the 25' No-Disturbance Zone as shown on the approved plan at 2051 Salem Street and additional markers shall be installed at 2053 Salem Street to be located 5-6 feet off the edge of the driveway and wrapping south of the end of the driveway at 30 foot intervals (for a DE11 HVc 02,12.tl 765 NACC Flndinps S,� ComhfilIMS 205� k 2053 S�,ikwi��iicc� Pa�,,!e 6 of H 2 DEP FILE# 242 - 1765 total of 8 markers at 2053 Salem). All markers to be placed on 4x4 pressure treated posts at 3 feet in height (or equivalent weather resistant materials): "Protected Wetland Resource Area". This will designate their sensitivity and assure no further inadvertent encroachment into the wetland. 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. These markers shall remain posted and be replaced as necessary in perpetuity. 51 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. 53. 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 erosion control monitor and the applicant to ensure that all of the Conditions of this 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). "STORMWATER MANAGEMENT CONDITIONS 54. Water quality in down gradient BVWs and Riverfront 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. 205 2 05 ;,,a err Strtce p V k N242-k 765 NACC IFindinp&I Cmidhflons Page 7¢,d n 1 DEP FILE P 242 - 1765 DURING CONSTRUCTION 55. The restoration trees to be planted shall be at least 1.5 inches in caliper. Trees shall exhibit 100% survivorship after 2 growing seasons post installation, dead or dying specimens shall be replaced. Any trees replaced shall exhibit 100% survivorship after 2 growing seasons post installation. 56. Invoices for the purchase of native New England Seed Mixes referenced above in Condition #20 shall be provided to the Conservation Department upon immediate availability and before seed application in the field. 57. Upon beginning work, the applicant shall submit written progress reports once a month detailing what work has been done in or near resource areas, and what work is anticipated to be done over the next period. This will update the construction sequence. The erosion control monitor's submissions can serve as a progress report. 58. 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, glass, processed glass aggregate, concrete, recycled concrete aggregate, tires, ashes, refrigerators, motor vehicles or parts on any of the foregoing. 59. All exposed soil finish grade surfaces shall be immediately landscaped and stabilized, or loamed, seeded and mulched, with a layer of mulch hay. All disturbed areas must be graded, loamed and seeded prior to November 15t of each year. Outside of the growing season, exposed soil finish grade surfaces shall be stabilized with a layer of straw until climate conditions allow for seeding. During construction, any area of exposed soils that will be left idle for more than 30 days shall be stabilized with a layer of mulch hay or other means approved by the NACC. 60. Re-grading in the buffer zone is neither proposed nor permitted under this Order. 61. The public right of way construction access for the project shall be swept daily to remove sediment deposited by construction vehicles accessing then site 62. There shall be no stockpiling of soil or other materials within twenty-five (25) feet of any resource area. 63. All disturbed areas located within wetland resource areas which are to be only temporarily disturbed during replanting, shall be restored to their original condition. Soil, if needed, used for this purpose will either be wetlands topsoil or a minimum of 4" of quality loam with a minimum of 20% organic material (soils to be amended with 205 f &,,2053 Sak,m S�roo BIT File 8242A T65, NLAXV Findings 6� Ciondifioas V',,w e 8 ci b 12 DEP FILE # 242 - 1765 clean leaf compost if needed). This shall all be done in accordance with DEP Massachusetts Inland Wetland Replication Guidelines. 64. All waste generated by, or associated with, the construction activity shall be contained within the limit of work, 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 durnpsters (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. 65. Accepted engineering and construction standards and procedures shall be followed in the completion of the project. 66. 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. "AFTER CONSTRUCTION 67. 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 Town's Wetland protection Bylaw. 68, 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 Welland Protection Bylaw and shall remain in perpetuity. 69. There shall be no dumping of leaves, grass clippings,brush, or other debris into a wetland resource areas or the 25-foot No-Disturb Zone. This condition shall remain in perpetuity. 70. Upon completion of construction and grading, all disturbed areas located outside resource areas shall be stabilized permanently against erosion. This shall be done by foaming and seeding according to NRCS standards. Stabilization will be considered complete once full vegetative cover has been achieved. 2051 &,2053 Sulem Shve� DEP He 424 2-p 765 NMV Finihngs&°Spc,�Ja �CoudiOions Pag!17 of 12 DEP FILE #242 - 1765 71. 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. 72. 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 locations and species of planted trees and shrubs within the BVW, Riverfront and Buffer Zone. Distances from structures to wetland resource areas - including the relocated storage shed at 2053 Salem. Structures include (but are not limited to) septic systems, additions,fences, sheds, stone walls,pools,retaining walls, subsurface utilities and decks. A line showing the limit of work and the extent of existing erosion control devices. "'Work"" includes 91 a disturbance of soils or vegetation. 11Y 87. The following special conditions shall survive the issuance of a Certificate of Compliance (COC) for this project: 25" No-Disturbance Zone and 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 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; Resource Area Markers (Condition#51); 205 11 N, 21:15)1 �,:akmi"mcet DEP I R5 N,A if'(' DEP FILE 4 242 - 1765 Discharge or spillage of pollutants (Condition #66); Prohibition of underground fuels (Condition #67); 1-imitations on the use of fertilizers, herbicides and pesticides (Conditions #68); No dumping of leaves, grass clippings, brush, or other debris into a wetland resource areas or the 25-foot No-Disturb Zone (Condition #69). 20,"7� S, 20`l SaNm S Yec V M P O-k 1)242-➢765 F nkhTIVS& Speck i DEP FILE #242 - 1765 APPENDIX A- AFFIDAVIT on oath(to hereby depose and state: (authorized agent applicant and/or current owner) (PLEASE CHECKAT LEAST ONE BLOC 1. 1 am the of (position with applicant) (applicant name or company name) the applicant upon whom Order of Conditions have been placed upon by (DEP or NACC number) the North Andover Conservation Commission. &/or 2. 1 am the of (position with owner) (owner name) the owner upon whose land Order of Conditions have been placed up by (DEP or NACC number) the North Andover Conservation Commission. 3. 1 hereby affirm and acknowledge that I have received said Order of Conditions and have read the same and understand each (DEP File #) and every condition which has been set forth in said Order of Conditions. 4. 1 hereby affirm and acknowledge that on this day of 19 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 Order of Conditions are presently in compliance. (DEP File #) 5. 1 hereby affirm and acknowledge that this document will be relied upon by the North Andover Conservation Commission as well as any potential buyers of said property which is subject to said Order of Conditions........—--------— (DEP File #) Signed under the pails and penalties of perjury this—day of 19 (Signature-authorized agent of applicant or owner) NNAOC, Page, �2 of 12