HomeMy WebLinkAbout- Permits #242-1669 - 265 SUMMER STREET 11/6/2019 ILIMassachusetts Department of Environmental Protection DPP File Number:
ureau of Resource Protection - Wetlands
WPA Form 7 — Extension Permit for Orders of Conditions 242-1669
Massachusetts, Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
A. General Information
Important.
When filling out I• Applicant:
forms on the
Jeff&Carrie Corl'iss
computer, use Nam.e..................
only the tab
key to move 265 Summer Street
your cursor- Mailing Address
do not use the North Andover MA 01845
return key. City/Town State Zip Code
Q2. Property Owner (if different):
Name
Mailing Address
City/Town, State Zip Code
B. Authorization
The Order of Conditions (or Extension Permit) issued to the applicant or property owner listed above on:
1/27/2016 Issued by: Town of North Andover
Date Conservation Commission
for work at: 265 Summer Street 107A 291
Street Address Assessor's Map/Plat Number ParcellLot Number
recorded at the Registry of Deeds for:
Northern Essex. 15593 263
..............................
County Book Page
Certificate(if registered land)
is hereby extended until: 1/27/2021 1/27/2020
Date Date the Order was last extended(if applicable)
This date can, be no more than 3 years from the expiration date of the Order of Conditions or the latest
extension. Only unexpired Orders of Conditions or Extension may be extended.
This Extension Permit must be signed by a majority of the Conservation Commission and a copy sent to
the applicant and the appropriate DEP Regional Office
(httpJ/www.ryiass.,aov/eea/aaencies/massdeiD/about/contacts/find-the-massdep-regic)naR-office-for-your-city-or-
town.htmil).
Signatures- '—p 11/06/2019
7w
Date
,
----------- ..........
NTaforrnTdoc-rev.W2912014 Page 1 of 2
Massachusetts Department of Environmental Protection
ILIBureau of Resource Protection - Wetlands DEP File Number:
WPA Form 7 — Extension Permit for Orders of Conditions 242-1669
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEF
C. Recording Confirmation
The applicant shall record this document in accordance with General Condition 8 of the Order of
Conditions (see below), complete the form attached to this Extension Permit, have it stamped by the
Registry of Deeds, and return it to the Conservation Commission.
Note: General Condition 8 of the Order of Conditions requires the applicant, prior to commencement of
work, to record the final Order(or in this case, the Extension Permit for the Order of Conditions) 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, it shall be noted in the Registry's Granter 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, it shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the
proposed work is done.
Detach this page and submit it to the Conservation Commission prior to the expiration of the Order of
Conditions subject to this Extension Permit.
To:
North Andover
Conservation Commission
Please be advised that the Extension Permit to the Order of Conditions for the project at:
265 Summer Street 242-1669
Project Location DEP File Number
has been recorded at the Registry of Deeds of:
Northern Essex
County
for:
Jeff&Carrie Corliss
Property Owner
and has been noted in the chain of title of the affected property in accordance with General Condition 8 of
the original Order of Conditions on:
Date Book g
If recorded land the instrument number which identifies this transaction is:
Instrument Number
If registered land, the document number which identifies this transaction is:
- ..........
Document Number
Signature of Applicant
wpaformTdoe-rev.512912014 Page 2 of 2