HomeMy WebLinkAbout- Certificate of Compliance - 659 FOREST STREET 10/22/2003 Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands DEP File Number: -
WPA Form 8B — Certificate of Compliance 242-1049
[Massachusetts Wetlands Protection Act M.G.L. c. 131, §40ILA Provided by DEP
A. Project Information
Important;
When filling out 1. This Certificate of Compliance is issued to;
forms or1 the Robert Reed
computer, use Name
only the tab
key to move 659 Forest Street
your cursor- Mailing Address
do not use the North Andover MA. 01845
return k��e--,y Cityrrown State Zip Code
2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to:
Robert Reed
Name
11/15/00 '242-1049
Dated DEP File Number
3, The project site is located at:
6591=orest Street North Andover
Street Address Cityrrown
Map 105D Parcel 38
Assessors Map/Plat Number Parcel/Lot Number
the final Order of Condition was recorded at the Registry of Deeds for:
Property Owner(if different)
Essex North Instrument#32662
County Book Page
NIA
Certificate
4. . A site inspection was made in the presence,of the applicant, or the applicant's agent, on:
10/7103
Date
B. Certification
Check all that apply:
® Complete Certification: It is hereby certified that the work regulated by the above-referenced
Order of Conditions has been satisfactoriljr 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:
wpafo[m Bb.doc•rev.1211 b100 Page 1 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands DEP File Number."
WPA Form 8B }-' Certificate of Compliance 242 1049
Massachusetts Wetlands Protection Act Ll M.G.L. c. 131, §40 Prov;ded 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therefore no longer valid.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: "
79
C. Authorization
Issued by:
North Andover 0193 03
Conservation Commission Date of issu nce
This Certificate must be signed by a majority of the Conservation Commission a opy sent to the
applicant and appropriate DEP Regional Office(See Appendix A).
Signat es:
/V
' -
On a�" Of 0640 bei�- oQ003
Day Month and Year
before me personally appeared
to me known to be the person described in and who executed the foregoing instrument and
acknow! ged that he/she executed the same as his/her free act and deed.
Notary Pubic 6q My.-oorrimi4on expires
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Massachusetts Department of Environmental'Protection
Bureau of Resource Protection -Wetlands DI P File Number:'
WPA Form 8B -- Certificate of Compliance - 242_1049
Massachusetts Wetlands Ll Protection Act M.G.L. c. 131, §40 Provided by r}Ei?
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.
242-1049
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
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