Loading...
HomeMy WebLinkAboutRequest for Certificate of Compliance 242-875 Massachusetts Department of Environmental Protection � DES File Number: Bureau of Resource Protection - Wetlands WPA Form BA — Request for Certificate of Compliance 7 Massochusetts Wetlands Protection Act �- - Praviaed by ti p ..... - ..................... .......... A. Project Information MAY When filling out 1. Thi€s request is being m8de by_ forms on the NorthpGint Reolty Development qrp.. NORM ANDOVER T IC COMMISSION ............... - cornputef, use Kame only the tab 231 Sutton treelt key to move —................ .. ..............----------- your curser- Meiling Address do not use the Flo Andover Ma 01845 -.. - - ................ ...... - ............ ........ return key- cif(Yi.rwrs Stake Zip code 978 687 620,0 +�+ Phrrnelr�m#}er 2, This request is in reference to work regulated by a final Order of Conditions Fssued to: North point.Realty Development orpf,t.€ . fealty Trust ...................... F1ppliCaal# ... — 9117197 24 -875 —.................... - -.-.... Daied DEP File Number Upon completion of the work - The project site is located at: authorized in 757 Turnp ke Street Cho Andover anOrder of --...... .... .. . ....... —_.............. .... 9kreet Address Ctt frown CondMons, the 2, 6,17,4FJ property owner g8D_...8 ........ ---........ must request a Assessors MapiPla#NUMber ParcWLot Miniber Certificate of 4, The final Order of Conditions was recorded at the Registry of Deeds for: Compliance from the issu[ng ................. — ....... ....... authority stab —.Pr..operty Owner(if difreren#). ................. that the woFk or Essex NorLh District 4 28 129 portion of the -....... .....---.. .._..-.---..... ... -....... work has been ourtty Book Page satisfactor€ly ..............._-- completed- Certificate(it inostored land) 5. This request is for certification that(check one): the work regulated by the above-referenced Order of Conditions has been satisfactorily completed- the follawing portions of the work regulated by the above-referenced Order of Conditions have been satisfactorily completed (use additional paper if necessary). © the above-re%nr aced Order of Conditions has lapsed and is therefore no longer valid, and the wo* regulated by it was never started. wparnrRkla dn..• a v 7fgeLI4 Pwa 1 nF - Massachusetts Department of Envieonmental Protection -- DEP Ear Nurnbef= Bureau of Resource Protection - Wetlands f WPA Form 8A — bequest for Certificate of Compliance Massachusetts Wetlands Protect Eon Act M.G,L. c. 13 1 r §40 Pfov ded t?y DEP ...... ................. A. Project Information (cola.) B. Did the Order of Conditiocs for this project, or the p4rtion of the project su bject to this request, contain an approval cf any plans stamped by a registered professional eLngineer, architect, landscape architect, or rand surveyor? `des if yes, attach a wri#ten statement by such a professional certifying substantial compliance with the pans and describing what deviation, if any, exists from the plans approved in the Order, ❑ No - --.-._...... . . ................. -- B. Submittal Requirements Requests for Certificates of Compliance should be directed to the issuing authority that issued the final Order of Gandifions (OOO). If the project received an DOC frorn the Conservation Commission, submit this request to that Commission- if the project was issued a Superseding Order of Conditions or was the subject of ari Adjudicatory Hearing Final Decision, submit this request to the appropriate DEP Region.M Office(see http=llwww-mass.govfdepfaboutfre iorrlfindyour.htm). wpararna4.duu •i ev.?AVM P lge 2 012