HomeMy WebLinkAboutCertificate of Compliance - 107 CAMPION ROAD 10/7/2015 k � �� �
LitMassachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands DEP File Number:
WPA Form ® Certificate of Compliance
NACC#126
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
A. Project Information
Important:
When filling out 1. This Certificate of Compliance is issued to:
forms on the
computer,use Dimitrios Saragas
only the tab key Name
to move your 16 Somerset Street
cursor-do not
use the return Mailing Address
key. Andover MA 01845
City/Town State Zip Code
2. This Certificate of Compliance is issued for work regulated by a final Order of
Conditions issued to:
Dimitrios Saragas
' Name
August 14, 2014 NACC#126
Dated DEP File Number
3. The project site is located at:
107 Campion Road North Andover
Street Address City/Town
Map 62 Parcel 89
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 Northern 14017 63
County Book Page
Certificate
4. A site inspection was made in the presence of the applicant, or the applicant's agent,
on:
10/7/15
Date
wpafrm8b.doc•rev.5/29114 WPA Form 8B,Certificate of Compliance-Page 1 of 3
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Massachusetts Department of Environmental Protection
Bureau Of Resource Protection - Wetlands oeP File Number:
WPJ& Form 8B ~_ Certificate U^
of Compliance" — NACC#126
Massachusetts Wetlands Protection Act M.G.L. C. 131. §40 Provided by DEP
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 satisfactorily completed.
LJ Partial Certification: Kis hereby certified that only the following portions ofwork
regulated by the above-referenced Order of Conditions have been satisfactorily
completed. The project onaesorvworke ottothisportio|oedihuetionthothavo
been completed and are released from this Order are:
Fl 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Conditions has lapsed and io therefore no longer valid. No future work eVbiectto
regulation under the VVedandaProtection Act may co0nmencevVithoVtfiUn ^enew
NoUoeof Intent and receiving oDavv Order ofCoDdh|onG. ~
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 o longer periud).
Condition Numbers:
69
C. Authorization
Issued by:
North Andover
Conservation Commission
This Certificate must be signed bva majority ofMheConoe[vaUonCommission' and
copy sent to the applicant and appropriate DEP Regional Office(See
Sig tures:
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xvomn8b.do `rev.u/2m^ vww Form^B,Certificate m Compliance'Page cmu
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Fora 8B ® Certificate of Compliance NACC#126
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:
107 Campion Road NACC#126
Project Location DEP File Number
Has been recorded at the Registry of Deeds of:
Essex Northern
County
for:
Dimitrios Saragas
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
wpafrm8b.doc•rev.5/29114 WPA Form 8B,Certificate of Compliance•Page 3 of 3
RECEIPT
Printed: October 8, 2015 a 10;09:52
Essex North Registry
M. Paul Iannuccillo
Register
Trans#: 21191 Oper:KEUINZ
CENTURY
Book: 14406 Page: 258 Inst#: 26403
Ctl#: 50 Rec:10-08-2015 ® 10:09:20a
AND 107 CAMPION RD
DOC DESCRIPTION TRANS AMT
COMPLIANCE
Surcharge CPA $20.00 20.00
50.00 recording fee 50.00
5.00 TECH FEE 5.00
Total fees: 75.00
** Total charges: 75.00
CHECK PM 2069 75.00