HomeMy WebLinkAboutMiscellaneous - 40 BOOTH STREET . ,
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iiiiMassachusetts Department of Environmental Protection
Bureau of Resource Protection -Wetlands DEP File Number:
WPA Form 8B - Certificate of Compliance 242-1059 s
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 Quality Realty Trust g
only the tab key Name
to move your 36 High Vale Lane
cursor-do not €-
use the return Mailing Address
key. Andover MA 01810
City/Town State Zip Code
tertab 2. This Certificate of Compliance is issued for work regulated by a final Order of
Conditions issued to:
,.=K... Stephen & Cheryl Juba '°
retum Name
May 2, 2001 242-1059 /_
Dated DEP File Number
3. The project site is located at:
40 Booth Street North Andover
Street Address City/Town
Map 98A Parcels 14, 15
Assessors Map/Plat Number Parcel/Lot Number
the final Order of Condition was recorded at the Registry of Deeds for:
s_
Property Owner(if different)
Essex North 107 85
County Book Page
13644
Certificate
4. A site inspection was made in the presence of the applicant, or the applicant's agent,
on:
/0/72(00
Date •
wpafrm8b.doc•rev.12/23/09 WPA Form 8B,Certificate of Compliance•Page 1 of 3
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Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
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WPA Form 8B — Certificate of Compliance
242-1059
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
B. Certification
Check all that apply: I
® Complete Certification: It is hereby certified that the work regulated by the
above-referenced Order of Conditions has been satisfactorily 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
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❑ 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Conditions has lapsed and is therefore no longer valid.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.
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® 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). t
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Condition Numbers: t
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64
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C. Authorization €'
Issued by r
North Andover ////'7///' 0
Conservation Commission Date of Issuance
This Certificate must be signed by a majority of the Conservation C. ission and a
copy sent to the applicant and appropriate DEP Regio 'I Office (•--
http://www.mass.qov/dep/about/region/findyour.htm). f
Signatures:
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:d°11717 A 44// i All
c__) /--, 74*(4
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wpafrm8b.doc•rev.12/23/09 WPA Form 8B,Certificate of Compliance•Page 2 of 3
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Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B - Certificate of Compliance 242-1059
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
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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:
40 Booth Street 242-1059
Project Location DEP File Number
Has been recorded at the Registry of Deeds of:
Essex North
County
for:
Property Owner
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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:
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If registered land, the document number which identifies this transaction is:
Document Number
Signature of Applicant
wpafrm8b.doc•rev.12/23/09 WPA Form 8B,Certificate of Compliance•Page 3 of 3