HomeMy WebLinkAboutMiscellaneous - 39 HEPATICA DRIVE • i
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Massachusetts Department of Environmental Protection #'
Bureau of Resource Protection -Wetlands DEP File Number:
WPA Form 8B — Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131 40 242-1538
r � Provided by DEP k,,;
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A. Project Information
Important:
When filling out 1. This Certificate of Compliance is issued to: j'-
forms on the
computer, use Teresa L. Swimm t
only the tab key Name ?`
to move your 39 Hepatica Drive
cursor-do not
use the return Mailing Address
key. North Andover MA 01845
City/Town State Zip Code
-U'a 2. This Certificate of Compliance is issued for work regulated by a final Order of `
Conditions issued to:
' David Swimm t
Name
December 8, 2011 242-1538
t.
Dated DEP File Number
3. The project site is located at
622 Salem Street North Andover
Street Address City/Town
Map 65 Parcel 283
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 13476 85
County Book Page
Certificate
4. A site inspection was made in the presence of the applicant, or the applicant's agent,
on:
9/8/15
Date
wpafrm8b.doc•rev.5/29/14 WPA Form 8B,Certificate of Compliance•Page 1 of 3
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Massachusetts Department of Environmental Protection '
LI Bureau of Resource Protection - Wetlands DEP File Number: '>'
WPA Form 8B - Certificate of Compliance
242-1538
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
;1'
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.
:
❑ 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:
1
❑ 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Conditions has lapsed and is therefore no longer valid.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:
69
C. Authorization
Issued by:
North Andover CT 9' ik
Conservation Commission Da of ssuance
This Certificate must be signed by a majority of the Conservation Commission and a
copy sent to the applicant and appropriate DEP Regional Office(See
http://www.mass.dov/eea/agencies/massdep/about/contacts/find-the-massdep-
regional-office-for-your-city-or-town.html).
Signatur :
1
/ JITT ,
—.—,rte—
G
wpafrm8b.doc•rev.5/29/14 WPA Form 8B,Certificate of Compliance•Page 2 of 3
Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B - Certificate of Compliance
242-1538
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:
622 Salem Street 242-1538
Project Location DEP File Number
Has been recorded at the Registry of Deeds of:
Essex Northern
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
wpafrm8b.doc•rev.5/29/14 WPA Form 8B,Certificate of Compliance•Page 3 of 3