HomeMy WebLinkAboutClerk's files Massachusetts Department of Environmental Protection
Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B — Certica
Massachusetts Wetlands Protection fite Act of Compliance M.G.L. c. 131 40 242-1114
Provided by DEP
A. Project Information
Important:
When filling out 1. This Certificate of Compliance is issued to
forms on the
computer, use Thomas D. Zahoruiko, Meetinghouse Commons LLC
only the tab key Name
to move your 78 Great Pond Road
cursor-do not
use the return Mailing Address
key. North Andover MA 01845
City/Town State Zip Code
1ta 2. This Certificate of Compliance is issued for work regulated by a final Order of
Conditions issued to:
�' Meetinghouse Commons LLC
Name
March 28, 2002 242-1114
Dated DEP File Number
3. The project site is located at:
Dale Street/South Bradford Street North Andover
Street Address City/Town
Map 104C Parcels 28 & 31
Assessors Map/Plat Number Parcel/Lot Number
the final Order of Condition was recorded at the Registry of Deeds for
Martin Smolak Revocable Trust, H. Michael & Helen R. Smolak
Property Owner(if different)
Essex Northern 8732 329
County Book Page
Certificate
4. A site inspection was made in the presence of the applicant, or the applicant's agent,
on:
4/8/2014
Date
wpafrm8b.doc•rev.12/23/09 WPA Form 8B,Certificate of Compliance•Page 1 of 3
a
vim
Li 1 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, §40 242-1114
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.
•
❑ 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:
t
❑ 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Conditions has lapsed and is therefore no longer valid.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 F
monitoring, that should continue for a longer period).
Condition Numbers:
76
C. Authorization
Issued by:
North Andover yl a3 l 4
Conservation Commission Da e of Is ance
This Certificate must be signed by a majority of the Conservation Commission and a
copy sent to the applicant and appropriate DEP Regio .1 Office (See
htt•://www.mass.•ov/de•/a•-•ut/re•',on/find our.htm).
Signatures: I 0.,„.„_...... ,
1 i ,
i zil,
ii. ■
I .._, ., i _to- L Q- ?.- 1 �-{-c_- (IJI' i,vr_zf. .. ,
C L y
wpafrm8b doc•rev.12/23/09 WPA Form 8B,Certificate of Compliance•Page 2 of 3
Massachusetts Department of Environmental Protection
L Bureau of Resource Protection - Wetlands DEP File Number:
WPA Form 8B - Certificate of Compliance
Massachusetts Wetlands Protection Act M.G.L. c. 131 40 242-1114
+ � 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
Dale Street/South Bradford Street 242-1114
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.12/23/09 WPA Form 8B,Certificate of Compliance•Page 3 of 3