The undersigned being a majority of the Planning Board of the Town of North Andover, MA hereby certify that the requirements for work on the ground called for by the Conditional Approval dated ___________________________, 19____ and recorded in Essex South District Registry of Deeds, Book _______, Page ____________ (or registered in _________________ Land Registry District as Document No. ____________, and noted on Certificate of Title No. _____________, in Registration Book _____________, Page _____________) have been completed to the satisfaction of the Planning Board as to the following enumerated lots shown on Plan entitled ___________________________________ recorded with said Deeds, Plan Book _____, Plan _____, (or registered in said Land Registry District, Plan Book ________, Plan _________) and said lots are hereby released from the restrictions as to sale and building specified thereon.

Lots designated on said Plan as follows: _________________________________________

__________________________________________________________________________

(To be attested by a Registered Land Surveyor)

I hereby certify that lot number (s) ______________________ on ________________________ Street(s) do conform to layout as shown on Definitive Plan entitled "____________________________ Section ________________ Sheet(s) _________________"

_____________________________________

Registered Land Surveyor

_______________________ Majority Of

_______________________ The Planning

_______________________ Board Of The

_______________________ Town of

_______________________ North Andover

COMMONWEALTH OF MASSACHUSETTS

________________________, ss. __________________________, 19____

Then personally appeared ____________________________, one of the above-named members of the Planning Board of the Town of North Andover, MA, and acknowledged the foregoing instrument to be the free act and deed of said Planning Board, before me,

_______________________________

Notary Public

My Commission Expires: