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35-029 (5) ENT OF APPROVAL NOT REQUIRED (ANR)PLAN with the Office of Planning and Development Uu` NOV 18 2004 City of Northampton,Massachusetts Use Tab Key To Move From F eld To I ield D PTOM UR l, l amps iire County Registry of Deeds ePI�d-Eowl: Book (O.R. Page 2?.!0 j4�IR-Strd;t,Adik&J& ©oFF A5[eR�Y s JIM-11 OF wEST A> {2r?40 3. Assessor's Map: 3 .__.. Lot(s). 29 Additional property description: 4. Number of newly created lots: 5. Check list of filing requirements(check the supplied items. Applications MUST have these items.) x Original,reproducible(mylar)Plan,with endorsed Seal of a Massachusetts Registered Professional Land Surveyor. x Six (6)prints of the Plan. X Original and Six(6)copies of the fully completed and endorsed ANR Application form. X $150 per sheet fee plus $50 for each newly created lot(payable to"City of Northampton"). If any portion of a plan falls within 500 feet of a published control point(see NorthamptonPlanning.org): four centimeter-accuracy points on each sheet tied into the Massachusetts State Plane Coordinate System(NAD 1983 datum),using said published control points or the global positioning system and noting the coordinates of the tie-in points,the datum, and the source and location of monuments used for data. x An electronic version of the plan in model space in DWG,DXF, or Shape format including: All property lines,buildings and geographic features shown on the plans. Closure of all property boundaries of one part in 20,000 (e—mailed to Planning Dept. on • Plans show all buildings owned by subject landowner(s)within 100'of any newly created 11/1/04) property lines. • Plans include a statement that the Planning Board's endorsement is not a determination that the lots shown are buildable lots. We believe and understand that: (1) The attached plan is not a division as defined in the Subdivision Control Law and we submit it for endorsement that Planning Board approval under this Law is not required; and (2) we have provided all the information required in the checklist above; and (3) The plans submitted are now in the public domain and may be copied freely in any form. Applicant(print or type): Mark A. Tanner Signature: — Address: MORSE & SACKS,_ 31 Trumbull Rd., Phone: 11(41- 84-1287 Northampton, MA 01060 Owner(print or type): Bill Willard, Inc. Signature: on behalf of Address: 1010 Ryan Road Phone: 584„1802 Florence, MA 01062 Surveyor(print or type): 14UWLet ASSOG1A'CC� P.L. Signature:o=�. Address: ROPIAAMM13 ; Phone: ,_,_S84 413 .144- 4- -,”, Allow 21 days for processing. It is the applicant's responsibility to pick up the original drawing and record it at the Registry of Deeds or Land Court within the time limits established by the Registry. All copies and forms remain with the City. Applicants may file one copy of this ANR form with the City Clerk to protect their a eal rights. � ° Date bmitte U&, Date Decisio Ci City Clerk ou(ANR Application,Form A: t revised 3/