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11C-069A florence street planning
r..r 1.00, FORM A NORTHAMPTON, MASS. Date APPLICATION FOR ENDORSEMENT OF PLAN BELIEVED NOT TO REQUIRE APPROVAL File one completed form with the Planning Board and one copy with the City Clerk in accordance with with requirements of Section 3.02. To the Planning Board: The undersigned, believing that the accompanying plan of his property in the City of Northampton does not constitute division within the meaning of the Subdivision Control Law, herewith submits said plan for a determination and endorsement that Planning Board approval under the Subdivision Control Law is not required. 1. Applicant r- Print or type name r Signa ure 2. Aaar Print or type name signature Address 3 • Surveyor 4,_, ,A,.rrzx•✓, ' �4sso� � ,, Print or type name Signa Address 4. Deed or property recorded in �if �SN /8E �✓�y Registry, Book 1993 Page / o ,7 7,S— 5. Location and Description of Property: Z- 3, 4 - 676 c-:r4 oi✓ Smvr�y S.pF ©t Date of Submission August 20, 198 City Clerk Si natu e 3 3