36-341 NQ
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FORMA C �(Y
NORTHAlYpTON, MA
APPLICATION FOR ENDORSEMENT
OF PLAN BELIEVED NOT TO REQUIRE APPROVAL
File seven completed forms and plans and one mylar with the City Clerk and the Planni Board in accordance with
the requirements of Section 3.02.
I (we) believe that the attached plan of property in the City of Northampton does not con.stirate division within the
meaning of the Subdivision Control Law, and herewith submits said plan for a determination and endorsement that
Planning Board approval under the Subdivision Control Law is not required.
1. Applicant (print or type): 4-4/Zelac't f r Signature: ��it ' l - A dress r / C23e . /7 tc /44. O' C Phone: 4/✓ — 5 q^?, / Si
-0,,tt vJzrk to,".;1y �
2. Owner (print or type): YtnJtf,4-ww�* Zfu'.aaG Signature: y ✓ .
Addre §s: / j l' 7 ?`t /'; Phone: `J r{ 6
3. Surveyor (print or type): 4Vh +(2 ASSOCIAteS FC • Signature/ . t,-�.
Address: /1/410f-144(2-.....440v. Phone: 4t3 52
4. Deed or property recorded in Hampshire County Registry of Deeds or Land Court:
Book 11 Page 30S
5. Street Name, and Property Location and Description: _
Street Name: CARD4+JAL WAY
Description: ;
6. Assessor's Map ID: Lot(s):
7. Number of newly created lots: (
Date Submitted for Planning - Date Planning .". s
Board Approval: Decision File. J - - AV ii 0 O
City Clerk (signature): City Clerk (signaL. e): _
(5/10 /2001)
SUBDIVISION REGULATIONS