29-106 (4) h r/�J
2
ENDORSEMENT OF APPROVAL NOT REQUIRED (ANR) PLAN
File with the Office of Planning and Development
City of Northampton, .Massachusetts
JQ,p,r 1 0 2,07
1. Deed recorded in Hampshire County Registry of Deeds or Land Court: Book 1.199 Page 464
2. Street Address: RYAN ROAD NORTHA>VIPTON MA 01060
3. Assessor's Map: '�q Lot(s): 106 Additional property description: PARECL i &2
4. Number of newly created lots: 1
5. Check list of tiling requirements(check the supplied items. Applications MUST have these items.)
is Original, reproducible(mylar)Plan, with endorsed Seal of a Massachusetts Registered
Professional Land Surveyor.
• Six(6)prints of the Plan.
• Original and Six(6)copies of the fully completed and endorsed ANR Application form.
• S 150 per sheet fee plus S50 for each newly created lot(payable to"City of Northampton").
a 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.
a An electronic version of the plan in model space in DWG, DXF,or Shape format including:
a All property lines,buildings and geographic features shown on the plans.
a Closure of all property boundaries of one part in 20,000
a Plans show all buildings owned by subject landowner(s)within 100'of any newly created
property lines.
a 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): THOEDORE TOWNE Signature: Tel
Address: �tj��/, �5% Phone: �--� Ct C,�� t
Owner(print or type): THOEDORE TOWNE Signature: ._.-
Address: Phone: C
Surveyor(print or type): HUNTLEY ASSOC. P.C. Signature: I J
Address: 30 Industrial Drive East Northampton Phone: (413) 584-7444
{lluw 1 1 ,lutis for procc.5sino_ It is the applicant*s rc5ponsibility to pick zip the original lratil ing and
�,ecord rt at the Registry of Deeds or Land Court ,,t ithin the time limits established by the Regtstri-. _111
L opies and Jorms remain,.i ith the Cin-. Applicants may the one copy of this A.%R form .t ith the Cinv Clerk
to protect their appeal rights.
Date Submitted: Date Decision Filed: J/ /dr/iICY /a _Q
Cite Clerk(sienarure): City Clerk(signature)