36-297 (3) FORM A
NORTHAMPTON, MA "rL
'.f APR 2 12000
APPLICATION FOR ENDORSEMENT ^:r
OF PLAN BELIEVED NOT TO REQUIRE APPROVAL
File 4e completed forms and plans and one mylar with the City Clerk and the
Planning Board in accordance with the requirements of Section 3.02.
To the Planning Board:
The undersigned, believing that the accompanying plan of his/her 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. ApplicantSa[n o
Prin or type name ignatureJ
i35Srx4v,r-ernn�on _
Address �^ Phone
�^ t
.JL�h l Xa Cow`'
2. Owner � `
Print or type name Sig ature
41 Sz��lere��n ll�u �1cx ��� 5��- I1D�
Address Phone
)-
3. Surveyory-eCJQ\S+ �LJk-
Print or type name Signature
ao-Da n.--t
Address Phone
4. Deed or property recorded in 1'TC.-lMDr:41t(Z•<-- Registry,
La+ 1 533 Paint. a1 k
z Book `J 0'8 1 Page 3I`}
�qZ)Location and Description of Property: A
ONi�ete.r�n L�a� " t �� yl�aci 1 �*ZCgG� io � cCc-�b;r'1cd 0t5 C
Ponce\ :
6.
Date Submitted r Planning Date gkUaa�n;ning B rd Board roval Y r C;J Deci ed a cc)
•
City ° City
S ure) i ature)
(8/13/91)
SUBDIVISION REGULATIONS-------PAGE 60