25A-099 R[EOCT -�
5 2Q01 FORM A
NORTHAMPTON, MA
O�NOR?NA iMON,MAPO��ONS
ION FOR ENDORSEMENT
OF PLAN BELIEVED NOT TO REQUIRE APPROVAL
File seven completed and signed forms and plans and one mylar with the City Clerk and the Planning 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 constitute 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):AtW Near 'AeauLt Signature:
Address: & nMnoNn Na'� + Phone:
58q . 44 4 2.
2. Owner(print or type): 5 - Signature:. a"
Address: J t Phone: 3 J>/Y �1f�4— —
3. Surveyor(print or type): & Assoc'. {NG. Signa 44���---�.
Address: km A kpp N4 O(0fo 0 Phone: k1'a. 5 8 . 1444 . X 110
4. Deed or property recorded in Hampshire County Registry of Deeds or Land Court:
Book Z884" Page 2$
5. Street Name,and Property Location and Description:
Street Name:
mrn„� , J µ2
Description:
2 �atrcetg o�n -4�• Q.ao ��du � 54uv�w.o,.�. �.hwe. .
6. Assessor's Map ID:'2SA Lot(s): 77
7. Number of newly created lots:
Date Submitted r anning Date Planning Board ii
Board Approval. - / Decisio ile -11 c C)I
• q o
City Clerk(sign City Cle s
(July 2000)
SUBDIVISION REGULATIONS-------
i