06-001 (4) r
APR - 6&M A
OF NORTHAM TON, MA
APPLICATION FOR ENDORSEMENT
OF PLAN BELIEVED NOT TO REQUIRE APPROVAL
File five 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.
i. Applicant JvDgk Aw,4 VILE
Print or type name Signature
AA`(DeQ V(LLE �fl, µTo ti] S$L-61(02
Address Phone
2. Owner S A M E
Print or type name Signature
Address Phon
3. Surveyor�)CHARO J. LAT�ASZGESQ. ) zliz-x Pr
or type name S' r
110 i":1QG ST N,-FC)ti1 58� - 10 I I
Address Phone
4. Deed or property recorded in HAM P59 illy Registry,
41 23 3Z-1
Book 4 9 G9 page 41
5. Location and Description of Property:
WEST SvVE of HAYDE1,1v1LLe- CZD (iZ.TE9) IMmeDiATEL`J
S' LYpF WkLL.1AM5FU1ZGTowxJ LtNc
6. Assessor's Map ID: (0 Lot(s) :
Date Submitted for Planning Date Planning Bo d
Boar proval. '� O D e c i s i qlrVi 1ed:
• e o • • e
Cit City
i ature) ure)
(8/13/91)
SUBDIVISION REGULATIONS-------PAGE 60