34-027 (6) 3�t - � 7
K
FORM A 5
4 20QZ NORTHAMPTON, MA
MAR 1 4 Q; LICATION FOR ENDORSEMENT
ELIEVED NOT TO REQUIRE APPROVAL
File sevl3tdft -an ans and one mylar with the City Clerk and the Planning Board in
ccor ance with the requiremen of Section 3.02.
1 (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.AppIicant (print or type): SOQ Qr'et 1JXsLlcSignature:
Address: 13S VZgcLA Phone: S27- g00 1
W es 41wv���o MA O t OZ7
2.Owner(print or t e :Scve,ej 5n C3u�Ld ers Z�L Signature:
Address: 135 Sc�hr_�i-nPfun Iifd- Phone: Lt1 3 -52 7- - U 0/
� 5�In c2✓r7 trr7 �'YL�.. 0102-7
3.Surveyor(print or type): Oke .. - Signature: (kAA�d
Addres?