36_-263_letterAA 163 Maple Ridge Rd- application for endorsementf
4
APPLICATION FOR ENDORSEMENT
OF PLAN BELIEVED NOT TO REQUIRE APPROVAL
FORM A
NORTHAMPTON, MA
September 18,
Date
File one completed form with the Planning Board
and one copy with the City Clerk 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 Subdivi3:_on Control Law, herewith submits said plan for a
determination and endorsement that Planning Board approval under the
Subdivision Control Law is not required.
1. Applicant Roger Allcroft
Print or type name
69 Adams Road, Haydenville, MA 01039
Address
2. Owner Roger Allcroft
Print or type name
69 Adams:Road, Haydenville, MA 0103?1
3.
Address
in
• ,
n
Signa u
(413) 268-3355
Phone
Signa 041 I/
(413) 268-3355
Phone
Hill -Engineers Architects, lkzjL:�
Surveyor Planners, Inc.
Print or type name S' e
P.O. Box 293, 50 Depot St., Dalton, MA 01226 (413) 788-7771
Address Phone
4. Deed or property recorded in Hampshire Registry,
Book 3388 Page 49 and Book 3178 Page 350
5. Location and Description of Property: Lots 17 & 18 Maple Ridge -Road
17
Date of Subm' ssio\
City Clerk
7g ure
FORM A
NORTHAMPTON,
71
Date ( i
APPLICATION FOR ENDORSEMENT
OF PLAN BELIEVED NOT TO REQUIRE APPROVAL
File four completed forms with the Planning Board
and one copy with the City Clerk in accordance with
the requirements of Section 3.02.
To the Planning Board:
The undersigned, believing that the accompanying plan of his/her prop-
erty 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 Sub-
division Control Law is not required.
1. Applicant
Print cY type name Signaturd/
7 (s-/' i�
Address Phone
2. Owner '`---
Print orJtype name Signa uie
615 0.ho L/P
Address Phone
3. Surveyor %ingr/Ieers'�lct�me r ✓i ��.-G
Print or type name Signature
P- 0• /fix y8� f�olrf�kC. i�16 ( ���1� Dye 533-7 `7l�
Address Phone
tP10-n op
4. Deo Property recorded inRegistry,
Book /147 Page
5. Location and Description of Property:
Date Submitted for Approval Date Planning Board
Dec' 'on Filed . July 28, 1989
City Clerk Signature City Clerk Si n tune