23D-122 (5) --------r'll
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FORMA '
__. Ns ,`, NORTHAMPT N
Of aUIL'.lpG INS p1G60 � ' MA
DE pg�µ 11,2,-TG�I le,
•
ATION FOR ENDORSEMENT
OF PLAN BELIEVED NOT TO REQUIRE APPROVAL
file six completed forms and plans and one mylar with the City Clerk and the Planning Board in accordance with the
P
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.
M .ee ko_ Pr.US G--d> ,,.
1. Applicant(print or type): DAV O A JA- A Signature: A G l ik. l?,�(it'A t/"
Address: �vo,•G S+•) t deoV((C� M4 Uto hone:
A4 i ativlifiii&ki/
2. Owner(print or type): J u e(�h A. l/A-L--drfi' Signature: �/1,�,L,c_4 ,
C(o q 3 vvvc.sf.) &tide r.41 fe.444 0103.1
Address: Phone:
ALMEtZ NU►JtLe{ JP---
3. Surveyor(print or type): fe AcssoLlA-7 as (J c-- Signa `e,gudA- _
MOR:TA p ?—roa Mt,, 4 t 3 5S4. 14,111
Address Phone
14. Deed or property recorded in Hampshire County Registry of Deeds or Land Court:
Book 1745 Page 2Pf1 .
•
5. Location and Description of Property:
Z PARc- -S -To 6l� Cop\ie\i'ED To sc'i--t i r-)&- paolE1-2.:c
6._
Date Submitted for Planning Date Planning :,.ard
Board Approval: Decision F. .'? 'b i-z/,, O1 'I t •
• , r,
City Clerk(signature): City Clergy• :''OP, � . �WOW-.�►
(!/!/98)
SUBDIVISION REGULATIONS PAGE 60