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23D-139 (5) • i C r tiJIId [ 1 1I , ,, , , 2 FORM A 3 199 NORTHAMPTON, MA DEPT OF BUIi' CAT1Cik FOR ENDORSEMENT NORTH M VED 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. 1. Applicant Rick Janes /�i24/4/J Print or type name Signe 22 Norfolk Ave. , Northampton 586 - 3664 Address Phone 2. Owner Estate of Monica Janes Agent Print or type name Signature 90 Hinckley Street, Northampton Address Phone 3. Surveyor Harold L. Eaton & AssocT;a/AAa 7 , Print or type name Signature 735 Rts sell Street. Hadley 584-7599 Address Phone 4. Deed or property recorded in Hampshire Registry, 1048 314 Book 1115 Page 357 5. Location and Description of Property: 6. Assessor's. Map ID: 23D Lot(s) : 139 . Date Submitted for Planning Date Planning Boas Board Approval: Decision Fil 19 v City Clerk: City Clerk: (Signature) igna u (8/13/91) SUBDIVISION REGULATIONS PAGE 60