11C-043A heffernan street planningFORM A
NORTHAMPTON, PASS.
Date
APPLICATION FOR ENDORSEME14T
' OF PLAN BELIEVED NOT TO REQUIRE APPROVAL
File one completed form with the Planning Board �.
and one copy with the City Clerk in accordance with `
with requirements of Section 3.02.
To the Planning Board:
The undersigned, believing that the accompanying plan of
his 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 Joe► ICI. N�a, I�JoWSki l "1 � /IV(
Print or type name C Signature
5b tte 40HE 5�12EE - � L� MAr•
Address 7
2_ C:;rer JOSH M , MD•�1 �u�sb� -� `f�'� %�1 �. -:' -:�:.
Print or type na.:�e Signature
Address ,
3. Surveyor ALMER HUN7LEY, JR. & ASSOC. INC.
rint or type name Signature
125 PLEASANT STREET, NORTF'L�MTQN, MA 01060
Address
4. Deed or '
property recorded in HA.;PSHIRE COL'?�TY Registry,
Book t `� 4 1 e 1 27- z boo 20 -70 Page &Z bo ol- Zok. paAc.. lo )
aM-d P�bate_ V oc.. 00 • 47-3 .
S_ Location and Description of Property:
two PApcEC-5 LoGATE5D 4T ei:M12 of IW�,MAONE QTR
ArND V5EHj 0 L-UT5 ON wE5T t of 1� �E IAiJ ST.
Date of Sut. ,.i -sion November 20, 19 85
Ass't.City Cler r�l,'?
- - Si na�tire
8
33