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� f <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> Tof ......../YLgs <br /> FORM A <br /> APPLICATION FOR ENDORSEMENT <br /> OF PLAN BELIEVED NOT TO REQUIRE APPROVAL <br /> File one completed form with the Planning Board and one copy with the <br /> City (or down): Clerk in accordance with the requirements of Section II-B. <br /> No......................... A- <br /> . �...__.............................. 19. 2 <br /> To the Planning Board: <br /> / .I <br /> The undersigned,believing that the accompanying plan of his property in the <br /> ................ - ...................---.........- <br /> ...docs not constitute a subdivision within the meaning of the <br /> 01ty or Town <br /> Subdivision Control Law, herewith submits said plan for a determination and endorsement that Planning <br /> Board approval under the Subdivision Control Law is not required. <br /> 1. Name of Applicant .. i��!�.+ ,_-✓ -................�9 /199 r s 72,�r s <br /> - ..-..-L:.........................._----------- - ........................................ <br /> Address .. o o------L`�•��,.v p 4 c✓.- - .-.v"`�.-----�..........� r /Y1.¢ O 2 G-S/p <br /> 2. Name of Engineer or Surveyor .__ Q,f?.................................................�Q•��s <br /> Address 4'/ Ste. 2 F <br /> .............................---------' ........------------- A"/YIgS-��ar�„ •_... . ... �z <br /> 3, Deed of property recorded in ............. 9r ry �� �/e <br /> .............s--........---....--------------------....----•--•----•--.........---- -•-- Registry, <br /> Book........... .......... e G .................: Pag ......... 3=...................... <br /> I <br /> 4, <br /> Location and Description of Property: <br /> �p 6� gh.>eX t� To 4 6✓ /j{rS, 'G�J�eureee�/ Priv-e- <br /> Signature of om,-ne ......................... <br /> Addre=s .................................................•---------•-•------------.................... <br /> R�RM 1880 HOBBS d WARREN. INC.. <br /> 1-a-es <br />