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THE COPTU*1EALTH OF MASSACHUSETTS <br /> ---TaW4--- of -MAaUEX----------------------- ll V <br /> FORM A <br /> NOV 5 19 2 <br /> APPLICATION FOR ENDORSEMENT I <br /> OF PLAN BELIEVED NOT TO REQUIRE APPROV 1B <br /> File one completed form with the Planning Board and one copy with the <br /> City (or Town) Clerk in accordance with the requirerrents of Section II-B. <br /> No.... . . . . . . . . . . . . . .. .. .. . ... .Octgber .14.. ....19.9?. <br /> To the Planning Board: <br /> The undersigned, believing that the accompanying plan of his property in <br /> the .. .. MASHPFR, -xA . . .. . .does not constitute a subdivision within the <br /> Cbl*jt or Town <br /> meaning of the Subdivision Control Law, herewith submits said plan for a <br /> a <br /> .I <br /> determination and endorsement that Planning Board approval under the <br /> Subdivision Control Law is not required. <br /> 1. Name of Applicant. .RIPA4370. Y-%,Foohep, &,JAgqugjyr�,B.,,GQdsfrey_ <br /> Address. . . . .Shorg,I?rave. ,; .799. irmiAlm. XIIIAge. . . . . .. . . . ... . . . ... <br /> 2. Name of Engineer or Surveyor. ..Qbgx:l.op. .$a.VAjl. .... . . . ... .. . . .. .. .. ... <br /> Address. . 111}. Moonakis. Road.. _'�kCJuoit.._ Ma.. . . . . . . . . .. .. . . ........ <br /> . . . . . . . . . . . . . . . <br /> 3. Deed of property recorded in. M15tr...0f..Barnstahle. Dauntyr.Registry. <br /> Book. . . . . . . 5.7. . . . . . . . . . . . .Page. . . . . .714 . .. .. . . . . .... .. <br /> 4. Location and Description of Property: <br /> SW corner of Shore Drive and <br /> Rock Island Road. <br /> House property. <br /> Signature of owner. <br /> Address. . P.O.O.. Bo 14 Mash ee., _Ma... .... . <br />