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THE COMMONWEALTH OF MASSACHUSETTS °M <br /> 2��..�.-.'Y._1--- of . .....................................- <br /> FORINT A <br /> APPLICATION FOR ENDORSEMENT <br /> OF PLAN BELIEVED NOT TO REQUIRE APPROVAL � �'• "�V, <br /> NAR <br /> , �� I% l w��w. <br /> File one completed form with the Planning Board and one copy with the TO " 5 Avk <br /> City (or Town) Clerk in accordance with the requirements of Section II-B.' l�,�' C` f` � <br /> r 'I b 'i, <br /> 11x'� <br /> 0...............•-•--•---- -----•--------- ---'•------c�._��......__...I9---9 <br /> -----.l. ',f <br /> To the Planning Board: ryl� <br /> The undersigned,believing that the accompanying plan of his property in the <br /> -'•........... <br /> &�t <br /> -------------------------- <br /> - ' "' •----docs not constitute a subdivision within the meaning of the <br /> ity or Town <br /> '1n� r•,�,��`Mi <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 /> L Name of Applicant n d S D Yl 4 yt !. . <br /> Address <br /> Warwick <br /> 2. Name of Engineer or Surveyor --•_-William M............ __ Associates Inc. <br /> _________________________-__ <br /> Address -�QX__$Ql_._..21.3._Qld._Ma�in-.Rd------I�lnrth..Falmouth,•-MA-.-0266fi...-.563=.2fi38.------------------- u <br /> - <br /> a <br /> Q J'� �( I A <br /> �V V 0 9 <br /> 3. Deed of property recorded in ------ ------- -L ---I -----•-••-- ------------•------ Registry, �M <br /> Book... D_ - e-----Pa" ! / ----- <br /> - --- t Olt <br /> J <br /> --- ---- a <br /> 4. Location and Description of Property: s� � Qh � <br /> r �Al' � .�"w" <br /> PmAis <br /> Signature of owner - <br /> Address �.......__- __.-...4.j._ .. .... -4- <br /> ---------- <br /> FORM <br /> 4 <br /> FORM 1680 M0139S&WARREN INC.. ( (, <br />