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THE COMMONWEALTH OF MASSACHUSETTS <br /> of ........ ....................... <br /> ....... <br /> FORM B <br /> APPLICATION FOR APPROVAL OF PRELIMINARY PLAN <br /> File one completed form with the Planning Board and one copy with the <br /> City, (or Town) Clerk in accordance with the requirements of Section 111-A. <br /> .. 192� <br /> No......................... . <br /> To the Planning Board: <br /> The undersigned herewith submits the accompanying Preliminary Plan of property located in the <br /> fora <br /> or approval ai subdivision as allowed under the Subdivision <br /> City or Town <br /> Control Law and the Rules and Regulations Governing the Subdivision of Land of the Planning Board in <br /> tjjP,Qtf(or Town) of........ ............................................... <br /> 1. Name of Subdivider 10 .............. .......... <br /> Address ......7,/ ......... ........... ........ /.-S.......... ............ <br /> 2, Name of Engineer or Suryeyor .....CO. 1 <br /> .....f%.../.— <br /> ......... <br /> Address . .......Z,/. ........... .0—_.----C' ...... <br /> I Deed of property recorded in ............ ..................7........ ni.. ......................... Registry. <br /> .. <br /> Book.....................� ...... Page ................................................ <br /> 4. Location and Description of Property: <br /> MAW9 <br /> Signature of,61 ................................ <br /> I M G. WELLER, 'AGEN-1- <br /> w <br /> Address ........................Lo..........L.Wellp.... .......................... <br /> P.O. Box 119 <br /> A 1,',t of the names and addresses of the abutters of this made by <br /> t1le Planning Board. <br /> FOAM 1681 14019139&WARREN. INC.. <br />