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COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASAPEE <br /> FORM A <br /> APPLICATION FOR ENDORSEMENT <br /> OF PLAN BELIEVED NOT TO REQUIRE APPROVAL . <br /> Date O O <br /> To the Planning Board: <br /> The undersigned, believing that the accompanying plan of his or her property in the Town of Mashpee <br /> does not constitute.a subdivision within the meaning of the Subdivision Control Law, herewith submits <br /> said plan for a determination and endorsement that Planning Board approval under the Subdivision <br /> Control Law is not requited. <br /> Name of Applicant J-0YA1 W ROD L?16ti&S PhoneSG? <br /> lox (c,y / <br /> Address / /� G✓slirE 1QC.tJ JAJA Y wE57 jjAQA1 ABLE �/q <br /> /fi/Y c�rrv�L /rc v> c <br /> Owner,if different C V r cTb1L su0.9-A-rZ Phone 7'9/ <br /> A l DC-ta /114, r_ n fl <br /> Address lq-fi�j gvw r /1 o 2-C5 r <br /> Attach copies or(a) most recent recorded deed mrd(b)tar bill orAssessors'certification. <br /> Engineer or Surveyor �/!ti(�!•>' �y�t/�� Phone 9:,+28 <br /> Address box 26S yo /��S�RY tQoAD NA6iSTa�V pt /L(, HA <br /> a72s , a o26y , <br /> Deed of property recorded in Barnstable County Registry Book 1 7 g p / 0 <br /> or Land Court Certificate of Title No. age <br /> Location and description of property <br /> 77 d�3 ,�n� Fov2 v9N M 1�EC ,ta <br /> • V#qC-AAI 1 L- T S —_ <br /> Mashpee Assessors Maps)and Block(s) a7 S3 <br /> Signature of Owner or Authorized Representative 72 � <br /> Attach written authorizatio igned byowner. <br /> C Y opals <br /> 7K us a <br />