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COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> FORM A <br /> APPLICATION FOR ENDORSEMENT <br /> O/^F� PLAN BELIEVED NOT TO REQUIRE APPROVAL <br /> Date Jc>Ly 1L77., .LdCt <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 required. II <br /> Name of Applicant G E LA H . S7W ars ,e—r , J e- Phone (Son)-411- S599 <br /> Address AS Mc-L-t5,5A Mk-sA4Pra-r, dA A., dL64'1 <br /> Owner,if different S+tiµE Phone. <br /> AddressKt= <br /> ' Attach copies of (a) most recent recorded deed and(b) tax bill or. Assessors'certification <br /> Engineer or Surveyor a4xT'eQ" l --ftlLuc. Phone �,DB)-425=tet i3, <br /> _ - Address 8�2 M/hu S7 EEt=T r 'Os762�r1u� R.tA: 02655 = <br /> Deed of property recorded in Barnstable County Registry Book '-T(A. Pages 9-1-'1 8 <br /> or Land Court Certificate of Title No. >--/n. <br /> Location and description of property <br /> LcwT 1 . AS Ar Pc.hs. i`3= K -164 (/tGE rc 1 A-P o 0E'7u& <br /> (!ewe 962e PsYaQy 91-9 a T s P 2eP o -rc c®u ty.-d= F72.FcFz A <br /> W1T}{ 'CTI iS Le-r. <br /> Mashpee Assessors Map(s)and Block(s) M 21 P,--L,,5 e. + 4.'LY Poc-g+ P«g <br /> Signature of Owner or Authorized Representative <br /> Attach written authorization sig red by wner. r <br /> r3A%tMW� "--f1=4 +Lm l & --A0-•, I' <br /> AAA <br />