8705_FORM A - 1255 MAIN STREET.pdf'67(f)--
~C(rf\ A-
\dSS-j\AQ\()
~+\ilL+
t. .. JJU.U.J
To the Department Officer making the Payment:
Received of Schlaffer Chiropractic Office as Listed Above ---.===-__
the sum of __ -----------;t.t---·....:7..::0:::.0:::0~--_::,..,.,...,..,..,.... Dollars
for the Form A fee ending 4/3/2013
for collectic
Treasurer
PAYMENT SUMMARY RECEIPT
To~ of Agawam
TOWN HALL
36 MAIN STREET
AGAWAM MA 01001
DATE: 04/04/13 CUSTOMERI/: OOOOOOOCO
TIME: 14: 55
CLERK: mac
RECPT#: 872021 PREV SAL:
TP!YR: MS/2013 AMT PAID: 70.00
BILL: ADJSTMNT:
EFF DT: 04/04/13 BAL DUE:
MISCELLANEOUS PAYMENT
---- - - - - - ----- ---TOTALS ------- - - - - - - - - - -
PRINCIPAL PAID: 70 .00
INTEREST PAID: .00
ADJUSTMENTS: .00
DISC TAKEN: .00
AMT TENDERED: 70 .00
AMT APPLIED: 70 . 00
CHANGE: .00
PAID BY: PLANNING BOARD
PAYMENT METH: CHECK
PAYMENT REF: 21474
• ,
_---=0'-"4/12/2013 10: 19 4138210637 AGAWAM INSPECT. SVSR PAGE 01/01
Town of Agawam
36 Main Street Agawam, Massachusetts 01001-1837
Tel. 413-786--0400 Fax 413.~ 786~9927
MEMO
TO: . B wIding Inspector
FROM: . Planning Board· '/.
SUBJECT: . Form A;-Main Street -Schlaffer
PATE: April 3,;2013
Please. review and corn!ro.ent on the attached FoIUI A for Schlaffer on Main Street prior to the
Board's April IS'" meE1(ing, .
Thank you.
DSP:prk. ~ ::z:
U) ;::; ""0
~\s LD"l"" g'f~ \t 'f,~ &V\~~""~\"~
:»0 . fTI· ..., . C") .= -t , 0 U1 :;r:
\-D~ ~\i,.L /1-J.. "ZetJfi. ~i(,Q ~-vc..cl" \6t-J ~ 180,'dJ '7. U U> r::rI.
::0
·r~ .. <
0 C") ..... ~ 'CIt ..
Town of Agawam
36 Main Street Agawam, Massachusetts 01001-1837
Tel. 413-786-0400 Fax 413-786-9927
MEMO
TO: . Building Inspector
FROM: . Planning Board
SUBJECT: Fonn A -Main Street -Schlaffer
DATE: . April 3, 2013
Pleasereviewand comment on the attached Fonn A for Schlaffer on Main Street prior to the
Board's April 18th meeting.
Thank you.
DSD:prk
TOWN OF AGA W AM, MASSACHUSETTS
FORMA
Application for Endorsement of Plan Not Believed to Require ApprovaL.
'=> c;;;
FILE ONE COMPLETED FORM WITH THE PLANNING BOARD AND ONE COPY :z:.
WITH THE TOWN CLERK IN ACCORDANCE WITH THE REQUIREMENTS OF ~
SECTION 11-B G
/lP('? 3,20I,...L.D_
TO THE PLANNING BOARD: N -,',
The undersigned, believing that the accompanying plan of his property in the Townt-" ~.,;
Agawam does not constitute a subdivision within the meaning of the Subdivision
Control Law, herewith submits said plan for a determination and endorsement that
Planning Board approval under the Subdivision Control Law is not required.
1.
2.
3.
4.
5.
~ ~iJ.
Address
(JlJ
ATTACHMENTS -Two originals and thr e opies of plan by certified land
urveyor. Filing Fe -50.00 plus $20.00 per lot.
Town of Agawam
36 Main Street Agawam, Massachusetts 01001-1837
PLANNING BOARD
April 24, 2013
Richard M. Theroux
Town Clerk
36 Main Street·
Agawam, MA 01001
. Dear Mr. Theroux:
Tel. 413-786-0400 Fax 413-786-9927
{.J .
~-
Attached is an application for a Fonn A that was submitted on April 3, 2013 by Joseph Schlaffer.
The Planning Board did not take action on this plan. The twenty-one (21) day time period for
action has lapsed.
Sincerely,
. 7A-~ r? 0tAA ~
~ . Travis P. Ward, Chainnan
AGAWAMPL~GBOARD
TPWIDSD:prk
cc: BuildingDepartment
File
Assessors
•
!
TOWN OF AGA W AM, MASSACHUSETTS
FORMA
Application for Endorsement of Plan Not Believed to Require ApprovaL.
= C;;
FILE ONE COMPLETED FORM WITH THE PLANNING BOARD AND ONE COPY :z".
WITH THE TOWN CLERK IN ACCORDANCE WITH THE REQUIREMENTS OF ;g
SECTION 11-B ~
Hp;<>; t-.3,20,L.LO_
7 ~ TO THE PLANNING BOARD: N
The undersigned, believing that the accompanying plan of his property in the Townt" g
Agawam does not constitute a subdivision within the meaning of the Subdivision
Control Law, herewith submits said plan for a determination and endorsement that
Planning Board approval under the Subdivision Control Law is not required.
1.
3.
4.
5.
<i c-ilt.
Name of Surveyor 0 d 0 r
Address r; 5 UA # VI sl. ~. AI
~~~~ __ F~# 29J~89b emrul, __________ _
Deed of Property Recorded in ~ ? [M.I (jfTo It. roo; !fJ-.l Page J-/ / 1.t~
Location of Property Si{)~ L~CIl-5'"S/ft?,',v ~ ?~41 )nr
D~~~:f:'"6:71i'/:~
Town of Agawam
36 Main Street Agawam, Massachusetts 01001-1837
Tel. 413-786-0400 Fax 413-786-9927
April 24, 2013
I HEREBY CERTIFY THAT THE AGAWAM PLANNING BOARD DID NOT TAKE
ACTION ON THE ATTACHED "APPROVAL NOT REQUIRED" PLAN FOR JOSEPH
SCHLAFFER FOR PROPERTY LOCATED ON MAIN STREET WITHIN THE TWENTY-
ONE DAY PERIOD.
ATTEST:
Clerk
.,
AGRICUL TURE
RESIDENCE A-2
I.P.
. /. ; . ';"' ~ ,
I
I
I
E~istjn9 Residence
H1255
199.84'
S1S40'36"W
M A I N
,-,
I I
Parcel A
157,524 s.f.
3.62 Acres
I.P. Set
S T R E E T
I.P. s.t
---
N13"40' 36"E
110.00'
Parcel B
15,001 s.f.
110.00'
S13"40' 36"W
'-;'
I.~
------
I.P. Set
L riI G.B.
R
::: LP.
I
This plon does not constitute 0.
subdivision th.erefore approval·
under the Subdivision Control
Law is not rE'quirecl.
Date'
Agawam Planning Board
Oeed Book 5527 Page 41·
Plan Book 212 Page 111
Lots C & 0
•
LEGEND
IRON PiPE FOUND
IRON PIPE TO BE SET
IRON BAR FOUND
BOUND FOUND
BOUND TO BESET
SCALE: 1" 40' DATE: March 2013
GRAPHIC SCALE
o
• •
•
4() 0 20 40 M 160 I~_~-~_·~~I~I~~I~~~I
( IN FEET)
1 inch = 40 ft.
ANDERSON ASSOCIATES
LAND SURVEYOR, LAND
PLANNING CONSULTANt;
SITE DESIGN
375 WALNUT STREEt EXTENTIQN
P.O. BOX 382
AGAWAM, MASSACHUSETTS 01001
Tel. 413 525-4145
Fax 413 273-1776
NO.
z
~
L:2 0·· ... . «
·Z·S ««.
~U
(l.«
PREPARED FOR:
Joseph Schlaffer
1255 Main 5REB
Agawam, MA
This plan preparE'din Qccorclo.nc<i
with thE' rules o.ncl regula tlors . of
thE' Registry of Deeds, ..
Do.tel At>~[ L 2) 2..0 J:3
DRAWING NO.