8732_FORM A - 105 AUTUMN STREET.pdf~10d
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Planning Boord endorsement under the. Subdivision
Control Low should not be construed as either an
endorsement or an approval of zoning lot area
requirements.
%
IC HODGE?
WE HAVE CONFORMED WITH THE RULES a REGULATIONS
OF THE~GISTRY OF DEEDS IN PREPARING THIS PLAN. 0: ~ f6/Z/n
M!CHA6.L D. SMITH ''-SMITH A'5'50CIA"TES SURVEYORS, INC.
APPROVAL UNDER THE
SUBDIVISION CONTROL
LAW NOT REQUIRED
AGAWAM
PLANN~G~OARD Il!L / VI ;t::-. .
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AUTUMN
GRAPHIC SCALE
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#105
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PLAN OF LAND
20 FTJIN
105 AU,U MN 5TRlO:.E.T
AGA'NAM, MA.
OwNED &y'
RY AN v. wc:RB:£EIVED
DEC 03 2013
AGAWAM
PLANNiNG BOARD
SMITH ASSOCIATES
SURVEYORS, INC.
46B BALDWItN ST .• EAST LOr;GMEADOW. MA 01028 (413) 525·8801 WNWSMITHASSOCIATESSURVEYORS.COM
Town of Agawam
36 Main Street Agawam, Massachusetts 01001-1837
December 5, 2013
Ryan 1. Wood
105 Autumn Street
Agawam, MA 01001
Dear Mr. Wood:
Tel. 413-786-0400 Fax 413-786-9927
q
c • c;
At its duly called meeting held on December 5, 2013, the Agawam Planning Board voted to
approve your plans under "Subdivision Control Law Not Required" fora parcel ofland located
on Autumn Street. Plans drawn by Smith Associates Surveyors and dated 10-01-13.
Sincerely,
Please be advised that failure to record the plan within six (6) months and provide proof of
recording will negate the action of the Board. Detach on dotted line and return to the Agawam
Planning Board, 36 Main Street, Agawam, MA 011001.
............................. ~ ..................................... -....... .
To Agawam Planning Board
Please be advised that the Form A plan that was filed by Wood and approved by the Agawam
Planning Board for a parcel ofland located on Autumn Street has been recorded at the Hampden
County Registry of Deeds. Book , Page ____ _
Signature of Applicant· _____________ _
MEMO
TO: Erik Wight, Building Inspector
FROM: Planning Board
SUBJECT: Fonn A -Autumn Street -Wood
DATE: December 3, 2013
Please review the attached Fonn A for the Planning Board's December 5th meeting.
Thank you.
DSD:prk
To the Department Officer making the Payment:
Received of Ryan Wood as Listed Above
the sum of 50.00 ~D::-o""lI-ars---
for the Form A fee ending 1213/2013
for colJectic
Treasurer
PAYMENT SUMMARY RECEIPT
TO~Of Aga .... am
TOWN HALL
36 MAIN STREET
AGAWAM MA 01001
DATE; 12/03/13 CUSTOMER#: 000000000
TIME; 15:00
CLERK; mac
R£CPT#: 921714 PREY EAL:
TP/YR: MS/2014 AMT PAID; 50.00
EILL: ADJSTMNT:
EFF DT; 12/03/13 SAL DUE:
MISCELLANEOUS PAYMENT
~~~-~------------TOTALS-----------------
PRINCIPAL PAID:
INTEREST PAID:
ADJUSTMENTS;
DISC TAKEN:
A.MT TENDERED;
AMT APPLIED:
CHANGE:
PAID BY: PLANNING
PAYMENT METH: CASH
PAYMENT REF:
50.00
. aa
.00
.00
so. 00
SO. 00
.00
TOWN OF AGAWAM, MASSACHUSETTS
FORMA
Application for Endorsement of Plan Not Believed to Require Approval
FILE ONE COMPLETED FORM WITH THE PLANNING BOARD AND ONE COPY~ = WITH THE TOWN CLERK IN ACCORDANCE WITH THE REQUIREMENTS OF c:;;
SECTION 11-B ~
_~~.~~~~~ ____ L ____ 20 I~
TO THE PLANNING BOARD:
,
c.·..) ...• ~
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The undersigned, believing that the accompanying plan of his property in the Towrfflt
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. Name of Applicant "j?.'11'l rv -r.-w 000
Address 115 AJVHN SUie'"
Phone # (~,~) 3~'1. 3De Fax # email .. '1" .. .."",,\0011" Rjp'dY .fb)l.1
2. Name of Surveyor 51-'!' rl-i A :3:; oe) '" Tt:,-"3 S4t.v~orr-J
Address '1"~ ~4>"-',,""", 'i't. 1£. LO'Y'-tSn ~f7O!-J
5'MrN<~3'Soc'~rE-.5 ~~S"
Phone # 5""2.:5" eeo I Fax # n..s e8'-'1 I email e 1(6[,1<-1,11' .(A<1
3. Deed of Property Recorded in f{>t!1.'APpev' ~ __ ~ ____________ -L ________________ __
Book I 18 & '3 Page ---.:1::....0_..,-'-__ _
4. Location of Property 16';,-,A'/fU\MI'-' ?to ~ ~&fll-vl"t"('-
5. Describe the proposal in this submission:
C d>V1 8 ) I'-t-E)(' I So'" 1"""6 ~ fl.-~.5 '-f f -f. Lj tJ I /VI' 0 <Oy'I/E"
Co,vr"'-'c.v.5 P/l(Lc.eL A fl:S SNt:JVV>..J •
ATTACHMENTS -Two originals and three copies of plan by certified land
surveyor. Filing Fee -$50.00 plus $20.00 per lot.
Signatureof~··------~L Address lor> Avrv"'lN ~
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