8748_FORM A - BURLINGTON DRIVE.pdf~l~-
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Lot No. 18
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257.70'
Lot No. lB
61,376 s.t.
N/FRose
O. 6927 P. 422
BUR lIN G rON N81'55'OO"w ""j
OR I V E R~150'
bt No. 17 I
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This plo.n does not constitute 0.
subcivlslon therefore o.pprovo.l
under the Subdivision Control
Lo.w Is not required.
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MILL S T R E E T
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74.82' Lot ~o. lA
29,116 s.t. t 3: t m .
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Lot No. 16
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Parcel A
65,861 s,f.
ON / F Richter
.10161 P. 209
N / F Show
0.14476 P. 543
Lot No.3
24,952 s.f.
Lot No.7
SCALE: 1"
LEGEND
IRON PIPE FOUND
IRON PIPE TO BE SET
IRON BAR FOUND
BOUND FOUND
BOUND TO BE SET
80" DATE: Feb., 2014
GRAPHIC SCALE
( IN FEET )
1 Inch = 80 It.
0, .' .' 8
•
ANDERSON ASSOCIATES
LAND SURVEYOR, LAND
PLANNING CONSULTANT,
SITE DESIGN
375 WALNUT STREET EXTENTION
P.O. BOX 382
AGAWAM, MASSACHUSETTS 01001
Tel. 413 525-4145
Fax 413 273-1776
PLAN OF LOTS
IN AGAWAM, MA
PREPARED FOR:
John Rose
133 Poplar Street
Agawam, MA
NO. DATE DESCRIPTION
This plo.n prepo.red In o.ccordo.nce
with the rules o.nd regulo. tlons of
the Registry of Deeds.
Do.tel
DRAWING NO.
TOWN OF AGA W AM, 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
SECTION 11-B
TO THE PLANNING BOARD:
The undersigned, believing that the accompanying plan of his property in the Town of
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.
/. Name of Applicant _~-,,~,,-,O~t1,-,,· t-(-'·_X=-'O",.<).uf2. ....... ___________ _
Address 13"6 Pa l"u4,/t Sf tt elZ~ (/0 rd 1. ... 214 tv; 7 Uj l7
Phone # 7'i{Y S",'jJ" Fax # email ;Taos, ~C.,. <1.10 ,. ... ~. " ...
2. Name of Surveyor At-'{fJ!!121M IIUoW'ltB I (ggyf/Li\ 2. tfu 0<)
Address 375 W141 A/iiI S("'. ~)(T. ;tCDAtUfjlVl, /l2fl.
Phone #lft 3 S2S'" -,/NY: Fax # <113 273 -177-/' email t2oNF"Kt>1A IdGII1Ij1L, {O"1
3. Deed of Property Recorded in -,-li-"..I'1.1-'Vl---ll..t,..,<16""""N,---,,( w"""''''''-i='11----------
Book(,,<'t "Z7 Page _"4-,l_'2 ___ _
4. Location of Property fQl{1 ..Jlj)E (" 91-7 fu(1a..,. .J(. 4Z.y
5. Describe the proposal in this submission: iiuwlI re. dwl plra!,,,,..., {"I <"'/d~.?
ATTACHMENTS -Two originals and three copies of plan by certified land
surveyor. Filing Fee -$50.00 plus $20.00 per lot.
Signature of Owner ~ [<tiL
Z/ Address /3 't p", LA..< S r
r,101-'O (~1L!5 ,
L c=
......-z4 Oit)).o
Town of Agawam
36 Main Street Agawam, Massachusetts 01001-1837
Tel. 413-786-0400 Fax 413-786-9927
MEMO
TO: Erik Wight, Building Inspector
FROM: Planning Board -17'0
--___ S __ VB_JE_:J..J : Fonn A -Burlington Drive -Rose
DATE: July 15,2014
Please review and comment on the attached Fonn A for Rose on Burlington Drive prior to the
Board's July 17'h meeting.
Thank you.
DSD:prk
.Jate: /I\:'I:.1U14
To the Department Officer making the Payment:
Received of John R. Rose as Listed Above
"""""'D~ol""la-:-rs:----the swn of 50.00
fur the ~F~o=nn~A~re=e----en~ilin=g---------~~~--~7~/~15~/~2~01~4
forcollectic --------'-'-=='-'-------------
Treasurer
•
,
..
PAYMENT SJ1~~-1ARY RECEIPT
Town of Agawam
TOWN HALL
36 MAIN STREET
AGAWAM MA 01001
DATE: 07/15/14 CUSTOMER#: 000000000
TIME; 12:10
CLERK: kad
RECPT#; 982374 PREV 8AL:
TP/YR: MS/2015 AMT PAID: 50.00
BILL: ADJSTMNT:
EFF DT: 07/15/14 BAL DUE:
MISCELLANEOUS PAYMENT
- ------- ---------TOTALS-- - ---- - - - -----
PRINCIPAL PAID: 50. 00
INTEREST PAID: .00
ADJUSTMENTS: .00
DISC TAKEN: .00
AMT TENDERED: 50. 00
AMT APPLI ED: 50. 00
CHANGE: .00
PAID BY: PLANNING BOARD
PAYMENT METH; CHECK
PAYMENT REF:
Town of Agawam
36 Main Street Agawam, Massachusetts 01001-1837
July 17,2014
John Rose
133 Poplar Street
Agawam, MA 01001
Dear Mr. Rose:
Tel. 413-786-0400 Fax 413-786-9927
At its duly called meeting held on July 17, 2014, the Agawam Planning Board voted to approve
your plans under "Subdivision Control Law Not Required" for a parcel ofland located on
Burlington Drive. Plans drawn by Anderson Associates and dated Feb., 2014.
Sincerely,
en
"Z t teas be a . ed thatfailure 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
Plarming Board, 36 Main Street, Agawam, MA 011001.
To Agawam Planning Board
Please be advised that the Form A plan that was filed by Rose and approved by the Agawam
Planning Board for a parcel of land located on Burlington Drive has been recorded at the
Hampden County Registry of Deeds. Book , Page __ ~ __
Signature of Applicant __ ~ __________ _
EXHIBIT A
The land in Agawam, Hampden County, Massachusetts, more particularly described as follows:
Lot No. IA as shown on a plan entitled "Plan of Lots in Agawam, MA Prepared for John Rose
133 Poplar Street, Agawam, MA", prepared by Anderson Associates Land Surveyor, Land
Planning Consultant, Site Design, dated Feb., 2014, and recorded with the Hampden County
Registry of Deeds in Plan Book~, Page ~.
BEING a portion of the premises conveyed to the grantors herein by deeds recorded with the
Hampden County Registry of Deeds in Book 16806, Page 243, Book 16806, Page 249 and Book
6927, Page 422.
569554.1
DONALD E. ASHE, REGISTER
HAMPDEN COUNTY REGISTRY OF DEEDS