8781_FORM A - SOUTH WEST STREET.pdfbl'i\ -
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LAND OF
DALE T. BOGLISCH
EXISTING
HOUSE #202
N 26·43'24" E
/10.06'
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SOUTH WEST STREET
NOTE
PARCEL A IS LAND OF LAURIE K. ROCKE, ROBERT N. KI~G AND ARTHUR G. KING
TO BE CONVEYED TO AND COMBINED
WITH LAND OF DALE T. BOGLISCH
TO FORM ONE CONTIGUOUS LOT.
PROPERTY LINE INFORMATION TAKEN FROM PLAN BOOK 130 PAGE 55 A~SO
PLAN BOOK 356 PAGE 29.
S 23"07'37" W
10.01'
I certify
the Rul
189.45'
LAND OF
LAURIE K. ROCKE
ROBERT N. KING
ARTHUR KING
189.99'
8
0
•
LAND N/F
WESTERN MASS ELEC. CO.
has been prepared in accordance with
ns of the Registers of Deeds.
Professional Land Surveyor
Legend
Concrete Bound (iFound)
Iron Pipe
Iron Pipe
(Found)
(Set)
Approval Under Subdivision
Control Law Not Required:
This Planning Board Endorsement
does not imply compliance with
the Massachusetts Wetlands
Protection Act or Zoning By-law.
Date:
Agawam Planning Board
Owner
LAURIE K. ROCKE, ROBERT N. KING
AND
ARTHUR G. KING
Plan Of Land In
Agawam, Massachusetts
Surveyed And Mapped For
DALE T. BOGLISCH
----------------.----------------
Daite: 10-07-2015 Scale: 1" = 30'
Prepared By
RLA
R LEVESQUE ASSOCIATES, INC
40 School Street
P.O. Box 640
Westfield, MA 01086
0' 30' 60' 90'
~iiiiiiiiiiiiii~I __ ~1
RLA Job No. 150813
3\33
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
SECTION 11-B
20 15 --------------------. September
TO THE PLANNING BOARD:
The undersigned, believing that the accompanying plan of his property in the Town.¢
Agawam does not constitute a subdivision within the meaning of the Subdivision -.C:
Control Law, herewith submits said plan for a determination and endorsement tha{J
Planning Board approval under the Subdivision Control Law is not required. ~
Name of Applicant ___ D_at_e_BO_9_IiS_h ________________________________ --';t~'
Address ___ 2_02_S_o_u_th_W_e_st_S_tr_ee_t_-_Ag_a_W_am ______________________________ (_
L
Phone # 860-670-2756 Fax # _____________ email ________ _
2. f S Marc E. Shute -R. Levesque Associates Inc Name 0 urveyor ___________________________________________ _
Address __ 4_0_S_ch_o_ol_S_tre_e_t W __ es_tfi_'e_ld_M_a ____________________________ -'--__ __
Phone # 413-562-7566 Fax # 562-2091 email toma@rtaland.com
3. Deed of Propeliy Recorded in __ H_a_m_pd_e_n_C_ou_n_ty ________________________ _
Book 1797 152 Page _________ _
4 Lo n· f P rty property is located on the westerly sideline of South West Street . ca on 0 rope
5. Describe the proposal in this submission: Creation of Parcel "Ar to be conveyed to Dale T
Boglish. ( southerly abutter)
ATTACHMENTS -Two originals and three copies of plan by certified land
surveyor. Filing Fee -$50.00 plus $20.00 per lot.
/ Sigm'= of OW"" ~ ~d"'" 2 17 "'t"-' pp at _
( ./ ~ C?I)~~i/!LL(;;:."Tt-I 585.:>"8
~ ,,"'$"1> ~4\.)~;\~
;-.. I "~I> A$ ";:'~')'"'''''' OI.t:>~O f~ I \1 "[ IH 5 W(lt St,
I:: H. ~(.\p 1~3Q
Jate. 10m2015
To the Department Officer making the Payment:
Received of R. Levesque Associates as Listed Above
the sum of 50.00 Dollars
for the Form A Filing Fee ending 10/7/2015
for collectic
• Treasurer ,
PAYMENT SUMMARY RECEIPT
Town of Agawam
TOWN HALL
36 MAIN STREET
AGAWAM MA 01001
DATE; 10/07/15 CUSTOMER#: 000000000
TIME; 15;30
CLERK: mac
RECPT#; 1086690 PREV SAL:
TP/YR; MS/2016 AMT PAID; 50.00
BILL; ADJSTMNT;
EFF DT: 10/07/15 BAL DUE;
MISCELLANEOUS PAYMENT
- - - - - - - - --- - - - - - -TOTALS - - - - - - - - - - - - - - ---
PRINCIPAL PAID:
INTEREST PAID:
ADJUSTMENTS:
DISC TAKEN;
AMT TENDERED:
AMT APPLIED:
CHANGE:
PAID BY: PLANNING
PAYMENT METH: CHECK
PAYMENT RBF: 4258
50.00
.00
.00
.00
50.00
50.00
.00
Town of Agawam
Interoffice Memorandum
To:
CC:
From:
Date:
Subject:
Erik Wight, Building Inspector
Planning Department
10nt15
Form A -South West Street -Boglish
Please review and comment on the attached Form A for Boglish on South West Street
prior to the Board's October 15th meeting.
Thank you.
:prk
FROM THE DESK OF ...
YOUR NAME
TITLE
TOWN OF AGAWAM
36MAINST
AGAWAM. MA 01 001
Email address Here
413-786-0400 X Extension
Fax: 413-786-9927
Town of Agawam
36 Main Street Agawam, Massachusetts 01001-1801
October 15,2015
Dale Boglisch
202 South West Street
Feeding Hills, MA 01030
Dear Mr. Boglisch:
Tel. 413-786-0400 Fax 413-786-9927
At its duly called meeting held on October IS, 20 IS, the Agawam Planning Board voted to'
approve your plans under "Subdivision Control Law Not Required" for a parcel ofland loeated
on South West Street. Plans drawn by R. Levesque Associates and dated 10-07-2015. c::
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 01001.
To Agawam Planning Board
Please be advised that the Form A plan that was filed by Boglisch and approved by the Agawam
Planning Board for a parcel ofland located on South West Street. Plan has been recorded at the
Hampden County Registry of Deeds. Book , Page ____ _
Signature of Applicant ______________ _