8844_FORM A - 803 N. WESTFIELD ST.Foy-m �
M3�t-
TOWN OF AGAWAM, MASSACHUSETTS
FORM A
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 11-13
Nov, k{ 20�
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.
1. Name of Applicant To w� \A4 lJ _
Address E30 ?) /'� Or1 - tf VQFa.S { C- I G.Lh
Phone # `� ,_? �/� `/13`/y Fax # email
2. Name of Surveyor"
Address �� IT,T►
Phone # q 13 C Fax # 413 2 73—i7 email Kgji1 PRM1i#—(:5 111
3. Deed of Property Recorded in _alqm eb aN co U vii
Book ) S7& 0 2- Page l_5'3 _
4. Location of Property Sj.,�j fa:- . 5 Aj�, Op '&J 6 a j# 14t�,FIEIEt� 7 ,
5. Describe the proposal in this submission:
k(9r&
ATTACHMENTS - Two originals and three copies of plan by certified land
surveyor. Filing Fee - $50.00 plus $20.00 per lot.
Signature of OwnerAddress Zd3 _ Ale, i t,)cs"
CAI W V - C; I fkf,-]N &!a z� 2&
s (Z+w+
Town of Agawam
Schedule of Departmental Payments to Treasurer
No: planning board - UA I t 11/16/2017
ORG. AND OBJECT SOURCE AMOUNT TOTAL
22010 42400 John D. West 90.00 90.00
0 0 - -
0 0 0 - -
0 0 Form A - -
0 0 803 North Westfield St. - -
0 0 0 -
0 0 0 - -
0 0 0
0 0 0
0 0 0
Total
No.
To the Accounting Office
90.00
Date: 11/16/2017
The above is a detailed list of moneys collected by me, amounting in the aggregate to
the sum of 90.00 Dollars,
for the Form A ending 11/16/2017
which I have paid to the Treasurer, whose receipt I hold therefor.
Planning and Community Development
Date: 11 /16/2017
To the Department Officer making the Payment:
Received of John D. West as Listed Above
''the sum of 90.00 Dollars
for the Farm A ending 11/16/2017
for collections as per schedule of this date, filed in my office.
Treasurer
PAYMENT SUMMARY RECEIPT
i
Town of Agawam
TOWN HALL
36 MAIN STREET
AGAWAM MA 01001
DATE: 11/16/17 CUSTOMER#: 000000000
TIME: 15:35
CLERK: Amy -Boyd
RECPT#: 1279891 PREV SAL:
TP/YR: MS/2018 AMT PAIR: 90.00
BILL: ADJSTMNT:
EFF DT: 11/16/17 BAL ➢UE:
MISCELLANEOUS PAYMENT
-----------------TOTALS------ -----
PRINCIPAL PAID: 90.00
INTEREST PAID: .00
ADJUSTMENTS: .00
DISC TAKEN: .00
AMT TEN➢ERED: 90.00
AMT APPLIED: 90.00
CHANGE: .00
PAID BY: PLANNING
PAYMENT METH: CHECK
PAYMENT REF:
Town of Agawam
Interoffice Memorandum
To: Erik Wight, Building Inspector
CC:
From: Planning Board
Date: 11/16/17
Subject: Form A - 803 North Westfield Street - J. West
Please review and comment on the attached Form A for J. West by Anderson
Associates before the Planning Board's next meeting on Thursday, December 7, 2017.
Please return the copy of the plan upon your review.
Thank you,
PRK:amb
IGTI,MIT, 7171T
FROM THE DESK OF...
YOUR NAME
TITLE
TOWN OF AGAWAM
36 MAIN ST
AGAWAM, MA 01001
Email address Here
413-786-0400 X Extension
Fax: 413-786-9927
ra
Town of Agawam
36 Main Street Agawam, Massachusetts 01001-1801
Tel. 413-786-0400 Fax 413-786-9927
December 7, 2017
John West
803 North Westfield Street
Feeding Hills, MA 01030
Dear Mr. West:
At its duty called meeting held on December 7, 2017, the Agawam Planning Board voted to
approve your plans under "Subdivision Control Law Not Required" for a parcel of land located
on North Westfield Street. Plans drawn by Anderson Associates and dated Nov. 2017.
Sincerely,
r-r
AGAWAM PL NNr.K BOARD
CC
�i
r
Please be advised 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
Planning Board, 36 Main Street, Agawam, MA 01001.
.........................................................................
To Agawam Planning Board
Please be advised that the Form A plan that was filed by West and approved by the Agawam
Planning Board for a parcel of land located on North Westfield Street. Plan has been recorded at
the Hampden County Registry of Deeds. Book , Page
Signature of Applicant
f
Town of Agawam
36 Main Street Agawam, Massachusetts 01001-1801
Tel. 413-786-0400 Fax 413-786-9927
December 7, 2017
John West
803 North Westfield Street
Feeding Hills, MA 01030
Dear Mr. West:
At its duty called meeting held on December 7, 2017, the Agawam Planning Board voted to
approve your plans under "Subdivision Control Law Not Required" for a parcel of land located
on North Westfield Street. Plans drawn by Anderson Associates and dated Nov. 2017.
Sincerely,
AGAWAM PL NN K BOARD
A
4Z,
-� - - - — —
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 West and approved by the Agawam
Planning Board for a parcel of !4 located on North Westfield Street. Plan has been recorded at
the Hampden County Regist o Dods. Pook, Page ]CZ
Signature of Applicant
f
PESKIN, COURCHESNE & ALLEN, P.C.
ATTORNEYS AT LAW
1391 Main Street • Suite 201
Springfield, MA 01 103
Tel. 413-734-1002 • 866-813-2533
Fax 413-734-0029
www.pcalaw.net
Hours: M-F 9:00am - 5:00pm
Judd L. Peskin *
Nyles L. Courchesne
Jonathan H. Allen
Katherine L. Milligan
W also admirted in Connecticut
Of Counsel:
Richard P. Courchesne
Writer's email: kl@pcalaw.net
January 10, 2018
Agawam Planning Board
36 Main Street
Agawam, MA 01001
Re: Plan of land on North Westfield Street, Agawam, MA
Dear Sir/Madam:
Enclosed please find the fully signed Form A Statement for a plan of land that was
recorded. Should you have any questions, please feel free to contact our office. Thank you for
your time in this matter.
Very truly yours,
Kyleigh Letourneau
Real Estate Paralegal
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