8611_FORM A ELIZABETH ST. LOT 1230 1
Uate. b? j12009
To the Department Officer making the Payment:
Received of D.L. Bean, Inc. as Listed Above
the sum of 90.00 Dollars
for the Form A Filing Fee ending 6/18/2009
for collectic
n
C`
Tr" surer
A G A W A M P L A N N I N G H O A R D
36 Main Street
Agawam, Massachusetts 01001
Tel. 413-786-0400 Ext. 245
FORM A
Application for Endorsement of Plan Believed Not 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
Date: May 18, 2009
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,
I. NAME OF APPLICANT Ralph DePalma
Address_ 267-Hillside Road, Southwick _
"
2. NAME OF SURVEYOR D.L. Bean, Inc.
Address 40 School Street - Westfield, MA 01085
3. DEED OF PROPERTY RECORDED IN Hampden County
17188
Book Page 404"'� �.
4. LOCATION OF PROPERTY: Property is located on the easterly
sideline of Elizabeth Street.
5. DESCRIBE THE PROPOSAL IN THIS SUBMISSION: Plan revised Lot #12 and
creates Parcel A.
ATTACHMENTS - TWO ORIGINALS AND THREE COPIES OF PLAN BY CERTIFIED
LAND SURVEYOR. THE PLANS WILL BE DISTRIBUTED AS FOLLOWS: i ORIGINAL
TO THE TOWN OF AGAWAM ENGINEERING DEPARTMENT, ONE ORIGINAL TO BE
RECORDED AT REGISTRY OF DEEDS BY THE APPLICANT, ONE COPY FOR THE
ASSESSORS OFFICE, ONE COPY FOR THE PLANNING BOARD OFFICE, AND ONE
CERTIFIED COPY FOR THE BUILDING DEPARTMENT.
Signature of Owner
w
Addresses yK
Tow- n of Ag'awam
36 Main Street Agawam, Massachusetts 01001-1837
Tel. 413-786-0400 Fax 413.-786-9927
MEMO
TO: Building Inspector
FROM:
Planning Board
SUBJECT:
Form A's (2) - Elizabeth Street - DePaima
DATE:
May 18, 2009
Please review and comment on the attached two Form A's for DePalma on Elizabeth Street prior
to the Board's May '21 s' meeting.
Thank you.
DSD:prk
Town of Agawam
36 Main Strut Agawam, Massachusetts 01-001-1837
Tel. 413-786-0400 Fax 413-786-9927
May 21, 2009
Ralph DePalma
267 Hillside Road .
Southwick, MA 01077
Dear Mr. DePalma: ti
At its duly called meeting held on May 21, 2009, the Agawam Planning Board voted to approve
your plans under "Subdivision Control Law Not Required" for a parcel of land located on Lot 12
Elizabeth Street. Plans drawn by D.L. Bean, Inc. and dated 5-18-2009.
Sincerely,
AGA`NAM PLANNING
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 DePalma and approved by the Agawam
Planning Board for a parcel of land located on Elizabeth St, has been recorded at the Hampden
County Registry of Deeds. Book , Page
Signature of Applicant
Town of Agawam
36 Main Street Agawam, Massachusetts 01001-1837
Tel. 413-786-0400 Fax 413.-786-9927
May 21, 2009
Ralph DePalma
267 Hillside Road
Southwick, MA 01077
Dear Mr. DePalma:
At its duly called meeting held on May 21, 2009, the Agawam Planning Board voted to approve
your plans under "Subdivision Control Law Not Required" for a parcel of land located on Lot 12
Elizabeth Street. Plans drawn by D.L. Bean, Inc. and dated 5-18-2009,
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 DePalma and approved by the Agawam
Planning Board for a parcel of land located on Elizabeth St. has been recorded at the lianiDden
County Registry of Deeds. Book 3 51� , Page, .,
ox -.
Signature of Applicant