8507_FORM A - PEMBROKE LANE - SITTERLY 607- dorm �
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P. �'/�i�i.�f?�/� � CERTIFY THAT I HAVE CONFORMED I `�a s ✓OA16/9 zad r CHECKED:
WITH THE RULES & REGULATIONS �, PLAN NO. SHEET NO.
OF THE REGIS R OF DEEDS
IN PREPt4R G HIS PLAN
Da l . B EAN Nr
SURVEYORS &
40 SCHOOL STREET
WE:STFIELD, MASSACHUSETTS ENGINEERS
LITHO IN USA NE BLUEPRINT 0272;3
Town of Agawam
40 coo
4% 36 Main Street Agawam, Massachusetts 01001-1837
Tel. 413-786-0400 Fax 411-786-9927
July 2, 2007
Rod Sitterly
22 Pembroke Lane
Agawam, MA 01001
Dear Mr. Sitterly:
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At its duly called meeting held on July 5, 2007, the Agawam Planning Board voted to approve c-).)--
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your plans under"Subdivision Control Law Not Required" for a parcel of land located on r— ZE
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Pembroke Lane. Plans drawn by D.L. Bean, Inc. and dated June 19, 2007. Cn M
Sincerely, X>C�
%D Cf) r4
AGAWAM PLANNING BOARD
Please be advised thatfailure to record the plait within sLr (6) months andprovide 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 Sitterly and approved by the Agawam
Planning Board for a parcel of land located on Pembroke Lane has been'recorded at the Hampden
County Registry of Deeds. Book Jage
Signature of Applicant
Town of Agawam
7�4 36 Main Street Agawam, Massachusetts 01001-1837
Tel. 413-786-0400 Fax 413-786-9927
M
MEMO
TO: Building Inspector& Engineering Department
FROM: Planning Board
SUBJECT: Form A - Pembroke Lane - Sitterly
DATE: June 27, 2007
Please review and comment on the attached Form A for Sitterly on Pembroke Lane prior to the
Board's July 51h meeting.
Thank you.
DSD:pik
A G A W A M P L A N N I N G 8 0 A R D
36 Main Street.
Agawam. Massachusetts 01001
Tel . 413-786-0400 Ext. 245
FORM A
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Apelication for Endorsement of Plan Believed Not to Regu reAoor`o�vai
FILE ONE COMPLETED FORM WITH THE PLANNING BOARD AND ONE C PY WITH
THE TOWN CLERK IN ACCORDANCE WITH THE REaUIREMENTS OF -SECTION 11-B
Date- June 26, 2007
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 Con'trol 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 - Rod Sitterly
Address 22 Pembroke Lane - Agawam, 14A
,2. NAME OF SURVEYOR- D.L. Bean, Ift.
Address 40 School Street - Westfield, MA
3. DEED OF PROPERTY RECORDED IN Hampden County
Book- 10116 Page 99
4. LOCATION OF PROPERTY: Prop6rty is located on the sout�erly
sideline of Pembroke Lane.
5. DESCR IBE THE PROPOSAL IN THIS SUBMISSION-. Plan shows creation -
of a parcel of property to be conveyed to owners of #22 Pembroke Lane.
. 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
LbIN DE
CERTIFIED COPY FOR THE BUI I EPARTMENT.
Signature of Owner.
Address Re7n�k_6v L4L"'w
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PLANNING
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��'T�• - #33010 DATE: SCALE:
1 CFRTIfY T14AT I HAVE CONFORMED {� .1 y CHECKED.
WITH THE RULES & REGULATIONS 11 14 PLAN NO. SHEET NO
OF THE RECIS. R OF DEEDS
- IN PREP" HIS PLANf DoLs EAN INC. SURVEYORS &
40 SCHOOL STREET ENGINEERS
WIESTFIELD, MASSACHUSETTS
LITHO IN USA NE BLUEPRINT 087233
z4 14 6
TOWN OF AGAWAM
Department:of Public Works
36 Main Street • Agawam, MA 01001
Tel (413) 786-0400 •. Fax (413) 786-9927
John P. Stone — Superintendent
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MEMORANDUM
To: Planning
CC: File
From: Engineering
Date: June 27, 2007
Subject: Form A— Pembroke Lane- Sitterl - F-297
Per you request, we have reviewed the Form An entitled: "Division -of Property — Agawam,
Massachusetts; For: Rod Sitterly & Kathleen M. Wynn, 22 Pembroke Lane, Agawam, MA; Scale:
V=40'; Date: June 19, 2007", and we approve the plan.
If you have any questions, please do not hesitate to contact our division.
Sincerely,
Vladimir C6ceres Michael C. Chase, E.I.T.
Civil Engineer I Interim Town Engineer
S:TORMAU97 53 PEMBROKE LNW1.DOC
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To the Department Officer making the Payment:
Received of D.L. Bean, Inc. as Listed Above
the sum of Seventy and 00/00 70.00 Dollars
for the 2 Form A Fees ending 6/27/2007
for collections as per schedule of this date, filed in my office.
Zdwj z7 AC4�
Trea urer,�