8228_FORM A - ADAMS STREET - CAMPBELL cDqy) p
Town of Agawam
36 Main Street Agawam, Massachusetts 01001-1837
Tel. 41.3-786-0400 Fax 413-786-9927
MEMO
TO: Building Inspector&Engineering Department
FROM: Planning Board
DATE: August 8, 2002
SUBJECT: Form A-Adams Street- Campbell
Please review and comment on the attached Form A for Campbell on Adams Street prior to the
Board's August 15, 2002 meeting.
Thank you.
DSD:pre
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: -61iguAt✓$ 002
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 ` Donald Campbell
Address 52 Adams Street - Agawam
2. NAME OF SURVEYOR D.L. Bean, Inc.
Address 40 School Street - Westfield MA 010$
3. DEED OF PROPERTY RECORDED IN Hampden County c4-)
Book 3006 Pagep=7
4. LOCATION OF PROPERTY: Property is loc � R the
northwesterly sideline of Adams Street.
CD
5. DESCRIBE THE PROPOSAL IN THIS SUBM I SS 1 s,. Cx eats parcel of land
to be added to lot located southwesterly to one contiguous parcel
of land.
ATTACHMENTS - TWO ORIGINALS AND THREE COPIES OF PLAN BY CERTIFIED
LAND SURVEYOR. THE PLANS WILL BE DISTRIBUTED AS FOLLOWS: 1 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
Address ~Z „�
No. August 8 20 02
To the Departmental Officer making the Payment:
D. L. Bean, Inc.
Received of , the sum of
Thirty-five and 00/00
Dollar's,
Form A Filing Fern
for the ending for
collections as per schedule of this date,filed in my office.
Treasurer,
Town of Agawam
36 Main Strftt Agawam. Massachusetts 01001-1837
Tel. 41.3-786-0400 Fax 413-786-9927
MEMO
TO: Building Inspector&Engineering Department
FROM: Planning Board
DATE: August 8, 2002
SUBJECT: Form A-Adams Street- Campbell
Please review and comment on the attached Form A for Campbell on Adams Street prior to the
Board's August 15, 2002 meeting.
Thank you.
DSD:pre "
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A G A W A M P L A N N I N G B O A R D
36 Main Street
Agawam, Massacnusetts 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 11-8
Date: August 8. 2002
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 Hoard approval
under the Subdivision Control Law is not required .
1 . NAME OF APPLICANT Donald Campbell
Address 52 Adams Street - Agawam T
2. NAME OF SURVEYOR D.L. Bean, Inc.
Address 40 School Street - Westfield MA 01085
3. DEED OF PROPERTY RECORDED IN Hampden County
Book 3006 Page
4 . LOGAT i ON OF PROPERTY: Property is loc all the 4
.;. v
northwesterly sideline of Adams Street.
5. DESCR I BE THE PROPOSAL . I N TH I S SUBM I SS I �,, Create parcel, of land
to be added to lot located southwesterly to one contiguous parcel
of land.
ATTACHMENTS - TWO ❑RIGINALS AND T 7E� clgialoPLAN BY CERTIFIED
LAND SURVEYOR. THE PLANS WILL B IRIBUTED .�FOLLOWS: 1 ORIGINAL
TO THE TOWN OF AGAWAM ENG I NEER I NC,j I7A�TfS ORIGINAL TO BE
RECORDED AT REGISTRY OF DEEDS B`� 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 tN.N _ �`-S
Town of Agawam
' 36 Maur Street Agawam, Massachusetts 0104.E-1837
Tel. 41.3-786-0400 Fax 413-786-9927
August 15, 2002
Donald J. Campbell
52 Adams Street
Agawam,NIA 01001
Dear Mr. Cambell:
At its duly called meeting held on August 15, 2002, the Agawam Planning Board voted to
approve your plans under"Subdivision Control Law Not Required" for a parcel of land located
on Adams Street. Plans drawn by D.L. Bean, Inc. and dated July 26, 2002.
Sincerely,
AGAWAM PL G BO
t --
cnl
vised that failure to record the plan within six(6) months and provide proof of
ill 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 Campbell and approved by the Agawam
Planning Board for a parcel of land located on Adams Street has been recorded at the Hampden
County Registry of Deeds. Book ,Page
Signature of Applicant
TOWN OF AGAwAm
MEMORANDUM z�
To: Planning Board
CC: John Stone, DPW Supt
From: James T. Daley
Date: August 14, 2002
Subject: Form A 52 Adams St. F213
Per your request of August 8, 2002, we have reviewed subject plan, dated July 26, 2002, and
approve it.
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1 CERTIFY THAT I HAVE CONFORMED
WITH THE RULES & REGULATIONS PLAN NO SHEET NO
OF THE R ISTER OF DEE
IN PREPPAING THIS P
D . L . BEAN,
INC. _ SURVEYORS &
40 SCHOOL STREET ENGINEERS
5fi— =Zia WESTFIELD, MASSACHUSETTS
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