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8241_FORM A - ELM STREET - WINGARD F(c) r a Fee,-.+ ` T y5 RESERVED FOR REGISTRY USE 0 Q loo U o 21Z oo ���sT. �, /✓�1 Z y 1 of ✓ s ti o ° S SCALE I'-ZO �L. ,yi.,/nJinJG �3o/g2 I� 2_0 /O D 20 .q o ✓A v'J�E2 5 cJC3�J/ ✓iS/ n/ Co,•/7-2 o /S •�ai /� cc v/2 I� . ► C.SRT v V -r - x-r Tr�t P�,A,r( 1-{h/� 4GJ�l EI> .I 5� PRaR�fl �rl �o�sM�T wl-r�4 r�1� C o 2/NNE wiit/G.921� L o c u.S 2E� oG �►-�� Cx�ry�orsW�.�--r� o oo� - ' 4 �i�. y3 9 o p 3 y o y7oo '� i�y �-_ r SOGIA`T Q �1C�r1 F�7 . USFE A Fomq4�i a J " cn FORESI L LAsa�S�� �OTF�TriLD�TR +T o /p2 a DER 7""�' � Gut E,CJ 2•''4 _ Z 1�(�Cr PFt�►►i��1�1..D, �� x w J T O- "n -of Agawam " 36 Main Street Agawam, Massachusetts 01001-1837 ~ Tel.. 41.3-786-0400 Fax 413-786-9927 FORM A Application for Endorsement.Qf 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 REQUIREM$ff., F SECTION 114 Agawam, MA o Z.7 20 0 L f t,.,.fir _ TO THE PLANNING BOARD: c.n. " The undersigned, believing that the accompanying plan of his tie Agawam does not constitute a subdivision within the meaning! ` ivision Control Law, herewith submits said plan for a determination and endorsement that Planning Board approval under the Subdivision Control Law is notrequired. 1. Name of Applicant 1 t i ` UJ j 6*ttt Addresslqq Ci 2. Name of Surveyor Address guy; ,: .� J�LJ ST. 089 3. Deed of Property Recorded in t4�,..v c-. , , e_ _S Book Lt 3 110 Page 3`-( o 4. Location of Property_ Ig,[-t� a �i7 T 5. Describe the proposal in this submission:� • .bt `�e' ATTACHMENTS - Two originals and three copies of plan by certified land s eyor. Filing Fee - $35.00. ne Signature of Ow &_%"cldress 61 �l� r Town of Agawam 1f' � 36 Main Street Agawam, Massachusetts 01€ 01-1837 Tel. 41.3-786-0400 Fax 413-786.9927 MEMO Z7 TO: Buildt4pector&Engineering Dept. FROM: Planning Board - A DATE: December 4, 2002 m U.j CT7 r SUBJECT: Form A- Elm Street-Wingard Please review and comment on the attached Form A prior to the Board's December 5'4 meeting. Thank you. DSD:pre /�- -CS ' T o- w. f Agawam r � 36 Main yStrec.eat Agawam, Masnehusetts 01001-1837 Tel. 41.3-786-0400 Fax 413-786-9927 FORM A C= Application for Endorsgrnent of Plan Not Believed a uire Ap&mvu FILE ONE COMPLETED FORM WITH THE PLANNING BOARD AND ONE COPY-, XIIEM THE TOWN CLERK IN ACCORDANCE WITH THE REQUIREME w Agawam, MA Roiv' :.7-'7 2Q O TO THE PLANNING BOARD: do i. The undersigned, believing that the accompanying plan of his j the Tvw. Qf Agawam does not constitute a subdivision within the meanin *06- g ivisiori Control Law, herewith submits said plan for a determination and endorsement that Planning Board approval under the Subdivision Control Law is notrequired. 1. Name of Applicant 1 r I ` Uj - Address �, � � =- 018aJ 2. Name of Surveyor Address 3. Deed of Property Recorded in C, �-s Book L{3 -i s Page 3 4 o 4. Location of Property I -1-7 0 1 T- 5. Describe the proposal in this submission: Ike-- 10,C4� P� �r11-� z �Q�s ATTACHMENTS - Two originals and three copies of plan by certified land s eyor. Piling Fee - $35.00. Signature of Owne - ddress [�V�l Town of Agawam 36Main St1,"t Agawam, Massachusetts 01001-1837 a TeL 443-786-0400 Fax 413-786-9927 MEMO TO: Building Inspector&Engineering Dept. FROM: Planning Board DATE: December 4,2002 SUBJECT: Form A-Elm Street- Wingard Please review and comment on the attached Form A prior to the Board's December 5"meeting. Thank you. DSD:pre No. Dec. 3 zp 02 To the Departmental Officer making the Payment: Received of Corinne Wingard the sum of Thirty-five and 00/00 Dolls, for the Form A Filing Fee ending for collections as per schedule of this date, filed in my office. Treasurer, Town of Agawam t• 36 Main S ti-eet Agawam, Massachusetts 01001-1837 Tel. 4:13-786-0400 Fax 413-786-9927 December 5, 2002 Corinne M. Wingard 194 Elm Street Agawam, MA 01001 Dear Ms. Wingard: At its duly called meeting held on December 5, 2002, the Agawam Planning Board voted to approve your plans under"Subdivision Control Law Not Required" for a parcel of land located on Elm Street. Plans drawn by R.A. Foresi Associates and dated Nov. 27, 2002. Sincerely, AGAWAM PLANNING BOARD 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 Wingard and approved by the Agawam Planning Board for a parcel of land located on Elm Street has been recorded at the Hampden County Registry of Deeds. Book , Page Signature of Applicant Town :of Agawam 36 Maiu S t3°eet Agawam, Massachusetts 01001-1837 Te). 4:13-786-0400 Fax 413-786-9927 January 2, 2003 Corinne M. Wingard 194 Elm Street Agawam, MA 01001 Dear Ms. Wingard: At its duly called meeting held on January 2, 2003, the Agawam Planning Board voted to approve your plans under"Subdivision Control Law Not Required" for a parcel of land located on EIm Street. Plans drawn by R.A. Foresi Associates and dated Nov. 27, 2002. Sincerely, AGAWAM PL G BOARD C7 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 Wingard and approved by the Agawam Planning Board for a parcel of land located on Elm Street has been recorded at the Hampden County Registry of Deeds. Book , Page Signature of Applicant-- -- _- COMMONWEALTH OF MASSACHUSETTS HAMPDEN COUNTY REGISTRY OF DEEDS DONALD E. ASHE REGISTER OF DEEDS PLAN DEPARTMENT PLAN RECORDING RECEIPT DATE: _( , ,I� , SOU -3 CHECK NUMBER: BOOK: 3Po'PAGE: Q _ CASH:, / $10.00 120.00 $30.00 S16.00. $20.00 :,V6.00 $25.00 $20.00 S43:00 TOTAL CHARGE; S. . 0 AGENCYICONWANY: �1��III ICJ r n, Q PHONE.- STREET ADDRESS: CITY: STATE: AUTHORIZE BY (PRmT): SIGNATURE:.- go STATE STREET SPRINGFIEI,D,MASSACHUSETTS 01103 PHONE: (413) 755••1722 FAX: (413) 731-8190 hnVden #ec.state.nwus