8281_FORM A- GOLD STREET- RICHTER (MICROTEST) Fc-�-
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To Agawam Planning Board
Please be advised that the Forni A plan that was filed by Richter and approved by the Agawam
Planning Board for a parcel of land located on Gold Stree has been recorded at the Hampden
County Registry of Deeds. Bo-1- :3 3 2 , Page 6 6
Signature of Applicant 1 G� �
A G A W A M P L A N N I N G B 0 A R D
z
36 Main Street C=
Agawam, Massachusetts 01001D
Tel . 413-786-0400 Ext . 245 n
Q'
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FORM A o
a
Application for Endorsement of Plan Believed Not o k4gQre Approval
-tr a
FILE ONE COMPLETED FORM WITH THE PLANNING BOARD AND C%Ev'COPY WITH
THE TOWN CLERK IN ACCORDANCE WITH THE REQUIREMENTS OF SECTION 11-B
Date:
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 _ SZ V 724 C,�L__
Address �f- rr
2. NAME OF SURVEYOR b� 1(rZ W C71� 2fE� r S�'iffi{ A�JaLt✓ .]c•(2cJ�y�L,(
Address E611 �✓l��Oy j `_OI 2�'
3. DEED OF PROPERTY RECORDED IN �•-}(-Nl O yJ VO" f F:�Uy
Book _ 12�09 Page_ 12S—
4 LOCATION OF PROPERTY
or �c.o ��
1 �15 JAf� 0 $ 2004 �
. 5. DESCRIBE THE PROPOSAL IN THIS SUBMIS. 0
A3 S o
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 la_ �
DEPA TMENT.
Signature of Owner C�
Address (04 (�O t SA ^AL,A,,�A.a. AC
Town of Ag '
wam
fit 36 Main Street Agawam, Massachusetts 01001-1837
Tel. 413-786-0400 Fax 413-786-9927
MEMO
TO: .Buildin tiYhs ector& Engineering Department
g A g g p
FROM: Planning Board
SUBJECT: Form A - Gold Street- Richter
DATE: January 7, 2004
Please review and comment on the attached Form A for Richter on Gold Street prior to the
Board's January 15" meeting.
Thank you.
rn
DSD:pre � •
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A G A W A M P L A N N I N G B 0 A R D
1N5P.SERV.180. OF APP � e �+ x
A 36 Main Street q
%Amam, Massachusetts 01001>
7 A f f: ST1 . 413=786-0400 Ex t. 245 A
AGAWAM. NA n crco
FORM A -D
' 3 n
Application for Endorsement of Plan believed Not Ito ltgsgre Approval
FILE ONE COMPLETED FORM WITH THE PLANNING BOARD AND AE"COPY WITH
THE TOWN CLERK IN ACCORDANCE WITH THE REQUIREMENTS OF SECTION 11-B
Date.
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 57E,l 62. Tu 2
Address r
2 . NAME OF SURVEYOR 1 6-'L W 0d ! SMl r}r A3 10 C-(A-ft33t2cl�yo✓t,{
Address [,0}�►�GA/iowd �- OI0
3. DEED OF PROPERTY RECORDED IN_ (-}MPS e'►'� --0 ,S U�
Book_ 12�� ` _ Page 17-3
7
4 . LOCATION OF PROPERTY:
JAN ) 6 2004
5. DESCRIBE THE PROPOSAL IN THIS SUBMIS
+ 13 c A3
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 B NG DEPA TMENT.
Signature of Owner �L
Address
Town of Agawam
36 Main Street Agawam, Massachusetts 01001-1837
RATED MP
`1 Tel. 413-786-0400 Fax 413-786-9927
MEMO
TO: Building Inspector & Engineering Department
FROM: Planning Board
SUBJECT: Form A - Gold Street - Richter
DATE: January 7, 2004
Please review and comment on the attached Form A for Richter on Gold Street prior to the
Board's January 15" meeting.
Thank you.
DSD:pre
Baystate Environmental
Consultants, Inc.
296 North Main Street
East Longmeadow, MA 01028 DATE JOB NO.
01/06/04 03-0508
(413) 525-3822 ATTENTION
FAX (413) 525-8348 RE: Micro-Test Labs, Inc.
TO: Town of Agawam
Planning Board
WE ARE SENDING YOU 0 Attached ❑ Under separate cover via the following items:
❑ Shop Drawings ❑ Prints ID Plans ❑ Samples ❑ Specifications
❑ Copy of Letter ❑ Change Order❑
COPIES DATE NO. DESCRIPTION
1 01/06/03 Form A for Gold Street, Lot 15A
2 10/31/03 Originals of ANR Plan
3 10/31/03 Copies of ANR Plan p
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THESE ARE TRANSMITTED as check below: .a
D For approval ❑ Approved as submitted ❑ Resubmit copies for approval
❑ For your use ❑ Approved as noted ❑ Submit copies for distribution
❑ As requested ❑ Returned for correction ❑ Return corrected prints
ED For review and comment❑
❑ FORBIDS DUE ❑ ITEMS RETURNED AFTER LOAN TO US
REMARKS
COPY TO: Bill Jenkins—Micro-Test Labs, Inc. „_SIGNED: Tom Jenkins, P.E.
If enclosures are not as noted,kindly notify us at once.
TOWN OF AGAWAM
O 9
INTEROFFICE
-
MEMORANDUM
To: Planning Board
CC: File
From: Engineering
Date: January 14, 2004
Subject: Form-A - #231 - Gold Street - Richter
Per your request dated January 7, 2004, we have reviewed the plan entitled, "Revised Plan of Land,
#104 Gold Street, Agawam, Mass., Owned by Steven G. Richter"; Prepared by: Smith Associates
Surveyors, Inc., 165 Shaker Road, East Longmeadow,MA 01028; Scale I"=40'; Date: October 31,
2003, and we note the following:
A member of Engineering spoke with Daniel O'Brien of Smith Associates Surveyors, Inc. Smith
Associates produced this Form A. Mr. O'Brien was asked to include all survey data for the Tennessee
Gas Pipeline Co.,the Town of Agawam Water, and the Western Mass. Electric Co. easements on the
plan. Mr. O'Brien was also asked to include the survey data for Lot 15 (#104 Gold St.) as well. We
have no further comment at this time.
If you have any questions, please do not hesitate to contact our division
Sincerely,
q
JAPd f 2004
RiA S. Seidnitzer 7eor' nne J. Ho an, PCivil Engineer I ngineer
Slf6miA1231101.wpd
No January 20 2004
I , -
To the Departmental Officer making the Payment:
' Received of Microtes t Laboratories , Inc . , the sum of
1
Thirty--five and 0//00 Dollars,
for the Form A Filing Fee ending for
collections as per schedule of this.date, filed in my office.
- � Treasurer,
R ,
Town ofAgawam
36 Main Street Agawam, Massachusetts 01001-1837
Epp Mp 11 Tel. 413-786-0400 Fax 413-786-9927
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January 29, 2004 _. !�
I>O
Steven Richter �
104 Gold Street r
h, rn
Agawam, MA 01001
Dear Mr. Richter:
At its duly called meeting held on January 29,'2004, the Agawam Planning Board voted to
approve your plans under "Subdivision Control Law Not Required" for a parcel of land located
on Gold Street. Plans drawn by Smith Associates and dated October 31, 2003, revised Januay
15, 2004.
Sincerely,
AGAWA PLANNI O RD
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 O11001.
To Agawam Planning Board
Please be advised that the Form A plan that was filed by Richter and approved by the Agawam
Planning Board for a parcel of land located on Gold Street has been recorded at the Hampden
County Registry of Deeds. Book , Page
Signature of Applicant
Town of Agawam
,t a,
36 Main Street Agawam, Massachusetts 01001-1837
ATEO MP
`1 Tel. 413-786-0400 Fax 413-786-9927
January 29, 2004
Steven Richter
104 Gold Street
Agawam, MA 01001
Dear Mr. Richter:
At its duly called meeting held on January 29, 2004, the Agawam Planning Board voted to
approve your plans under "Subdivision Control Law Not Required" for a parcel of land located
on Gold Street. Plans drawn by Smith Associates and dated October 31, 2003, revised January
15, 2004.
Sincerely,
AGAWA PLANNi O RD
Please he 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 Richter and approved by the Agawam
Planning Board for a parcel of land located on Gold Street has been recorded at the Hampden
County Registry of Deeds. Book 13922 , Page 435
Signature of Applicant ^
cD.# - c) (r0c4 co -~
JOB # a
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