HomeMy WebLinkAbout2497G Form A TCPLANNING BOARD
TOWN OF YARMOUTH,
MASSACHUSETTS
APPLICATION FOR ENDORSEMENT
OF PLAN
APPROVAL NOT REQUIRED
FORM A
Date: � 1[)-q�>2-3
To the Yarmouth Planning Board:
For Office Use
Reference No. 1�_I q 94 G
Hearing Date: '01 1 (O 1 Z.3
[(3 signed copies of Form A
[YFee ($250 <= 3 lots, then $75 per lot
®"original plan and digital file
fd10 copies of plan
The undersigned, believing the accompanying plan of property in the Town of Yarmouth
does not constitute a subdivision within the meaning of the Subdivision Control Law,
requests a determination and endorsement by the Planning Board that approval under
the Subdivision Control Law is not required.
'* BwK 28 g i, PRE / q8 AM.) 50Oc3Y� Pis
Deed to the PP.,
erty is recorded in the Barnstable County Registry of Deeds,
Book 2-81 Page 250 '' or registered in the Barnstable Land Court
Certificate of Title as shown on the Town of Yarmouth
Assessor's Map number 10 , parcel 0,'
Owner:
z S Z U ,J 100 sTYZ,c�'i—
Applicant: 'j-b *PJ fit. 6(&0
clo rmniff-L� P
Print name:
ignatur
0)
56viv-- y , i� pro 2GO
Address
Surveyor:
14-01) U-VAC,K .. 19tN D I t-30
Print name
3Lk M07UN N
Address
Address
SS o H -7-
Registration No.
srrc�-,- #yyI
VT— 05 94 �
Continued