HomeMy WebLinkAbout2940 Form A TCPLANNING BOARD
TOWN OF YARMOUTH,
MASSACHUSETTS
APPLICATION FOR ENDORSEMENT
OF PLAN
APPROVAL NOT REQUIRED
FORM A
Date: OCA 2-9 A722
To the Yarmouth Planning Board:
Reference No. ?-qWo
Hearing Date: 1i r►S IZ3
e3 signed copies of Form A
EfFee ($250 <_ 3 lots, then $75 per lot
Q,6dginal plan and digital fie
a',0 copies of plan
[FPRDdF�
U C I 27 RECD iT
ENT
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.
Deed to the property is recorded in the Barnstable County Registry of Deeds,
Book -6(Z 4 , Page 2(dk or registered in the Barnstable Land Court
Certificate of Title as shown on the Town of Yarmouth
Assessor's Map number parcel�j/0�
Owner: [_var eU W� Applicant:
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Address
Surveyor:
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Print name
Address
Print name:
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Address
Registration No.
Continued