108 JEFFERSON AVE - PLANNING (3) Form A Decision
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FORM A - DECISION
Feb. 24, 1986 II
Ms. Josephine Fusco
City Clerk
City Hall
Salem, MA 01970
Dear Ms. Fusco: •
At a regularly scheduled meeting of the Saler. Planning Board held
on Feb. 20, 1986 it was voted to endorse "Approval Under Sub-
division Control Law Not Required" on the following described plan:
1. Applicant: Salem Hospital
by: Attorney John R. Serafini, Jr.
63 Federal St.
Salem; MA.
2. Location and Description -
One lot at 108 Jefferson Avenue to be divided into
separate lots, each of which has sufficient lot .
area and frontage for the R-1 district.
Land Court Cert. #43020
Deed of property records in Essex South District Registry. .
Sincerely,
Uaw
Walter Power III V
Chairman
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Fes 70 4 o3 PM 'B6
FILE 0
NOTICE TO BE ATTACHED TO CITYCLCR'. S1LEM,MAS&
FORM "A"APPLICATIONS
R
j\ See Form "A" applications for
AFBv - complete instructions for filing.
/'V 2 g A11 insertions shall be typewritten
p(gry1 ti 9�6 r or printed neatly in ink.
Date: ___February 20, 1986 —
City Clerk
Salem, Massachusetts 01970
Dear Sir:
I hand you herewith two copies of Form A, an application submitted by me this day to the Plan-
ning Board of the City of Salem requesting a determination and an endorsement on a plan filed with
said application that Planning Board approval under the Subdivision Control Rules and Regulations is
not required.
The land shown on the accompanying plan is located at 108 Jefferson Avenue
------------
-------------
------------------------------------------------------------------ - in Ward -----3---
(insert street and street numbers here)
Signature of Owner ---By attorney:
..--------------------------------
---------------------- -' - ---------- ---------
Street Address ---63__Eederal_Stseet---------___
City/Town &State salenj---M'-----01970 - - ------------------
Telephone Number 744-0212
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,Salem, Anssachusetts 01970
FORM A
APPLICATION FOR ENDORSEMENT
OF PLAN BELIEVED NOT TO REQUIRE egg -4
APPROVAL
In accordance with provisions of Section II-B, the FUE�p
applicant must file, by delivery or registered mail, a CTTY.CLE.r f�M 'MASS
Notice with the City Clerk stating the date of sub-
mission for such determination. The notice shall be
attached to two copies of this Form A application.
The notice and both copies of the application must
he "date stamped" by the City Clerk and then one
copy of this Form A, with the Plan, filed with the
Planning Board by the applicant. All notices and
applications shall be typewritten or neatly printed
in ink.
Salem, Mass., ---------Febru_ary 20--__-___--19__8 L_
To the Planning Board:
The undersigned, believing that the accompanying plan of his property in the City of Salem does not
constitute a subdivision within the meaning of the Subdivision Control Law because (See Sect. II-A and
statespecific reasons) --------------lot to be subdivided shall create two- lots
-----------------------------------
____which_rorfoxm_to-.xequlations_of_underly_inq_zoning_dietrict
----------------------------------------------------------------------------------------------------------------------------
and herewith submits said plan for a determination and endorsement that Planning Board approval
under the Subdivision Control Law is not required.------ -
Address ---
1. Name of Owner Salem Hospital _
------------ ----------------------------------------------------------
81 Highland Avenue, Salem
----------------------------------- ------------------------------------------ - ..............
- -
- -------- --------
2. Name of Engineer or Surveyor _____Essex Survey Associates -
, Inc.
- - - --- --------------------
Address 181 Essex Street, Salem
------- -- ------- -----------------------------------------------------------
3. Deed of property records in ------------------------------ ----------------------------- Registry
Book -----------____--------------- Page ------_-- ---------__------- Land Court Cert. #43020
4. Location and Description of Property- -----------------------------------------------------------------------------------
--------------n" Zseo
e_ IIt__at__108_- ffersn__Amenue.__ta_he-__divided _into__segarate_lots-____--
____each-of which-has _sufficient__lot_area and frontage for_the R-1____________ _
district.
-------------------------------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------------------------- -
----------------------------------
5. All streets and abutting lot lines shall be shown on the Plan together withn es of,the ers
of the abutting lots. . A 'N
Signature of Owner----By_their attar ney_ _
Address ....___63---------------------------------Federal street. _
.- - --------------------------------
Telephone Number ---------------7.44--212--------------------------------------------
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