40 WARREN STREET - ZONING (2) Form A Decisions
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Ctg of Sateen, fflttssar4usetts
Planning Pourb
@Iiig�1ell
Salem, �lU[assachusetis 01970
NOTICE TO BE ATTACHED TO
FORM''A"APPLICATIONS
See Form "A" applications for
complete instructions for Sling.
All insertions shall be typewritten
or printed neatly in ink.
Date: ---
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 Sled 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 ----- 4c____Sk--------_---
Sa-'—kU-r----- 0Vj-t --- in Ward ----3---------------------------------------------------
(insert street and street numbers here)
Y Signature of Canner ------ ----- - —
�`�vf
--------- ------------
Street Address ----LA--_4 o.n.e —5�'----------------—------—------------------------
City/I'own&State----5 -/�------ -
k-C-- ------' -ls-Z-Q -- —------ --------- ----------
Telephone Number l_TC7T�------------------------------------------------------
Ctv of "Mem, ttssttcl�use##s
Planning Poarb
_
QTitq �dtt1l
,Salem, gaeenrhuectte 01970
FORM A
APPLICATION FOR Ei\DOIISLj\IFNT
OF PLAN BELIGVED NOT TO REQUIRL,
APPROVAL
In accordance with provisions of Section 1I-13, the
applicant must file, by delivery or registered mail, a
Notice with the City Clerk stating the date of sub-
mission for such determination. The notice shall be
attached to tivo copies of this Form A application.
The notice and both copies of the application must
be "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.. ------- 3(' - - - - - - 19—[
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 Contr I Law because (See Sect. II-A and
state specific reasons) ____�e� p _ -J.� _ , _ _ __ �e�� e� y1—_________
--- ----------------------------------------------------------------------------------------------------------------- --------------------
and herewith submits said plan for a determination and endorsement that Planning Board approval
under the Subdivision Control Law is not required. �
e 1. Name of Owner -----
Address -------------------------- - ------- -----
2. Name of Engineer or Surveyor __/Vjzr->f---___tziKi> _ U A Y __ce-2&-C—____ ____________
Address ------------ - sd---51—S_- ---- - -
3. Deed of property records in�SsL-_-__-- �s_-`?-Lz7/1 s ei-. Registry
Book ------4116------------------ -- -. Page -3-96 ------------------
4. Location and Description of Property: _ - _. _.__-- ------
__ -- - ----- - --- -
___________________
`I_C?-----��f .e ��-----�r.�� 1:=----- ----ytoke `'`-e'--- ----
----------------------------------------------------------- ---------------------------------------------------------------- ------------------ -
5. All streets and abutting lot lines shall be shown on the Plan together with the names he Owners
of the abutting lots. Z
f Signature of Owner------------------ ----
Address----q0--- a' e =----------------------- -----
-------------------
Telephone Number ----