[Amended 5-18-95]
DATE:______________
(Stamp-two (2) forms with the Town Clerk. File one (1) form with the Town Clerk and one (1) form with the Planning Board)P
To the Planning Board:
The undersigned, believing that the accompanying plan of property in the Town of Ipswich, Massachusetts, does not constitute a subdivision within the meaning of the Subdivision Control Law, herewith submits said plan for a determination and endorsement that the Planning Board approval under the Subdivision Control Law is not required.
1. Name of Applicant:___________________________________________
Address:_____________________________________________________
Phone#: _____________________________________________________
2. Location and Description of Property [include Assessor's Map &
Lot and Zoning District(s)]:_________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
3. Deed Reference: Book______, Page______ or Certificate of Title
__________
4. Name of Surveyor:____________________________________________
Address:_____________________________________________________
Phone #:_____________________________________________________
Signature of Owner(s):__________________________________________
Address:________________________________________________________
TOWN OF IPSWICH PLANNING BOARD
Form A: Planning Board Approval Not Required
Please indicate the grounds (either A,B, C or D, not a combination) on which you believe your plan not to be a subdivision.
A. Each lot on the plan meets one of the following criteria:
1. Has the frontage, lot area, and lot width required under the Protective Zoning By-Law on: a) ______ a public way, or b) ______ a way which the Town Clerk certifies is maintained & used as a public way, or c) ______ a way shown on a plan approved and endorsed by the Planning Board under the Subdivision Control Law, recorded in Plan Book_____ , Plan _____, or d) ______ a way in existence before the adoption of the Subdivision Control Law by the Town and which the Board finds adequate for the way's proposed use, or e) ______ a way shown on a plan of a subdivision recorded at the Registry of Deeds or Land Court prior to the adoption of the Subdivision Control Law.
B. Each Lot has been clearly marked on the plan to be either: a) ______ joined to and made part of an adjacent lot, or b) ______ labeled "Not A Building Lot".
C. ______ Each lot on the plan contains a building which existed prior to the adoption of the Subdivision Control Law.
D. ______ The plan shows an existing parcel with no new lot division(s) and has frontage on a way described above.
Received: Town of Ipswich Town Clerk (date stamp):
_____________________________________________________
Signature of Town Official Receiving this Application
DATE:_____________
(Stamp two (2) forms with the Town Clerk. File one (1) form with the Town Clerk and one (1) form with the Planning Board)
To the Planning Board:
The undersigned, being an applicant under Chapter 41, Section 81S, MGL, for approval of a proposed subdivision plan, hereby submits a Preliminary Plan and makes application for approval to the Ipswich Planning Board:
1. Name of Applicant:_____________________________________________
Address:_______________________________________________________
2. Name of Subdivision:___________________________________________
3. Location and Description of Property (include Assessor's Map & Lot and Zoning District(s)]:_______________________________________
_______________________________________________________________
_______________________________________________________________
4. Deed Reference: Book_____, Page_____, or Certificate of Title
______________
5. Name of Surveyor/Engineer:_____________________________________
Address:_______________________________________________________
Signature of Owner(s):____________________________________________
Address:__________________________________________________________
Received: Town of Ipswich Town Clerk (date stamp):
_____________________________________________________
Signature of Town Official Receiving this Application
TOWN OF IPSWICH
IPSWICH, MASSACHUSETTS 01938
PLANNING BOARD
DATE:__________________
(Stamp two (2) forms with the Town Clerk. File one (1) form with the Town Clerk and one (1) form with the Planning Board)
To the Planning Board:
The undersigned, being an applicant under Chapter 41, Section 810, MGL, for approval of a proposed subdivision plan, hereby submits a Definitive Plan and makes application for approval to the Ipswich Planning Board:
1. Name of Applicant:_______________________________________________
Address:_________________________________________________________
2. Name of Subdivision:_____________________________________________
3. Location and Description of Property [include Assessor's Map & Lot and Zoning District(s)]:_________________________________________
_________________________________________________________________
_________________________________________________________________
4. Deed Reference: Book____, Page____, or Certificate of Title
_______________________
5. Name of Surveyor/Engineer:_______________________________________
Address:_________________________________________________________
6. Easements & Restrictions of Record (Describe & Include Deed
References):_____________________________________________________
7. Preliminary Plan Submitted?____; Plan Approved?____; Date:_______
Signature of Owner(s):______________________________________________
Address:____________________________________________________________t
Received: Town of Ipswich Town Clerk (date stamp):
_____________________________________________________
Signature of Town Official Receiving this Application
KNOW ALL MEN BY THESE PRESENTS that____________________________ as Principal and_______________________________________________ a corporation duly organized and existing under the laws of the State of_______________________, and having a usual place of business in_________________________________________, as Surety, hereby bind and obligate themselves and their respective heirs, executors, administrators, successors and assigns, jointly and severally, to the Town of Ipswich, a Massachusetts municipal corporation, in the sum of_______________________ Dollars.
The condition of this obligation is that if the Principal shall fully satisfactorily observe and perform in the manner and in the time therein specified, all of the covenants, conditions, agreements, terms and provisions contained in the following:
1. Application for Approval of Definitive Plan (Form C) signed by the Principal and dated_____________________________________
2. The Rules and Regulations Governing the Subdivision of Land in Ipswich adopted by the Planning Board; and
3. The Definitive Plan as defined by the above Rules and Regulations and as qualified by the Certificate of Approval (Form H) issued by the Planning Board dated ___________________, then this obligation shall be void; otherwise, it shall remain in full force and effect.
Whenever the Principal shall be, and is declared by the Planning Board to be, in default under the Definitive Plan and its Certificate of Approval, the Surety may promptly remedy the default or shall promptly:
1. Complete all of the work required by the Definitive Plan in accordance with its terms and conditions, or
2. Obtain a bid or bids for submission to the Planning Board for completing all of the work required by the Definitive Plan in accordance with its terms and conditions, and upon determination by Planning Board and Surety of the lowest responsible bidder, arrange for a contract between such bidder and Planning Board and make available as work progresses sufficient funds to pay the cost of completion; but not exceeding, including other costs and damages for which the Surety may be liable hereunder, the amount set forth in the first paragraph hereof.
IN WITNESS WHEREOF we have hereunto set our hands and seals this________________ day of_____________________ 19________.
Principal
_________________________________
By_______________________ (Title)
Surety
_________________________________
By_______________________________
(Attorney-in-Fact)
Signed and sealed in the presence of:
_____________________________________
