2020-ANR APPLICATION- 5 SUNVIEW TERRACEt /^eccivecf Sy u/r
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FORMA
DARTMOUTH
PLANNING BOARD
400 Slocum Road
Dartmouth, NL\ 02747
(508) 910-1816
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TIME STAMP HERE
APPLICATION FOR ENDORSEMENT OF ANR (Approval Not Required^ PLAN
(Please Print or Type)
Date: 10/27/2020
Applicant’s Name: Lisa M. Balaschak Phone No.: 617-733-3876
Applicant’s Address: 5 Sunview Terrace, Dartmouth, MA 02748
Name:Property Owner
(if different than applicant)
Address:
Phone No.: 508-636-5905 x202Contact Person : Mark A. Boucher. PLS______________
(if questions regarding plan)
Email: mboucher@boucherassociates.com
ANR Plan entitled: Approval Not Required Plan Drawn For Lisa M. Balaschak & The Kathleen A. Lang
Revocable Trust - 2007
Plan Dated; 10/27/2020
Location of Subject Property: 5 Sunview Terrace
Assessor’s Map/Lot(s): Map 117, Lot 41
All Applicable Zoning Districts: GR
9/25/2017 Form A
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The applicant believes approval is not required for the following reasons;
(Check as appropriate)
1. g(Every lot created has frontage on (check one):
^ a public street: name of public street Sunview Terrace_________
□ a street (improved to Town Standards) shown on a plan approved and endorsed under
Subdivision Control Law; name of street_______________________________________
o a private street which existed before April 7,1953;
name of street
2. □ The plan changes the size and shape of lots, while maintaining frontage required by
zoning.
3. ^ The plan creates parcels without required frontage, with such parcels labeled
“non-buildable”.
4. □ The plan shows a division of land, where two or more buildings were standing before
April 7, 1953, into separate lots on each of which one such building remains standing.
The applicant is responsible for proving the age of buildings.
5. D The plan submitted is in accordance with a Board of Appeals decision recorded at the
Bristol County (S.D.) Registry of Deeds, Book___________ Page___________.
I have diligently researched the property, including walking the property, to determine whether any burial
grounds or human skeletal remains are located on or near the proposed lot. To the best of my knowledge
and belief, no burial grounds or human remains, except those shown on the plan, lie on the proposed lot
or would be affected by the proposgd plan. The Town will rely on this statement in determining whether
to issue permits. A false or|mi^kqn statement will be grounds for denying permits and, if issued, for
revoking it.
Applicant’s Signature:
Owner’s Signature:
(rf other than applicant)
Print Name: Lisa M. Baiaschak
Print Name:
9/25/2017
SUBMITTAL CHECKLIST
® Application Form (2x) - Please note both copies must be originals, 1 copy for
Planning and 1 copy for Town Clerk
1^ Application Fee is $100.00 plus $100.00 for each tot to be affected payable to
Town of Dartmouth.
1^ One original plan suitable for recording at the Bristol County (S.D.) Registry of
Deeds, Two (2) full-sized sets of the plan, seven (7) 11 x 17 prints of the plan,
an electronic set of plans forwarded to the Planning Director (CAD & PDF), and
if an Estate Lot ANR or OSRD ANR, the appropriate covenant.
Form A
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