Form Center

2. Board of Assessors
   Town of Charlton
   37 Main Street Charlton, MA 01507
   Phone: 508-248-2233 Fax: 508-248-2376
3. Date
   Date
5. Property Owner First Name*
6. Property Owner Last Name*
8. Mail Address*
10. City*
11. State*
12. Zip Code*
14. Phone Number*
15. Fax Number
17. Email Address
19. Subject Property Location*
21. Map
22. Block
23. Lot
25. Department Requesting Abutters

    1. Conservation - 100 Feet from Subject
    2. Planning Board - Notice of Intent - 300 Feet from Subject
    3. Selectman - Beer, Wine and Auto Repair - Immediate Distance from Subject
    4. Selectman - License Class 1, 2 and 3 - Immediate Distance from Subject
    5. Zoning Board of Appeals - 300 Feet from Subject
    6. Other
26. If other, please specify all details necessary to identify:
28. I understand that up to 5 days may be required for approval, and that there will be a minimum of $25 for each list prepared.
30. How will your payment be made?

    1. Fax
    2. Pickup
    3. Prepaid
    4. U.S. Mail
31. Date Required
    Date Required
33. Signature
34. Prepared By
Leave This Blank:


36. Submit

* indicates a required field