CERTIFICATE OF PERFORMANCE
To the Planning Board of the Town of Lenox:
I hereby certify that the required improvements for the following described subdivision have been constructed and conform in all respects to the Rules and Regulations of the Planning Board and the recommendations of the Board of Health and the specifications of the Board of Selectmen.
Subdivision Names (or Plan Title)_______________________________
Name of Subdivider__________________________________________
Stations ____________________________________ to ________________ _________________
Civil Engineer Land Surveyor
Registration Number & Seal Registration Number & Seal