Lenox Town Hall
6 Walker Street, Lenox, MA 01240
ph: 413-637-5500
Form F

Lenox, Massachusetts
_____________, 20_____
The undersigned, being a majority of the Planning Board of the Town of Lenox, Massachusetts, hereby certify that the requirements for work on the ground called for by the Covenant dated____________, 20___ and recorded in the Berkshire Middle District Registry of Deeds, Book _________, Page _________, (or registered in___________________________ Land Registry District as Document No. ___________ and noted on Certificate of Title No. ___________ in Registration Book _________, Page ______) have been completed to the satisfaction of the Planning Board as to the following enumerated lots shown on Plan entitled___________________________________ ____________________, recorded with said Registry, Plan Book ______________ Page_______________ (or registered in said Land Registry District, Plan
Book _____________, Page___________) and said lots are hereby released from the restrictions as to sale and building specified thereon.
Covenant Approval Release (Continued)

Lots designated on said plan as follows:
___________ Majority of the _________________ Planning Board of the ______________ Town of Lenox

BERKSHIRE, SS. __________________, 20______
Then personally appeared ______________ one of the above-named members of the Planning Board of the Town of Lenox, Massachusetts, and acknowledged the foregoing instrument to be the free act and deed of said Planning Board, before me
Notary Public

My Commission Expires:___________________