32C-030 (11) 12/05/2013 12_14 4135873268
— CHILDRENS CLINIC
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Louis Hasbrouck __L�~�'`'. Phaoq:(413)6871239 Chuck Miller
Building Commissioner `� (413)587-1272 .Assistant Commissioner
/ 1-471-4)i-Ki
FAX THIS TO: 413.587-1272 sf\k\'"- k
REQUEST FOR PERMISSION TO VIEW RECORDS
OR HAVE COPIES OF DOCUMENTS MADE
*PLEASE KEEP THESE DOCUMENTS IN CHRONOLOGICAL ORDER*
v ' v BLOCK: 3o
DATE: 1 a/5/J3 MAP::
FILE ADDRESS:
NAME: in CLA1-2%-.—al r G..f_C' f P t''\ c�_ + S'
s4 ADDRESS: I L)d` R iaJi-u.- .A co i )• • r
PHONE #: 4 .,. • \S
UNDER MASS GENERAL LAWS WE HAVE THE RIGHT TO MEET THE
ABOVE REQUEST WITHIN TEN (10) DAYS OF THE ABOVE LISTED DATE.
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