36-279 (5) jQX/lACkUSfttf
DEPARTMENT OF I3UILDD+tt:3 INSPECTIONS
INSPECTOR 212 Main Street • Municipal Building
Northampton, Mass. 01060
Francis X. Sienkiewicz
--) .
REQUEST FOR PERMISSION TO VIEW RECORDS
OR HAVE COPIES OF- DOCUMENTS MADE
DATE: PAGE: j PLOT:T
FILE ADDRESS.:
NAME:-r�/�" �' ` � ADDRESS:
PHONE #. `
UNDER MASSACHUSETTS -GENERAL LAWS WE HAVE -THE RIGHT TO MEET
THE ABOVE REQUEST WITHIN TEN (10) DAYS OF THE ABOVE LISTED
DATE.