25A-109 (12) a4'tH�MPTD
M
,�lassAClluactta ^
r •
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street ' Municipal Building
Northampton, Mass. 01080
REQUEST FOR PERMISSION TO VIEW RECORDS
OR HAVE COPIES OF DOCUMENTS MADE
**-APL AS�E.KEEP THESE DOCUMENTS IN CHRONOLOGICAL ORDER***
DATE:--, t�3 I PAGE: PLOT:
FILE AD RESS: �/ -
NAME: 1� ADDRESS :
�� mkt � '� J
PHONE # :
UNDER MASSACHUSETTS GENERAL LAWS WE HAVE THE RIGHT TO MEET
THE ABOVE REQUEST WITHIN TEN ( 10) DAYS OF THE ABOVE LISTED
DATE.