22B-032 (2) City of Northampton
-- Massachusetts
DEP NT OF BUILDING INSPECTIONS yq
[[ 212!
' in Street • Municipal Building
ii "'i MAY 8 20�J Northampton, MA 01060t'�Y
U PERIODIC INSPECTIONS
Electric, Plumbing&Gas Inspections
Northampton,MA 01060
Application Sent on May 26, 2015
PREMISE NAME: RIVER VALLEY OF FLORENCE LLC
PREMISE ADDRESS: 159 PINE ST
OWNER(S) OF RECORD:
OWNERS: ADDRESS:
FLORENCE, MA
�- 69 3
TELEPHONE NO:
NAME ON CERTIFICATE: RIVER VALLEY OF FLORENCE
TYPE OF BUSINESS
USE GROUP: ° S
INSPECTION FEE: $ 200.00
Please complete and return this application to the Department of Building Inspections, 212 Main Street,
Northampton, MA 01060. We will contact you to arrange a time to inspect your property. If this information is
not correct, or if you no longer own this property, please note any changes at the bottom or on the back of this
form and return it to the building department. Feel free to contact us if you have any questions. We can be
reached at (413) 587 4 . Thank you.
Applicant name: 'mow
V4
Applicant Title:
Telephone
1)CY
Preferred inspection time/date V 00 "
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Comments: