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City of Northampton
Massachusetts 's
D ARTMENT OF BUILDING INSPECTIONS `
•,,21 Main Street • Municipal Building �� •. �b
Northampton, MA 01060
peA-10111 PERIODIC INSPECTIONS
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Application Sent on February 25, 2015
PREMISE NAME:
PREMISE ADDRESS: 55 CRESCENT ST
OWNER(S) OF RECORD: PHYLLISS WOOLF
OWNERS: ADDRESS:
NORTHAI,,^DTON, MA. 01062
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TELEPHONE NO: ri i 3- S �e , o l-i LA-,
NAME ON CERTIFICATE: PHYLLIS$WOOLF
TYPE OF BUSINESS MuL'n
USE GROUP: I
INSPECTION FEE: $ 100.00
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) 587-1240. Thank you.
Applicant name:
Applicant Title:
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Telephone �3 v S `3
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Preferred inspection time/date
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