32C-063 (10) L City of Northampton
Massachusetts
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_ DEPARTMENT OF BUILDING INSPECTIONS
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Northampton, MA 01060 tWT
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Application Sent on February 25, 2015
Electric, Plumbing&Gas Inspections
Northam 496601,116,
PREMISE NAM . SOCIATION
PREMISE ADDRESS: 20 HAMPTON AVE
OWNER(S) OF RECORD:
OWNERS: ADDRESS:
NORTHAMPTON. MA. 01060
TELEPHONE NO:
NAME ON CERTIFICATE: HAMPTON HOUSING ASSOCIATION
TYPE OF BUSINESS
USE GROUP: g6 Le
INSPECTION FEE: $ 500.00
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:
Telephone
Preferred inspection time/date