30B-085 (4) 4 ' __-City of Northampton
ssachusetts
DEC �Q W,
'�3�PAR OF BUILDING INSPECTIONS y
, 212 M in treet • Municipal Building
F(;r,ONS No thampton, MA 01060
NOATI!AMPTO"v,
M'A01r'8o PERIODIC INSPECTIONS
Application Sent on December 11, 2015
PREMISE NAME: O'ROURKE'S AUTO SCHOOL
PREMISE ADDRESS: 122 FEDERAL ST
OWNER(S) OF RECORD: Ka H-6eV r A'g
OWNERS: ADDRESS:
NORTHAMPTON , MA 01060
TELEPHONE NO: (LAI3) Sgu- 4000
NAME ON CERTIFICATE: O'ROUKE'S AUTO SCHOOL
TYPE OF BUSINESS — furl Vin 9'-hat
USE GROUP:
INSPECTION FEE: 150
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:
Itil. r
Telephone
Preferred inspection time/date
l L* n or 22rd�
Comments: