05-001 (36) City of Northampton
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Ilr,"a �� DEPARTMENT 0£ eUItDZNG INSPECTIONS
212 Main Street o Municipal Building V•�s a'��
SE,C, _Nr? Northampton, MA 01060
PERIODIC INSPECTIONS
Application Sent on May 6, 2016
PREMISE NAME: HIGHVIEW OF NORTHAMPTON
PREMISE ADDRESS: 222 RIVER RD
OWNER(S) OF RECORD:
OWNERS: ADDRESS:
LEEDS, MA 01053 ---
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TELEPHONE NO: L113 _ S134 - g45)
NAME ON CERTIFICATE: HIGHVIEW OF NORTHAMPTON
TYPE OF BUSINESS
USE GROUP:
INSPECTION FEE $210
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:
JoSC.p\r-.
Applicant Title:
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Telephone
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Preferred inspection time/date
Comments: