25A-091 30 coolidge ave City of Northampton
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DEPARTMENT OF BUILDING INSPECTIONS
\ 212 Main Street a Municipal Building 2pT; i
Northampton, M8 01060
INSPECTOR
Louis Hasbrouck COMPLAINT FORM Chuck Miller
FiE Qr EDner Assistant Commissioner
;Re:ceived
e hone [ ] Complaint No.:
nal [ ] Date: 20
[ ] Time: AM [ ] PM [LDEPTai [ ] Telephone No. :ainant's Name:
Complainant's Address: 335- kodkWit l Qd ,l )rc� �r�tMti4 0149-7
Complainant's Email: R07 �4 _ za (�eeZ (chi Ae)� co,,-,
Complaint received by:
Violation(s) of: [ ] Chapter 350, Zoning Ordinances, City of Northampton
[y) 780 CMR, Massachusetts State Building Code
Complaint reported against: �jd - 6b3- 14a.a-- N7-7 Qen�ccs Phone
Name: McSA —Telephone No. ( 13 3X: SR 7.2
Address: 30 CDO a0 - AOt MA Old(e0
Location of complaint: orn i I Ou 1 Map: Lot:
Signature(s) of Complainant(s): �
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Logged: Yes [ ] No [ ] o1c`c<
Investigation: Yes [ ] No [ ] Investigated by: s-aa 7
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