24C-046 RECORDS REQUEST tom! r.
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L �'%gity V gq'l� / r PARTMENT OP BUILDING INSPECTIONS =_ :
212 Main Street ' Municipal Building c
Northampton, Mass. 01000
110
REQUEST FOR PERMISSION TO VIEW RECORDS
OR HAVE COPIES OF DOCUMENTS M?.DE
' ^PI LASE KEEP THESE I)OCWEN1 IN CMV LOGiC!0 only,
3-'G —o y PAGE: O •�
DATE: %
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NAME: ,.DDRESS : i
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UNDER MA.SSACHUSETTS GENERAL LAWS WE
HAVE THE RIGHT TO MEEP
THE ABOVE REQUEST WITHIN TEN ( 10 ) DAYS OF THE ABOVE LISTED
DATE.