32C-043 (4) City of Northampton
Massachusetts 9 ��
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J� 212 Mai S eat • Municipal Building ti �AC�b
r ampton, MA 01060 s�1Y1
DIC INSPECTIONS
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rt h ampt Application Sent on March 2, 2015
Noon,MA 01D60
PREMISE NAME: koCAVD �i►UG� C�_ CCit'
PREMISE ADDRESS: 58 PLEASANT ST
OWNERS OF RECORD:-nn-rQ1r-1A of rnW. n
OWNERS:ADDRESS:
-40RTi I VIF 1,911, MA 01 6e
FS 4
TELEPHONE NO:
NAME ON CERTIFICATE: NEW-ENG D-�E&THETS-- V' IkVk v(
TYPE OF BUSINESS
USE GROUP: g
INSPECTION FEE: $ 100.00 f
Please complete and return this application to the Department of Building Inspections, 212 Main Street,
Northampton MA 0.1060. 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: t
Applicant Title:
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Telephone Mlo
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Preferred inspection time/date 5 \