31D-093 (12)City of Northampton
Massachusetts
'0- u DEARTMENT OF BUILDING INSPECTIONS
2f Main Street •Municipal Building
f f j f Northampton, MA 01060
PERIODIC INSPECTIONS
PREMISE NAME: MAPLE HEIGHTS INVESTMENT
PREMISE ADDRESS: 54 WEST ST
OWNER(S) OF RECORD:
OWNERS: ADDRESS:
NORTHAMPTON, MA 01060
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TELEPHONE NO: �✓� _ +� 1' y (�
NAME ON CERTIFICATE: MAPLE HEIGHTS INVESTMENT
TYPE OF BUSINESS
USE GROUP:
INSPECTION FEE: $ 180.00
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Application Sent on February 25, 2015
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 bac of this
form and return it to the building department. Feel free to contact us if you have any questions. We ca be
reached at (413) 587-1240. Thank you.
Applicant name: J4 �e
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Applicant Title:
Telephone
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Preferred inspection time/date'