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23D-107 (5) City of Northampton _y r ` Massachusetts 12 Main Street • Municipal Building y` DEPARTMENT OF BUILDING INSPE _ . _ p _ilding �f�„• -,��`b Northampton, MA 01060 PERIODIC INSPECTIONS Application Sent on July 15, 2015 PREMISE NAME: HEALTH BRIDGE MANAGEMENT— CALVIN COOLIDGE NURSING HOME PREMISE ADDRESS: 548 ELM ST OWNER(S) OF RECORD: OWNERS: ADDRESS: NORTHAMPTON , MA 01060 -- SEP TELEPHONE NO: NAME ON CERTIFICATE: HEALTH BRIDGE MANAGEMENT — CALVIN COOLIDGE NURSING HOME TYPE OF BUSINESS 3 �” 9 USE GROUP: rJ b 6 INSPECTION FEE: 325 J 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: �. Applicant Title: i�Ic �V\V\\1Q-V\0101( Telephone Preferred inspection time/ ate Comments: Commonwealth OfMassachusetts City ofNorthampton Map: Block: Lot: 23D 107 001 In Accordance With The Massachusetts State Building Code, Section 110, This CERTIFICATE OF INSPECTION is issued to Health Bridge Management ey'd that I have Inspected the I2 Nursing Home known as Calvin Coolidge Nursing VY located at 548 ELM ST, in the City of Northampton The Means OfEgress Are Sufficient For The Following Number Of Persons: BY STORY Story Capacity Story Capacity BY PLACE OF ASSEMBLY OR STRUCTURE Place of Assembly or Structure Capacity Location Place of Assembly or Structure Ca acit All 125 Units/Beds P Y Location CI-2016-0020 09/17/2015 09/17/2016 Certificate Number Date Certificate Issued Date Certificate Expires Building Official **A COPY OF THIS CERTIFICATE MUST BE POSTED IN CLEAR VIEW NEAR ALL ENTRANCES 212 Main Street-Rm 100*NORTHAMPTON,MA*Phone:(413)587-1240*Fax:(413)587-1272