23D-107 (5) City of Northampton
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12 Main Street • Municipal Building
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DEPARTMENT OF BUILDING INSPE
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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
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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