23B-046 COI (2) � '"" The Commonwealth of Massachusetts Sys , s,'It ,
14I City of Northampton
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='= New and Renewal Certificate of Inspection rsNtr 10%
In accordance to 780 CMR Chapter 1 (The Ninth Edition of the Building Code) and Chapter 110 and the Acts of 2004, to further
enhance fire and life safety, this certificate of inspection is issued to the premise or structure or part there as herein identified.
Issued to Identify Name of Establishment: Certificate No.
COOLEY DICKINSON HOSPITAL 0002
Located at Identify property address including street number, name city or town and county Certificate Expiration
30 LOCUST ST, Northampton 02/2/2023
2 3 B-046-001
Use Group Classifications Allowable Occupant Load
1-2 1,177
This certificate of inspection is hereby issued by the undersigned to certify that the premise,structure or portion thereof as herein specified has been inspected for
general fire and life safety features.This certificate shall be framed behind clear glass and/or laminated and posted in a conspicuous place within the space as directed
by the undersigned. Failure to post or tampering with the contents of the certificate is strictly prohibited.
Name of Municipal Name of Municipal
Fire Chief Building Inspector Jonathan Flagg Date of Inspection 02/02/2022
Signature of Signature of Municipal
Municipal Fire Chief Building Inspector 49, Date of Issuance 02/02/2022
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City of amp ton
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DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building �tdpd
mrt3 Northampton, MA 01060 b' "VOX
PERIODIC INSPECTIONS
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APPLICATION FOR REQUIRED INSPECTION
Application Date: 1' 17- 22
PREMISE NAME:
PREMISE ADDRESS: 3cr.) ��,�,,�.� T A4/4- 0(060
O\A/NER(S) OF RECORD:
OWNER ADDRESS: c� „p
TELEPHONE NO: k{It 3 -
TYPE OF BUSINESS: \ r I i "Zafi
USE GROUP: Determined by the Building Department
INSPECTION FEE: Determined by the Building Department ' 36)0. c'o
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: �� � � x4 �
Telephone: 44 f 3
Preferred inspection time/date: � �, ,sae gq • `� , dN —F
Comments:
Map/Plot: Determined by the Building Department
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02/01/2013 4