23B-043 ON CALL URGENT CARE APPLICATION 2022 ls i'`�'' rj
The Commonwealth of Massachusetts -
t. City of Northampton 3
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New and Renewal{�rtiftcate of Ins pection
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.
ONCALL URGENT CARE LLC 0046
Located at Identify property address including street number, name city or town and county Certificate Expiration
51 LOCUST ST UNIT 1 , Northampton 12/01/2023
23B-043-001
Use Group Classifications Allowable Occupant Load
B 25
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 12/01/2022
Signature of Signature of Municipal
Municipal Fire Chief Building Inspector 9 SL
� I' Date of Issuance 12/01/2022
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2313 -O43-Do ( - DDT
City of Northampton
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DEPARTMENT OF BUILDING INSPECTIONS y �
212 Main Street•Municipal Building
Northampton,MA 01060 s,'W bt''
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PERIODIC INSPECTIONS fC_�Iw
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PREMISE NAME: ON CALL -
PREMISE ADDRESS: OWNER(S) OF RECORD: a
OWNERS: t�1,.CAlI Ulr t Colt-.c ( l.0 �I ( t�c `''�} S-tv.�} plc,-i�w,mp'1-tom ry�W otC�(co J
ADDRESS: ST: 51 LOCUST ST
TELEPHONE NO: +-I13- `}-�'y'-�
NAME ON CERTIFICATE: 6k15.401 eo
TYPE OF BUSINESS : lett,clicat oFfit.,e_/ ys►Lian of 1_,L U
USE GROUP: 3
INSPECTION FEE $100.00
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: jud-c. Sc✓e-vtSCn
Applicant Title: Prot 't` - Y1'tavvo.
Telephone -ti --t 'I - 1-Cx3ES
C' y13-3-x0 -1-114
Preferred inspection time/date ; P-ny h►^A-4- lo<- ► g c - - L 9 lz) i I2z 1 L)y f ry
call rry 3z0-312 1
Comments:
Basic Periodic Inspection Checklist
Structural Items
All structural and associated components(foundation,roof,walls,support members,stairs,sidewalks,etc.)are
maintained in a safe and sound condition.
Buildings are maintained in compliance with the Massachusetts Board of Fire Prevention Regulations and he Massachusetts
State Building Code.
Required occupancy separations are provided and maintained. Examples are dwelling unit/corridor, unit/unit,
commercial/commercial or residential/commercial separations.
Guardrails and handrails are maintained in safe and sound condition. Handrail required for stairs with three or more risers or
as required by the Massachusetts State Building Code. Guardrail required for walkway areas with adjacent drop off
exceeding 30".