31A-112 (6) T. Commonwealth OfMassachusetts
City ofNorthampton Map: Block: Lot:
31A 112 001
In Accordance With The Massachusetts State Building Code, Section 110, This
CERTIFICATE OF INSPECTION
is issued to COMMUNITY ACTION
. . . . . . . . . . . . . . . . . . .
I Certify that I . . .have Inspected the I2 & E Daycare , , , , , , , known ,as Community Action Vernon Street.
. . . .
located at 56 VERNON ST,, .RI. . . . . . . . . . . . . . . . . . . . . . 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 Capacity Location
I st Floor 110 E and 1-2 use 2nd Floor 100 B use
CI-2016-0017 08/19/2015 08/19/2016
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*Faz:(413)587-1272
City of Northampton
Massachusetts
_ NT OF BUILDING INSPECTIONS
Street • Municipal Building
Northampton, MA 01060
j PERIODIC INSPECTIONS
JUN
Yiu!"'ring& pections
Electric.
Application Sent on June 2, 2015
Gas Irs
PREMISE NAME „t°n.WA cry
N VERNON STREET SCHOOL
PREMISE ADDRESS: 56 VERNON ST
OWNER(S) OF RECORD:
OWNERS: ADDRESS: 54, `fie rnan Sri.
NORTHAMPTON , MA 01060
TELEPHONE NO:
NAME ON CERTIFICATE: COMMUNITY ACTION VERNON STREET SCHOOL
TYPE OF BUSINESS
USE GROUP:
INSPECTION FEE: $150.00
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:
Applicant Title:,?
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Telephone
I3. 3 0- 9G/
Preferred inspection time/date
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