06-055 (20) Commonwealth OfMassachusetts
City of Northampton Map: Block: Lot:
06 055 001
In Accordance With The Massachusetts State Building Code, Section 110, This
CERTIFICATE OF INSPECTION
is issued to Linda Manor Extended Care Facility
1 Certify that I have Inspected the Extended Care Facility known as Linda Manor Extended Care Facility
located at 349 HAYDENVILLE RD - Route 9, 40200 in the City of Northampton
The Means OfEgress Are Sufficient For The Following Number Of Persons:
BY STORY
Story Capacity Story Capacity
First Floor 82 Second Floor 41
BY PLACE OF ASSEMBLY OR STRUCTURE
Place of Assembly or Structure Capacity Location Place of Assembly or Structure Capacity Location
CI-2020-0011 12/06/2019 12/06/2020
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
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. DEPARTMENT OF BUILDING INEPECTI DNS
t
212 Main Street . Municipal Building �s
Northampton, MA 01060
PERIODIC INSPECTIONS
Basic Periodic Inspection Checklist IJJh tAAwR C RM �:ACILIT�
Structural Items
710 All structural and associated corn ponents.(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 the 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".
Maintenance Items
❑❑ All doors and hardware are maintained in good and functional condition.
❑❑ All windows and hardware are maintained in a good and functional condition and meet natural light and ventilation
requirements.
❑❑ All interior walls,ceilings,floors and other interior public and service areas are maintained in a safe and sanitary condition.
❑❑ Chimneys and flue piping are properly installed and maintained.
Egress
❑❑ Every means of egress maintained in good condition and free of obstruction-
Do
bstruction.❑❑ Required escape/rescue openings are provided and maintained-
DX
aintained.❑X Required exit signs provided and maintained in good condition. S'71)1RLvr-LL �l17 bDo{Z 66
❑❑ Required emergency egress lighting provided and maintained in good condition-
00
ondition.❑❑ Required"fire doors"maintained self-closing and self-latching.
❑❑ Fire escapes are safe and maintained in good condition.
❑❑ Required Accessible parking spaces and Accessible routes are clear and maintained in good condition.
Mechanical/Plumbing/Electrical
❑❑ No electrical hazards from overloading,poor condition,inadequate insulation,improper fusing.
❑❑ Fixtures and equipment are maintained as manufactured-No unapproved extension cords,multi-plugs,or adapters.
❑❑ Plumbing system fixtures,supply piping and drainage piping are installed and maintained in good and sanitary condition.
❑❑ Gas piping and appliances are properly installed and safely maintained.
❑❑ Heating and cooling equipment is properly installed and safely maintained.
❑❑ Mechanical rooms and electrical service rooms maintained free of excess combustible storage.Three feet clearance
maintained in front of electrical panels and disconnects.
❑❑ Public Toilets are maintained in accordance with Architectural Access Board regulations.
Fire Safety
❑❑ All fire extinguishing devices and all early warning fire protection systems are properly installed and maintained in good
working condition.
❑❑ Smoke alarms are installed as per manufacturer's instructions and as required by Codes in common areas,on each floor level
within dwelling units,and all bedrooms and hallways leading to bedrooms.
❑❑ Fully charged,currently inspected 2A-1OBC(minimum size)fire extinguishers mounted in accessible locations,as required
by the building and fire codes.
❑❑ Required annual FIRE ALARM TEST AND MAINTENANCE form must be submitted to Fire Department for review.
❑❑ Annual automatic sprinkler test and maintenance form must be submitted to Fire Department for review if building is so
equipped.
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`--- City of Northampton
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Massachusetts 314
•�, ', DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
Northampton, MA 01060 sH1Y i�~
PGR10 C 1tR I V E D
PREMISE NAME: LINDA MANOR NOV 2 0 2019
PREMISE ADDRESS: 349 HAYDENVILLE RD \
OWNER(S) OF RECORD: DFPT F BUILDING INSPECTIONS
NOR
OWNERS: �� v
ADDRESS: ST:
TELEPHONE NO:
NAME ON CERTIFICATE:
TYPE OF BI ISINESS
USE GROUP.-
INSPECTION
ROUP:INSPECTION FEE $315
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:
Telephone q(3 l3
Preferred inspection time/date
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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 Fompliance with the Massachusetts Board of Fire Prevention Regulations and the Massachusetts
State Building Code.
Required occupancy separations are provided and maintained. Examples are dwelling unit/corridor, unit/unit,
commercial/commercial or rgsidential/commercial separations.