23A-146 CLOVERDALE COI 11/20/2023 ~�'"�'i The Commonwealth of Massachusetts
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New and Renewal Certificate of Inspection
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.
CLOVERDALE COOPERATIVE NURSERY SCHOOL 0015
Located at Identify property address including street number, name city or town and county Certificate Expiration
130 PINE ST, Northampton 11/30/2024
Use Group Classifications Allowable Occupant Load
E-DAYCARE/PRESCHOOL
24
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 CHIEF ANDY PELIS Building Inspector JONATHAN S. FLAGG Date of Inspection 11/20/2023
Signature of Signature of Municipal III
Municipal Fire Chief Building Inspector i 0 ; „A .To
Date of Issuance 11/20/2023
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City of Northampton
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. ; DEPARTMENT OF BUILDING INSPECTIONS y,
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oir 212 Main Street • Municipal Building ��
,, Northampton, MA 01060 4 IPi '
PERIODIC INSPECTIONS
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APPLICATION FOR REQUIRED INSPECTION
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PREMISE NA.MF: CI OVFRPA1 F NI IRS IDO°=
PREMISE ADDRESS: OWNER(S) OF RECORD:
OWNERS:
ADDRESS: ST: 130 PINE ST
TELEPHONE NO: L` f 3 _ i? '- ', _ 1 i o
NAME ON CERTIFICATE: CIOv e- -da.--Le_ Co o per,.-wive Ni ups �c---41---ao !
TYPE OF BUSINESS
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USE GROUP: F_ t, co.-,-- / rr .5 C.Iti-D t� '
INSPECTION FEE $100
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:
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Applicant Title:
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Telephone
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Preferred inspection time/date
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