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38B-075 (3)
346- g ©'2 5 City of Northampton Massachusetts DEPARTMENT OF BUILDING INSPECTIONS 212 Main Street • Municipal Building .f. Northampton, MA 01060 PERIODIC INSPECTIONS Mp,T.OF 6UIlDING INSPECT")NS NORTHAMPT ON,MA01060 Application Sent on March 2, 2015 PREMISE NAME: LATHROP HOME PREMISE ADDRESS: 215 SOUTH ST OWNERS) OF RECORD: rD 1 3 OWNERS: ADDRESS: NORTHAMPTON, MA 01060 TELEPHONE NO: 13 _ Ll _ (.-6 �- NAME ON CERTIFICATE: LATHROP HOME TYPE OF BUSINESS USE GROUP: INSPECTION FEE: $ 200.00 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: Telephone Preferred inspection time/date llv1 3a 075 s � , W ENGLAND SECURITY & TECHNOLOGY P.O. BOX 515 kt e-e�6s GRANBY, MA 01033 (413) 467-3784 (413) 532-3210 ALARM INSPECTION &TESTING REPORT NAME ACCOUNT# MONITORjrG1-," QUARTERLY SE AL CALL DATE ADDRESS FIRE DOT TEL.# ^l CITY BOX# CITY BOX RESET AM PM 4A CITY STATE ZIP CONTROLPANELTYPE LOCATION TIME No.of No. ✓okay No.of No. ✓okay Devices Tested X See below Devices Tested X See below Control Panel Trouble Devices r9 C Pull Station City Connection Signal Devices Batteries Heat Detectors Charger Smoke Detectors Door Holders Annuncia,qrs Fan Shutdown F. e—` a. &—(,=V , 7 zl;7 , I ---if- L/ I /V CO I REMARKS PARTS JS 7D ETC. r-5 rc� ( -is --rj 0 7 or arid I' Id -5d,A of X- o ou ) A k-r r, C e- -4-,, ourr 4 ,-&,, vo a V.,t UGC Jl� 4 10 KDILf e-7 "s VIC! V fc) wo- C- I Customers Signature j.",V Tech.Signature V V , Commonwealth OfMassachusetts City of Northampton Map: Block: Lot: 38B 075 001 In Accordance With The Massachusetts State Building Code, Section 110, This CERTIFICATE OF INSPECTION is issued to Lathrop Home I Certify that I have Inspected the I2 Nursing Home known as Lathrop Home located at 215 SOUTH ST, 30400 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 1 st Floor 10 Units 2nd Floor 20 Units 3rd Floor 11 Units CI-2015-0063 03/20/2015 03/20/2016 Certificate Number Date Certificate Issued Date Certificate Expires Building Official, Kyle J. Scott **A COPY OF THLS 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