05-001 (31) City of Northampton 5
Massachusetts �s`s
—DEPARTMENT OF BUILDING INSPECTIONS
! 'i212"Rairx Street • Municipal Building
-. N rthampton, MA 01060
F/ect�`c 70/� fJ /j ERIODIC INSPECTIONS
Nor/�
o9 as Ins Application Sent on May 11, 2015
q p10 Pecy/070
PREMISE NAME: HIGHVIEW OF AMPTON
PREMISE ADDRESS: 222 RIVER RD
OWNER(S) OF RECORD:
OWNERS: ADDRESS:
LEEDS, MA 01053
TELEPHONE NO: �'�- �% _ 4c1�� V S 68_1 w?
NAME ON CERTIFICATE: HIGHVIEW OF NORTHAMPTON
TYPE OF BUSINESS S''k,'V/e o/ �fjh -,��
USE GROUP: O0
INSPECTION FEE: $ 210.00
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:
esf�P �
Applicant Title:
Telephone
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Preferred inspection time/date
3
Comments:
Commonwealth OfMassachusetts
City ofNorthampton Map: Block: Lot:
05 001 001
In Accordance With The Massachusetts State Building Code, Section 110, This
CERTIFICATE OF INSPECTION
is issued to HIGHVIEW OF NORTHAMPTON
I Certify that I have Inspected the I2 Nursing Home known as HIGHVIEW OF NORTHAMPTON
located at 222 RIVER RD, 30700 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
All 120 Beds
CI-2015-0140 06/16/2015 06/16/2016
Certificate Number Date Certificate Issued Date Certificate Expires Building iicial, Kyle J. Scott
**A COPY OF THIS CERTIFICATE MUST BE POSTED IN CLEAR MEW NEAR ALL ENTRANCES **
212 Main Street-Rm 100*NORTHAMPTON,MA*Phone:(413)587-1240*Fax:(413)587-1272
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