17C-253 (19) Commonwealth OfMassachusetts
City ofNorthampton Map: Block: Lot:
17C 253 001
In Accordance With The Massachusetts State Building Code, Section 110, This
CERTIFICATE OF INSPECTION
is issued to Clinical and Support Options
I Certify that I have Inspected the I2 Conventional known as C S O Respite Care
located at 29 NORTH MAIN ST, 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
FIRST FLOOR 12 1 ST FLOOR SECOND FLOOR 13 2ND FLOOR
CI-2016-0100 04/28/2016 04/28/2017 6( 1
Certificate Number Date Certificate Issued Date Certificate Expires Buildin Offici , Kyle JScott
A COPY OF THIS CERTIFICATE MUST BE POSTED IN CLEAR VIE JV NEAR ALL ENTRANCES
212 Main Street-Rm 100*NORTHAMPTON,MA*Phone:(413)587-1240*Fax:(413)587-1272
City of I4orthampton
ssa�husetts
2 JJpC-�10 Or BZ'ILDING INSPECTIONS s
reef M Municipal Building
thampt�n, MA 01060�1,7-, L
.3 ��•
LDEP_TCiBULaiN GINSPPTt"I
Application Sent on April 7, 2016
PREMISE NAME: CLINICAL & SUPPORT OPTIONS
PREMISE ADDRESS: 29 NORTH MAIN ST
OWNER(S) OF RECORD:
OWNERS: ADDRESS:
NORTHAMPTON, MA 01060
TELEPHONENO: � 7.7..2-�.... � -2-.W.�.�._.._ ...._.r.._. __._..._... .. ._._.... K.._.... ....._,._...- ,._..__..._._..,_....._..._... __
NAME ON CERTIFICATE: CLINICAL & SUPP09T OPTIONS
TYPE OF BUSINESS
USE GROUP:
INSPECTION FEE $200
Please complete and return this application to the De artment 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: r--
Telephone
Preferred inspection time/date
Comments:
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