22B-032 (6) Commonwealth OfMassachusetts
City of Northampton Map: Block: Lot:
22B 032 001
In Accordance With The Massachusetts State Building Code, Section 110, This
CERTIFICATE OF INSPECTION
is issued to River Valley of Florence, LLC
I Certify that I have Inspected the 12 Nursing Home known as River Valley Rest Home
located at 159 PINE ST, in the City of Northampton
The Means Of Egress Are Sufficient For The Following Number Of Persons:
BY STORY
Story Capacity Story Capacity
First Floor 13 Second Floor 14
BY PLACE OF ASSEMBLY OR STRUCTURE
Place of Assembly or Structure Capacity Location Place of Assembly or Structure Capacity Location
C1-2017-0126 06/08/2017 06/08/2019
Certificate Number Date Certificate Issued Date Certificate Expires Building Official
**A COPY OF THIS CERl111CAl/3 61 UST BE POSTED IN CLEAR VIEW NEAR ALL EN/RANGES **
212 Main Street-Rip 100•NOR"HAMPTON,MA*Piione:(4I3)587-1240*Fax:(413)587-1272
City of Northampton
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f'L �� vo2 PERIODIC INSPECTIONS
on Application Sent on May 11, 2017
PREMISE NAME: RIV VALLEY OF FLORENCE LLC /� p ,{P
PREMISE ADDRESS: 159 PINE ST l / I
OWNER(S) OF RECORD: �
OWNERS: ADDRESS ST: 159 PINE ST �l0/
FLORENCE MA
TELEPHONE NO: i3 , ssLk . 3`77 b
NAME ON CERTIFICATE: �^ f
TYPE OF BUSINESS "\ �� U_Vt..\) [V
USE GROUP:
INSPECTION FEE $200
Please complete and return this application to the Department of Building Inspections, 212 Main Street,
Northampton, MA 01060. We will contact you to arrange a time to inspect your property. If this information is
not correct, or if you no longer own this property, please note any changes at the bottom or on the back of this
form and return it to the building department. Feel free to contact us if you have any questions. We can be
reached at (413) 587-1240. Thank you.
Applicant name: V
Applicant Title: A (�W nt_ p / <
Telephone "t \ S$ 3-r7
Preferred inspection time/date
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Comments:
Basic Periodic Inspection Checklist