31A-112 INSPECTION City of Northampton
Massachusetts 4,, -- ct,
l . fx DEPARTMENT OF BUILDING INSPECTIONS .g
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` r 212 Main Street • Municipal Building 6,-. pa
Northampton, MA 01060
PERIODIC INSPECTIONS . '
PREMISE NAME: COMMUNITY ACTION
PREMISE ADDRESS: 56 VERNON ST
OWNER(S) OF RECORD:
OWNERS: C. (9414 t�l44kt„t s Valigkik-mizt9freft-
ADDRESS: ST: 3 3 / �� , ��!?
TELEPHONE NO:
NAME ON CERTIFICATE: L MMUil( � �� P ( DneQC VOA I ►C, re'/t,/
TYPE OF BUSINESS L II''
?rnf6or,i0,1.5C 'V lei alE;(��(
USE GROUP: ti.1(h I cl C a't / Jucu
INSPECTION FEE $150
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: Cuith/ Aet1O& G U eArno S+1/4
Applicant Title: I KQ 5 U,.bbV V\ :Tea' RO 5 f li.K. ! .1 _-
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Telephone
Preferred inspection time/date
Comments:
T,JPI ?e,Chlt11 COI t 0V - �� V
Basic Periodic Inspection Checklist
Structural Items
Li All structural and associated components(foundation,roof,walls,support members,stairs,sidewalks,etc.)are
maintained in a safe and sound condition.
D Buildings are maintained in compliance with the Massachusetts Board of Fire Prevention Regulations and the Massachusetts
State Building Code.
Required occupancy separations are provided and maintained.Examples are dwelling unit/corridor,unitiuni
commercial/commercial or residential/commercial separations.
;474 The Commonwealth of Massachusetts s
A_+' City of Northampton * r.
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New and Renewal Certificate of Inspection
In accordance with 780 CMR,Chapter 1(The Sixth Edition of the Massachusetts State Building Code)and Chapter 304 and Acts of 2004(an Act to further
enhance fire and life safety), this certificate of inspection is issued to the premise or structure or part thereof as herein identified.
Identify Name of Establishment Certificate No.
Issued to
CRITERION CHILD ENRICHMENT
Identify property address including street number,name city or town and county Certificate Expiration
Located at
228 KING STREET,SUITE#2
Basement First Floor - Second Floor Third Floor Fourth Floor Other
Use Group
Classification(s) E
Allowable
Occupant Load
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 Building Inspector JONATHAN S. FLAGG Date of Inspection FEB.18,2021
Signature of Signature of Municipal Municipal Fire Chief Building InspectortiL ,(> W �1/
Date of Issuance -a/��
•
Human Services
j1 Irj Management Corporation
Andy Piacentini
Director of Facilities
Cell:(508)244-7612
Fax:(508)473-0994
Email:apiacentininhsmc.org
• ui Last Main Street,Milford,MA 01757 I www:hsmc.org