30B-022 (14) oa "p The Commonwealth of Massachusetts Sys °
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City of Northampton w
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New and Renewal Certificate of Inspection
In accordance to 780 CMR Chapter 1 (The Ninth Edition of the Building Code) and Chapter 110 and the Acts of 2004, to further
enhance fire and life safety,this certificate of inspection is issued to the premise or structure or part there as herein identified.
Issued to Identify Name of Establishment: Certificate No.
NONOTUCK COMMUNITY SCHOOL 0006
Located at Identify property address including street number, name city or town and county Certificate Expiration
221 RIVERSIDE DR, Northampton 03/03/2023
30B-022-001
Use Group Classifications Allowable Occupant Load
E 90
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 CIEF JON DAVINE Building Inspector JONATHAN S. FLAGG Date of Inspection 03/03/2022
Signature of Signature of Municipal i�
Municipal Fire Chief Building Inspector � : �' • ,3 Date of Issuance 03/03/2022
1
a.ty of Northampton
/aA� •
Massachusetts
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20?c D7PARptENT OF BUILDING INSPECTIONS
Catiff- 12 Main Street • Municipal Building �r
NOOK—u40 � Northampton, MA 01060 r a
TNaMPrnN InijSP CT --1 PERIODIC INSPECTIONS
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APPLICATION FOR REQUIRED INSPECTION
Application Date: 3 /! ;l 2-
PREMISE NAME. A 0 :41.4 c c 11 c.
PREMISE ADDRESS: 221 ; 3 +ie S r c L.
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OWNER(S) OF RECORD: '`ti ^, J; e
OWNER ADDRESS: 1 i V /5 t tJ D c
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,hp{?.-i 11/S 4
TELEPHONE NO:
TYPE OF BUSINESS
USE GROUP: Determined by the Building Department
INSPECTION FEE. Determined by the Building Department
Please complete and return this application to the Department of Building Inspections,212 Main Street,
Northampton wIVIA 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: 44nIA -d'i
Applicant Title: 1144 i ,3-1( h , ") 't c r.
Telephone: / 7 f e
Preferred inspection time/date: $ j'3 / L
Comments:
Map/Piot: Determined by the Building Department
02/01/2013
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59214
Fire Seru'CG 5POUP BILLING ADDRESS
Fire Protection Testing & Maintenance Provider COMPANY:
1010 Thorndike Street Palmer, MA 01069 STREET:
PHONE:413-668-9100 FAX:413-213-6567
Fire Alarms•Fire Sprinklers•Fire Pumps•Backflow Preventers CITY: STATE: ZIP:
QTY MATERIALS PRICE AMOUNT CALL INFORMATION
C] T&M n T&M R A T&M OT 11 Quoted Contract/Extra
SERVICE DATE: . Bri JOB PHONE:
CUST.P.O.NUMBE' :
JOB NAME: r', i' . lib,. .• ,. :z
JOB STREET:
JOB CITY: r JOB STATE: ,
STATIC: RESIDUAL:
FACP MAKE&MODEL: 4'
SERVICE DESCRIPTION ;'''
Total_- _. A.. .''i
OWNER/AUTHORIZED REPRESENTATIVE ;<-S NO/NA c _
Are all control valves in the open position? 119111011 TIME OTHER CHARGES
Are fire pumps and jockey pumps in service? nom IN ROUTE: TRUCKING/FUEL:
All air compressors in service? ARRIVED: ; EQUIPMENT:
Is the fire alarm control panel reading normal? In=LEFT JOB: PERMIT FEES:
Has the alarm monitoring company been notified? MUM ARRIVED: DISPOSAL FEES_❑
Has the fire department been notified? MIMI All systems left in service? liMilll TOTAL OTHER
Is the system free of impairments? 1111 „0 I :12.17ki 11r/[I4* 11:t1 HRS RATE AMOUNT
Explain any"NO"answers: REG
E.R.
.• O.T.ME
-_
CO
O.T. -_
TOTAL LABOR
Signature: Date: TOTAL MATERIALS
1 .. i) ,, , \ •, Li , -. TOTAL OTHER
Print Name&Title: + , .,1'` `,
: ,�S.N �� � � TAX
I hereby acknowledge the satisfactory completion of the described service and Thanks. j
confirmed and reviewed the above questions with the service tech. l�(��/(k J!Or, choosing
NET TERMS:Balance due within 30 days.
Interest shall be charged at the rate of 1.5%per month on unpaid balances over 30 TOTAL
days.this is an annual percentage rate of 18%.
Rea.No:G 583300305