17C-253 (28) oMp' The Commonwealth of Massachusetts ys ��� s.�,,
,M, City of Northampton w
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New and Renewal Certificate of Inspection h- Y")
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.
CSO RESPITE CARE 0011
Located at Identify property address including street number, name city or town and county Certificate Expiration
29 NORTH MAIN ST, Northampton 05/10/2024
17C-253-001
Use Group Classifications Allowable Occupant Load
R-1 28
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 05/11/2022
Signature of Signature of Municipal '
Municipal Fire Chief Building Inspector r�, Date of Issuance 05/11/2022
I )
RECFIVEil, City of Northampton
Massachusetts Aft/ �-- '/ee\
AY 1 1 2022
Lr`, DEPARTMENT OF BUILDING INSPECTIONS ; �'
212 Main Street • Municipal Building O,
Northampton, MA 01060 �'W TO\'^
OF 6Ull_DING INSPECTIONS
"-wTHAmn-r()N MA 01060 PERIODIC INSPECTIONS /Y /Cr()� Cr-Pd f CGt f' U
APPLICATION FOR REQUIRED INSPECTION
/7C 3 Application Date: 5.11.22
PREMISE NAME: C S 0 Respite Care
PREMISE ADDRESS: 29 North Main St Florence MA
OWNER(S) OF RECORD: Clinical and Support Options Inc.
OWNER ADDRESS: 8 Atwood Dr
Northampton MA
01060
TELEPHONE NO: 413-773-1314
TYPE OF BUSINESS: Mental Health
USE GROUP: Determined by the Building Department
INSPECTION FEE: Determined by the Building Departrrient
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 lt the bottom or on the back of this
form and return it to the building department. Feel free to contact us if you hve any questions. We can be
reached at (413) 587-1240. Thank you.
Applicant name: Jared Heeter
Applicant Title: Facilities Director
Telephone: 413-770-2772
Preferred inspection time/date: As soon as possible
Comments:
Map/Plot. Determined by the Building Department
02/01/2013