23B-046 COI oat"'"`P' The Commonwealth of Massachusetts -;5r-
(4 I City of Northampton 3,
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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.
COOLEY DICKINSON HOSPITAL 0003
Located at Identify property address including street number, name city or town and county Certificate Expiration
30 LOCUST ST, Northampton 02/15/2024
23B-046-001
Use Group Classifications Allowable Occupant Load
1-2 1,177
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 CHIEF JON DAVINE Building Inspector JONATHAN S. FLAGG Date of Inspection 02/15/2023
Signature of Signature of Municipal
Municipal Fire Chief Building Inspector (�; ► If• Date of Issuance 02/15/2023
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City of Northampton
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^ i i f DEPARTMENT OF BUILDING INSPECTIONS ,,
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i`o� 212 Main Street • Municipal Building /i, `,.,C
-^cs"l. Northampton, MA 01060 Jv .,-)
PERIODIC INSPECTIONS
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APPLICATION FOR REQUIRED INSPECTION, C �� 1 " ^'
F E B 1 " 2023
PREMISE NAME: COOLEY DICKINSON HOSPITAL I
PREMISE ADDRESS: OWNER(S) OF RECORD: I L �"i
DEPT.OErun.o+rl .MA01INSPEOTIO'15
OWNERS: Cooley Dickinson Hospital NQfiTHAM. _ .. ___ . .0
ADDRESS: ST: 30 Locust St
TELEPHONE NO: 413- 582- 2311
NAME ON CERTIFICATE: COOLEY DICKINSON HOSPITAL
TYPE OF BUSINESS: Healthcare/ medical facility
USE GROUP:
INSPECT! N FEE $200 i'
Please co a 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 e back of this
form and return it to the building department. Feel free to contact us if you have any questions. e can be
reached at (413) 587-1240. Thank you.
Applicant name: Mark Jordan
Applicant Title: Facilities Coordinator
Telephone: 4132- 582- 2313
Preferred inspection time/date: Scheduled for February 16, 2023
Comments:
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