24C-019 COI (2) '-CHAMP
49 The Commonwealth of Massachusetts
(A( I, . 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.
HAMPSHIRE REGIONAL YMCA 0023
Located at Identify property address including street number, name city or town and county Certificate Expiration
286 PROSPECT ST, Northampton 05/31/2024
24C-019-001
Use Group Classifications Allowable Occupant Load
A-3/E 1425
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 05/31/2023
Signature of Signature of Municipal
Municipal Fire Chief Building Inspector Date of Issuance 05/31/2023
City of Northampton
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14z4,1DEPARTMENT OF BUILDING INSPECTIONS
.� 212 Main Street • Municipal Building 1OI ���- - �
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PERIODIC INSPECTIONS
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APPLICATION FOR REQUIRED INSPECTION
PREMISE NAME: Hampshire Regional YMCA
PREMISE A.DnRFSS. OWNER(S) OF RECORD: 286 Prospect St Northampton, MA 01060
OWNERS: Julie Bianco
ADDRESS: ST: TELEPHONE NO:413-584-7086
NAME ON CERTIFICATE:
TYPE OF BUSINESS A3/E Recreation Center
USE GROUP:
INSPECTION FEE $100
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:
Jake Chase
Applicant Title:
Facility Director
Telephone
413-537-3343
Preferred inspection time/date
Permit expires 6/7/23
Comments:
Usually has fire department conduct theirs at the same time
Basic Periodic Inspection Checklist