36-284 COI 09-06-2023 City of Northampton
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a'r• '/` DEPARTMENT OF B LD NG INSPECTIONS y. bx
' • ,, 4 &C [` 12 Main Street • Municipal Building JtiJ No�'
d,.w 1� ,O Northampton, MA 01060 3'�jh' 101.
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,O PERIODI INSPECTIONS(�J 1‘/. -)
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PREMISE NAME: L • , c • 7 • EN ' R
PREMISE ADDRESS: , : R(S OF RECORD: 6 ---lo cgitus 7 epoL iflovii-Aii7F-07v-
OWNERS:
ADDRESS: ST:
TELEPHONE NO:
64.44/1/4 er'717. 17-- — 7.33 OL%77—COAltfe.i-14 .Alle- SPA-6, /Wk. ON Fr
NAME ON CERTIFICATE:
TYPE OF BUSINESS birb411/2ff A. _ .-....o__ -.. .„-._....W.
USE GROUP: p 3 & r �
INSPECTION FEE $150.00
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:
laql Iv' S J Mfg IlNs.. .. vbklZ G .N c<I" Z. 0/2&
Applicant Title:
-14-rithTT-6.1 *A (1-07_, _______— .....— ......
Telephone l�
Preferred inspection time/date .
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Comments: AjiJw1i(/ 0)1 4i 2 c/ J @ i ? %) Q fi ji�
Basic Periodic Inspection Checklist
Structural Items
All structural and associated components(foundation,roof,walls,support members,stairs, sidewalks,etc.)are
maintained in a safe and sound condition.
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,unit/unit,
commercial/commercial or residential/commercial separations.
(HAM
pT° The Commonwealth of Massachusetts
City of Northampton •` \
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= New and Renewal Certificate of Inspection bw ''‘
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.
GANDARA CENTER (PRIDE HOUSE) GROUP HOME 0034
Located at Identify property address including street number, name city or town and county Certificate Expiration
610 BURTS PIT RD, Northampton 09/06/2024
36-284-001
Use Group Classifications Allowable Occupant Load
R-3 16 RESIDENTS/6 STAFF
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 ANDY PELIS Building Inspector JONATHAN S. FLAGG Date of Inspection 09/06/2023
•
Signature of Signature of Municipal f 1,
Municipal Fire Chief Building Inspector ' , A76XCII Date of Issuance 09/06/2023