Table 1 – Documentation required of compliance with fire safety requirements:

Provider Type:
	
Inspection of Egresses, Preventing Spread & Fire Extinguishers:
	
Compliance with Local Ordinances (Fire Certificate):	
Hospital – except freestanding outpatient satellite : 
(MGL Ch.111, s51) 
	Department of Public Safety Certificate of Inspection.	Local Fire Department.	
Rest Home: 
(MGL Ch.111, s.71)
	Department of Public Safety Certificate of Inspection.	Local Fire Department.	
	
Nursing Home: 
(MGL Ch.111, s.71)	DPH/DHCQ Life Safety Code survey per Cir. Letter 4-84-102.
	Local Fire Department.	
In-patient Hospice: 
(MGL Ch. 111, s.57D)
	DPH/DHCQ Life Safety Code survey per 105 CMR 141.102(E).
	Local Fire Department.	
	
Hospital – freestanding outpatient satellite clinic:
(MGL Ch.111, s51) 
	Local Certificate of Occupancy.
	Local Fire Department.
	
Clinic, including Ambulatory Surgical Center: 
(MGL Ch.111, s51) 	Local Certificate of Occupancy.
	Local Fire Department.
	
Dialysis Center: 
(MGL Ch.111, s51A) 	Local Certificate of Occupancy.
	Local Fire Department.

NOTE:  For new construction only, DPS and Fire certificates, or local certificate of occupancy as appropriate may be submitted following completion of construction.  A licensure survey will not be conducted until these documents have been received.

FILE=O/LICENSING/1.1 LICENSE APPLICATION TABLE 1 DPS & FIRE 7-1-09