Are you responsible for a fleet of vehicles? Are you concerned about ensuring that your fleet is compliant with legal safety requirements? If so, then it may be time to consider obtaining a MassDPS Inspection Certificate Form. This form proves that your vehicle meets the strict regulatory standards set forth by the Massachusetts Department of Public Safety (MassDPS). Read on to learn more about this important inspection and how to ensure you have everything necessary in order to obtain yours!
| Question | Answer |
|---|---|
| Form Name | Mass Dps Inspection Certificate Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | mass dps inspection, massachusetts dps application certificate inspection, dps webload, department dps massachusetts get |
Commonwealth of Massachusetts
Department of Public Safety (DPS)
Application for Certificate of Inspection
APPLICATION FOR CERTIFICATE OF INSPECTION
PROCEDURES
s:\dps\webload\active website forms\certificate of inspection application revised
Attached, please find a Department of Public Safety (DPS) Application for Certificate of Inspection for a new or existing building or location. Please note that effective October 3, 2008, inspection fees have been revised.
The application must be completed pursuant to Massachusetts General Law (MGL) Chapter 111 §§ 51 and 71 and 780 CMR (The State Building Code, Section 106 and Table 106. (Also see MGL Chapter 140 § 206 for Public Swimming Pools.)
Following an inspection by a Department of Public Safety Building Inspector, please mail the “completed” application along with a check payable to the Commonwealth of Massachusetts to the following address
Department of Public Safety
1380 Bay Street, Building B
Taunton, MA 02780
Attention: Linda Shea
Phone Number: (508)
Please Note:
1.Application forms with accompanying fee must be filed for each building or structure or part thereof that is to be inspected and certified.
2.Completed Applications with appropriate fees must be received by the Department of Public Safety (DPS) prior to the issuance of a certificate of inspection. A certificate of inspection will not be issued until the application and fee has been received and processed by the Department of Public Safety.
3.Certificates for premises that serve alcohol
4.Inspection requests must be received by the Department of Public Safety (DPS) at least thirty (30) days prior to the expiration of a current certificate.
Commonwealth of Massachusetts
Department of Public Safety (DPS)
Application for Certificate of Inspection
In accordance with the provisions of Massachusetts General Law Chapter 111 and\or 780 CMR (The State Building Code), Table
106, I herby apply for a Certificate of Inspection for the
Address of Premise |
Street Name |
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and Number |
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City\Town |
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Zip Code |
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Purpose for which premise is used |
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Certificate to be issued to |
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Identify exact name of premise to be |
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printed on certificate |
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Owner of Record |
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Contact Person |
Contact Name |
Contact Phone Number |
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Please indicate the person |
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responsible for assuring inspections |
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Contact |
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are completed |
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Signature of person to whom the |
Print Name and Title |
Signature |
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Certificate of Inspection shall be |
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issued |
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FEE SCHEDULE & CERTIFICATE INFORMATION
Please enclose a copy of the expired DPS certificate for all existing locations.
Please provide the DPS Tag |
Tag Number |
Is this a New Facility? |
Is this an Existing Facility? |
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Number if known |
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Yes |
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No |
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No |
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Certificate of Inspection |
Frequency |
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Number of units |
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Total Fee |
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Group Residences |
Biennial |
$200.00 |
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Clinics, Infirmaries |
Biennial |
$200.00 |
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(Institutional Buildings) |
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Biennial |
$200.00 |
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Each Additional 25 Beds |
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$ 10.00 |
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Day Care Centers |
Annual |
$ 100.00 |
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Assemblies |
Annual |
$ 100.00 |
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(1 to 500 occupants) |
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Each additional 200 occupants |
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$ 10.00 |
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Residential |
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Total Fee Submitted
Return this application with a check made payable to the Commonwealth of Massachusetts to:
Department of Public Safety
1380 Bay Street, Building B
Taunton, MA 02780
Attention: Linda Shea
Inspected
By
Date
Inspected
s:\dps\webload\active website forms\certificate of inspection application revised