FITNESS CERTIFICATE

(To be filled by the Inspection Officer) (Junior Engineer)

1
Name of the officer
2 Name of Anganvady

3 Location with name of education District/Sub

District Alappuzha municipality

4
Classification of building as specified in
column 4 of the application for fitness
certificate and viz.etc

5 Period for which the certificate is issued

6
Nature of defects any NIL

a
Foundation & Basement NIL
b Super Structures NIL
c Door and Windows NIL

d
Wood work wrought and put up NIL
e Roof NIL
f Painting NIL

g
Miscellaneous(minor cracks if any) NIL

7 Any major defects noticed which will founder

the building unsafe in any manner minor cracks

8 Whether maintenance work has been done

properly no

9 Whether the structure is sound or note for Structure is sound for conducting clasess under normal
functioning classes wind & weather condition.

Note:-1. In the stabilility of structure should be examined also with reference to location,altitude intesity
of wide,exposire to flood etc.
2.Any additional observations of daimed necessary for the certificate may be furnish separately
with the clarification.
 Certified that the anganvady was inspected by me on ………………and found to be fit to a
conductct classes for period
Place- Alappuzha Signature
Date -

Designation