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23B-046 (245) p ..,_�i� Wti.. ��i���..�..�.ie.�it P.,✓�_.i.}'.'. Jpf Y � f4, t !i 4 �EPAR��z ,.. 212 Xzin Municipal Building . �• ' �,�, erarrhampean, 1y.. 07.bE� °"��5yyy �` TENT PERMIT APPLICATION JUN 102015 (For Tents over 120 square feet) ° Electric, Fiu�'�;I uas .G 3 , /®� 0 Nor ihampt n MA 01060°ions PePrt�lt fee: ���.DU Check# V (I C KEASE TYPE OR PRINT ALL(INFORMATION 1. Name of Applicant; 3'!f'-0-r7 6�,ny e),00g�P Address: / Telephone: 2. Owner of Property: C� J(' �3 Address: 3 0 � C LJ f Telephone: 3. Status of Applicant: Owner _Contractor 4. Tent Location Address): 5. Use of Property: Residential: Commercial: 6. Description of Tent: � 3/' x Z/O ' Size; n Occupant Capacity: Dates of Use: 'r. AI, ORMAnON_MusT_BE COMPLETED;PERMIT CAN BE DEN150 DUI=TO LACK OF•INFORMATION. I a. Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge_ DATE: �57 �'� APPLICANT'S SIGNATURE NOTE:Issuance of a permit does not relieve an applicant's burden to comply with all zoning requirements and obtain all required permits from the Conservation Commission, Department of Publlc Works and other appllcable permit granting authorities— . Ad 30 LOCUST ST BP-2015-1281 GIS#: COMMONWEALTH OF MASSACHUSETTS Map:Block:23B-046 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: Tents BUILDING PERMIT Permit# BP-2015-1281 Project# JS-2015-002348 Est. Cost: Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sq.ft.): 1325051.64 Owner: COOLEY DICKINSON HOSPITAL INC Zoning: M(99)/WP(21)//URB(1)/ Applicant: COOLEY DICKINSON HOSPITAL INC AT. 30 LOCUST ST Applicant Address: Phone: Insurance: 30 LOCUST ST (413) 582-2216 () NORTHAMPTONMA01060 ISSUED ON:611012015 0:00:00 TO PERFORM THE FOLLOWING WORK.-ERECT 30 X 40 TENT 6/17/15 POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Driveway Final: Final: Final: Rough Frame: Gas: Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Signature: FeeType• Date Paid: Amount: Building 6/10/2015 0:00:00 $25.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner