23B-046 (254) S
n �.t 5 DEPARTMENT OF BEILDIIJG INSPECTIONS
212 Main Street o Municipal Building
Northampton, A 01060 }
n
TENT PERMIT APPUCATION
-I ED
(Eox-tents over 120 square feet)
Permit Fee: $25.00 Check
DEPT.CF r __
_ PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: 4 : "°
Address: jr AA �-• �> Telephone:Cti31
2. Owner of Property:
Address: '�Z(5 J M �P � Telephone:0412 lot-
3. Status of Applicant: Owner Contractor
4. Tent Location Address):��\ol
Parcel lD;_. Zoning Map# District(s)
(f0_BE FILLED IN BY THE BUILDING DEPARTMENI�
5. Use of Property: Residential: Commercial:_
6. Description of Tent:
f �
Size:
Occupant Capacity: -C)
Dates of Use: (I t-4 k 1 s
7. ALL INFORMATION MUST BE COMPLETED: PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION.
8. Certification: I hereby certify that the information contained herein is true and accurate to the best
of my knowledge.
DATE: /'em�/z/r 4— APPLICANT'S SIGNATURE-7%✓��
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 Public Works and other
applicable permit granting authorities._
30 LOCUST ST BP-2016-0579
GIs#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 23B-046 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Buildinq DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: Tents BUILDING PERMIT
Permit# BP-2016-0579
Project# JS-2016-000965
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 (�
NORTHAMPTON MAO 1060 ISSUED ON:1 0/2 7/2 01 5 0:00:00
TO PERFORM THE FOLLOWING WORK.-ERECT 100 X 30 TENT
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 Occupan gy signature:
FeeType: Date Paid: Amount:
Building 10/27/2015 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner