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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