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23B-046 (281)
6e'f9a 3y SSA City of Northampton HAMF. #°a °ti 5,,5 s,C _4' � Massachusetts 4<� 'ev k ,. ,` DEPARTMENT OF BUILDING INSPECTIONS . x,' h ' rJ ,qv ,r 212 Main Street • Municipal Building , ,,. -*' r Northampton, MA 01060 ''i, ., )%' / TENT PERMIT APPLICATION 4,..,- 19 (For Tents over 120 square feet) -----„..�o°ti o1 � :Permit Fee: $30.00 Check # giO,A \ r0 '^isp l N•444 cri 6a/ONS PLEASE TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: Address: 3 0 (m...r_,..,Apr" � Telephone: 'f( — S2—`4 If 2. Owner of Property: Address: Telephone: �,,,.,, 3. Status of Applicant: x Owner Contractor 4. Tent Location Address): C_Pt r 4Q, 4 A0V _ 4-4....� Z-9-€4 e:,•-fr- t,( am.►) Cr`,) r z-/s(- _( - ( CZ- Parcel ID: Zoning Map# Parcel# District(s) (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Use of Property: Residential: Commercial: 6. Description of Tent: Size: p(© 3© 6.C_Ul Occupant Capacity: Cot Dates of Use: ( ' S 2 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: // 12( APPLICANT'S SIGNATURE 4` '-. ` � / 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. BP-2021-2218 30 LOCUST ST COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 23B-046-001 CITY OF NORTHAMPTON Permit: Temp Structure (Tents) PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit # BP-2021-2218 PERMISSION IS HEREBY GRANTED TO: Project# TENT Contractor: License: Est. Cost: Const.Class: Exp.Date: Use Group: Owner: COOLEY DICKINSON HOSPITAL INC Lot Size (sq.ft.) Zoning: M/WP Applicant: COOLEY DICKINSON HOSPITAL INC Applicant Address Phone: Insurance: 30 LOCUST ST NORTHAMPTON, MA 01060 ISSUED ON:11/19/2021 TO PERFORM THE FOLLOWING WORK: TENT FOR HOT CHOCOLATE RUN 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. Signature: Fees Paid: $30.00 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Building Commissioner