31B-249 (9) 10. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
Are there any proposed changes to or additions of signs intended for the property? YES NO
IF YES, describe size, type and location:
11. Will the construction activity disturb (clearing, grading, excavation, or filling) over 1 acre or is it part of a common
plan of development that will disturb over 1 acre? YES NO
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
12. ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION
This column reserved
for use by the Building
De•artrnent
EXISTING PROPOSED ( 39
Lot Size 1_
Frontage i.
I;.
Setbacks Front
Side L: R: L: R: jt._ #L
Rear
Building Height
_
Building Square Footage
% Open Space: (lot area
minus building & paved
parking
# of Parking Spaces
# of Loading Docks _.
Fill:
i 1,-,-
(volume & location)
L
13. Certification: I hereby certify that the information contained herein is true and accurate to the best of
my knowledge.
ate: 9 _) C _ 1 1 Applicant's Signature 0 /
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all zoning
requirements and obtain all required permits from the Board of Health, Conservation Commission,
Historic and Architectural Boards, Department of Public Works and other applicable permit granting
authorities.
w:\Dommlents\FO MS \ori arBuiidi::_-Irspest T7_,�r P- r- m, tzpii^aIion- nzsive_doc 5/4/2004
FEE$ ,5, 00 /tern , `
AUG i 6 2011 "6/P/01/7 7
1141-12WitI4E52g191AffiLkilV2-1-EITEATIOW§Ija4?)177:73:-A2." --:4747:1
File No.
Please type or print air information and return this form to the Buildling
Inspector's Office ' check or money order) payable to the
City of Northampton
/1. Name of Applicant: 3('' )'�. C. 11 c „) C c l.t J -A K� `) z� , °;,::14. .
/Address: 1 C W e) )-. S --' ? � l 'Telephone: ( S) s S Z S v
/L. Owner of Property: 3 h,, C 10 j z -
Address: Telephone:
3. Status of Applicant: Owner Contract Purchaser \ Lessee Other (explain)
74. Job Location: 4r1,p•...3 Ce.�, e 1 : (rra , 1 - , I OA') 100 E 1- Sire. }-
�° r Zi: z• ' e is 7, e- � '�'- _ am 77:'.'
`- -�� r�-- �.. -S a y am - '° -_ - �
I /. Existing Use of Structure /Property:
LIST EVENT ' ,SS 6k, akta ...
q-ECep -:s n
6. Description of Proposed Use/Work/Project /Occupation: (Use additional sheets if necessary):
V
LIST DATES OF EVENT • fis a�,y /�t..�i 1 C1, 2vil fr,;e :of ?ft -lc ) :,4a i ''S
NO OF /SIZES OF TENTS 2- r }ti1O' le-.- C,,,ke
WHEN TENTS READY FOR INSPECTIONi le fr i.!lc- f , � . u � � 1 1 4, Lo it @ /2 �`
7. Attached. Plans: Sketch Plan Site Plan Engineered /Surveyed Plans
8. Has a Special Perrnit/ Variance /Finding ever been issued for / on the site?
NO DONT KNOW V" YES IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DONT KNOW YES
iF YES: enter Book Page and /or Document
9 "Does the site contain a brook, body of water or wetlands? NO DONT KNOW YES
iF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained Obtained , date issued:
(Form Continues On Other Side)
1 ,V - :1Bcc.: -te. M1, -- C IVIS‘e':oi,al\a n specto= 2onins_ Per?,it- ATVlimtior.- pvssive.doc 8/4'2004
100 ELM ST CAMPUS CENTER BP- 2012 -0177
GIS #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 31B - 249 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- 2012 -0177
Project # JS- 2012 - 000272
Est. Cost:
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 15855.84 Owner: SMITH COLLEGE OFFICE OF TREASURER
Zoning: URC(100) / /EU Applicant: SMITH COLLEGE OFFICE OF TREASURER
AT: 100 ELM ST CAMPUS CENTER
Applicant Address: Phone: Insurance:
COLLEGE HALL 4
NORTHAMPTONMA01063 ISSUED ON:8/18/2011 0:00:00
TO PERFORM THE FOLLOWING WORK: ERECT 2 9 X 10 TENTS FRONT OF CAMPUS
CTR
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 8/18/2011 0:00:00 $25.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner