23B-046 (7) 04/23/2012 11:45 14135871272 NTON BLD DEPT t'A(it mini
City of Northampton
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Massachusetts •
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DEPARTMNT OF BUILDING rxsPacrzoxs
s.., 212 Main X ttawi • Municipal Building , � � •
Irorth ton, Mik 01060 '�e;al iii
wg ate TENT PERMIT APPLICATION
.Pic NEC (For Tents over 120 square feet}
ticoviviAmf Permit Fee: $25.00 gam Check #
PLEASE TYPE oR PRINT ALL INFORMATION
1. Name of Applicant: /
Conk/ J� tJ 0 71"/
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Address: 30 / ' d „ Sr - Telephone: Z. 2 3 /
2. Owner of Property: C i) 1 J'I- Telephone: 45i '�-
3. Status of Applicant: k Owner Contractor
4. Tent Location Address): , 7 0 /0 CUS S� Aff ciA, � i1 'dam! •
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5. Use of Property: Residential: Commercial:
6. Description of Tent: /
Size; J
Occupant Capacity:
Dates of Use: Ay /0 ,2O/
7. 6},LJUE„g1 RATION MUST BE COMPLETED: PERMIT CAN BE DENIED DUE TO LACK OFINFORMAT1ON.
8. Certification: I hereby certify that the information contained herein is true and accurate to the best
of my knowledge.
I
DATE: / 1” 6
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- APPLICANT'S SIGNATURE .4`.� /..il /f /.fL L./
NOTE: Issuance of a permit does not relieve an applicant's burden to comply with all zoning requirements
and obtain al required permits from the Conservation Commission. Department of PUblIc Works and other
applicable perrnit granting authorities._
30 LOCUST ST BP- 2012 -0952
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- 2012 -0952
Project # JS- 2012 - 001658
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 0
NORTHAMPTONMA01060 ISSUED ON:5/2/2012 0:00:00
TO PERFORM THE FOLLOWING WORK: ERECT 20 X 30 TENT 5/10/12
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 5/2/2012 0:00:00 $25.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck — Building Commissioner
30 LOCUST ST BP- 2012 -0952
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- 2012 -0952
Project # JS- 2012 - 001658
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:5/2/2012 0:00:00
TO PERFORM THE FOLLOWING WORK: ERECT 20 X 30 TEN*41
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: Ot<c 1
THIS PERMIT MAY BE REVO E ITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND ' ' UI ".77,
id"" /4 4UPv
Certificate of Occupancy ignature:
FeeType: Date Paid: Amount:
Building 5/2/2012 0:00:00 $25.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Louis Hasbrouck – Building Commissioner