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23B-046 (226) City of Northampton ys '< Massachusetts - ARTMENT OF BUILDING INSPECTIONS r` 2 Main Street • Municipal Building Northampton, MA 01060 22 � i Electric on ENT PERMIT APPLICATION (For Tents over 120 square feet) Permit Fee: $25.00 Check# c PLEASE TYPE OR PRINT ALL INFORMATION S 1. Name of Applicant: C O( 7- —0c)A h S Of, 3 o 2 Telephone: 2 3 !4/ I Address: �L(1 2. Owner of Property: ��'�r') r—Y t/j-GA1--, d-7S"Q-A7 �Z_ Z3 �3 Address:_ Q 16 C (/S,% S'7- Telephone: 3. Status of Applicant: Owner Contractor 4. Tent Location Address): 0 5 Al G ` 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: 30 Ll 0 / Occupant Capacity: 'mAry, / a Dates of Use: 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: /✓ APPLICANT'S SIGNATURE Z 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-2014-1107 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) Categoa: Tents BUILDING PERMIT Permit# BP-2014-1107 Project# JS-2014-001860 Est.Cost: Fee:$25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: Homeowner as Contractor Lot Size(sa. ft.): 1325051.64 Owner: COOLEY DICKINSON HOSPITAL INC Zoning: M(99)//WP(21)/U (1)/ Applicant: COOLEY DICKINSON HOSPITAL INC AT. 30 LOCUST ST Applicant Address: Phone: Insurance: 30 LOCUST ST (413) 582-2216 () NORTHAMPTONMA01060 ISSUED ON:412412014 0:00:00 TO PERFORM THE FOLLOWING WORK.-ERECT 30 X 40 TENT BEHIND MCCALLUM BLDG 5/8/14 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 Occupant Signature: FeeType• Date Paid: Amount: Building 4/24/2014 0:00:00 $25.00 212 Main Street,Phone(413)587-1240, Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner