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,.. 212 Xzin Municipal Building
. �• ' �,�, erarrhampean, 1y.. 07.bE� °"��5yyy �`
TENT PERMIT APPLICATION
JUN 102015
(For Tents over 120 square feet) °
Electric, Fiu�'�;I uas .G 3 , /®� 0
Nor ihampt n MA 01060°ions PePrt�lt fee: ���.DU Check# V (I C
KEASE TYPE OR PRINT ALL(INFORMATION
1. Name of Applicant; 3'!f'-0-r7 6�,ny e),00g�P
Address: / Telephone:
2. Owner of Property:
C� J(' �3
Address: 3 0 � C LJ f Telephone:
3. Status of Applicant: Owner _Contractor
4. Tent Location Address):
5. Use of Property: Residential: Commercial:
6. Description of Tent: �
3/' x Z/O '
Size; n
Occupant Capacity:
Dates of Use:
'r. AI, ORMAnON_MusT_BE COMPLETED;PERMIT CAN BE DEN150 DUI=TO LACK OF•INFORMATION. I
a. Certification: I hereby certify that the information contained herein is true and accurate to the best
of my knowledge_
DATE: �57 �'� APPLICANT'S SIGNATURE
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 Publlc Works and other
appllcable permit granting authorities—
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30 LOCUST ST BP-2015-1281
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-2015-1281
Project# JS-2015-002348
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:611012015 0:00:00
TO PERFORM THE FOLLOWING WORK.-ERECT 30 X 40 TENT 6/17/15
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 6/10/2015 0:00:00 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner