32C-345 (3) ��' ?Cg- 09-5, -Vohm zcp��o
City of Northampton
Massachusetts ��, �- `'•�t�
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building + ,ArCS
Northampton, MA 01060
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OEC 3 TENT PERMIT APPLICATION
2019
DEPT (For Tents over 120 square feet) .y (O
Ar
NORTHgMP INN INSPECTIONS & aV
TON'MA 01060 Permit Fee: $30.00 Check # GAO
PLEASE TYPE OR PRINT ALL INFORMATION
/ �
1. Name of Applicant:
Address: �� (dj--r rc� Cr-1 Telephone: `((I • S�Z' � ��
2. Owner of Property:
Address: Telephone:
1 Status of Applicant: Owner Contractor
4. Tent Location Address): P10_X x, 2 rU r
lip.,,'GL"" ,-*" x"f- d4), &W6t5k C
Parcel ID: Zoning Map# Parcel# District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Use of Property: Residential: Commercial: rte`
6. Description of Tent:
Size: C)
Occupant Capacity: �dL� AF'c V n
Dates of Use: (�2—— 1B — 2_,O 1!5!
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
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.
MAINTENANCE DEPARTMENT
Work Order#: 525234(WEB ASSIGNED)
Control# NONE Equipment Type NONE Risk 0
Issue Date/Time Priority Est Hrs Status OPEN
11/27/2019 11:21:00 AM NONE 0.00 Status Date/Time 11/27/2019 11:21:00 AM
Assigned Engineer Department Location MC CALLUM
NONE INFORMATION SERVICES Campus COOLEY DICKINSON HOS
Specialty Cost Center# Dpt Phone# Building MC CALLUM
NONE 8130 2246 Wing NONE
Subcode Requester Req Phone# Floor FOURTH
NONE NONE Room NONE Space NONE
Request
8 Atwood Middle Reception Keyboard Tray is broken and needs service or replacement
Requester: Susan Pollard((413)582-2113)
smpollard@cooleydickinson.org
Department: INFORMATION SERVICES
Location: MC CALLUM
Control#:
Initials Start Date/Time Time OT WO Code Part# Qty Notes
Action