23B-046 (2) 7 3&-- O /(a
City of Northampton
,: Massachusetts -:.
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DEPARTMENT OF BUILDING INSPECTIONS
`\ 212 Main Street • Municipal Building
`' r Northampton, M1► 01060 w ,.lyty
RECEIVED JUL 2 1 2022
TENT PERMIT APPLICATION
(For Tents over 120 square feet)
Permit Fee: $30.00 Check# /___c1"7
DEPT.OF BUILDING INSPECTIONS
NORTHAMPlON.MA 01060
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: It) t ` S'f,achNift."4„,, t / ` Telephone: L f 2. s-$2-Z3 13
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2. Owner of Property: `k,,,..a,,.,2--)
Address: ( ul. �,�) Telephone: C a-1
3. Status of Applicant: O(Owner Contractor
4. Tent Location Address): 31C1 Lemu,...( fr V
VWo4.v-4l�, /11.14 a 10‘>1:)i
1111111.111.1111119111111111.1111111111111111111111111111111111111111111111111111.
5. Use of Property: Residential: Commercial: � 5\ Z io
6. Description of Tent: Li
0 �� 9
Size: D 0 X 0 i y,
Occupant Capacity: 3&
Dates of Use: S[/3011 V
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: 7//3/L Z APPLICANT'S SIGNATURE
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 permit granting authorities.
B1-2022-0867
30 LOCUST ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
23B-046-001 CITY OF NORTHAMPTON
Permit: Temp Structure
(Tents)
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2022-0867 PERMISSIONISHEREBYGRANT4D TO:
Project# TENT Contractor: License:
Est. Cost:
Const.Class: Exp.Date:
Use Group: Owner: COOLEY DICKINSON HOSPITAL IN
Lot Size (sq.ft.)
Zoning: M/WP Applicant: COOLEY DICKINSON HOSPITAL IN
Applicant Address Phone: Insurance:
30 LOCUST ST
NORTHAMPTON, MA 01060
ISSUED ON:07/21/2022
TO PERFORM THE FOLLO WING WORK:
30X40 TENT FOR 8/30/22 USE
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:
Final: Final: Final: Rough Frame:
Gas: Fire Department Drne«ap Final: Fireplace/Chimney:
Rough: Oil: Insulation:
Smoke: Final: 6 V 8 Zq-z z .2
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOL TION OF
ANY OF ITS RULES AND REGULATIONS.
Signature:
Fees Paid: $30.00
212 Main Street,Phone(413)587-1240,Fax:(413)587-1272
Office of the Building Commissioner