25C-251 (97) City of Northampton a5 e c;)/EDtnn S
44:1"m ?at.
Mas /
R. t .may 'qDEPARTMENT OF BUILDING INSPECTIONS
`rh+ 212 Main Street • Municipal Building \� pD
Northampton, MA 01060n' va
TENT PERMIT APPLICATION
J, APR 17
(For Tents over 120 square feett))j/
r. Permit Fee: $30.00 Check # "G /
PLEASE TYPE OR PRINT ALL INFOR ATION
T
1. Name of Applicant: —7-1 1/43/ ri% Qapp^-�'L'e, QS /172-/t al'1/4r �r / y
Address)rc ' dt * v Coli e, %t+TTelephone:
�r� DIT® 1
2. Owner of Property: 7�C , un^�. �i � /
Address: tY 54 , yy/jfix
Telephone:
3. Status of Applicant: ,O/wnerr ?Cconttractor / - (� ,1�I/' /.�
4. Tent Location Address):` /� `¢Q 0 IL/ \lr_W^d`S, 1 • B /-(/T'
Parcel ID: Zoning Map# Parcel# District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Use of Property: Residential: Commercial:
6. Description of��ygyC Tent. (+ (`
Size: / 2t) °
Occupant Capacity: IS
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: i11)JJ 117 APPLICANT'S SIGNATURE • /
NOTE: Issuance of a permit does not relieve an applicant's burd to comply with all zoning requirements
and obtain all required permits from the Conservation C mission, De•artment of Public Works and other
applicable permit granting authorities.
y/7/7