31D-020 (54) wh �/j� Z��7
City of Northampton
-" Massachusetts
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DEPARTMENT OF BUILDING INSPECTIONS o
212 Main Street • Municipal Building JiC`
Northampton, MA 01060
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P TENT PERMIT APPLICATION
(For Tents over 120 square feet) 1
Permit Fee: $30.00 Check #-E7Y�?f7
,
PLEASE TYPE TYPE OR PRINT ALL INFORMATION
1. Nameof Applicant 3n, IL alic,9C ('ll KJr}gna wo k,
Address 11(e Wu} S}fpe , Telephone (913) X145. 290
2. Owner of Property.
Address Telephone'.
3. Status of Applicant. Owner _Contractor CC
4 Tent Location Address): 1n F?,}a� C ii T11
1 fn"n
G� l awe• C, �Izz� 11,e
Parcel ID: Zoning Map# - Parcel# District(s)
DO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Use of Property: Residential: Commercial:_
6 Description of Tent.
Size I -2020 ' 1,? iA
Occupant Capacity
nty
Dates of Use: A-) r,
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.
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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.