25C-251 (125) 7 W X33 f
City of Northampton Q(�I
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Massachusetts'" "
EDDEP TMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
JUL 2Q1J Northampton, MA 01060
O� SUILDIN
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Onrf{AMr70N'NreSPECTIONSq01060
ENT PERMIT APPLICATION
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(For Tents over 120 square feet)
Permit Fee: $30.00 Check #
PLEASE TYPE OR PRINT ALL INFORMATION �,�, /
1. N me of Applicant: Uw &z J�{SO f� � KJnn� 4-6,Q '�i u'�(/
Address:=CIO
(, 1, _Telephone: (CO3 - 7-20-/3"'
2. Ov ner of Property: hnp_,____`0
Address: _Telephone:
3. Ste tus of Applicant: Owner Contractor . e
4. Ter t Location Address): All F,5-I-1
5. Use of Property: Residential: Commercial:
6. Des ription``of Tent: ►CJI�
ize: l � 7 �w. 1-i�tJ'�f L f 1 I (07-60
ccupant Capacity:
"66
ates of Use:
7
f-T 13L C� ��j
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.
DA E: -7 � APPLICANT'S SIGNATURE 0
NOT : Issuance of a permit does not relieve an applicant's bu comply with all zoning requirements
and o twin all required permits from the Conservation Commission, Department of Public WornS and other
applic ible permit granting authorities.