25C-251 (129) 6 P- 6�0
City of Northampton
S`5 S'C
'' "• Massachusetts
G
�`
DEPARTMENT OF BUILDING INSPECTIONS y �
212 Main Street • Municipal Building J,S
Northampton, MA 01060 SNh `�O
H E C E I v E D TENT PERMIT APPLICATION
AUG 1 6 2019 (For Tents over 120 square feet)
Permit Fee: $30.00 Check#���-
nFPT OF BUILDING INSPECTIONS X3
NORTHAMPTON,MA01060
(� PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:76-ec \C 1J RT4 TSS
Address: 54 R.t Telephone: Y/3 5%4 l a-28-7
2. Owner of Property: nyz1�rC. �Ccm n°1-} ,,y,,Qd{,n �1C 13�dmt SOCA
Address: k. Telephone: e
3. Status of Applicant: J Owner Contractor
4. Tent Location Address): �G.:�fQ M"ras
Parcel ID: Zoning Map# Parcel# District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT) /I^^
5. Use of Property:Y: Residential: Commercial:
(� r1
6. Description of Tent:
Size:
Occupant Capacity:
Dates of Use: ( I � (�
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 knowle ge.
DATE: / APPLICANT'S SIGNATU�?iQth
NOTE: Issuance of a permit does not relieve an applicant's buall zoning requirements
and obtain all required permits from the Conservation Commission, Department of Public Works and other
applicable permit granting authorities.