25C-251 (130) 6 P- CK -A 3(/ z
City of Northampton
/ •*' Massachusetts
c
TENT OF BUILDING INSPECTIONS
E ` J D 1 212 in street • Municipal Building
y Northampton, MA 01060
AUG 2 3 2019
jor
NT PERMIT APPLICATION d
INSPECTIO
r;ORTHAMPTON,MA01060 Tents over 120 square feet)
Permit Fee: $30.00 Check
PLEASES PE OR PRINT ALL INFORM TION
1. Name of Applicant:
Address: zp Telephone: 12
2. Owner of Property: Ar ,A/ A, If-W/�yY-ak
Address:
�. Ll �K•r SyL . Telephone: �`�3
3. Status of Applicant: Owner Contractor
4. Tent Location Address): ✓Z a ( �� i` � � ��� �� �v
G fir �
Parcel 1
D: pf111 1<i 1B
5. Use of Property: Residential: Commercial:
6. Description of Tent:
Size: 3L7
Occupant Capacity:
Dates of User,?!� j L_`LnS 9 ?, 20� /
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: l APPLICANT'S SIGNATURE//"?0
NOTE: Issuance of a permit does not relieve an applicant's burden to comply with a I zoning requirements
and obtain all required permits from the Conservation Commission, Department of Public Works and other
applicable permit granting authorities.