13-038 (41) City of Northampton
Massachusetts
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DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
Northampton, MA 01060
SEC IV
ETENT PERMIT APPLICATION
Ll NOV 14
2019 (For Tents over 120 square feet)
DFpT nF�Uf! er it Fee: $30.00 Check #
NORTHAt"li,I pN.1 P 1CpFC-r
A 01G60
(PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: i �/C r V a- 2 y Co -04
Address: 330 Nf`ilit ,S 4,% a� lea � '4lephone:LU-(2) S� `C' "��y J67
2. Owner of Property: S*,,,.tip►
Address: Telephone:
3. Status of Applicant: Owner Contractor {� /�
4. Tent Location Address): 33 Q /,� • �h 5 ( /V� � "�'A�� / �M
Parcel ID: Zoning Map# Parcel# District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Use of Property: Residential: Commercial:
6. Description of Tent:
i
Size: z o , X Q
Occupant Capacity 3 U
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: 1 t /'4 APPLICANT'S SIGNATOR
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.
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