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25C-251 City of Northampton .374.44 tk Massachusetts el: IlEPARTMEMOFBurznram IIISPECTIONS 212 MAit Street * Municipal Buildinu Northampton, MA 01060 (D TENT PERMIT APPLICATION c'0,97 g-e- 444pcv/vr, (For Tents over 120 square feet) ?o,?' •414 oc7./0 4 3 0 7,s0 ,vs Permit Fee: $30.00 check# IgCfi PLEASE TYPE OR PRINT ALL INFORMATION 1 Name of Applicant Iff\tlevikt..) 1-.20(109 1").q...4...) Address: gq 'FCC) OCA4(A-14elephone é7ZD -16;67 2 Owner of Property- ILA*/ 46-Pi Address: Fi(ft it—)CANi'refftes-- /2779 Tephon 11 Z '5E1- 3. status of Applicant: Owner Contractor 4. Tent Location Addressj- ••• 4 Parcel ID; Zoning Map* Parcel* Districts) (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 1 5, Use of Property: Residential Commercial: t (CC-'0 I 901 0 6. Description oi Tent 0°A IC6 1 htO Size: 9001 60 Occupant Capacity. 0.0t, i0O 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 tru n ccurate to the best of my knowledge. DATE: 71//19' APPLICANT'S SIGNATURE NOTE:issuance of a permit does not relieve an applicant's burde comply with all zoning requirements and obtain all required permits from the Conservation Commission, Department of Public Works and other applicable permit granting authorities. ri' '3'1 7 r141(.