32A-271 TENT City of Northampton
y 1iassachusetts
.y ` DEPARTMENT CN BUILDING INSPECTIONS
212 Main Street o Municipal Building 3, ca
Northampton, MA 01060 II-ry - �A'‘
RECEIVE'
1 I TENT PERMIT APPLICATION
II! MAY - 2
I 2022 (For Tents over 120 square feet) 4
DEPT.0FBUILC)INGINSPECTIGN; Permit Fee: $30.00 Check # (-3(e ,G
NO!3TNAMPTQN.MA 01060
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: (_,' GU dt O GUerc o
Address: I Fp(I Ck9Q c+i m Oat-let 0,PfDA MO a4relephone: 1 3 SI fr (c . 13
2. Owner of Property: C(Gud D (5'U- C\
.((
Address: ��S N Fv1N 01 FCC i N)ten-Q MA oi('celephone: LA k3 S M 2 945
3. Status of Applicant: X Owner Contractor
4. Tent Location Address): 13“die. SEcee+l m trf�^corlo )A AAA CID 0
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: (�� (� (1 'r
Size: I,0 T1 �y �v - 0�11�
100 `` e V 2
Occupant Capacity: ��t �^ 2
Dates of Use: 6' l` 10 3 . 112 - S-�12.1
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: lc 122 APPLICANT'S SIGNATURE
NOTE: Issuance of a permit does not relieve an applicant's burden t comply with all zoning requirements
and obtain all required permits from the Conservation Commission, Department of Public Works and other
applicable permit granting authorities.