38B-006 (59) r City of Northampton
Massachusetts �•
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DEPARTMENT OF BUILDING INSPECTIONS '
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\�� .►- 212 Main Street • Municipal Building
Northampton, MA 01060
TENT PERMIT APPLICATI 4
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(For Tents over 120 square fe t)
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Permit Fee: $25.00 Check #
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PLEASE TYPE OR PRINT ALL INFORMATION V
1. Name of Applicant: .-gJk C11!?IQ
Address: ))-( Uej4 1j-�-� e--1 Telephone: (qf3)
2. Owner of Property: J(� f k
Address: Telephone:
3. Status of Applicant: Owner _Contractor
4. Tent Location Address):_ C,r-0(&.1 CQ&-.3iJ' bc,ck,
100 Elm S�J ec}
�?arce_1�DZOnIng=Mak ,_. � '�a�celi �` "+ n� ?.rIQdStI7✓t�S)��- ,`' r�e x�`��`..rE�i':�'s�x_..r �
_�O.aB��1LLEd�fJ,B'T,_l�-_E�BUI LQ(tJG}�EP;�Rn E"i5r}
5. Use of Property: Residential: Commercial:
6. Description of Tent:
Size:` r ,X 10 1 lei�,%4 C on"L W
Occupant Capacity:
Dates of Use:_ Tr�'.,4 JuAy 201 N :oa�M (Oi0?M
I�u�1S41ay dull PLC 204 12 .
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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: APPLICANT'S SIGNATURE G�
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._