38B-006 (63) z` City of Northampton -
' Massachusetts `R f
1
DEPARTMENT OF BUILDING INSPECTIONS r_' '
»= - 212 Main Street • Municipal Building
Northampton, MA 01060
TENT PERMIT APPLICATION
292014 '! l (For Tents over 120 square feet)
Electric, Plumbing&Gas Inspections Permit Fee: $25.00 Check # Al
Northampton, MA 01066
PLEASES TYPE OR PRINT ALL INFORMATION 1. Name of Applicant: S ng J Q)lg�e ko o-en rio w j k,
Address: )2[„ IfeJ �.����� Telephone: oo) �_,g5 -Zgfy
2. Owner of Property: cl(�� �e� ��e5g
Address: Telephone:
3. Status of Applicant: Owner Contractor
4. Tent Location Address): `e J A Ir n�� I�v/�•�� � t t 4>> �i°�� � r'` �� �` � �
5. Use of Property: Residential: Commercial:
6. Description of Tent:
k
Size: � 1 - av ,�20x� .i CL-`LV`
Occupant Capacity: M
Dates of Use: fif a���y q, ZG i 4 n
j�.� ..
I, s,-J . ILL
2� iti
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: -2- � 2`'DIY APPLICANT'S SIGNATURE
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._