38B-006 (65) City of Northampton
Massachusetts w_ s
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
Northampton, MA 01060
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OGT 3 1 ZOR
TENT PERMIT APPLICATION
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Electri N P U 'U nc
_ (For Tents over 120 square feet)
Permit Fee: $25.00 Check#
iPLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: Sni l' h C flg�e fRic L,,-A ko yo ,-e,,io wj k,
Address: )2G t cij S4rec,4 Telephone: (y 3) �� "Zqf3
2_ Owner of Property: (n 1 k e., I WO-
Address: Telephone:
3. Status of Applicant: Owner _Contractor
4. Tent Location Address):_ 2 icS t-Ie,l�1•Pareel'IB- Zonm,„1c�Map
5. Use of Property: Residential: Commercial:
6. Description of Tent:
Size: 20�� 2C T @� }.
Occupant Capacity:
Dates of Use: Scj , i t • I -20 i N
T-s,re-' ` it tja/ 1 0(,}i 6,,, 3 i, 101,4 0
7. ALL INFORMATION MUST BE COMPLETED: PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION
& Certification: 1 hereby certify that the information contained herein is true and accurate to the best
of my knowledge.
DATE: 10 �3 20 1 G
APPLICANTS 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._ ) D
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