31A-324 (6) SN pr, City of Northampton ---------
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( f ' •. Massachusetts * -'°,
J '�'�V ill V DEPARTMENT OF BUILDING INSPECTIONS U �^'
x 212 Main Street • Municipal Building sPai;- ,....x
""' ...7 .f Northampton, MA 01060 J7 ''
--RECEIVED TENT PERMIT APPLICATION
MAY 2 3 k (For Tents over 120 square feet)
DEPT.OF BUILDINF.INE"tCrONS Permit Fee: $25.00 Check# F(OO "13
(iPLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:_ M i�h Cu 11G e 'L(1. kof9-envJ Q..;k
.G tJ
Address: )2eJ4 1sj-rec-4 Telephone: (y1 S J> S8S-"24If9
2. Owner of Property: c5 '-L C. /lle5cL.
Address: Telephone:
3. Status of Applicant: Owner Contractor
4. Tent Location Address): �ieJ.0 ON 1 1 N Ou-Jc
S ( . 11o)t. 1- e
,;a IT no In J J :2 ce 1:44,.';',12.':-.', S, d ux a� ' x `?�i: ;g_
r el L t Dg. �'eki.Li 6D ``� r�4a`"J ''.
5. Use of Property Residential: Commercial:
6. Description of Tent: 11 ,, ` \\
Size: a.' 201,2o -FCw�.i
)- 3 - 9 `x10` 7'c�/-) (CimAcc1-P06
Occupant Capacity:
Dates of Use: (�uy 13110 Ito o h,"y 23---12J t(,
"1 lec..m. 1nif,„A May 13; Loi (o .i p.). 12.'U7
7. ALL INFORMATION MUST BE COMPLETED: PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION.
6. Certification: I hereby certify that the information contained herein is true and accurate to the best
of my knowledge.
DATE: S - II " iv P G APPLICANT'S SIGNATURE C?, ...___--,
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._