31A-065 (6) s
City of Northampton
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Massachusetts 4?s`S_ �O�
- � DEPARTMENT OF BUILDING INSPECTIONS
212 Main Stcaet a Municipal Building 2�`..
Noathaspton, em 01060 O
TENT PERMIT APPLICATION
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(For Tents over 120 square feet) O
Vill ra Permit Fee: $30.00 Check #
PLEASE TYPE OR PRINT ALL INFORMATION
I. Name of Applicant 5ni fL CA,,, c, Xorie,.> uj k.
Address: IIG L&lh S}fpe � Telephone: NO) &8 -2yS6
2. Owner of Property.
Address Telephone.
3. Status of Applicant: Owner _Contractor
4. Tent LocaconAddress): �y�jjNnt�. < �l.h.� �ruic —le rrac[
I �Farn'k,,C �Iki
ParcellD. Zoning Map# - Parcel# Disfncgs)
tT0 BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Use of Property: Residential: Commercial_
6. Description of Tent.
Size. I' '3C • `I L cr's,l I-20 A ZG
Occupant Capacity:
Dates of Use: (4pc
Ap'.t
7. ALL INFORMATION MUST BE COMPLETED: PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION
B. Certification: I hereby certify that the information contained herein is true and accurate to the best
of my knowledge. I
DATE: q - 4' - 21JS 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.