32A-152 TENT - IBIZA TAPAS E P zoo()- 13D a
m
City of Northampton
C
z? Massachusetts , -,,.
Gr +
2 G d4 .0 C
v Z f DEPARTMENT OF BUILDING .INSPECTIONS
�� . 212 Main Street •♦ Hunicipal Building t
0. w 4;:.:4! Northampton. MA 01060 '-_i. j;
o
_ pGQ�i
ow
�i WE
lk- J TENT PERMIT APPLICATION
(For Tents over 120 square feet)
Permit Fee: $'3Ii Check# A
PLEASE TYPE OR PRINT ALL INFORMATION
1 Name of Applicant 2-ien l 6-1, /Lc. /0t3A h`,t,r -,,,,: ,.-t «�<3iia "7; yZ
Address:1 . 4't 'iN AfP Lys-A,. ' w• Telephone: `l.5•.5q -r0 6 Z
2 Owner of Property:(.)T,elf 4 a g.-1}/./y
(..)
Address Telephone:
3. Status of Applicant Owner Contractor -,,, i--,_-`i,c:te---
4. Tent Location Address)
Parcel 1D: Zoning Map#a.L f21 Parcel# /h 2 District(s) (2 )
(TO BE FILLED IN BY THE BUILDING DEPARTMENT,
5 Use of Property: Residential Commercial:
.,-.,• • • :, ,,,,:a;,,,,'.11 of Tent:
Size: lO r, LJ
OCcupant Capacity; ?
Dates of Use (ef2C; - r/(/ t4 ..0
7 ALL INFORMATION MUST BE COMPLETED;PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION.
8. Certification: I hereby certify that the information contained hereiajis true and accurate to the best
of ttmy knowledge. ;'
f�,
DATE: C 4 APPLICANT'S SIGNATURE ,//`
NOTE issuance of a permit does not relieve an applicant's bun 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,