38B-006 (34) City of Northampton
Massachusetts
DEPARTMENT OF BUILDING INSPECT ONS T, 251_
212 Main Street • Municipal Buil. ng �fS
� .� Northampton, MA 01060 MAY I
DEPT.OF BUILDING sT, oNg
NORTHAMPTON,MA 01060
TENT PERMIT APPLICATION
(For Tents over 120 square feet) 0
Permit Fee: $25.00 Check# 1 i
i PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: -S;^n i.� 1k f�,:C,L AA
Address: 12(,, I,JOJc SiI-fee Telephone: ( i if) 6-31-24C9
2. Owner of Property: 6 PI+ Ph C. fl eSz°
Address: Telebphone:
3. Status of Applicant: Owner Contractor
4. Tent Location Address): 'se 5 i CA f'h f 5 00ut
8 reel reteA sQ eA
arrelmZorttriagMommilwalPa ee] kWat,lct( �T ;, . -m.- _, r
5. Use of Property: Residential: Commercial:
6. Description of Tent:
Size: 2- 2.0
Occupant Capacity:
Dates of Use: 3UvtC .?-6, 2013 -mot TuAt 10
Li vN c Lo 13 �x J }c- 12,104) +ti u c-\,
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: �'�-° V 13 APPLICANT'S SIGNATURE
NOTE: Issuance of a permit does not relieve an applicant's burden to cxmply with all zoning requirements
and obtain all required permits from the Conservation Commission, D_,'drtment of Public Works and other
applicable permit granting authorities._ �f/