38B-006 (43) City of Northampton , --,,:
c .
�k 4 Massachusetts ,4 ;i
,
s
DEPARTMENT OF BUILDING INSPECTIONS F ",�
V-02,440.:, . 212 Main Street r Municipal Building �f`�.{ �'1
\ - Northampton, MA 01060 '-s '?r�?,
3 . -E> ---- o 0 TENT PERMIT APPLICATION
(For Tents over 120 square feet)
Permit Fee: $25.00 Check#
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: Sri\14-k o!/O.9.2 C Ju A ko ii-en.ro WJ G�,
Address: 12(, t,1e.J Sc3-rea4 Telephone: (q13) 68.1-zcify
2. Owner of Property: c3(i 1 P. C. 11 e9e,
Address: Telephone:
3. Status of Applicant: Owner Contractor
4. Tent Location Address): ( I\ctp,A Dowse LA wrN C S4Iti ,iy AbrCc, a f“.')
3 ac,r;,. r,'„Jo .
mg-or zyfil1C.�, iiim €t - .-Par4L'C;3 r w61StrigSp ea — ar ,f=,<
ETO BE F-Kio t 1mtro.g IL-DINC"'L a aw kt
5. Use of Property: Residential: Commercial:
6. Description of Tent: �1 t 1 �T 1
Size: 6- 91 '-(10 i 4evJ- . I`e,Lt le hi-4
Occupant Capacity:
Dates of Use: I G t eso c.Y Scel-, 211 L )3 ((��A
Il o..1e.1 , s,P-� . 2„3 Loi3 .j:j1_ 12,■ J t.N,aa)
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: q: 2J` zo i3 APPLICANT'S SIGNATURE Gjr*:--1. .
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, Departm-• • 'ublic Works and other
applicable permit granting authorities._
, q-d q -13 r-i 'vta (1