38B-006 City of Northampton _40(4.
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Massachusetts �`
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04Ix1 DEPARTMENT OF BUILDING INSPECTIONS ',.
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\yi tea. 212 Main Street • Municipal Building ,f
T0' Northampton, MA 01060 -l'i 'y" "
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TENT PERMIT APPLICATION
�' � 13.C;\ \ (For Tents over 120 square feet)
vec,` Permit Fee: $25.00 Check#
PLEASE TYPE OR PRINT ALL INFORMATION r
1. Name of Applicant: Sinnij\ Cf1.y t�t✓haaAA ker}enioLJ k'
Address: 1:2,C, tie-14 ST,e0-4 Telephone: No) tr3—atif3
2. Owner of Property: 6 P i.1L C. floe,
Address: Telephone:
3. Status of Applicant: Owner Contractor
4. Tent Location Address): r'�:e-J\LA$h. t 1 ( tk-S Z One,LA ji.trct k+^ 4 e'`'J
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5. Use of Property: Residential: Commercial:
6. Description of Tent:
Size: I - 2® 'n 20 ' iCik
Occupant Capacity: /
Dates of Use: CC Yo �QP 20 , `2.0 i Y (5404..4 7)
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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: e_=L- /OA-M-3 APPLICANT'S SIGNATURE G1F- -
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 C). ssion, Depa,--nt of Public Works and other
applicable permit granting authorities. /
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