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38B-006 (51) City of Northampton �g �%©� � � Massachusetts 4 � w i sk a DEPARTMENT OF BUILDING INSPECTIONS rJr M } M 212 Main Street o Municipal Building f Northampton, MA 01060 ��0►4 u 5 1 TENT PERMIT APPLICATION &Gas Inspections �� E�eo+� plumbing .I„a°''0°0 (For Tents over 120 square feet) Permit Fee: $25.00 Check# PLEASE TYPE OR PRINT ALL INFORMATION 1. NameofApplicant:_ ,Sm1Jk C-ull!�Cj_ ` RcL,—A �Op}eh{p �oV` Address: UG Oc„t4 SL-ea-1 Telephone: (qff) C8. -zgrS 2. Owner of Property: Address: Telephone: 3. Status of Applicant: Owner Contractor 4. Tent Location Address): �33 Elm Alur w-te kor-o t Po n I�e�1•hi�'1 �y �$`�iS�r0.�4'un ��"l� PTO SE'FILLED�IN,BY THE BU1L-DItJ�bEi?AR�,MEN,TY 5. Use of Property: Residential: Commercial: 6. Description of Tent: Size: i-20 1x301 c,h� I w 20 N, C�n•,�cle9 Occupant Capacity: Dates of Use: -is-2ot4 -Z$ -2o N fin,-V.J"3 t-N4I laj Zoi`1 r>erniMj 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: APPLICANT'S SIGNATURE )w 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._