38B-006 (60) City of Northampton
Massachusetts
DEPARTMENT OF BUILDING INSPECTIONS r'�r
�? 212 Main Street • Municipal Building tz
Northampton, MA 01060
JUL 4
TENT PERMIT APPLICATION
Ep; c-r:ne., Gas Inspections
,060 (For Tents over 120 square feet)
Permit Fee: $25.00 Check#
PLEASE TYPE OR PRINTALL INFORMATION j
1. Name of Applicant: S n� k Coij!?5e `��� ti oo-enio W:1l��,
Address: i)-G 00-ij S1/-J Telephone: (q13) C_zgfS
2. Owner of Property: c�(�� �v n esq_
Address: Telephone:
3. Status of Applicant: Owner _Contractor
4. Tent Location Address): uC11rAA
4� l-k"D n fi�lZ
ParcellDZonmg`MaP# Parcelzrr
DR&o F1LLED 11J BY;THEBUILDI�IG bFPAR RM
5. Use of Property: Residential: Commercial:
6. Description of Tent:
Size: Z " 9�X lU ' Tew.! C NAZ 'A
Occupant Capacity.-
Dates of Use:
ap�Cr
7. ALL INFORMATION MUST BE COMPLETED: PERMIT CAN BE DENIED DUE TO LACY OF INFORMATION.
8. Certification: I hereby certify that the information contained herein is true and accurate to the best
of my knowledge.
DATE: 'z'201�( APPLICANT'S SIGNATURE
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._