38B-006 (72) City of Northampton
Massachusetts ;
iii OF BUILDING INSPECTIONS-V� treet • Municipal Building
AUG � q' thampton, MA 01060
ry
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EJectric
NortharnpItIq Uas Insp
017,
01 PERMIT PERMIT APPLICATION
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(For Tents over 120 square feet)
Permit Fee: $25.00 Check #
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: Ml k G,1k5@ f�ichv�t� j'(�yl}ehapt�;��y
Address: )2G Oe.J4 Telephone: (q13)
2. Owner of Property: A C. /I e15 0—
Address: Telephone:
3. Status of Applicant: Owner Contractor `
4. Tent Location Address): f V t C Unn e-1 Cutif t Yc �r A
�L T iCc e.
5. Use of Property: Residential: Commercial:
6. Description of Tent:
e
Size: -@ ;2- I P^
Occupant Capacity: (�
Dates of Use: q 16 ``s '� 1 '22-' 2,0 1'�
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: r�" "2J 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 Jf Public Works and other
applicable permit granting authorities._
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City of Northampton
Massachusetts '
NT OF BUILDING INSPECTIONS ) ..
in Street • Municipal Building
Northampton, MA 01060
�! AW 2 8 2015
Electri, ih bin&Ga mP T PERMIT APPLICATION
(For Tents over 120 square feet)
Permit Fee: $25.00 Check #
ii iih
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: Sint-t C llg�e R c,ko A k o o-e,,o L,)j k,
Address: )2(, L)cij S-I/-e Telephone: (q 1j) �ig�"Z���
2. Owner of Property: c3 rh , k C. /I'e5q,
Address: Telephone:
3. Status of Applicant: Owner Contractor
4. Tent Location Address): nfi t eJ,���in Ill3%�kS Q 6%,c k ts✓r�.
f e�A , CG
��O.;�BE�FILL�ED�ft�1 E�UILTJIIJ�EP�R,.�iMENT�
5. Use of Property: Residential: Commercial:
6. Description of Tent:
Size:0-20',Q0i) t
Occupant Capacity:
Dates of Use: Cf(c&. ( Sgeltr`i
c' j ��0 J ((
I'Ly�..Uj �!�
�1n j�C:.l r�i� yL✓ S�.�7'(11117.r i ��LVr� L'ti7 e� Jv)
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
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, Depart nt of Public Works and other
applicable permit granting authorities._ l
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