31B-253 (14) City of Northampton
Massachusetts
} _`L'.3471 DEYARTMENT OF WILDING INSPECTIONS pt /r
Tt. . y 212 Main Street • Municipal Building (
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Northampton, MA 01060 SYIY }_" /^�}
r _ TENT PERMIT APPLICATION
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!` 2 3 ! (For Tents overt 20 square fecet)t) /
°Fpr1 at Permit Fee: $25.00 Check # !3 CY0 -
,.:;....» :7;:"us 640
PLEASE TYPE OR PRINT ALL..INFORMATION
1. Name of Applicant SMri'k Co)j p, ' LA kor3Cn.0 LJJ
Address: )2f; Uci4 S}rec.} Telephone (tt13) c-24c3
2. Owner of Property: 6(htIL C o e,
Address: Telephone'.
3. Status of Applicant: Owner Contractor
4. Tent Location Address): A LaMne, Otw,>C flow
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37 Elul Si/en
PleVeit foeleari,g btrf.,:3S:tz a of��k:k*��.�, " pile aL:,'`stl` ;ra'f't- wE',)`` 1:, ,-,
c rtNa I3 ETeUILPMO`IIEPF n
5, Use of Property: Residential: Commercial'.
6. Description of Tent:
rr }rA)
Size 20 30' Peak r 2u '�26 (n��- Cs�lrtfa
Occupant Capacity
Dates of Use Mny is , 20 Id }ohay 1? , 2016
9Inn c , S-Q-zaiL cf'Lr l2ac. ur ,
7, ALL INFORMATION MUST BE CIU _ETED P MIT CAN = SEWED DUE TO LACK OUNFORMATION.
8. Certification: I hereby certify that the information contained herein is true and accurate to the best
of my knowledge.
DATE: S _1 I - 2u 1 b APPLICANTS 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._
6I°— �Ce -/22