39-060 (23) City of Northampton
- 24c
> Massachusetts
bi
\ S DEPARTMENT OF HULLOING INSPECTIONS 212 Main Street •• Municipal BUildino
Northampton, MA 01060 4 /Y P
+1' !' Ja
TENT PERMIT APPLICATION
(For Tents over 120 square feet)/'�/
Permit Fee: $30.00 Check# /off /
r _ PLEASE TYPE OR PRINT ALL INFORMATION.
1. Name of Applicant WOW ,)\dtI1 { lIN1 _ `Cart. (^ qAddress: 0 . - � r , 1 it L 1 " one: a113}SSZ'L(.rlO
2. Owner of Properly: a2.T _pA ^A��sco6l&€ �t y��.�
Address: ]l) SI It'*tit MLWY WY, Tetephone(jl%) TY9— J't W
3. Status of Applicant: Owner( Contractor ��....nn h ���� ,,�L��
4. Tent Location Address): A"k4Q��INL�) ge�T�4lyN.e!`Wl
_ .. _.
Parcel ID: Zoning Map# ` Parcel# -- DEiNTs)
E9
(TO BE FILLED IN BY.THUILDING�DEPARTMENT)
5 W \ 1
se of Property: Residential: Commercial: C
6. Description ofTent;
Size: tQf0 X'T0 `,/
Occupant Capacity: 1w
Dates of Use: 1(1) P
7. ALL INFORMATION MUST BE COMPLETED:PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION
B. Certification: I hereby certify that the information contained herein is true and accurate to the bast
of my knowledge.
DATE: (kIaQ /id 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.