18D-001 ,mak City of Northampton
Massachusetts �®
l r
y DEPARTMENT OF BUILDING INSPECTIONS ,
212 Main Street Municipal Building
Northampton, MA 01060 A a
!—
TENT PERMIT APPLICATION l
ADR 7 '";.
(For Tents over 120 square feet)
Permit Fee: $30.00 Check # I '1$ 0 }Vt.
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: 1/5' t /'ODa5
Address: 13 Co N o r-rk r� N c S T r`et-C Telephone: Y 13 -- 3 `/S - 6
998
2. Owner of Properly: 6,5 'f FOO I S
Address: 2I `IS Roo5EY6.I71- A✓e- SiA(tr4 M' Telephone: �/ 13 " 7gy " 06ob
3. Status of Applicant: ✓Owner Contractor
4. Tent Location Address): / 3G toorThh L;,a ST ec- -
Parcel 10: Zoning Map# Parcel# District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5. Use of Property: Residential: Commercial: t/
6. Description of Tent:
Size: a 0 X ra U `
Occupant Capacity: 4'0 11
Dates of Use: ue bw+ /VIAS! aNC QO i-'N ura /14A ;• 3 %`�
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. �7
DATE: `1 -I LI- 17 APPLICANT'S SIGNATURE -C W
NOTE: Issuance of a permit does not relieve an applicants 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. �// a g-72-72
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RED TEXTURED R=35'
C• .- 30' WIDE PAVEMENT WITH WHITE /1/ IQ
EYP ) V TRAVELWAY / B R STRIPES (TYP.)
/c / / g,
m n u
noR taanc ran RENTAL CENTER INC
NORTHAMPTON RENTAL CENTER, INC 496
59 Service Center Road 93 SERVICE CENTER RD
NORT5nnr ure MA 61068
Northampton,MA 01060 Open
413-564.5072
NORTHAMPTON RENTAL CENTER Save
Tel: 413/6$45072 Save Term 102 ID: 240662924
www.northamptonrentaicenter.com '`^^ 1° 5954
out Sale
Due VISA-PURCH
XXXXXXXX8XXX3258
Entre flatbed: Manual
Awed: Online Batchlt: BRB001
big y 04/12/17 11:16:18
north king st AVS code: a
ncthampton, ma 01060 Cvu2 Cod., x
illtiiiiiiiiiiiilikaillilki
cu_C 6. 1
Tel: 218-9860 Customer ID 24266 Invl 00880883 Accr Code: 0099
A989066: t 109879.63
Rental Reservation az: $ 0.08
Total: $ 1.038.63 I
Rental Items
2Ea Frame Tent,20x20-frame (Kit) r"'s°e^ F°°•
4 Ea Sides,Tent, 30', solid nlaxR YOU
4 Ea Table, _8' BANQUET l
80 Ea Chair, brown samsonite l
Check visa 04/12/2017 1,098.63 Party rental 44.00
Tent rental 870.00
Chair rental 120.00
Subtotal 1,034.00
T1: Ma sales 64.63
Total Charges 1,098.63
Deposit 1,098 63
Sign Name Print