38B-006 (109) City of Northampton
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'= DEPnRTMENT OF auZLpSNO INSPECTIONS
222 Main Street • MnMACi010 euiltlSng
:7;04%N* Northampton, MA 01060 �Ssisr" ...t
TENT PERMIT APPLICATION U(p
t7
(For Tents over 120 square feet) �"
Permit Fee: $30.00 Check #270446
670446 7
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PLEASE TYPE OR Pih;NT ALL INFORMATION
1. Name of Applicant $niFL Go Iie34, (3„LLJi Ron em c 14.4 k,
Address. IIL h.1Q1)- ,c)fre€ Telephone (`1i3) 665- 2Li6
2. Owner of Property:
Address. Telephone.
3 Status of Applicant: Owner Contractor
4 Tent Location Address)._ 14 LJ^✓4- J}' '. 0
‘ }ParTin lo,Y.,5 '1‘ 41-
Parcel
cel ID: Zoning Map# Parcel# District(s)
(TO BE FILLED IN BY THE BUILDING DEPARTMENT)
5 Use of Property: Residential. Commercial_,.,
6. Description of Tent.
Size._ 1 ` 10 n 3e leo)
Occupant Capacity.
Dates of Use: Ma/ 13 2013 }a )Uvt0 1 l i01
Pio,,, TAapra MAY 1e.='-,zol}
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:�T I.)- 20I 3- APPLICANT'S SIGNATURE jA�
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.