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16A-002 (15)
City of Northampton Massachusetts w c s xxtl?"'affiPl' of 8171rwG IIrBPtCTICwa 2 ;pe 212 Hain Btraat a l ieipal Building 0 Northampton, NA 01060 --'� LETCEVED TENT PERMIT APPLICATION 2018 (For Tents over 120 square feet) DEPT OFFUIN 'OPT HAMPTON, SPECnMF0IIXA'ON4 Permit Fee: $30.00 Check# 319 P- r8- PLEASE TWE OR PRINT ALL INFORMATION 1. Name of Applicant C k lS¢ow �&t b r JCo T'rt SK FES7-'1 VA'1- I INC, Address: P. 0. 6o II"1 KLAHb wK) Ma © l)O Telephone: 2. Owner of Property: l..00K ?Air t< Address: 366 /4 H*W ST-,? FWIt.67,1« M Telephone: 41.3 -S-PY -6-YI-9 3. Status of Applicant:_Owner Contractor 4. Tent Loosion Address): 40K (PhCA/K I /t}!)/ '0/[C F- " 5. Use of Property: Residential:_ Commercial:X 6. Description of Tent: Size: 4A X Occupant Capacity: UXI KNCt✓ A/ Datesof Use: JyL-f 21 ?-018 To BE s'tT uP 7 26//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 best of my knowledge. DATE: Lr�Y�/� APPLICANT'S SIGNATURE oh NOTE:issuance of a permit does not relieve an appikent'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 autitodties.