31B-253 (21) City of Northampton
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TENT PERMIT APPLICATION
2 16 3 h
(For Tents over 120 square feet)
Permit Fee: $30.00 Check#�U
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PLEASE TYPE OR PRINT ALL INFORMATION
I. Name ofApplicam:_ Smith College Richard Korzeniowski
Address: 126 West Street Telephone: (413)585-2458
2. Owner of Property:_,
Address._,_ Telephone:
3. Status of Appncant:_Owner _Contractor
4. Tem Location Address}: 33 Elm Street-Front Lawn of Alumnae House
Registration Tents
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(CQ,&E.E,&E.EI pjNBY 7NEb lJ)INCi DEPARTMENT)
5. Use of Property: Reseer ialr_ Commercial_
6. Description of Tent:
Size: 1-20' x 20' and 1-20' x 30'Tent
Occupant Capacity.
Dates of Use: May 16,2019 to May 29.2019
Inspection May 15, 2019 after 12:00 (noon)
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: Y-26 -2019 APPLICANT'S SIGNATURE�� �
NOTE:Issuance of a permit does not relieve an applic;mi burden to comply with all zoning requirements
and ObtWn all required permfts from the Conservation Commission, Department of Public Works and other
applicable permit greneng authorities.