31B-203 (10) City of Northampton
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DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building 5
NarNempton, MA 01e60
aQ '2 TENT PERMIT APPLICATION
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3� (For Tents over 120 square feet)
Permit Fee: $30.00 Check#
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant Smith College Richard Korceniowski
Address. 126 West Street Telephone'. (413) 585-2458
2. Owner of Property.
Address'. Telephone.
3. Status of Applicant._Owner _Contractor
4. Tent Location Address). Campus School (Gill School)
33 Prospect Street
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5. Use of Property. Residential:_ Commercial.
6. Description of Tent.
Size'. 1 -20' x 20' Tent
Occupant Capacity:
Dates of Use: Friday,April 26th, 2019
Inspection Thursday May 25th, 2019, After 12:00 Noon
7. ALL INFORMATION MUST BE COMPLETED PERMIT CAN BE DENIED DUE TO LACK OF INFORMATION.
e. Certification: I hereby certify that the information contained herein is true and accurate to the best
of my knowledge.
DATE: L+- 2G' W9 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.