31B-221 (13) City of Northampton • 0i Massachusetts lL
D2R OF BUILDING INSPECTIONS
21gain!n Sfi Mun
212 • icipal euildinq
Northampton, MA 01060
F- RECEIVED 316- 1
TENT PERMIT APPLICATION
JUN - 6 2019 (For Tents over 120 square feet)
Drat C=suu MNm INSPFCnONS Permit Fee: $30.00 Check# 715
091 HA*nn�ON.CdA 0 i0Fi0
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: E�lk t L + ` V-Q�
Address: 2- Z3 j )� `lr✓Z K /ST 2102 -f- Telephone: 9 3 —3 --iL
2. Owner of Property:
-- rr.''/YN1 I"N �01� �
Address:/\L 6W 51>7 C jTelephone:
3. Status of Applicant: Owner JJ_Contractor ) ,r 7 � 11II —
4. Tent Location Address): Ir`c-tris j24W k-� � o4 --u4 NAV,J�l�t.,�yr Ilau�.
071 J r'✓1�1..A-.-�✓JG. S
� v^
5. Use of Property: Residential:_ Commercial:
6. Description of Tent:
Size: ZO X20 q5109— 0121111-
Occupant Capacity:/
Dates of Use: t0I i p'I " �✓ II (e
Installer: EK IL. /? UTH-ff IQ
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. /J/, ,�
DATE: le � Zai APPLICANT'S SIGNATURE a r t7 &t,
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.