23B-046 (274) *1C000MW? 3tte'F�be
4s�Teo
City of Northampton
Massachusetts ?' �O5
I�AR38SN3' OF 9OZLOING INSPi XONS i
313 Win Street • Hunicipel Building -�'• `
auNeeptan, M 01060
6P �9-13a9
TENT PERMIT APPLICATION RECE'VED
I n (For Tents over 120 square feet) NAY Z ) 2019
�UY Permit e: S30.00 Check# �kt�7 nEP*oP gurLorNe
N�THAMPTON INSPECTrq.13
AA m,,
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: 30 (e,r�ea1J' [� Telephone: ti13 `S'9Z• 23(3
2. Caner of Property:
Address: O Telephone:
3. Status of Applicant r% Contractor
4. Tent Location Address):
PercellD: Zoning Map* ar rcels VuG Dintdct(ss)
(TO BE FILLED IN BY THE NG DEPARTMENT)
5. Useof Property: Residential:_ Commercial: k
6. Description of Tent
l
Size: i
Occupant Capacity: 2S
08te6 of Use: nF2fD 17
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: i E APPLICANT'S SIGNATURE
NOTE: Issuance of a permit does not relieve an applicant's burden to complyall zoning requirements
and obtain all required permits from the Conservation Commission, Department of Public Works and other
applicable permit granting authorities.
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