16A-002 (18) City of Northampton
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DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
�.: Northampton, MA 01060 ssi' •., e'
CEIVED
JUN 2 7 2022 TENT PERMIT APPLICATION
6A-AA' 7C/I)
DEFT. F (For Tents over 120 square feet)
BUILDING INSPECTIONS
NORTHAMPTON,MA 01060
eTIinit Fee: $30.00 Check# 3Y39
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant: 6..)cAscoud LC —ivl�r C vTYi CH FBI vIft_, /`l C
Address: n t7 (3.0A b1trV)rOt) 144 nog- Telephone: 1143-S'`—d,S'S''O,Plrr
2. Owner of Property: /�,/ /�
Address: 3co f !/!N ' i 'FwXM t6t)14 Telephone: 9a " y
3. Status of Applicant: Owner (X' Contractor
4. Tent Location Address): L Oo� �RLK 4Ix1 4t� Ft c2)
5. Use of Property: Residential: Commercial:
6. Description of Tent:
Size: 4710 I X /CV
Occupant Capacity:
^^ U ,.,airc w,.✓
Dates of Use: VUt-y 14 2O2 2. (-rb gc 5ir'r uP 7//d ZOZZ�
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: 1012-211-2- APPLICANT'S SIGNATURE �Gv`r2
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.