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38A-061 (9) Z 70 'C `s ts7 d e � _ Y : 3 0 .. s In Z pm G yZ z . o Ck t � 0 -- �. Zoning Miscellaneous Additions,Repairs,Alterations,etc. Tel.No. �� 1 �, Alterations ti NORTHAMPTON, MASS. 1 T' — 19—,LS Additions ' APPLICATION FOR PERMIT TO ALTER Repair Garage 1. Location ��S f Lot No. 2. Owners name Address 3. Builder's name Address N-y,�_.��. Z w{ ��,,�p�►-��. 1n Mass.Construction Supervisor's License No. C 5-_f� �5��---Expiration Date �, �9 9 4. Addition_��,,. 1c r — A- =:c o 5. Alteration 6. New Porch 7. Is existing building to be demolished? 8. Repair after the fire 9. Garage No.of cars Size 10. Method of heating 11. Distance to lot lines 12. Type of roof c, G 5 h a 13. Siding house 14. Estimated cost- SC The undersigned certifies that the above statements are true to the best of his, he 1 knowledge and belief. Signature of responsible app'icant Remarks a $ � �lasaac4ttsctta ,AW I 11999 DEP`ARTMEN'T OF BUILDING INSPECTIONS DEPT OF SU` 212'Main Street ' Municipal Building ' Northampton, Mass. 01060 WORKER'S COMPENSATION INSURANCE AFFIDAVIT (licenseclPcT ttec) with a principal plact of business/residence at: C:57 (phone#) �J 47) 1 (streei/city/statrlap) qss do hereby certify, under the pains and penalties of penury, that: ( ) I am an employer providing the following worker's compensation coverage for my employees working on this job: (Insurance Company) (Policy Number) (Expiration Date) ( ) I am a sole proprieto general contractor or homeowner(circle one) and have hired the contractors listed below who have the following worker's compensation policies: (Name of Contractor) (Insurance Company/Poky Numbcr) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (Name of Contractor) (Insurance arr4 ny/Policy Number) (Expiration Date) (Name of Contractor) (Insurance Company/Policy Number) (Expiration Date) (attach additi=d shod ifneccauy to inc}ude infocmitioa patnining w all o dradors) (� I am a sole proprietor and have no one working for me. ( } I am a home owner performing all the work myself. NOTE:Please be awaro that wbilo homcowuers who employ Pazo=to do main+�coatvcs.ion or repair work on a dwelling of not mom than throe units is which the homeowner resida or oa the grounds T urtcaad tbencto are cot gaxlally oomakfod to be employers undo the woeiceei compens4oa Ad(GL152,ss 1(5)�application by a homeowner for a license or permit may evideaco tho legal sts>xra of an employer under the Workoes Compemation Act I und=wAnd that a copy of this statement may be forwarded to the Depar nm of Industria!Aoci�O$oo of Irrnusnoo for the coverage verifiestion and that failtme to scarce coverags under soctioa 25A of MOL 152 cera ked to tba imposition of criminal penalties g of a fine of up to 11,500.00 andlor impm of up to one year and evil pcmhia in the form of a Stop Work Order and a 1 f m of 3100.00 141Y agniast me; For&P=ta tabl uw oaly Permit Number �..Cl Map<t Lot# Signat of Lic=seelPermittce 10. Do any signs exist on the property? YES NO V IF YES,describe size,type and location: Are there any proposed changes to or additions of signs intended for the property?YES NO V IF YES, describe size,type and location: 11 . ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE DENIED DQE TO LACK OF INFORMATION. This colu= to be fillad in by the Building Department Required Existing Proposed By Zoning Lot size Frontage Setbacks - frnnt 45- - 5- side L: R: L: R: 7 - rear Building height Bldg Square footage Cf %Open Space: (Lot area minus bldg &paved parking) # of Parking Spaces # 'of Loading Docks Fill: (volume -& location) 13 . Certification: I hereby certify that the information contained herein rf is true and accurate to the best of my knowledge. .1 DATE: - APPLICANT's SIGNATURE \J NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply with all Czoning requirements and obtain all required permits from the Board of Health, Conservation ommission, Department of Public Works and other applicable permit granting authorities. FILE # Tr'� Fi 1 e No. M7 " �ERi of BUsQ_ N PERMIT APPLICATION (§10 . 2) TYPE OR P=T ALL INFORMATION 1. Name of Applicant: o � Address: � �U`�`n v�t,.SS Telephone: \s -�— 2. Owner of Property: ', V"' P Address: 5 SA' ,c7g C Telephone: �-( 13 - 3. Status of Applicant: Owner V Contract Purchaser Lessee Other(explain): 4. Job Location: �e W-� S� S�r�e ��' -' Parcel Id: Zoning Map# Parcel# � District(s): (TO BE FILLED IN BY THE BUILDING DEPARTMENT) 5. Existing Use of Structure/Property �� rl 6. Description of Proposed Use/Work/Project/Occupation: (Use additional sheets if necessary): c' cT-y- 7. 7. Attached Plans: Sketch Plan v Site Plan Engineered/Surveyed Plans Answers to the following 2 questions may be obtained by checking with the Building Dept or Planning Departinent Files. S. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO_ V DON'T KNOA YES IF YES,date issued: IF YES: Was the permit recorded at the Registry of Deeds? NO V DON'T KNOW YES IF YES: enter Book Page and/or Document# 9. Does the site contain a brook, body of water or wetlands? NO DON'T KNOW YES IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained Obtained ,date issued: (FORM CONTINUES ON OTHER SIDE) File#BP-1999-0625 APPLICANT/CONTACT PERSON ROBERT D THIBODO ADDRESS/PHONE P O BOX 201(413)527-8966 PROPERTY LOCATION 178 WEST ST MAP 38 PARCEL 061 ZONE URB THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT ✓ Fee Paid Buildintr Permit Filled out Fee Paid ' Typeof Construction: STORAGE SHED OFF MAIN BARN ✓ New Construction X L"6 Non Structural interior renovations Addition to Existing Accessory Structure Building Plans Included: Owner/Statement or License 065699 3 sets of Plans/Plot Plan THE,XOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION: ,Approved as presented/based on information presented. Denied as presented: Special Permit and/or Site Plan Required under: § PLANNING BOARD ZONING BOARD Received&Recorded at Registry of Deeds Proof Enclosed Finding Required under: § w/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed Variance Required under: § w/ZONING BOARD OF APPEALS Received&Recorded at Registry of Deeds Proof Enclosed Other Permits Required: Curb Cut from DPW Water Availability Sewer Availability Septic Approval Board of Health Well Water Potability Board of Health Permit from Conservation CommiSsio n Signature of B 'lding Official Date' Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning requirements and obtain all required permits from Board of Health,Conservation Commission,Department of public works and other applicable permit granting authorities. w 178 WEST ST BP-1999-0625 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 38 -061 CITY OF NORTHAMPTON Lot: -001 Permit: Building Category: shed BUILDING PERMIT Permit# BP-1999-0625 Project# JS-1999-1186 Est. Cost: $5500.00 Fee: $40.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: ROBERT D THIBODO 065699 Lot Size(sg. ft.): 184258.80 Owner: Smith College Zoning: URB Applicant: ROBERT D THIBODO AT. 178 WEST ST Applicant Address: Phone: Insurance: P O BOX 201 (413) 527-8966 NORTHAMPTON 01061 ISSUED ON:1/14/99 TO PERFORM THE FOLLOWING WORK.STORAGE SHED OFF MAIN BARN POST THIS CARD SO IT IS VISIBLE FROM THE STREET Inspector of Plumbing Inspector of Wiring D.P.W. Inspector of Buildings Underground: Service: Meter: Footings: Rough: Rough: House# Foundation: Final: Final: Rough Frame: Gas Fire Department Fireplace/Chimney: Rough: Oil: Insulation: Final: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF ANY OF ITS RULES AND REGULATIONS. Certificate of Occupancy Sip-nature: Fee Type: Receipt No: Date Paid: Check No: Amount: Building 1/14/99 $40.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo