18C-018 PROPOSAL
The Jubb Co., Inc. d.b.a.
MA Registration 100001
LARRY JUBB'S MA Cons. Sup. Lic. 055333 Page2of2
IMPROVE - ' OM
7 Devens Street P.O. Box 51
P.O. Box 429 Hatfield, MA 01038
Greenfield, MA 01302 -0429
(413) 772 -6217 (413) 504 - 3716
I■tIONL DA1E
f(D: LaFreniere, John 586 -3 -646 !-
JOU NAME / LOCAI ION
293 Hatfield Street
Northampton, Ma. 01060 Vinyl Siding installed to:
293 Hatfield Street
Northampton, Ma.
,1011 NUMUI :I I JOB PI IONG
Jo hereby submit specifications and estimates tor:
9 ). to remove and re- install door canopy.
10).not to cover front window frames as they are presently covered.
11).to repair lower rotted sheathing of rear wall at left of rear door as facing. up
approximately 2'... to use 1/2" pressure treated plywood.
SERVICE FEE $250.00: (includes permit & disposal of all job related refuse).
(service fee amount not included in total below & is to be billed at job completion].
We Propose hereby to runtish matetial and labor — complete in accordance will' the above specifications, Ior the sum oI:
- r , • . r r • 4110" , $ e '0 • -v- . n• 01 111 Doll. dollars ($ / 1 )•
Payment to be made as follows:
$2,000.00 DEPOSIT UPON ACCEPTANCE. INVOICES ARE DUE UPON RECEIPT! An interest charge of 2%
per month (24% per annum) on past due balances, plus all costs, including reasonable
attnrnpy's Epps, incurred is collecting any sums owed.
All material is guaranteed to bo as specified. All work to bo completed in n professional
manner according to standard practices. Any alteration or deviation Iron atxrvu specifier Authorized VCR--
lions involving extra costs will be executed only upon written ordors, and will become an Signature �;jliV
extra charge over and above tho estimate. All agreements contingent upon strikes, accidents
or delays beyond our control. Owner to carry fire, tornado, and other necessary insurance. Note: This proposal rr be
Our workers are fully covered by Worker's Compensation insurance. withdrawn by us if not accepted within 30 days.
Acceptance of Proposal — The above prices. specifications and
conditions are satisfactory and are hereby accepted. You are authorized to do the work Signature , I i i. _ �� �� L
as specified. Payment will be made as oultin d ab tve.
.../ � ! � �
Date of Acceptance:.....---- .- -. -... (� � b .
,e=
. .
PROPOSAL
The Jubb Co., Inc. d.b.a.
LARRY JUBB'S MA Registration 100001
MA Cons. Sup. Lic. 055333 Page 1 of 2
IMPROVE -A- • TM
7 Devens Street P.O. Box 51
P.O. Box 429 Hatfield, MA U1038
Greenfield, MA 01302 -0429 Northampton, MA
(413) 772 - 6217 (413) 584 -3716
1'I IONE FJATE
TO: LaFreniere, John 586 - 3646. ________ _ ..0.5.L18,L1..Q____- -_.___
Jul! NAML / LODU ION
293 Hatfield Street
Northampton, Ma. 01060 Vinyl Siding installed to:
293 Hatfield Street
Northampton, Ma.
-_
Jul! •Iu:11 JUl! PIIUNL
A
Wo hereby submit specifications and estimates for:
•
- SUPPLY & INSTALL MASTIC OVATION WOODGRAIN VINYL SIDING-
- width: (4 ")
- choice of siding color: ( ) corner color: ( )
- *trim color: *all trims to be WHITE unless otherwise specified. *an additional charge may
apply. ( *SPECIFIED TRIM COLOR: ) *trim colors for: soffits, fascias, j- channels,
window & door casings, light blocks, louvers and other accessories.
- 3/8" *backer beneath siding. *(substrate /SUBSTRATUM, wall leveler).
- to nail siding approximately 16" on center & according to manufacture specs.
- replace minor areas of exterior sheathing wood rot. (replacement allowance of up to a total
of 3 @ 7/16" each osb sub sheathing).
- vent all soffits where possible to heated areas of main house only. excludes side peaks.
- install center vented vinyl soffit panels on all applicable overhangs.
- install j -block light blocks and dryer vents as necessary. excludes furnace & stove vents.
-rake and broom clean job site at end of each working day.
- lifetime manufacture guarantee on Vinyl Siding.
-labor guarantee as required by MA building regulations and standards.
NOTE:
1). siding will be horizontal.
2). to repair rotted fascia (roof edge board) at driveway side front corner.
3). to clad horizontal board at bottom edge of gable peaks.
4). not to cove rear door frame. .
5). to remove orange extension cord and replace after siding installation.
6). a/c pipe clips to be loosend to allow siding installation behind pipes.
7). not to cover redish brown wall area at front.
8). to remove shutters. *not sure if they can be re- installed as they are tightly attached to
the • - ...• • - ". • - •41- slamag.e.4!_ during. removal. Jubb cannot be responsible. We willdo
WirP19360SC hereby to furnish material and labor -- complete in accurdance will the above specilications, for lho sum of:
font' d dollars ($ Cont'd )•
Payment to be made as follows:
$2,000.00 DEPOSIT UPON ACCEPTANCE. INVOICES ARE DUE UPON RECEIPT! An interest charge of 2%
per month (24% per annum) on past due balances, plus all costs, including reasonable
All material is guaranteed to bo as specified. All work to bo completed In a professional c.. manner according to standard practices. Any alteration or deviation horn above specilica- Authorized (. / /�J ����/
lions involving extra costs will be executed only upon written orders, and will become an Signature V [k•
�
extra charge over and above the estimate. All agreements contingent upon strikes, accidents
or delays beyond our control. Owner to carry lire, tornado, and other necessary insurance. Note: This proposal may be
Our workers are fully covered by Worker's Compensation insurance. withdrawn by us it not accepted within 30 days.
Acceptance of Proposal — The above prices, specifications and , I � A�
conditions are satisfactory and are hereby accepted. You are authorized to do the work Siynalure t
as specified. Payment will be made as outlined be .
Signature
Dale of Acceptance:.___.__.. _._... ...4 . /4 / V .
The Commonwealth of Massachusetts
=w_ Department of Industrial Accidents
It
4.4 �i:� Office of Investigations
_i =M= _ 600 Washington Street
. �, = ie G Boston, MA 02111
www mass.gov /dia
Workers' Compensation Insurance Affidavit: Builders /Contractors /Electricians /Plumbers
Applicant Information Please Print Legibly
Name ( Business /Organi/Individual): I ILL _ J
zation u r, �� Ol ti l ��c /`I _� Y
Address: 0. go,
City /State /Zip: f. 7 - �_ �-� l Phone #: (K' ( / 7
Are you an employer? Check the appropriate box: 'Type of project (required):
1. ❑ I am a employer with 4. ❑ I am a general contractor and 1 6. ❑ New construction
employees (full and /or part-time).* have hired the sub - contractors
2. ❑ I am a sole proprietor or partner- listed on the attached sheet. t I ❑Remodeling
ship and have no employees These sub - contractors have 8. ❑ Demolition
working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition
[No workers' comp. insurance 5. ❑ We are a corporation and its
required.] officers have exercised their 10.0 Electrical repairs or additions
3. ❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions
myself. [No workers' comp. c. 152, § 1(4), and we have no 12. ❑ Roof repairs
insurance required.] t employees. [No workers' 13.0 Other
comp. insurance required.]
*Any applicant that checks box N1 must also fill out the section below showing their workers' compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
Contractors that check this box must attached an additional sheet showing the name of the sub - contractors and their workers' comp. policy information.
I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: , e ) -1- f �, ���'C� t "1
Policy # or Self -ins. Lic. #: {� 4' C v C Expiration Date: 5 3 /)
Job Site Address: City /State /Zip:
Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and /or one -year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct.
Signature: �-- e' —i�, Date:
Phone #: - 7 " ( 7
Official use only. Do not write in this area, to be completed by city or town official
City or Town: Permit/License #
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6. Other
Contact Person: Phone #:
119/F1 /201E1 15:52 41.363'3658 AHRIST PAGE 01/01
•
‘„ _ CERTIFICATE OF LIABILITY INSURANCE 05/07/2010
PRODUCER Phone 4171 - 437.3 r -:., 413.883•sBEU THIS CERTIFICATE IS ISSUEr) AS A MATTER OF INFORMATION
A.H. RIST INSURANCE AGENCY, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
159 AVENUE A HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR •
P.0, BOX 391 ALTER THE COVERAGE AL FORDED BY THE P9L1'2IES PEI,OW,
TURNERS FALLS MA 01376
INSURERS AFFORDING COVERAGE NAIL it
INSURED INSURER A; PEERLESS INSURANCE COMPANY
THE JUBB COMPANY, INC. INSURER B!
P.O. BOX 429 INSURER C:
GREENFIELD MA 01302
INSURER D:
INSURER E:
COVERAGES
TI.IE POLICIES OF INSURANCE LISPED L'FLOW HAVE BEEN ISSUED TO Tlir_ INSURED NAMED ABOVE FOR THE roucv PERIOD INIbICATED, NCTNITI ISTAN'C'I•. ± ^_—
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR UT!•IER DOCUMENT 'PITH-' RESPECT TO WHICH THIS CEHtiFiDATE MAY DE IS L:ED OR
MAY PERTAIN, THE INSURANCE AFFORDED DY THE POLICIES CESCRIRp HEREIN IS SUO.'ECT TO ALL 'NE TERMS, FY,C:LUSICNS AND CON`.)ITIoNS '0F' S :_
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED 13Y PA'D CLA; %AS
INBR AOD'L POLICY EFFECTIVE POLICY EXPIRATION
L *F 1N3;C TYPE OF INSURANCE POLICY NUM qAT . IIA'A+DDM(I DATC U.1R1; LIMITS
GENERAL LIABILITY CBP 8661749 05/03/10 05/03/11 EACH OCCURRENCE •= 1,000,000
X COMMERCIAL GENERAL LIABILITY � TO REN
T O ,r 100,000
REMIaG3 ;En ocauran_n)
CLAIMS MADE 1101 OCCUR h(r6, EX(' (Any ono no•'e_0) S 15,000
A PERSONAL F, ADV INJUP,Y 2 1,000,000
GENERAL AGGRr_CiATE 2.000,000
GEN I_ AGGREGATE LIMIT APPLIES PER: PRODUCT; - COMP /OP ACC g, 2,000.000
PRO -
POLICY ri Jr-CT, . [ .-0C ...
AUTOMOBILE LIABILITY CA 8669247 05/03/10 05/03/11 coMOINFD SINOI. LIMIT :a 1,000,000
ANY AUTO (FR dc:Id•nt)
ALL OVJNED AUTOS BODILY INJURY
X SCHEDULED AUTOS IPOr porron) '^
A X HIRED AUTOS I
_ 13GD I Y INJURY
X NON -OWNED AUTOS I-'or ocei6ant)
PROPERTY DAMAGE'
;PQrecclDonti $
! GARAGE LIABILITY N/A AUTO CNI.Y - EA ACCIDENT m
• ANY AUTO OTI4FR THAN EA ACC
AUTO ONLY AC"
t'X0 E$Sl UMBRELLA LIABILITY N/A EACH OCCURRENCt'
OCCUR n CLAIMS MADE AGGREGATE c.
e
DEDUCTU.E 1
I TENTON S .
• WORKERS COMPENSATION AND WC 8664947 05/03/10 05/03/11 X I TOR' uNIT3 I I cTHI'R
EMPLOYERS' LIABILITY Y / E.I. EACH ACCIDENT >• 100,000
A ANY PRDPRIETORiPARTNRyRIEXF ;CUTIVt; Li
OFFICER/MEMBER EXCLUDED? F L. DISEASG•FA EMPI OYES 500,000
IMnndntnry In N$II
Itycs, dd5anacUnder F,1., DISEASE-POLIC.YLIMIT ` 100,000
^ePCG61L PF.ovisioN8 bcl. _
OTHER N/A
DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
CLASSIFICATION: CARPENTRY /SIDING INSTALLATION
WORKERS COMP POLICY INCLUDES COVERAGE FOR CORPORATE OFFICERS
CERTIFICATE HOLDER CANCELLATION
THE JUBB COMPANY, INC. SHOULD ANY Or TI•IE ABOVE, DESCRIBED PCI,ICIF.S GI: CAMCr_L_ED S,.•CRF II
EXPIRATION DATE_ THFRF•;)P, T■'I[ iSf..iL'J•D3 INSURER WILL E'4DEAVOR 17.: MAIL. L;' ,hvS
P.O. BOX 429 WRITTEN NOTICE TO N-IP CERTFLCAT= I IOLnER NAMED TC TI d-. 1.1-.1 - I BU" ; A L IRE. T
GREENFIELD MA 01302 DC SO SI - TALI. nnFOse NO Cr+LICATION OR. LIAkILITV cr• ANY KIND .J=n;. f1 -n- INS JI•.ER. T s
AOI,r OR REPRESENTATIVES
AUTHORIZED REPRESENTATIVE
� -� --":
Attention: "`YaceWfi. Qk +r�ICZ
ACORD 25 (2009/01) Certifleste it 22985 O 1988.2009 ACORD CORPORATION, All rights reserved,
The ACORD name anc logo are registered marks of ACORD
•
•
• .. . • AFFIDAVIT • . . • • • •
• • . As a result of the provisions of MGL c 40, S54, I acknowledge that as a condition of Building Pe :
. Number • all debris resulting from the construction activity governed by this
• •; Building Permit shall be disposed of in a properly licensed solid waste disposal facility, as defined by MGL .
c 111, S 150A_ . •
I certify that I will notify the Building Official by • . •
. (Two months maximum) of the location of the solid waste disposal facility where the debris resulting from ,
. the. said construction activity shall be disposed of, and I sba11 submit the appropriate forr.for attachment
• .. to the Building Permit
'` cM f -
, I ; • _: I.--
.
• • . • Date Signature of Permit Applicant
. ' (Print or type the following information) lob .
•
•
• Name of Permit Applicant
• •
. 1 k e J ( a • • s
. • Firm Name,. if any •
•
. • . . • • Address .
. • ••••Tire "dbris' `i•ri.11 be': dispose ..
i c_I-10 CO A • . " . • •
(Location of Facility)
•
•
•
•
•
•
Nlas.aclioset - Departincnt of Public Safe(
Board of Building Het...illations and 'Niandards
N 1/4 - (:onstruct Ion `:,iii) 1
License: CS 55333
Restricted to: 00 •.?+
LAWRENCE A JUBB JR
PO BOX 429
GREENFIELD, MA 01302 -
Expiration: 5/21/2012
TO: 24599
?7%e -� e
Office of Consumer Affairs and usi ness Regulation
I
- =
^__• 10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 100001
-t 1/ 1 Type: Private Corporation
l 7 4 11 r 1 J Expiration: 6/8/2012 Tr# 297762
The Jubb Company, Inc . i +`� ' ; -,'
Larry Jubb 1 ;
P. O. Box 429 \, E I' , , i
Greenfield, MA 01302 i i r =/
.; i. f l ‘, Update Address and return card. Mark reason for change.
Address Ei Renewal Ej Employment ❑ Lost Card
)PS -CA1 0 50M- 04/04- G101216
34
`,
- ,
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor:
' ,^ Not Applicable ❑
Y
Name of License Holder : .C C.l) + r- ( e ) �`�� j , 3 3
License Number
gam* 0-9 s , Q-I 11
Address 1 Expiration Date
Signature Telephone
9. Realstered Home ImprovementContractor Not Applicable ❑
- --�-�, e- Jh C o / OO CO )
Company Name Registration N mbar
00 o J1
Address - `
Expiration Da � � —
G'
Telephone
SECTION 10- WORKERS' COMPENSATION IN i RANCE AFFIDAVIT (M.G.L. c. 152, § 25C(6))
Workers Compensation Insurance affidavit • st be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the buildin c permit
Signed Affidavit Attached Yes a No ❑
11. - Home Owner Exemption
The current exemption for "homeowners" was extended to include Owner - occupied Dwellines of one (1) or two(2) families
and to allow such homeowner to engage an individual for hire who does not possess a license, provided that the owner acts
as supervisor. CMR 780, Sixth Edition Section 108.3.5,1.
Definition of Homeowner: Person (s) who on a parcel of land on which he /she resides or intends to reside, on which there
is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/ or farm
structures. A person who constructs more than one home in a two -year period shall not be considered a homeowner.
Such "homeowner" shall submit to the Building Official, on a form acceptable to the Building Official, that he/she shall be
responsible for all such work performed under the buildine permit.
As acting Construction Supervisor your presence on the job site will be required from time to time, during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152 (Workers' Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death) of the Massachusetts General Laws Annotated, you may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned "homeowner" certifies and assumes responsibility for compliance with the State Building Code, City of
Northampton Ordinances, State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
��
SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable)
New House [] Addition ❑ Replacement Windows Alteration(s) Q Rooting Q
Or Doors 0
Accessory Bldg. ❑ Demolition ❑ New Signs [DJ Decks [O SidIng Other [D]
Brief Descriptiovf -Pro //
Work: � Ti 1 1( V I YAc.t S i i r�
Alteration of existing bedroom Yes No Adding new bedroom Yes No
9 9
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
8a. If New house and or addition to existing housing, complete the following:
a. Use of building : One Family Two Family Other
b. Number of rooms in each family unit Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft. of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No .
I. Septic Tank City Sewer Private well City water Supply
SECTION 7a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, ( X I V Qt 11 , as Owner of the subject
property
hereby authorize
to act on my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Date
1, -� Y�� �_ -( i , as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury. �--.
Print Name
Signature ofOwner /Agent Date
.L.
Department use only
City of Northampton Status of Permit
j r' „Budding Department Curb Cut/Driveway Permit
22Main Street Sewer /Septic Availability
? Om 100 Water/Well Availability
N61th pton, MA 01060 Two Sets of Structural Plans
phorre4,13;' 87 -1240 Fax 413 - 587 -1272 Plot/Site Plans
Other Specify
APPLICAJ4PN TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELUNG
c .
SECTION 1 - SITE
1.1 Property Address: jj r This section to be completed by office
S I- Map Lot Unit
00 ) 1 c f2 Zone Overlay District
Elm St. District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Reco :
Name (Print) Current Mailing Add
Telephone
Signature
2.2 Authorized Anent:
\.-,G r u �� PCB o C--/
Pin#
Name (Print) Current Mailing Address:
A nnik, .41,40:4Z7 _/ -�
Sig` - i e Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building (a) Building Permit Fee
2. Electrical (b) Estimated Total Cost of
Construction from (6)
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total = (1 +2 +3 +4 +5) _ ; Ov Check Number / f J ,35
This Section For Official Use Only O
Date
Building Permit Number: Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
. .
2TFIELD BP- 2010 -1170
GIS #: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: BUILDING PERMIT
Permit # BP- 2010 -1170
Project # JS- 2010- 001706
Est. Cost: $5147.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: THE JUBB CO INC 055333
Lot Size(sq. ft.): 8145.72 Owner: LAFRENIERE JOHN
Zoning: SR(100)/ Applicant: THE JUBB CO INC
AT: 293 HATFIELD ST
Applicant Address: Phone: Insurance:
P O Box 429 (413) 772 -6217 Workers
Compensation
GREENFIELDMA01302 ISSUED ON:6/22/2010 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL VINYL SIDING
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House # Foundation:
Driveway Final:
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 Signature:
FeeType: Date Paid: Amount:
Building 6/22/2010 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo