29-110 (2) •
LO Postal
m CERTIFIED MAILTm RECEIPT
(Domestic Only;
C3 For delivery Information visit our website at www.usps.conis
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Chri_-topher £ Susan Wilson
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sneer,Apt.No-; 204 Acrebrook Dr
or PO Sox No.
cy,srare,zrP+a Florence MA 01062
PS Form 3�00,June rr
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Total Postage&Fee $ '
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Chri topher £ Susan__Wilson__________________
Street,Apt.IV` 204 Acrebrook Dr
or PO Box No.
------------------------
City Siate,zia+d'Florence MA 01062
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► X 1
COMI�VMONWEAL► II OF MASSACHUSE TS
DIr,1i'AIi',►I'MEN'I' OF INDUSTRIAL ACCIDENTS
600 WASHINGTON S'I'1tEEff
BOSTON, MASSACHUSL"'ITS 02111
WOltlMIRS' CO1VIPENSATION iNSURANCIE: AurlwA.Va
j� The Jubb Co, Inc d.b.a. Larry Jubb's Improve-A-Home
(licensee/permitt�j ,
with a principal plucle of business/residence at:
7 Devens Sbreeb P.O. Box 429 Greenfield, Ma. 01302-0429_
City/SUItc/Zip
do hereby certify, under the pains and penalties or perjury, iliut:
M 1 unt an cnnploycr providing tits rulluwing workers' conipu satiun euverttgc rur.tny cmi)luyces
working on this,fob.
u_IU C_W C o 3CI A-+)j? 10:.
Insurance Company Policy Number
O I am a sole proprietor and have no one working rut- mc.
O I am a sole proprietor, general contractor or lwtucowlter (circle 0110) 1111d liuve lilted tlic contractors
listed below who have the following workers' compensation insurance policies;
Naine of Contractor Insurance Company/Pollcy Number
Name of Contractor Insurance Company/Polley Number
Name of Contractor Insurance Company/Polley Number '
( ) I atn a homeowner performing all the work myself.
NOTE: Please be aware that while homeowners who employ parsons to do tuatutennnce, construction or repair work
on a dwelling of not more than three units In which the homeowner also resides or on the grounds appurtenant thereto are'ttot
generally considered to be employers under the Workers' Compensation Act(OL C. 152. sect. 1(5), application by a
homeowner for a license or permit may evidence (lie legal status of an employer under ilia Worker's Compensation Act.
I understand that a copy of ails statement will be forwarded to the Department of Industrial Accidents' Office of instiranc6'for
coverage verificatlon and that failure to secure coverage as required under Section 25A of MOL 152 can lead to the Imposition
of crhuinal penalties consisting of a fine of up to$1500.00 and/or Imprlsounte it of up to one year and civil penalties In tite forth
of a Stop Work Order and a fine of$100.00 a day against me.
Signed this day of .gin a�
LicenseilPermittee L ice-n-so r/P&GI tO r
y��`•-� ✓1Z�: �V4�lJ?/!>'L(�J'LL(1G'G�GG1l- U•1�/r��.Gt/Jt3GJ.fil2t',tl.Q�i�6
Board of Buildin g l e ulations
One Ashburton Place, m 1301
Boston, Ma 02108-1618
License: CONSTRUCTION SUPERVISOR LICENSE Dirthdato: 05121/1961
Number: CS 055333 Expires: 05/21/2006 Restricted To: 00
LAwitLNU A JUB13 JR
PO BOX 429
GREENFIELD, MA 01302
Tr.no: 21956 ,
Keop top for rocolpt and change of address notification.
AZAR '
�� ✓7e �iius►trouu.ueu�(/ r���lltAUU�uJe�lo ��
I BOARD OF BUILDING REGULATIONS
1 License: CONSTRUCTION SUPERVISOR I ,
Nurnbor: CS 055333
l Blrthdate: 05/2111901
`nh.r.�...rr....r Lq Expires: 05/21/2000 Tr.no: 21956
Rostrictod: 00
LAWRENCE A JUBB JR
PO BOX 429
GREENFIELD, MA 01002 �
I Z11\
.. ActU►g C un s onor ,
Bar° nnin q0
. � la oAand f I
One Ashburton Place - Room 1301
Boston, Massachusetts 02108
Home Improvemelzt Contractor Registration
Registration: 100001
TYpe: Private Corporation '
The Jubb Company, Inc, Expiration: 6/8/2006
Larry Jubb Jr. _._.._....._.�.._.. .... . .. _i.. ..
PO Box 429/ 7 DEVENS ST
Greenfield, MA 01302 '
tlirdale Address soul ralorn card.Merit rensuu for thange.
i I Address I j Itanowal' iJ Lttq►iuynit 111 Lust Cnrd
THE JUBB CO., INC.d.b.a. Page No. , of 2 Pages.
.� LARRY JUBB'S
IMPROVE-A-HOME PROPOSAL
7 Devens Street 18 North Hatfield Road
P.O.Box 429 Hatfield,MA 01038
Greenfield,MA 01302-0429 MA Registration 100001
(413)772-6217 Northampton,MA
(413)5843716 MA Cons.Sup. Uc. 055333
PHONE DATE
TO OVrien,Geooryle J.h&.&M1. 584-8255 owl"
607 Ryan ROW JOB NAME/LOCATION
Fbrme,t%.01082 VINYL SIDMG
584 Ryan Road
Fl FMM,K%.01082
JOB NUMBER JOB PHONE
:7i Lt v, S
We hereby submi§Vpttorticrs teAMiOAJMAS g 0111 ROOD VINYL SIDING .048 GUAGE 1ffiCKl1LSS
-choice of widths (2-2/3" or 4" ) r
-choice of: aiding color. ( t ) corner color.
-*trim color: (_*white ) [11M: other trim colors slightly extra] *trines j-chanele,
soffits, window a door casings, fascias, light blocks, louvers and other accessories.
-customized baked enamel aluminum trim on any presently *un-clad window casings. to clad
door eaninge, 6 fascias. *see below note.
-*3/8" backer beneath aiding. *(aubstrata/SIBSTRATUS, wall leveler) .
-nail aiding approssimately 16" on oenter i a000rding to manufacture specifications.
-replace minor areas of exterior sheathing wood rot. (replacement allowance of up to a total
of 3 0 7/16—" each oeb sub sheathing) . Ovv05 tntAol o,5 0 �0 to "j 6(7 �
-vent all soffits where possible to heated areas of main house only. azle_p
-install center vented vinyl soffits panels on all applicable overhangs. 4-125-
-install j-block light blocks a dryer vents as necessary. l
-rake and broom clean job night at end of each working day. Q Oo
-lifetime transferable manufacture guarantee on Barkwood vinyl aiding.
-labor guarantee as required by NA, regulations 6 standards.
-?1=i *new vinyl window casings are presently clad and will not be re-clad by Jubb.
ir-to install new wood casings around rear porch windows and clad..N- Z
-SUGOST: new aluminum storm windows to rear porch.
-to supply E install 03 louvers. C kq 3 I UO Zil, 57
-to supply & install 02 pair of poly vinyl 14" wide closed louvered shutters by Girardin
at front wall.
-to aide front wall area that is vertical with horizontal vinyl an the rest of the house.
/� ... W(b SIP®IPOVS hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of:
Cent dollars($ Centb ).
Payment to be made as follows:
$1,00000 DEPOSIT UPON ACCEPTANCE,NIfVOICES ARE DUE UPON RECEFn An hd- eat cha Vet 2%per month
(24%per smum)on pact due bdown,plural carts.N�oltMNp t bM attorneys fie:,Nosn+�d in oeleslMg any sutra
oywd:
All material is guaranteed to be as specified. All work to be completed in a professional
manner according to standard practices. Any alteration or deviation from above specifica- Authorized
tions involving extra costs will be executed only upon written orders, and will become an Signature
extra charge over and above the estimate. All agreements contingent upon strikes,accidents or
delays beyond our control. Owner to carry fire,tornado,and other necessary Insurance.Our 46Z Note:Thls proposal may
workers are fully covered by Worker's Compensation Insurance. withdrawn by us if not accepted within 30 days.
Aci calpQamc(p ®0 TR'®pnell —The above prices, specifications
and conditions are satisfactory and are hereby accepted. You are authorized Signature
to do the work as specified. Payment will be made as outlined above.
Signature
'Pate of Acceptance:
r •
,
SECTION 8ir,�ONS=fRUGTIONISERVICEE
8 1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: ""V e�' N J � �� S 0 f
License Number
AlUk 0 S c) 2— -5/;�—( /OG
Address Expira ion D to
Signature Telephone
iRest ee r1 Wme1-m=rov • - � M Not Applicable .❑
( OD0OI
Company Name Registration Number
Address ' Expin Date
4�—'J � ,ej � Telephone `T`12
SECTION 10 WORKERS:',COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c, 152, § 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affid�
will result in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes....... No...... ❑
'on
The current exemption for"homeowners"was extended to include Owner-occupied Dwellines of one(1) or two(2)famili
and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner act:
as supervisor. CMR 780 Sixth Edition Section 108.3.5.1.
Definition of Homeowner:Person(s)who own 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 buildings 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(
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
Yw'„ Y,YMt ip�G.'Zk6 i d !. u Yv.:tfs �• .. r w.." V K 1 rr 1 7 y Q �
� , � ?c;. r�x '� 2 � ,
Cl'�Of �S D SCPp 10 0 �P OSEDWO c e as is „Yw�t,w bm
NpRSMMWNF9Nf?!1NRR: T♦.1iNtiMMXTFMMII!vf?w,4wt P.MI"kMM?M91i. NMWTf IWIiMNN tu.NVV.,,n. ro'YMfS.n"7w1. q
NV.N_YJCh4bM- -NT In ftflf l vw,u il,r'lNIM IM111:.:v4f1k�Ylla� id,4Y;%:!i fk'`if 'EM..:'iv.; ipM.MR:i+N!A1p nF'3!fgip�RS'lg!*lEdl"a '... Y{: y.'.:f-1 h 1(.+,1}Gr`,5::.•3
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding Other( ]
Brief Description of Proposed Work:—!- / )-
Alteration of existing bedroom Yes ;l No Adding new bedroom Y Ps ✓ No
Attached Narrative o Renovating unfinished basement Yes No
Plans Attached Roll ❑• Sheet D
IMM. house"and�o"r d"ditio to fisting housi i%,fddfffg Refth—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. Mascheck 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
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
S,EC7�l ONn7a0VIf NERA�UTHORIZATION�"TO,BE�COMPLETED 'WH,EN
O.YYNERSAC�EIT�OtrtCOtTRACTOR�APF'LIES FOR]RUILDINGIPRMIT
i'N40„W.�, ..N',1�,> w..xYxl,w•- ...c
I, as Owner of the subject prope
hereby authorize to ac
my behalf, in all matters relative to work authorized by this building permit application.
Signature of Owner Dat
u-0to J r 1'' r'u- 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
lei
Signature of Owner/Agent Date
i
City of Northampton S
Buildiht Department
212 twin Street
Room 100 e
Northampton, MA 01060
phone 413-587.1240 Fax 413-587.1272 e
NMI—
APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION,11 SITE!INkORMATION
1.1 Property Address: ` `{ v ;~ 4tT �s^sect"�" o tie co' `peed by office ��� F
(( t
Zoneh��a �•+,t �,,: O e a Dis c
Elm St Ristrict '' a CB District` r
SECTION 2.- PROPERTY OWNERSHIP/AUTHORIZED.AGENT
2.1 Owner of Record:
Name(Print) Current Mailing dress:
Telephone
Signature
2.2 Authorized Agent:
Name(Print T Current Mailing Address:
Signature Telephone
1 ,'!d �
SECTIONIS ESTIMATEC3'iCONS'TRUCTION COSTS
Item Estimated Cost(Dollars)to be l U$e10Ply
completed by ermit ap licant '1.1
1, Building (a)'Building'PerrnitFee 1
1
2. Electrical (b) Estimated Total Cost of
Construction.frorri' 6
3. Plumbing 'Building Permit;F'e'e ,
4. Mechanical (HVAC)
5. Fire Protection
6. Total =(1 + 2 + 3+ 4 + 5) (Ip �'� 00 Check Number 7S;V
.This Section For Official Use Ohl
BUildmg PermNtxNumbe�'?'' Date Issued.
�...u!y-b• CAI all,. 1pl I II ^,'�I'Ni'I I .' .1.�,i iIaIII�IJ.I�'il�r .I III,IrI,� lY IAN,.!{) 11','',' If 't11��11 r'�� 1' p��� {1�I •gl', '11
17ii,4•.H'��g� ,! ,a N IiJ
X51 nature .i�iN U GI i q �'I '�
�!� ,:Y !1 a!a,y�ti�6ulldfngCommisslotier,(In�pQctoroJ;B,u(Jdings,!,:1 Da�e,�;,!,I , r,„1
59AL BP-2006-1162
GIS#: COMMONWEALTH OF MASSACHUSETTS
CITY OF NORTHAMPTON
Lot: -001
Permit: Building
Category BUILDING PERMIT
Permit# BP-2006-1162
Project# JS-2006-1712
Est.Cost: $6896.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: THE JUBB CO INC 100001
Lot Size(sq. ft.): 22520.52 Owner: O'BRIEN GEORGE&RUTH
Zoning URA Applicant: THE JUBB CO INC
AT: 584 RYAN RD
Applicant Address: Phone: Insurance:
P O Box 429 (413) 772-6217 Workers
Compensation
GREENFIELDMA01302 ISSUED ON:51112006 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 si nature:
FeeType• Date Paid: Amount:
Building 5/1/2006 0:00:00 $25.008974
212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272
Building Commissioner-Anthony Patillo