42-074 (4) 1 '
THE JUBB CO., INC. d.b.a. Page No. 0l Pages,
LARRY JUBB'S
IM PRO E-A-HOME PROPOSAL
7 Devens Street 18 North Hatfield Road
P.O.Box 429 Hatfield,MA 01038 MA Registration
Greenfield, 77 -6217 01302-0429 Northampton,MA MA Cons. Sup. L co 055333
(413)772 6217 (413)584-3716 P
PHONE DATE
TO Odgers, Craig
97 Glendale Road JOB NAME/LOCATION
Northampton,Ma. 01060 Same
97 Glendale Road
Northampton,Mo.
JOB NUMBE JOB PHONE
lit 3�
We hereby submitspecifications and estimates for:
-SUPPLY & INSTALL IKO CAMBRIDGE SERIES 30 YEAR ORGANIC ROOF SHINGLES- Oc��
choice of color: ( �6
remove and dispose of *existing shingle layers. (*up to 2 layers.)
replace up to 3 @ 4' x 8' x 1/2" cdx plywood as necessary. -- 51vjX,:,0111'+ C�
*supply & install 3' width of ice and water membrane at roof bottom. (�
supply & install 15 lb. felt to remaining exposed wood. \
supply & install 5" aluminum drip edge to all fascias. color:
supply & install shingle over ridge vent.
supply a install 01 vent stack boots. \,t{v''")•
supply & install new aluminum step flashing at all intersecting gables and chimney's.
rake and broom clean job site daily at end of each working day.
shingle guarantee as described above. (see separate copy of manufactures guarantee) .
labor guarantee as required by MA contractors registration regulation.
SERVICE FEE: $350.00 (includes permit & disposal of all job related refuse) .
[service fee not included in total at bottom & is to be billed as separate] .
W& IPTI)T(0011 hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of:
3 ix Thousand and 00/100 Dollars dollars($ 6,000.00 ,.
Payment to be made as follows:
,000.00 DEPOSIT UPON ACCEPTANCE, INVOICES ARE DUE UPON RECEIPTI An interest charge of 2%per month
04%per annum)on past due balances,plus al costs, including reasonable attorney's fees, incurred in collecting any sums
III AWd
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.accidonts or
delays beyond our control. Owner to carry fire,tornado„and other necessary insurance.Our Note:This proposal may bo
workers are fully covered by Worker's Compensation Insurance. withdrawn b u s 30 jdays.
n� 'cc t6' 1t y .Pot accepted within
��vc(9jp1&m(ce (u �iP� ���tll —The above prices, specifications
and conditions are satisfactory and are hereby accepted. You are authorizod Signatu o &)Do
to do the work as specified. Payment will be made as outlined above.
Signature
Dete of Acceptance:
I:OIValV1UN1'YI?;nl�I'II ()l' IVIASSACI1USL'1TS
1)LI'l1lt'I'IVII N'1' U1� INi)US'1'1UAL ACC1ULN'I'S
600 1'YASIIINC'I'UN S'I'RKV 1'
B0S'I'()N, NIASSACIIUSL 1"I'S U2111
WoltKLeItS' COMPENSATION INSURANCE AFFIDAVIT
The Jubb Co, Inc. d.b.a. Larry Jubb's Ini prove-/1-1 lonte
(liccuscc/peru►ittcc)
with a principal place of business/residcttce al:
7 Deveris street- P.O. pox 429 Greenfield, Hzi. 0130"2.-0,I2t)
City/state/Zil,
do hereby cerlily, under tltc pains and peualtics ul• perjury, dolt:
M I uu► u►n ellipluyer pruvidh1j; the I*uiluwhig workers' Cur u:y eitiltluyeeti
wurkiug oil this job.
GUAIW J UWC905794
Insurunce Cutnpalty Pulley Nunther
( ) I alit a sole pruprietur Mid Ilavc t►u une working for lite.
O I attt a sole pruprietur, general cuttlractur or Iwn:euwtter (circle unc) and have (aired the cuutracturs
listed below who have lice folluwing workers' Cun►pet-ratiuu insurance pulicies:
Naihie of Contractor Insurance Cuntpany/Policy Number
Naive of Contractor Insurance Cuntpany/Pulicy Number
Naine of Contractor lllsuranee Culupany/Pulley Number
( ) I am a hoineowner performing all the wurk myself.
NOTE: Please be aware that while howcowners wl►o cnipluy persons to do alaialcaaace, construction or repair work
on a dwelllug of not more that►three units In which the hoatcowacr also resides or on the grounds appurtctlant thereto arc rtot
generally considered to be employers under the Workers' Cowpcasatiutl Act (CL C. 152, sect. 1(5), application by a
horneowuer for a license or permit stay evidcacc the legal status of an employer uadcr the Worker's Compensailoa Act.
I uudcrstaud that a copy of this statcatcat will be forwarded to tl:e DeparUucnt of htdustrlal Aceideuls' Office of lasuraace for
coverage verlrtcmtion mud that failure to secure covcrage,as rctlulrcd under Sectiuit 25A of MCL 152 call lead to the lutpusitiva
of crlmhial peualtics cousistiag of m fiuc of up to $15W.W and/or imprisuantcttt of up to oac year and civil pcaaltics lit the furru
of a Stop Work Order turd a fine of MUM u day against rite.
Signed (his clay of .20
LieenseeMermillee Licensor/P , niil r
�J;�t' ° �,/1LG' -GU-II LlI GU-1 GCUG'l.�G t%Il- U f f�.�!/GGli,1;1<,�C1L000G'Gf.Cy
I y' ec
13oarcl o(' 13uilding IZcbulations and Standards
One Ashburton PI�ICC - ROOM 1301
Boston. NkISS�ICIIUSc:ltS 02108
1-101-11c I111proVCI11cI1L Colll.ractor RegiSl.rat.lon
Registration: 100001
Type: Private Corporation
E=xpiration: 610104
The Jubb Company, Inc.
Larry Jubb, Jr.
PO Box 429/ 7 DEVENS ST - ------•---•-
Greenfield, MA 01302 _. .. . _ .. ...__._. ._.�.. __
Ulnlale Address and return card. 119aric reason for change.
I I Address I I Itenewal I' I Euyiloyuicut I'_I Lust Card
�� �l2e "�l��r�»La>LCUec��Gf o ✓�2t;rilJU�f�tl�e1�6
Board of Buildinq Re I ulations
" One Ashburton Place, m 1301
Boston, Ma 02108-1618
License: CONSTRUCTION SUPERVISOR LICENSE Birtiidate: 05121/1961
Number: CS 055333 Expires: 05/21/2004 Restricted To: 00
LAWRENCE A JUBB JR
110 BOX 429
GIZEENPIELD, MA 01302
Tr.no: .22343
Keep lop for receipt and chango of address notification.
ti
SECTION '�PONSTRUCTION SERVICES r R
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: La,ca, 1; A
License Number
5b-1 Z oz-�
Address Expiration Date
Signature Telephone
Re
Fe `0Mtf "p`ro`vem
Not Applicable ❑
Company Name Registration lNumber
Address Expiration Date
f �ox kV A Telephone 7 7�' I
SECTION 10-WORKERS' COMPENSATIONINSURANC AVIT(M.G.L. c.152, §25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affil:
will result in the denial of the issuance of the building permit.
Signed Affidavit Attached Yes....... No...... ❑
f. 3_om e0 nexe n
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)famili
and to a1low 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 building 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
?._ '"
�*'^* •`'-ea' Ws s U Fa. u",$ r.,; `
SECTION5 DESCRI TION�O��PROPOSED�INORK ch���lla ticabte b .
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing
Or Doors ❑
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other[ ]
Brief Description of Proposed Work:
i
Alteration of existing bedroom Yes No Al ling new bedroo r( Yes o
Attached Narrative❑ Renovating unfinished basement Yes No
Plans Attached Roll ❑- Sheet❑
6'�1€�NEw hatasek=and off'" 'dd;tior to xist"o,79].T tiffs te i&te` the #dlld—in
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 .
1. Septic Tank City Sewer Private well City water Supply
SECTI6N 7a OWNER�AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APP11EStF BUILDING PERMIT
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 Date
..J ia_Lktl J ✓ - as Owner/Authorized Agent
hereby declare that the statements and inf rmation 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 of Owner/Agent Date
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE
DENIED DUE TO LACK OF INFORMATION
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: R:
Rear
Building Height
Bldg.Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document #
B. 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:
C. Do any signs exist on the property? YES NO
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ?YES—
No
IF YES, describe size, type and location:
City of Northampton
Building Department {
212 Main Street r i
' Room 100 a x
Northampton; MA 01060 . ets o a
phone 413.587-1240 Fax 413.587.1272
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION
1.1 Property Address: Tn�s se� ion tobe�timpfeted y office
Mapt L`ot Una#
e
.%il ver ay D�str�ct �
Eim St.`District' D�stnct µ
SECTION 2.- PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
Name(Print) i Current Mailing Address: �.
Telephone
Signature
2.2 Authorized Agent:
Ti, C (JUx
Name(Print Current Mailing Address: C'1 2-
4=-W !;-9=� -7-7 �L
Signature Telephone
SECTION 3 - ESTthiATED'CONSTFiiCTION''COSTS
Item Estimated Cost(Dollars)to be Official Use Only
com feted by ermit applicant
1. Building + // (a) Building Permit Fe6l.
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) ( t CSC.` . tX,. Check Number
This Section For Official Use Only
Building Permit_Number;-, Date Issued:
Signature.
Building Commissioner%Inspector of.Builtlhgs .' '.,., Date.
97 GLENDALE RD BP-2004-0978
GIs#: COMMONWEALTH OF MASSACHUSETTS
MU:Block:42-074 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-2004-0978
Project# 35-2004-1455
Est. Cost: $6000.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: THE JUBB CO INC 100001
Lot Size(sq. ft.): 4486.68 Owner: ODGERS MARY C&CRAIG W
Zoning: SR Applicant: THE JUBB CO INC
AT. 97 GLENDALE RD
Applicant Address: Phone: Insurance:
P O Box 429 (413) 772-6217 Workers
Compensation
GREEN FIELDMA01302 ISSUED ON:418104 0:00:00
TO PERFORM THE FOLLOWING WORK.STRIP & SHINGLE ROOF
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• Receipt No: Date Paid: Check No: Amount:
Building 4/8/04 0:00:00 7175 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
BP-2004-0978
97 GLENDALE RD
GIs L COMMONWEALTH OF MASSACHUSETTS
Map:Block: 42-074 CITY OF NORTHAMPTON
Lot: -001
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A)
Category:
BUILDING PERMIT
-
Permit
_ # BP-2004-0978
Project# JS-2004-001455
Est Cost: $6000.00
Fee: $50.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: THE JUBB CO INC 100001
Lot Size(sa. ft.): 4486.68 Owner: ODGERS MARY C&CRAIG W
Zoning: SR Applicant: THE JUBB CO INC
AT. 97 GLENDALE RD
Applicant Address: Phone: Insurance:
P O Box 429 (413) 772-6217 Workers
Compensation
GREENFIELDMA01302 ISSUED ON:41812004 0:00:00
TO PERFORM THE FOLLOWING WORK.-STRIP & SHINGLE ROOF & REFRAME ROOF
FOR CATHEDRAL CEILING
POST THIS CARD SO IT IS VISIBLE FROM THE STREET Building Inspector
Inspector of Plumbing Inspector of Wiring D.P.W. g p
Underground: Service: Meter:
Footings:
Rough: Rough: / e//�j,� House# Foundation:
g 7 3� D � uu
Driveway Final:
6rvd,
Final: Final:/// //lam y �n�►4��Q� Rough Frame:
X17`Dt '
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
C k 7-9-0'/ .-.�i
Final: Smoke: Final: R00F fly
RS1=RhMG /' I1 -6.016
THIS PERMIT MAY BE REVOKED BY THE ITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGUL TIONS /
Certificate of Occu anc S nature:
Feel e: Date Paid: Amount:
Building 4/8/2004 0:00:00 $50.007175
212 Main Street,Phone(413)587-1240,Fax: (4 13)587-1272
Building Commissioner-Anthony Patillo