38B-208 Pages
• �Replacement �.�.inbot Propog ( at Page No. /of
Main Office:
7 Devens Street • P.O. Box 429 THE JUBB CO., INC. d.b.a. Northampton, MA:
Greenfield, MA 01302 (413) 584 -3716
(413) 772 -6217 LARRY JUBB'S Brattleboro, VT & Keene, NH
18 North Hatfield Road IMPROVE- A- HOMETM 1-888-639-JUBB
Hatfield, MA 01038 Email: JubbCompanyinc @aol.com
PROPOSAL SUBMITTED TO PHONE DATE
SI —oN &o t( -Ie"/ StS - V 07 42 17/69
STREET JOB NAME
cEamy{\\ r NH c4
CITY, STATE ANDP JOB LOCATION
r Ps-r,.. ,�l�lA
� AJ .
TENTATIVE JOB SCHEDULE (Weather Perm ling) MA Registration 100001
Approximately W � weeks from date of signed proposal received by Jubb Co., Inc. MA Cons. Sup. Lic. 055333
We hereby submit specifications and estimates for:
Supply & Install Mastic Roved 7Uateitf Vinyl Replacement Windows --
• 1/2 Screens (double hung only). • Interlock meeting rail.
• Locking Screens (double hung only). • Welded sash & frame.
• Tilt -in Sashes (double hung only). • Five degree sloped sill.
• Non - conductive intercept glass system. • Seven - eights thermo glass. (
• Continuous Balances (double hung only). • Insulated padded frame. `7
• Sun Shield Vinyl Compound (Mastic exclusive). • Energy Star approved.
• Twin locks on double hung units 32" or wider. • Virgin vinyl.
• Twenty year manufacture guarantee on glass seal failure. tf (7 4-
• Lifetime transferable manufacture gu. •tee on vinyl window frame.
• Labor guarantee as required by CAW H, VT contractor regulations.
Color: Linen White IJ Almond* ( *extra charges apply for this colors)
TOTAL UNITS REPLACED: ctic-GA ,4i2 ,4
❑ Grids (Note: Grids are beveled)
Low "E" Glass )
.Argon ❑ Insulation (into weight pockets) /v //9 ( Storm Window Remova j/,
❑ Aluminum Clad Exterior Castings (❑ Full ❑ Partial) N//q
OTHER / NOTE:
eve
6u/u, ADO 3 S
K7 22, . N7 'd4
•
✓ € - uryllvino coeaGt;1L or✓&crxl:lacluuleat j 't, =)' Board of Building Regulations and Standards
(. }' : One Ashburton Place - Room 1 301
Boston. Massachusetts 02108
Construction Supervisor License .
License CS: 55333
Restriction: 00
•
Expiration: 5/21/2010 Till 25290
LAWRENCE A JUBB JR _. .. .__._._...--• ______ •- — -- .............._- .._
POBOX 429 _...- --.-•---- •--- ...------ ,--- .— ._.._... —...
GREENFIELD, MA 01302 — — - - -- - --
Update Address and return curd. Marl( reason tor change.
0 6UM- 0/i07- 1,cu•4110 1 -1 Address 0 Renewal 1:•-1 Lust Card
•
qt—// -
le .� 'r Q Y a B oa at B uil ink egula oil an tandarots
r~ V
' -',/ One Ashburton Place - Room 1301
Boston. Massachusetts 02108
Home improvement Contractor Registration
Registration: 100001
Type: Private Corporation
Expiration: 6/6/2010 TO 267161
The Jubb Company, Inc.
Larry Jubb . .
P. 0. Box 429 �------`—
Greenfield, MA 01 302 ----- - - - - --
Update Address and return card. Mark reason fur change.
5 60M•07/07- PC0490
L] Address El Renewal [ j Employment 11 Lust Card
•
•
• The Commonwealth of illassuc /utsctts
. Department of Industrial Accidents
a 1a
.s Office of Investigations
3 ° 600 IVushington Street
?; I'{! y Boston, MA 02111
iv►v►t:mass.gut' /din
Workers' Compensation Insurance Affidavit: Builders /Contractors /Electricians /Plumbers
Auulicrwl Information r Please Print Le1.il,ly
Name ( Business /Organization/individual): 1 CI?. .c`
Address: O. (2)c,X. +.2-9
City /State /Zip: g-► MA 0 t3 02.Photie #: - 7 - 73- -(v. --C
Are you an employer? Check the appropriate lox: Type of project (required):
1.1� 1 am a employer with 4. ❑ 1 mu a general contractor and 1 6. ❑ New construction
employees (full and/orpart- time).* have hired the sub - contractors
2. ❑ I ant a sole proprietor or inn listed on the attached sheet. t ❑ Remodeling
ship and have no employees These sub - contractors have 8. ❑ Demolition
working for me in any capacity. workcrs' comp. insurance. 9. ❑ Building addition
[No workers' comp. insurance 5. ❑ We arc a corporation and its
required.] officers have exercised their 10.0 Electrical repairs or additions
3. ❑ I ant 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. ❑ 1 of repairs
insurance required.] t employees. [No workers'
comp. insurance required./
13. Other Qi tN t "' Ou
*Any applicant that checks box 1!1 must also fill out the section below showing their workers' compensation policy information. I I
t llomcowncrs who submit this affidavit indicating they arc doing all work and then biro outside contractors must submit a new affidavit indicating such.
1 Conlractors that check this box must attached tnt additional sheet showing the nn►ne of Ilia subcontractors and their workcrs' comp. policy information.
I ant an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Narne:
Policy 11 or Self-ins. Lic. (o (v 4-c 4-9 Expiration Date: Os7c 3/ c o
r M A
Job Site Address: l �` • City /State /Zip: f`-�0� `a o CD()
cfx Attach a copy of the workers' compensation policy declaration page (showing the policy number and exliiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of crifnunal 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
Investigation of the DIA for insurance coverage verification.
1 do hereby certify under the pair nd enalties of perjury that the information provided above is true and correct.
,Signature: l Al I I l Q
Phone 11: - 7 7z- 2- 1
Official use only. .Do not write in this area, to be completed by city or town official
City or Tuwu: Permit/License 1/
Issuing Authority (circle one):
1. Board of Health 2. Building Department 3. CilyTI'own Clerk 4. Electrical Inspector 5. Plumbing Inspector .
6. Other • 1
Contact Person: Phone #:
Amer
SECTION 8 - CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder : Lakk' r-P4'-CR-- A ' --j 6 � '`j r •, Pry c) 55 3 � 3
License Number
n /
PO X 4"� C`_ Y e ^e- exer e 4 J /
M A 13 2 0 51a l Aor o
Address Expiration Date
.„4„.....44, , 7 ? )_ - (p 2_1 - 7 Signature Telephone
9. Realstered Home Improvement Contractor. Not Applicable ❑
i i_ J uJo 6 _ -. 1 00000 I
Company Name Registration Number
Po 0X 4- 2- 6 i 0 (p7o q /� l c
A ddress Expirati n Date
, C1L "eCGti'E 4 . / A o I-3'C7L
Telephone -1 73-- - (-4"L 1 7
SECTION 10- WORKERS' COMPENSATION INSURANCE AFFIDAVIT (M.G.L. c. 152, g 25C(6))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit
Signed Affidavit Attached Yes No ❑
11. — Home Owner Exemption
The current exemption for "homeowners" was extended to include Owner - occupied Dwellings 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 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 aril/ or faun
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(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 ❑ Replacemen Vindows Alteration(s) ❑ Roofing 0
Or Doors ((��1
Accessory Bldg. El Demolition ❑ New Signs [0] Decks [O Siding [O] Other [0]
Brief Description of Pr. posed ,-
Work: T wi' I( + V t i • 1�1�0. w i b V
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative Renovating unfinished basement Yes No
Plans Attached Roll - Sheet
ea. 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
I, , 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.
See. 1 , „3 , vo p o 5 a( IA) t CA.i -5` o vKe v �fu re-
Signature of Owner 1 Date
LU tom_ A- -1 N r. I'4-t5 . • as Owner /Authorized
Agent hereby declare that the statements 2(nd infom(ation 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 4.
Signature of Owner /Agent e
l
1
c''. / .
,'"- Department use only
City of Northampton S tatus of Permit
Building Department Curb Cut/Driveway Permit
212 Main Street Sewer /Septic Availability
Room 100 Water/Well Availability
, Northampton, MA 01060 Two Sets of Structural Plans
phone 413 - 587 -1240 Fax 413 - 587 -1272 Plot/Site Plans
Other Specify
f APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELUNG
SECTION 1 - SITE INFORMATION
1.1 Property Address: This section to be completed by office
49 OuotALI-L-44, ,CI Map Lot Unit
N o t t l� vk I v Zone Overlay District
Elm SL District CB District
SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT
2.1 Owner of Record:
5 -k.44- - 0 - 1 , ._._ ---.4- l (.-.. -f --e-.t I.,, /t1 irl'L& ,i,,, -ti, - - ti.) o v : t1ti.,u i vi
Name (Print) Current Mailing Address: 5 _ , --1 , 0 --i
Telephone
Signature
2.2 Authorized Anent: , s. (� 2 J� I q
A
LLt� u - Y A, J i, j , J r r Y°�c P . I" O x '"C "�cl e, ,e l ct , M
Name (Print) Current Mailing Address:
-T--7,)____.,)__I-1
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS I
Item Estimated Cost (Dollars) to be Official Use Only
completed by permit applicant
1. Building l (9.--) (41 ^ 0 (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) l .J (4.. G 0 Check Number / li ��
This Section For Official Use Only 7�''t�
Date
Building Permit Number: Issued:
Signature:
Building Commissioner/Inspector of Buildings Date
49MAIAN ST BP- 2010 -0613
GIS #: COMMONWEALTH OF MASSACHUSETTS
208 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 -0613
Project # JS- 2010 - 000895
Est. Cost: $1216.00
Fee: $35.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: THE JUBB CO INC 055333
Lot Size(sq. ft.): 16552.80 Owner: GOLDSTEIN SHARON L & JAMES RADER
Zoning. URB(100)/ Applicant: THE JUBB CO INC
AT: 49 MANHAN ST
Applicant Address: Phone: Insurance:
P O Box 429 (413) 772 -6217 Workers
Compensation
GREENFIELDMA01302 ISSUED ON:12/17/2009 0:00:00
TO PERFORM THE FOLLOWING WORK:INSTALL REPLACEMENT WINDOWS
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 12/17/2009 0:00:00 $35.00
212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272
Building Commissioner - Anthony Patillo