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22B-049
P] OPOSAL 35 The Jubb Co., Inc. d.b.a. Page 2 of 2 LARRY JUBB'S MA Registration 100001 MA Cons. Sup. Lic. 055333 IMPROVE- A- HOMETM 7 Devens Street P.O. Box 51 P.O. Box 429 Hatfield, MA 01038 Greenfield, MA 01302 - 0429 (413) 772 -6217 Northampton, MA (413) 584 -3716 Sherette, Clyde Mr & Mrs. PHONt1d4 -b393 DATtU /U3 /1.2 TO: 19 Ryan Road Florence, MA. 01062 JOBNA1T10IftOdd Florence, MA. 01062 JOB NUMBER JOB PHONE We hereby submit specifications and estimates for where dumpster is placed. Jubb nor the dumpster company will assume liability for said ' possible damage. 2). Jubb will make every effort to clean up nails from ground: (gardens, lawns, driveways, etc.) It is also the responsibility of the homeowner to excersis reasonable diligence in looking for and clean up of same after roof work is completed and to look for nails that may present themselves as much as several weeks or months after roof work is complete. Jubb will not assume liability for flat tires. SERVICE FEE: $660.00 (includes permit & disposal of all job related refuse). [service fee not included in total at bottom and will be added to final invoice at job completion]. VVevPrm C,fAbrhtireB0o ftrfais olmaldriaEargill r omplatwth k@ciragalae Withithalibbve specifications, for the sum of: 5, 684 . 00 dollars ($ ). PBCI ®b®MaMtys:UPON ACCEPTANCE. INVOICES DUE UPON RECEIPT! An interest charge of 2% per month (24% per annum) on past due balances, plus all costs, including reasonable attorney's fees, incurred in collecting any sums owed. All material is be as specified. An or deviation All work be completed in a professiona manner according to to standard rd practices. Any alteration or deviation ion from above specifica- Authorized tons involving extra costs wit be executed only upon written orders, and will become an Signature extra charge over and above the estimate. All agreements contingent upon strikes, accidents / 3 0 or delays beyond our control. Owner to carry fire, tomado, and other necessary insurance. Not : This proposal may be Our workers are fully covered by Worker's Compensation insurance. withdrawn by us if not accepted within days. Acceptance of Proposal — The above prices, specifications and A V,t conditions are satisfactory and are hereby accepted. You are authorized to do the work Signature as specified. Payment will be made as outlined above. • Signature Date of Acceptance: ,7 PROPOSAL 35 The Jubb Co., Inc. d.b.a. Page 1 of 2 LARRY JUBB'S MA Registration 100001 MA Cons. Sup. Lic. 055333 IMPROVE- A- HOMETM 7 Devens Street P.O. Box 51 P.O. Box 429 Hatfield, MA 01038 Greenfield, MA 01302 -0429 Northampton, MA (413) 772 -6217 (413) 584-3716 Sherette, Clyde Mr & Mrs. PHONti84 -5.39.3 DATtU /UJ /12 TO: 19 Ryan Road Florence, MA. 01062 JOB NA / L 3Aitot Koact Florence, MA. 01062 JOB NUMBER JOB PHONE We hereby submit specifications and estimates for - SUPPLY & INSTALL ELK /GAF PRESTIQUE 1 SERIES Lifetime ARCHITECTUAL ROOF SHINGLES - > - Choice of color: ( ), - Remove & dispose of existing roof shingle layers ( *up to one layer) - Replace up to 3 @ 4' x 8' 1/2" CDX plywood as necessary. additional plywood replacement an additional $50.00 per sheet replaced. No credit for plywood not needed. - Supply & install 6' width of ice & water membrane at roof bottom & to all valley's of heated areas. - Supply & install 15 lb. felt to remaining exposed wood. - Supply & install 5" aluminum drip edge to all fascias. Color: white - or brown. (circle) - Supply & install shingle over ridge vent. - Supply & install # vent stack boots. - Supply & install aluminum step flashing at all intersecting gables and chimney's if necessary. -Rake and broom clean job site at end of each working day. - lifetime limited shingle guarantee from manufacture. (see separate copy of manufacture warranty) -Labor guarantee as required by MA Board of Building Regulations and Standards. - any work not specifically described here -in will be executed only upon a mutually agreeable and accepted written change order. NOTES: 1). Includes front porch and rear entry canopy. Excludes any un- attached out buildings. 2). Includes new lead counter flashing at chimney. NOTICE: 1). Homeowner to provide a suitably accessible location for roll -off dumpster placement. Homeowner is advised that due to weight of dumpster that damage may possibly occur at location \enPtdpose hereby to furnish material and labor — complete in accordance with the above specifications, for the sum of: Cont' d dollars ($ ). Pi6nddfltib®kha 61IbtTvs:UPON ACCEPTANCE. INVOICES DUE UPON RECEIPT! An interest charge of 2% per month (24% per annum) on past due balances, plus all costs, including reasonable attorney's fees, incurred in collecting any sums owed. All material is guaranteed to be as specified. All work to be completed in a professional �`Ae , mann er according to standard practices. Any alteration or deviation from above specifiea- Authorized (/ 1 / /// tions involving extra costs will be executed only upon written orders, and will become an Signature extra charge over and above the estimate. At agreements contingent upon strikes, accidents 30 or delays beyond our control. Owner to carry fire, tomado, and other necessary insurance. Not . This roposal may be Our workers are fully covered by Worker's Compensation insurance. withdrawn by us if not accepted within days. Acceptance of Proposal — The above prices, specifications and �( conditions are satisfactory and are hereby accepted. You are authorized to do the work Signature ! /�,� ]�\ as specified. Payment will be made as outlined above. to c U V �, Signature 7:44_9 c t) Date of Acceptance: 1 / r _ r • ... , .• • . -. • . • • •• . : •‘• • • ••• • • • • • . • . . . • • • . .. ' • ' • • • .. • -• . . • ••• ' • • • • . . • .. • • . .... • , . , • • .. • • • . • • • . . -- . . . „ .. . i • . • • • " .. .• • ' • . . . . . . ' • .. • • AFFIDAVIT • • • • . . . . .• • • .. • • . • . . .• As a result of the provisions of Ivi'GL c 40, S54, I acknowledge that as a amdition of Building Permit . •,. • 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 .defuaed by MGL. . • . • •• ' c Ilf, S 150A- . . 1 . . . . . • . . . . . • • • . •• • . • - . • . . • . . • .. . .. I certify that I will notify the Building Official by : . . • • . • (Two months maximum) of the location of the solid waste disposal facility wherethe debris •resulting from ' , • • the. said construction activity shall be disposed or, and I shall submit the.appropriate form:for attachment •:. . • • • to the Building Permit - . • •• . . . . • • • • • • ..• . . . . • . , . .. • • . . . . . ' • • ...• .• ' .. . • • -• .. , . . . . .• .. • . .. . ,, .... . • . • / .• . • • /AM (077, • • • C-- i ;54!:,z (.../: • • -'' .-. • • • • ' . • • Date ' •- • ' Ignature of"Permit Applicant ' . . . . . • . . . . . . . • • . ' . . . • , • . • • • ' • (Print or type the following information) • • • ' . • ' ... -, • . • . . • • . • .• .. • . • ' .. " • • ' . . . ' .. . . . . •• . . . 77 -e, j;.1.13A• idi7)i)cei)_ti -1-- • .., • . . • ., ,.. • • • • • • • Varne of Permit Applicant • ' • . • . • . • . • ' • • . . . . . • • . ' • • ". • • ' . p 06d)( .4•ia3T .t • . • • . ‘• .• .. .. .. . • • • • • • . Firm Name, if any • . . . . • • • . ... • . . • • " ' • • . . . . . . . • • • ' • • • • . • . •• ' • • • ' • • •• • . • . • • re • `/Uin /30;Z •• '•'• •••-;• •:•,• - ••• .. • • . • . . • ' • . • Address • .• • . • • • . . .. • • . . , . • . . • . . .. .. . .. ... . . . , .:..•:::*::•• I...:. ' ; ::: .'"'''...• ;. r, . di ... t ,.. bstr .. 0 , f . : ...,.:...:,-. ::::: . . ; ,,.• .....•:: . :, .. .....,.....•:::::...1... i .. • • 1 5a-pet/2 ._(). - • • • • • . . Location of Facilit) • . • . • • . . . • • • •• • . • • • . . ." • • .. : .... . . .. . . • • . . • .,. •111•11111.....1■1■111. "PePartOetit:Ofhid4StilatAteideitik. =.1.."••■Z= . . Office of:Investigations ‘1" Votaid=r; 600,WaShitIgiOnStreet- .: 0- • Boston, MA 02111 ga • W W w. m ass. go v/dia Workers' Compensation InSuranceAfficlavit;BuilderstontractOrs/EleetricianstPlumbers Applicant Infoiniation . ' Please Print Legibly . , Name (Business/Organizitionandividtfal): A.% ,t 1::41., Address: pu )\1.- City/State/Zip.: A, 4. 1111 A • :Plion — Are you an eniployer? Check • Type of project (required): 1.0 I am . a employer with 4. 0 I andi I 6 : fl New construction employees (full and/or part-time).* have hiredthe sub-contractors ' /. Remodeling 2.0 I am a sole proprietor or'partner- listed on'the' attached sheet, t ship and have no erriployees These sub.;-contractors have . 8. r] Demolition working for me in any capacity. workers' comp. insurance. 9. Building addition [No workers' comp. insurance 5., We, are a corporation and its • 10 .[J Electrical repairs or additions required.] . officers have'exercised their 3.0 I am a homeowner.daing.all work . right of exeniption.per:MGL . 11.0, Plumbing repairs or additions myself. [No.workers':,comp. • c. 152, §1:(4),:andive'have no 12.0 Roof repairs insurance requiredA t employees [No workers' 13 Other comp. insurance required.] • . • *Any applicant that check s box #1 must also fill outthe,section below showing their workers' compensation policy information. Homeowners who submit this.affidavitindicatingthiyare doing alt work and then hire outside contractors a new affidavit indicating such 1 Contractors that check;thia.box,mus4ttactied:an.additionallsheefihoWing thiiiie'd*subontra'ctiiisadd their workers' domp. policy inforrnation. I am an employer that is providing w.orkers' compensation inSurancifbtmy Below is the policy. and job site information. Insurance Company Name: S1 0( Q_, 1c1 ru Policy # jk . -cw Expiration Date: Job Site Address: City/State/Zip: Attach a , copy of the workers' Compensation policy declarationpage(showing the•policy number.and expiration date). • Failure to.secure'coverage as required under Section 25A •of MGL c. 152 can.lead.t6 the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year iniprisonment, as well as ivi1 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. ofthis4staternent.may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify unittp-the;paks.Ofpenalt'oofkrjury that the. infoimation provided above is true' and correct. )147,0 Signature: - %.° 4 ' Date: • Phone #: 7a-D • Official use only. Do not write in this area be completed by city oritown 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 #: • k SECTION 8 - CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: / Not Applicable ❑ Name of License Holder : / / P �../ iL 4 2( )/T) 10 0 /)( �( - License Number Pa 60 a 9 G eer)gin( /-1 DI 3o3 - r s/21 //y Address - Expiration Date ) 3) -1` (4 - ct Signature Telephone • 9. Registered Home Improvement Contractor. Not Applicable ❑ -- 777e vJu L eon a%� i 1 il' joove,/ Company Name Registration Number Po &36 'd9 (rppn e lc( -/A 01 6 /e //>z Address / Expiration Date Telephone /03)71,1 /2 — 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 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 108.3.51. 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(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 s C 0 fWCl ('T 1 ' Section 4. ZONING All Information Must Be Completed. Permit Can Be Denied Due To Incomplete Information Existing Proposed Required by Zoning This column to be Shed in by Building Department Lot Size Frontage ' Setbacks Front Side L: ' R:' L: ' R: Rear Building Height , o o _P Bldg. Square Footage il / T Open Space Footage % (Lot area minus bldg & paved i ping) # of Parking Spaces Fill: (volume & Location) A. Has a S al Permit /Variance /Finding ever been issued for /on the site? NO DONT KNOW 0 YES IF YES, date issued:' IF YES: Was the permit recorded at the Registry of Deeds? NO 0 DONT KNOW 0 YES IF YES: enter Book : Page ! and /or Document # B. Does the site contain a brook, body of water or wetlands? NO er DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Conservation Commission? Needs to be obtained O 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 i i IF YES, describe size, type and Location: E. Will the construction activity disturb (clearing, grading, ex ation, or filling) over 1 acre or is it part of a common plan that will disturb over 1 acre? YES O NO IF YES, then a Northampton Storm Water Management Permit from the DPW is required. SECTION 5- DESCRIPTION OF PROPOSED WORK (check all applicable) New House Q Addition ❑ Replacement Windows Alteration(s) Q Roofing 50 Or Doors 0 Accessory Bldg. ❑ Demolition ❑ New Signs [0] Decks [0 Siding [O] Other [0] Brief Description of Proposed Work: _Si !lp i i 3(") lj r ( �hIr es Alteration of existing bedroom Yes ✓ No Adding new bedroom Yes ✓ No Attached Narrative Renovating unfinished basement Yes — No Plans Attached Roll - Sheet sa. 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, C ki4 P_ , as Owner of the subject property �J . y '� I I ��+l�l� hereby authorize / - ma//r' J Comp n c to act on my behalf, in all matters relative to work authorized by thi uiiding permit application. e Ira ( f Signature of Owner Date I, a 60"ence 4 / b (Tr_ , 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 / d1dL/ J a -- Signature of Owner /Agent Date Department use only City of Northampton Status of Permit: Building Department Curb Cut/Driveway Permit _ - 9M 212 Main Street Sewer /Septic Availability Room 100 Water/Well Availability h RECT DNS N rthampton, MA 01060 Two Sets of Structural Plans p � Pr ,oF gU i + -587 -1240 Fax 413- 587 -1272 Plot/Site Plans stork- A t hPT�N, M Other Specify APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -SITE INFORMATION 1.1 Property Address: This section to be completed by office I Rja"„ R""((�``�� "` Map Lot Unit FIQrefce_ Mil ®lot Zone Overlay District Elm St District CB District SECTION 2 - PROPERTY OWNERSHIP /AUTHORIZED AGENT 2.1 Owner of Record: C= I yd e_ )1 e l q R ctn Road rely() . Name (Print) Current Maili Address: C f)fl -i- rt ('t ii Telephone Signature 2.2 Authorized Agent: Tom. , Vh Cnm m \C__ Po e-bx 4d9 Grr 'n-ki Id 1-1A Df3 j Name (Print) Current Mailing Address: / Signature Telephone SECTION 3 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be Official Use Only completed by permit aEPlicant 1. Building (a) Building Permit Fee 2. Electrical (b) Estimated Total Cost of Construction from (6) 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) '3 J _ 5. Fire Protection 6. Total = (1 +2 +3+4 +5) 61„8 Check Number ///3Q 6t3 This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date 19 RYAN RD BP-2013-0687 GIS #: COMMONWEALTH OF MASSACHUSETTS Map:Block: 22B - 049 CITY OF NORTHAMPTON Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) Category: ROOF BUILDING PERMIT Permit # BP- 2013 -0687 Project # JS- 2013- 001136 Est. Cost: $5684.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: THE JUBB CO INC 55333 Lot Size(sq. ft.): 15812.28 Owner: SHERETTE CLYDE R & JUDITH A Zoning: WP (100)/WSP(100) /GI(73) /URA(27)/ Applicant: THE JUBB CO INC AT: 19 RYAN RD Applicant Address: Phone: Insurance: P 0 Box 429 (413) 772 -6217 Workers Compensation GREENFIELDMA01302 ISSUED ON:1/7/2013 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: Date Paid: Amount: Building 1/7/2013 0:00:00 $35.00 212 Main Street, Phone (413) 587 -1240, Fax: (413) 587 -1272 Louis Hasbrouck — Building Commissioner