Loading...
17A-127 DEBRIS AFFIDAVIT As a result of the provisions of MGL c. 40, S 54, I acknowledge that as a condition of this Building Permit, 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 definedbyMGLc. ll1, S 150A. I certify that I will notify the Building Commissioner of any change in the location of the solid waste disposal facility to be used within 72 hours. 6/07/ja Date Sig • •••4'.f Pe , it Applicant Print or type the following information: U71/36 (90( )/(C., Name of Permit Applicant Firm name (if a licable) 9 f1� 3� / �OW -i-/C� . Address The debris will be disposed of: c%� 6 C: Facility 71-P/(44—S atZUf. 6/nZir/Address ' /�>"� PROPOSAL 90 The Jubb Co., Inc. d.b.a. LARRY JURB'S MA Registration 100001 MA Cons. Sup. Lic. 055333 Page 2 of 2 IMPROVE-A-HOME® 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 PHONE DATE TO: Wanczyk, Richard 586-2946 7/03/13 305 Bridge Road JOB NAME/LOCATION Florence, Ma. 01062 305 Bridge Road Florence, MA. 01062 ---------- ------------ --------- JOB NUMBER JOB PHONE We hereby submit specifications and estimates for: 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 where dumpster is placed. Jubb nor the dumpster company will assume liability for said possible damage. 2) . It is the homeowners responsibility to cover and protect items stored in attics, garages, sheds, etc. where dirt, dust or debris mall fall due to nature of work. 3) . 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: $875.00 (includes permit & disposal of all job related refuse) . [service fee not included in total at bottom and will be added to final invoice at job completion] . We Propose hereby to furnish material and labor —complete in accordance with the above specifications,for the sum of: Thirteen Thousand One Hundred Twenty Five and 00/100 Dollars dollars($ 13, 125.00 ). Payment to be made as follows: $4, 700.00 DEPOSIT UPON ACCEPTANCE. $4, 700. 00 upon start. Balance due upon completion. 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 manner according tc standard practices. Any alteration or deviation from above specific— Authorized :Ions involving extra costs will be executed anfy upon written orders, and will become an Signature ---"r-f 4i. 411L ` - -wA extra charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry tire,tornado,and other necessary insurance. Note:This proposal ay Our workers are fully covered by Worker's Compensation insurance. withdrawn by us if not accepted wi 30 days. A d �0p�1� C( �� I) 1poSal fh, ho P prico specifications ns and Signature XV/ y / _onon ois are siti:+actzy r ri re hereby accepted. You are authorized to do the work as specified,Payment will be made as outlined above t 1 3 f Signature _ Date of Acceptance: Crta.. M_` �, .l ad, --__-- __-- _-- L—_,.-- - The Jubb Co., Inc. d.b.a. PROPOSAL 90 LARRY JUBB'B MA Registration 100001 MA Cons. Sup. tic. 055333Page 1 of 2 IMPROVE-A-HOME® 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 PHONE DATE TO: Wanczyk, Richard 586-2946 7/03/13 305 Bridge Road JOBNAME!LOCATION 305 Bridge Road Florence, Ma. 01062 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 2 @ 4 ' x 8 ' 1/2" CDX plywood as necessary. additional plywood replacement an additional $50.00 per sheet replaced. No credit for plywood not needed. -Supply & install 6' width of ice & water membrane at roof bottom & to all valley's of heated l areas. -Supply & install 15 lb. felt to remaining exposed wood. -Supply & install 5" - 8" aluminum drip edge to all fascias. Color: white. -Supply & install shingle over ridge vent. -Supply & install # vent stack boots. -Supply & install aluminum step flashing at all intersecting gables and chimney's if necessary. -Rake and broom clean job site at end of each working day. -lifetime limited shingle guarantee from manufacture. (see separate copy of manufacture warranty) -Labor guarantee as required by MA Board of Building Regulations and Standards. -any work not specifically described here-in will be executed only upon a mutually agreeable and accepted written change order. NOTES: 1) . Remove & re-install Gutter Helmet to the front gutter. 2) . Power wash the entire house, garage and shed roof. 3) . Install zinc strips to the just under the bottom edge of the top row of shingles. Approximately 8" down from the ridge. 4) . Install new garage door weather stripping to the 02 garage doors. Tops and sides of each. \7 ropose hereby to furnish material and labor -complete in accordance with the above specifications,for the sum of: Cont d dollars($ Cont'd )• Payment to be i nati as toilows: $4, 700.00 DEPOSIT UPON ACCEPTANCE. $4, 700.00 upon start. Balance due upon completion. 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 i 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 specifics- Authorized r ,/+� �y ,.} tip t, involving extra costs will he executed only upon written orders, and will become an Signature _ ` ��' �"jB 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. Note:This prososal m./ Our workers are fully covered by Worker's Compensation insurance. withdrawn by us if not accepted hin 30 days. Acceptance of Proposal The above prices,specifications and ;, onuiiions are satisfactory and .e hereby accepted. You are authorized to do the work Signature sr. as specified.Payment will be mace as outlined ahoy J Signature ■ Date of Acceptance'— _ - _. - _ --- ---- ------ =-*,..., = Department of Industrial Accidents Sinti Et Office of Investigations =Ee 1_ " °�� - 600 WashingtonStreet _aII.I ,. • vii= c •� . Boston,.MA 02111 . :.*4 : www.mass.gov/dia . • Workers' Compensation Insillrance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Infdrmation ' : .Please-.Print::Legibly . Name (Business/OrgnizatTh,e4 ion/Individual): 0(,6 C"O .... ' • Address: �.Pr - .(Sf` • •City/State/Zip: - Phone•# ( `97 - ( ./ Are you an employer?'Check the°appropriate box:•. Type of project(required): I.❑ I am a employer with 4, ❑ I am a general'contractor and I. 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 Z.:,D Remodeling . ship and have no employees •These subcontractors have -.., 8:;:t1Demolition .: working for me in any'ca aci . workers' comp.insurance. g Y p tY 9. Q Building addition [No workers' comp. insurance . 5..:❑ We are a corporation and its required.] • . officers have exercised•their 10:[) Electrical repairs.or additions 3.❑ •I am a homeowner doing.:all work; : right.of exetnptiori per MGL Ti. ::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.�] Other. comp, insurance-required;] *Any applicant that checks box#1 must also fill out:the section below showing:their workers'compensation,policy information. • t Homeowners who.submit this affidavit indicating.they±are doing.lall work:andtheri hire outside-contractors mTist;submit anew affidavit indicating such tContractors that check thus box tiiust attacli'ed an additrona;sheet:showing the:iiame of.the sub contiicriiis and;thif workers'como-rpolicy information;" I am an employer that is providing workers'compensation.insurance for myemployees.,-Below.is the policy:and job site information: Insurance Company Name: /1)4-11177)G.•../ � 'C 7.1r- s . : . .. . • . Policy#or Self-ins. Lic, #:. : :(/�.]�`fi0. '\"�� . . Expiration.Date::.' . 4)3./f�?Q/ • Job Site Address: i : ' _.. :, . . -,. City/State7Zip `. - , Attach a.copy of the workers'compensa_tions.policy;declarations page.(sliowingahe.policy number:and.expiration date). • Failure to secure°coverage as required under Section 25A ofMGL c.:.1.52'-canlead.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..'B`e advised that a:copy:ofthis'statetnerit.may be forwarded to:the Office of Investigations of the DIA for insurance:edverage verification." . • • . • I do hereby-certify:under i A and.aerialties of perjury that th'e infotmdtion provlrleehibo e�k trueandcor'reci~ Signature: �/ !' 2r ----., Date:: y. .... . Phone#: V1 -- 779 .. ... •. • Official use only Do not write in this area,to be completed by city or;town official • City or Town: Perniit/License ii • 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#: • • SECTION 8-CONSTRUCTION SERVICES 8.1 Licensed Construction Supervisor: Not d �� Not Applicable ❑ Name of License Holder: t,�}Gv ice n c(2.- '- J1.hb[fr C _S -0,65-3,33 License Number hi- &x yay / (lri (J /)t/cIf Address Expiration Date Slg u ---------- Telephone 9.Registered Home Improvement Contractor. Not Applicable ❑ Company Name� J L h C y)14 V'! (J( Registration Number W / COrre 1 1 -uz-IC 6tist/c /ki Address Expiration Da Telephone ' 72 (,j2 1--' i' 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 108.3.5,1. 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(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) ❑ Roofing Or Doors ❑ Accessory Bldg. ❑ Demolition ❑ New Signs [O] Decks [C] Siding[0] Other[0] Brief Descn on of�� �OSa — �TCA f f fic h(� 7` P Q 1-1 C�C�. IS �7 P u i �i 11� }/ S�lrl Work: ,UU(''1�. J 11 Alteration of existing bedroom Yes No Adding new bedroom Yes No Attached Narrative Renovating unfinished basement Yes No Plans Attached Roll -Sheet ga.If New house and or addition to existing housing, complete_t__he 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. Signature of Owner Date I, (�)�lI , � as Owner/Authorized A�nt ereb declare that the sta ents and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signe nder the pains and penalties of perjury. i r . /le ,<int/(1` Print Name e Signature 4 e ge Date 33/Wy A.2, 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 filled in by Building Department Lot Size Frontage , Setbacks Front Side L: ' R: L: R: Rear Building Height Bldg. Square Footage % i Open Space Footage % (Lot area minus bldg&paved parking) #of Parking Spaces '1 Fill: (volume&Location) A. Has a Special Permit/Variance/Finding ever been issued for/on the site? NO 0 DONT KNOW 'fit-) YES IF YES, date issued:' IF YES: Was the permit recorded at the Re istry of Deeds? NO 0 DONT KNOW YES IF YES: enter Book Page i and/or Document# B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW O YES O IF YES, has a permit been or need to be obtained from the Con ervation Commission? Needs to be obtained O Obtained © , Date Issued: i 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 O NO IF YES,describe size, type and location: ! E. WV the construction activity disturb(clearing,gradin ,e cavation,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. Department use only • RECEIVED City of Northampton Status of Permit wilding Department Curb Cut/Driveway Permit fl ' 212 Main Street Sewer/Septic Availability Room 100 Water/Well Availability N 'rthampton, MA 01060 Two Sets of Structural Plans cz'T-7-71-.'-u: 7:77&'44 41 587-1240 Fax 413-587-1272 Plot/Site Plans Other Specify APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELUNG SECTION 1 -SITE INFORMATION This section to be completed by office 1.1 Property Address: ` „ 0 3 t ,l;kdt 1 Map Lot ._ Unit F-`vin C- --. fly (j j(9c). Zone Overlay District Elm St District CB District SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record: V+c,bl1r1 cOr),,\czy►< 36- A -IIrl C Name(Print) Current Mailing Address: > `(Y Telephone Signature 2.2 Authorized Agent: —Ghb a, )nc Via- y�9, (_2pp n fi-eifi Name(Print) Current Mailing Address: .// (Jib- 2--‘z/ - Sign. .re 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 /!, l CO L/ 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) :OM Check Number /iv 59 $‘.3-5 This Section For Official Use Only Date Building Permit Number: Issued: Signature: Building Commissioner/Inspector of Buildings Date 305 BRIDGE RD BP-2014-0066 GIs#: COMMONWEALTH OF MASSACHUSETTS Map:Block: 17A- 127 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-2014-0066 Project# JS-2014-000144 Est. Cost: $14000.00 Fee: $35.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: THE JUBB CO INC 55333 Lot Size(sq. ft.): 22999.68 Owner: WANCZYK RICHARD J&JUDITH M Zoning:URA(100)/ Applicant: THE JUBB CO INC AT: 305 BRIDGE RD Applicant Address: Phone: Insurance: P 0 Box 429 (413) 772-6217 Workers Compensation GREEN FI ELDMA01302 ISSUED ON:7/23/2013 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 7/23/2013 0:00:00 $35.00 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Louis Hasbrouck—Building Commissioner