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29-317 �r x � COMMONWLAUJI-l. OF MASSACHUSL1 1. rS DEPAIirI'MEN'I' OF INDUSTRIAL ACCIDENTS 600 WASHINGTON 5' 'ItLL' ' BOS'T'ON, MASSA.CRUSTI"I'S 02111 WORIMRS' COMPENSAXION INSURANCE AF IDAVU j� The Jubb Co, Inc. d.b.a. Larry Jubb's Improve-A-Nome (licenseelpernllttee) with a principal place of business/residence at: ' 7 Devens Street P.O. Box 429 Greenfield, Ma. 01302-0429 City/state/ZIp do hereby certiry, under the pules and penulties ul'pei}ury, (1utt: (X) 1 um un nmpluycr providing the Yellowing workers' compullsatiull cuvcrltgo rol'_Illy c11100yees working un this Job. 039 A-+) 8 / o Insurance Cua1p11ny 11WIuy Number O I atn a sole proprietor and have no one working fur tile. O I ant a sole proprietor, generul contractor or Iwnlcowner (circle one) and have hired the contractors listed below who have the following workers' compensation insurance policies: Naine of Contractor Insurance Company/Policy Number Name of Contractor Insurance Company/Policy Nutnber Naine of Contractor Insurance Company/Polley Number O I ain a homeowner performing all tile work inyself. NOTE: Please be aware dint while hoincowners who employ persons to do maintenance, constructlon or repair work on a dwelling of not Moto than three units In which tiro homeowner also resides or on the grounds appurtenant thereto arwilot generally considered to be employers udder the Workers' Compensation Act(OL C. 152, sect. 1(5), application by a homeowner for a license or permit may evidence ilia legal status of an employer under ilia Worker's Componsatloil Act. I understand that a copy of this statement will be forwarded to ilia Department of Industrial Accidents' Office of in3Grancd4or coverage verification and lint [allure to secure coverage as required under Section 25A of MOL 152 can load to the Imposition of crhnlnal penalties consisting of a fine of up to$1500.00 and/or iinprisonnient of up to one year and civil penalties lit the form of a Stop Work Order and a fine of$100.00 a day against me, Signed tits _ �� day of �j _7n LicenseilPermittee Licensor/P snit r 91te Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 100001 Type: Private Corporation Expiration: 6/8/2008 The Jubb Company, Inc. Larry Jubb Jr. _--- — P. O. Box 429 - Greenfield, MA 01302 -- Update Address and return card.Mark reason for change. 50M-04/05-PC8698 )PS-CAI ES Address [] Renewal [j Employment Lost Card Board o f Buildin egulations One Ashburton Pace, fpm 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 05/21/1961 Number: CS 055333 Expires:05/21/2008 Restricted To: 00 LAWRENCE A JUBB JR PO BOX 429 GREENFIELD, MA 01302 Tr.no: 23246 Keep top for receipt and change of address notificatlon. :)PS-CAI 0 5OM-04/05-PC8698 e ' The Jubb Co., Inc. d.b.a. PROPOSAL 20 LARRY JUBB'S MA Registration 100001 MA Cons. Sup. Lic. 055333 page 2 of 2 IMPROVE-A-HOME TM 7 Devens Street 18 North Hatfield Road P.O.Box 429 Hatfield,MA 01038 Greenfield,MA 01302-0429 (413)772-6217 Northampton,MA (413)584-3716 PHONE DATE TO: Mackay, Judy 586-1358 07/20/06 115 Brookside Circle JOB NAME/LOCATION Vinyl Siding installed to: Florence, Ma. 01062 House only. 115 Brookside Circle Florence, Ma. 01062 JOB NUMBER JOB PHONE We hereby submit specifications and estimates for: - SEAMLESS GUTTERS: $504.00 ' *YES *add to belwo price. SERVICE FEE $250.00: (includes permit & disposal of all job related refuse) . (service fee amount not included in total below & is to be billed at job completion] . We Propose hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of: Five Thousand Seven Hundred Twenty Three and 00/100 Dollars dollars($ 5,723.00 ) Payment to be made as follows: $1,000.00 DEPOSIT UPON ACCEPTANCE. INVOICES ARE 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 collectina any sums owed. 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 specifics- 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,tomado,and other necessary insurance. Note:This propod,may e Our workers are fully covered by Worker's compensation insurance. withdrawn by us if not accepted within 30 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. Signature Date of Acceptance: / n� PRODUCT 13128 FOLD AT I,)TO FIT COMPANION 771 OU-O-VUE ENVELOPE. NEBS To Reorder:1-800-225-6380 or www.nebs.com PRINTED IN U.B.A. B ~ The Jubb Co., Inc. d.b.a. PROPOSAL 20 LARRY JUBB'S MA Registration 100001 MA Cons. Sup. Lic. 055333 Page 1 of 2 IMPROVE-A-HOME TM 7 Devens Street 18 North Hatfield Road P.O.Box 429 Hatfield,MA 01038 Greenfield,MA 01302-0429 (413)772-6217 Northampton,MA (413)584-3716 PHONE DATE TO: Mackay, Judy 586-1358 07/20/06 115 Brookside Circle JOB NAME/LOCATION Vinyl Siding installed to: Florence, Ma. 01062 House only. 115 Brookside Circle Florence, Ma. 01062 JOB NUMBERT / <7 JOB PHONE We hereby submit specifications and estimates for: - 1 —SUPPLY & INSTALL ALCOA/MASTIC BARKWOOD VINYL SIDING .048 GAUAGE THICKNESS- -width: ( 4" ) '9 1 -siding color: ( Victorian Grey) corner color: ( Victorian Grey ) # Z�-3 -*trim color: *all trims to be WHITE unless otherwise specified. *an additional charge may apply. (*SPECIFIED TRIM COLOR: ) *trim colors for: soffits, fascias, j-channels, window & door casings, light blocks, louvers and other accessories. -3/8" *backer beneath siding. * (substrate/SUBSTRATUM, wall levele r) . -to nail siding approximately 16" on center & according to manufacture specs. -replace minor areas of exterior sheathing wood rot. (replacement allowance of up to a total of 3 @ 7/16" each osb sub sheathing) . -vent all soffits where possible to heated areas of main house only. excludes side peaks. -install center vented vinyl soffit panels on all applicable overhangs. _ -install j-block light blocks and dryer vents as necessary. excludes furnace & stove vents. -remove and dispose of exisitng siding. -install wind and weather barrier prior to backer installation. -supply & install 02 @ 12" x 18" louvers. -to supply & install 03 pair of Girardin closed louvered poly vinyl shutters 14" width. -rake and broom clean job site at end of each working day. -lifetime manufacture guarantee on Carvedwood2 Vinyl Siding. -labor guarantee as required by MA building regulations and standards. NOTE: 1) . Jubb to repalce two rotted fascia boards at side porch entry overhang fascia. 2) . Jubb to remove railing and install vertical ledger for future railing installation by other than Jubb. 3) . not to cover side entry overhang inner ceiling area, posts, rails, skirts, lattice, door jambs or kick plates. We Propose 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 made as follows: $1,000.00 DEPOSIT UPON ACCEPTANCE. INVOICES ARE 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 manner according to standard practices.Any alteration or deviation from above specifica- Authorized I/ lions involving extra costs will be executed only upon written orders,and will become an Signature 1• extra charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tomado,and other necessary insurance. Note:This propo I may be Our workers are fully covered by Worker's Compensation insurance. withdrawn by us if not accepted within 30 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. Signature Date of Acceptance: ►R0011CT 1[1[1 FOLD AT 1.170 RT COMPUIIOM Tit OU•0•WF[MY[LOP! NFRR Tn Rnnrrlwr•1•Ann.99A-A1An m www nwh%nnm MINT[D IN 11. R ' R SECT 0 N8Y CO�NSTRUCTIONSERVICESr � : 8 1 Licensed Construction Supervisor: Not Applicable ❑ J P © i 3 Name of License Holder:�y'PiG�.(�Pi � � � �,�-� License Number 01602- 51 o Address ,�;_� Expiration Date Signature Telephone Re e£"eti 'om m rovemen Contractors ;,R Not Applicable'-.0 ( D o0o I Company Name Registration Number o ? essQ ^ L�, Expirat on to 1 `� Telephone —'(g, Z-1 SECTION 10 WORKERS'';C,OMPENSATION INSURANCE.AFFI DAVIT'(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....... Nc No...... ❑ The current exemption for"homeowners"was extended to include Owner-occupied Dwellings 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 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 pen-nit. 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 ;; :r} yi,p�� p � pNl�t�rAl' K1 ry .�F�'�'L�tr� sy,'L { �ly it.N. ! h S C710 5 D SC PN-1owe APR ED O f a �a IJc bl ny NNxWx'#.IxnW!i ?xn9pnTMP9!xfnx. .xws.�raaw+wvpa.r,...v-,w.._,px,.wM,n,wa e.xvra-r pnKrwx.r�. �ry �, ,r„rn'.p,nr! A,rmY;�, . P'!l!, 7GdeiKuk'EiPIIC'dM”rr %! !gPti'T'n�iS4'rif.idG'61+"" °M•'1 .rWWKN,;k:.9%SNRNpUAW:RN�AAG'.'.K: S" .A,::d'.sy ur....t-_ '��'F'6KE9'�:l•G New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑ Or Doors ❑ Accessory Bldg. ❑ Demolition[] New Signs [ ] Decks [ ] Siding( Other [ ] Brief Description of Proposed Work: +T'"'0✓ i.�J l�t Alteration of existing bedroom Yes No Adding new bedroom s No / Attached Narrative❑ Renovating unfinished basement Yes ✓ No Plans Attached Roll❑- Sheet❑ w�fftNe�h-ouse and or additin ot e igf f ouisiiik dmpletee 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. 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 SECTION 7a ;OYVNEMAUTNORIZAFION 4 PTO BE COMPLETED WHEN OWNERS�AGEI�T�OtC.OITR/ CTORYgPPI:IESFOR�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 I, La W ir-e, -. t.� �, °� �r., t't-" 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 Signature of Owner/Agent Date City of Northampton Building Department 212 Main Street J�j i� 2 21C .' Room 100 Northampton, MA 01060 s phon#413 11,587.1240 Fax 413-587.1272 e e Pe APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTION 1 -',SITE (,NFORMATION o' ect""" o e"tc p etl b office >� '< 1.1 Property Address: ff a a t Lo r t � �- G Zone 0 e a Dis Elm St District n , '',• f _ :CBLD�15trylct"r XYw . 4 '. :SEC TION"2-;PROPERTY'OWNERSHIP/AUTHO.RIZED AGENT 2.1 Owner of Record: Name(Print) C ru peDi ailing Address: Telephone SV� " ' Signature 2.2 Authorized Agent: PO 2--9 ij A ° t 3 0 2 Name(Print Current Mailing Address: Signature Telephone SECTION 3' ESTIMAT ED`CONSTRUCTION CO5TS . Item Estimated Cost(Dollars)to be Official Use•Only completed by ermit applicant 1. Building (a)'Building'Perrnit Fee S `7 2....3. cr:>0 2. Electrical (b) Estimated Total Cost of Construction:from, 6 3. Plumbing Building Permit Fee 4. Mechanical (HVAC) 5. Fire Protection 6. Total =0 + 2 + 3 + 4 + 5) S 23 a Check Number This Section For Official Use Only Buildrng:Fermrt�Numberx Date Issued: Mt Signature Budding Commissioiier/Inspector of;BuiJdiggs Date"� .r. BP-2007-0115 GIS#: COMMONWEALTH OF MASSACHUSETTS CITY OF NORTHAMPTON Lot: -001 Permit: Building Category_ BUILDING PERMIT Permit# BP-2007-0115 Project# JS-2007-0174 Est. Cost: $5723.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: THE JUBB CO INC 100001 Lot Size(sq.ft.): 12937.32 Owner: MACKAY JUDITH A Zoning:URA Applicant: THE JUBB CO INC AT: 115 BROOKSIDE CIR Applicant Address: Phone: Insurance: P O Box 429 (413) 772-6217 Workers Compensation GREENFIELDMA01302 ISSUED ON.713112006 0:00:00 TO PERFORM THE FOLLOWING WORK.-REPLACE 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 7/31/2006 0:00:00 $25.009207 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo