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36-004� fie Board or 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. Al A conn•oaio,-rcoaoo Address ❑ Itcucrval E] Employment Lost Card Board of Build' Mac egC�ulations One Ashburton e, 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 notification. -CAI A 60M•04105-PC0898 The Commonwealth of lllassachcrselts .i 3 1)epur•turent of Indctstr•ial It ecidents Office of In vesligations 600 Washington Street Boston, MA 02111 Ivlv►v.nrass.go tAlia Workers' Compensation Insurance Affidavit: Builders/Corttr actors/Llectriciaiis/Plulubers Aimlicant Itlforulalion Please Print Legibly Name (Busincss/Orbaniration/individual): 1—r-, Address:, I' O . -ox +_)_9 City/State/Zip: d , M A- o i•30Z-1'lione #: -7-7 2L-6,2l Arc ou an employer?Check the appropriate box: Type of project(required): LM I attt a employer with -5 4. ❑ I ant a general contractur and 1 G. ❑ New construction employees(full and/or part-tin►c).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on (lie atlached sheet. t 7. ❑ Remodeling slip and have no employees These sub-contractors have 8. ❑ Den►olition working for n►o in uny cupacity. workers' comp. insurance. y, ❑ Building addition [No workers' comp.uisurance 5. ❑ We are a corporation and its required.] officers have exercised their IU.❑ Electrical repairs or additions 3.❑ I aM a homeowner doing all work right of exemption per MGL 11.❑ Plutnbblg repairs or additions Myself. [No workers'comp. c. 152, §1(4),loud we have no 12.❑ of re airs insurance required.]t en►ployces. [No workers' 13. 011►cr r� i v� o l j S comp. insurance required.] Any applicant[hat checks box N 1 must also fill out the section below showing their workers'compensation policy information. t l lonrcowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that cheek this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. lam an employer drat is providing workers'compensation insurance for my employees. Below is the policy and job site Information. Insurance Company Nalne: S t Policy 0 or Self-ins.Lie.It:_ (2,W C-, 0 3°I+9-2g Expiration Date: J O-1 d _ [ ` � O I o Job Site Ad Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration dale). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of cruninal penalties of a find up to$1,500.00 and/or one-year ilnprisolunent,as well as civil penalties in the forin of a STOP WORK ORDER and a fuse of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to tlue Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pair nd nalties of perjury that the information provided above is true and correct. Si nature: 4t... Date: 0 Phone#: -7 7 2L—�Zl—1 Official use only. Do not lvrile in this area,to be completed by city or lows official. City or Towu: 1'ern►il/License It Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical inspector 5. Plumbing Inspector G.Other Contact Person: Page No. of Pages Ae lacement inboW ro ont Main Office: ton, MA: 7 Dev s Street•P.O. Box 429 THE JUBB CO., INC. d.b.a. Northampton, 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 ADAm z S r�Z- STREET z JOB NAME I & Fvacesr C CITY,STATE AND ZIP JOB LOCATION �D LrE IK . TENTATIVE JOB SCHEDULE(Weather Permitting) MA Registration 100001 Approximately weeks from date of signed proposal received by Jubb Co., Inc. I MA Cons. Sup. Lic. 055333 We hereby submit specifications and estimates for: Supply & Install Mastic RayAe TUa n o�rd 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. 11 • Continuous Balances (double hung only). • Insulated padded frame. • Sun Shield Vinyl Compound (Mastic exclusive). • Energy Star approved. *�)_o3 , • Twin locks on double hung units 32" or wider. • Virgin vinyl. • Twenty year manufacture guarantee on glass seal failure. • Lifetime transferable manufacture guarantee on vinyl window frame. • Labor guarantee as required by CTO NH, VT contractor regulations. Color: Linen White ❑ Almond* (*extra charges ap p! for this colors) TOTAL UNITS REPLACED: a4 u `; uwi r i U f/ifv M ❑ Grids No (Note: Grids are beveled) S i1/F O o" Window Low "E" Glass• ❑ Argon Insulation (into welg pockets) V-Stofrn Removal Aluminum Clad Exterior Castings (`XFull ❑ Partial ) /o 14LL /V45: q 1,JiNopL,; 11U577W46F1> OTHER/ NOTE: -f�,nr� SP�SKF� o N (3F�Tt-IRAOa� two tV�u.�S `T6 I9� v155, 01 ED � ` GLASS - � , o,Vj, �-t �,nlc� $L°o rA utj rr to reSE vr%_ l4 LiT� .s'G iv�'k' W;rr/ A 1C> l CcstV v - D %a C7Q6&4" C IV i9 CeIr" Flu IV 6S c P.LAM24e wIv.)sx>tj t`N rYIc D►�LE , SECT�O�,N�8�r,�iC�O�NS�`fR�UCTIO�N,4SERVICES'i���`•t�A!�, 8.1 Licensed Construction Supervisor: Not Applicable ❑ Name of License Holder : F—R�.�1 ir-Q�L Gf'� J (t J Y' O�s" ' License Number l Pty Pno x cl Address Expiration gate Signature Telephone Re is eredTFfomi:llmpro emen�'C`ontractor ' '.'r° u.��a x '` s�l NotApplicable .0 I oyoo Company Name Registration Number J?C) O�, ei AA-A 0 ?5C,-2- 01"21oklwg Address Expiration Date Telephone­77�"_�Zt -7 4N 'SEC �ON;aU'„V1fORKERSI,;COMPENSA710N INSURANCEAFFIDAVIT(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....... No...... ❑ _ V. 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 lie/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 persons 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 r• 1� ,r, I Ylfa It ,iii_ '�'g �dW iF;+Fi + r.„+ .v i r i �':ci, � a '.:. - �' �7}+ � {` dtiFLX4id ri7 F��N:tT�j34'�i�i�d414�irtti.N'u��kJ�rF{I Jai�h'�n'G�•MF���i tlir SECTIONSFDESCt21PTION�OF�PROPOSEDbWORFSt{clieckt�alltapplililc) rr-,.rrtn'nv.v.i,us.•rv.:r xK nm'•ai..v;r+•.rra,.»n+nn+ +�-...lb. .RfKRFte»±IAVI�FWC'!/IKpNYI"a MYUU':RIt9¢FF'D�R.Ip+9µryll!'i•:V dR.l.i,C{:rM+�•Ftr.r �rwr. ' .,• 'f:Y,fln FA'.tl',.i b??Tti'.Rh3.NYCy',•1•• "FaK� •f•. •e. M•.911,r:!CMt4i71!nit,7:OhN11!'.'N�k9r/P9YiCVIA aMIa.'V!iYlkaMunFjI:1't"Iv:m f'l w%M,1.;7+A+�.•' 'r' ^°i' r New House ❑ Addition ❑ neplacellleyt Windows Alteration(s) ❑ Roofing ❑ Or Doors Accessory Bldg. ❑ Demolition❑ New Signs [ j Decks [ ] Siding[ ] Other [ ] Brief Description of Proposed Work:2 Alteration of existing bedroom Yes No Addint new bedroom Yes No Attached Narrative❑ Renovating unfinished basement Yes No Plans Attached Roll O• Sheet❑ �a;�If�Neinr�house';ra-nd�'rfi'acli�ifi"on"�toTezisfitigfhou's"ing"•coiiiplete+ttierfo(fowing_ 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 L 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 S,ECII,ON�7aKOWNERAUTHORIZA710N� +TOBE�COMPLETED''.WHEN � rrtS«AGEl,TOCQ1�TAC7rORAP,PLIESFtORBUILDING'PERMIT l• , as Owner of the subject prope hereby authorize to ac my behalf, in all matters relative to work authorized by this building permit application. tn1 C'.t,�S � .✓ Signature of Owner Date (, ►' f.� t.�� t�--��J —J(-. �i , as Owner/Authorized Agent hereby declare that the statements and infor 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 Signature of Owner/Agent nto s ' r City of Northamptona r Building Department 212 Main Street Room 100. a e e Northampton, MA'01060 e o a a P a phone 413-587.1240 Fax 413.587.1272 o SS.e P 1.0- .0 ........... f4 APPLICATION TO CONSTRUCT, ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING SECTL0Nt1r SITEIJNFORMATION,, , ,, , �.. r ..N"� tr,T tis;sectio "fo lie"comp e ed by offic'eIN. 1.1 Property Address: , ,• r,rJ. ti y t .,•ri i w A' IL P0 ni ( © ��, Zone N .O,verlaDlstrlc ! o 1 �: f t11'( 1, tdEtg y , r .r r�rl1,'i�. ,` •,'t ��'l; .�CB'lsti'iCtM�[�i�3�titj'?'�ri�� �Elm'St:Dislricl .��„ rx `` yn 'SEC'TIQN12 -1 PROPERTYr p,1r VN,.��R,$HIR%AUTHORIZED',AGENT' till 4:i: 2.1 Owner of Record: Name(Print) Current Mailing Address: _ 3 j Telephone cp Signature 2.2 Authorized Agent: Name(Print) Current Mailing Address: ©i 3c 2 Signature Telephone I,tE(NI F:da, ,.. ;SEON`"3 -�ES'TIAMATED�CONS'TRUCTION COSTS r� Item Estimated Cost(Dollars)to be (filial UselOrn�I , ` :I ,liAr�lgi iw rd th; r5-� -,� I .r completed by ermit applicant 1. Building (a)'Bullding'Perrpit'F�ee 111 1 ,,F 2. Electrical (b) Estimated Total;,Cost;of Construction,;k6 !'(6 3. Plumbing Building .Kermit .ee•''r'' 4. Mechanical (HVAC) 5. Fire Protection 4b I 6. Total =0 + 2 + 3 +4+ 5) S. 0 o Check Number fi.hls ec on Official U For selonl S ti , J , �,r •r��u ire •, '. r t 4. Id h i" tN4 rl� I,, I i 4 ' II1,�V.�,,I i ! I ' r I'"11 f'I'41 11 i91 N a BUIIdIrnlgl Ryp tt�ItxNUmlle�` �d�,' aril i , , Date Issued � 11 tI IIYI a�lk 9' 'l rrygQ ,1,f qi 7��4J i, � .� rJ�5: 1 .. � .,.:a 1 i 1,.0 iN I' r +•N.�",�r � I!! ' , 1,., •�f ppi'L•r71�1•G��,, ry i I IcI1y,Flryp,J7�,W"IdJI.A,p� '�$PI��,IiII,�Jd7,II A•{fIJ' N r•�•, ' yy�{.{ 1 r '1 �t .. .t rl. 4M)U lr�ltply�6e+- Y� , �Y;MM�NP q11���F�1��7' Pil 'F 4' nFq.fi .�f I ' ,t II: 14 1 -. t41�S"!{ rls,l ' P � Buildi;rig Commissio.tier,/•tnsgectoeof!Bui.fdings,,.* *I Date4 BP-2008-0265 GIs#: COMMONWEALTH OF MASSACHUSETTS �► 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-2008-0265 Project# JS-2008-000389 Est. Cost: $4995.00 Fee: $25.00 PERMISSION IS HEREBY GRANTED TO: Const. Class: Contractor: License: Use Group: THE JUBB CO INC 100001 Lot Size(sq. ft.): 15420.24 Owner: PRYMOWICZ ADAM M JR&VIOLA M Zonis URA Applicant. THE JUBB CO INC AT: 16 FOREST GLEN DR Applicant Address: Phone: Insurance: P O Box 429 (413) 772-6217 Workers Compensation GREENFIELDMA01302 ISSUED ON.-911412007 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 9/14/2007 0:00:00 $25.0010155 212 Main Street,Phone(413)587-1240,Fax: (413)587-1272 Building Commissioner-Anthony Patillo