36-011 91te -P
Board of Building Regula ions and Standards
One Ashburton Place - Room 1301
I vi 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.
;AI A 50M-04/05-PC8696 Address Renewal Employment Lost Card
Board of Building egulations
One Ashburton Prace, 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.
3-CAI A 50M-04/05-PC8898
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The Commonwealth of Massachusetts ��, y;•�_i'� J '��- 1 � �
Department of Industrial Ac•c•idents
Office of Investigations
600 Washington Street
Boston, Mil 02111
wwminass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Pluinbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): rr.-e— `J LA_," CO.
Address: P O
City/State/Zip: -V��,,-C�i d, M A U t30ZYhone il: -7-1 2-(0 2t
AFlou an employer?Check the appropriate box: Type of project(required):
1. am a employer with 4. ❑ 1 am a general contractor and 1 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. _ E] Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. workers' comp. insurance. 9, ❑ 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 exemption per MGL 11.❑Plumbing repairs or additions
myself. [No workers' comp. c. 152, §1(4),and we have no 12.[:] P of repairs
insurance required.]t employees. [No workers'
comp. insurance required.] 13. Other
*Any applicant that checks box 91 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
?Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lie.#: C-W C, D 3°14-4-28 Expiration Date: J ��
Job Site Address:_ S� I=r� Q,S l,u� �A✓ . City/State/Zip �-(ter _ , /fit/� 1 U Z,
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead 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. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pair rnallies of perjury that the information provided above is true and correct.
Signature: '" Date: 51,5/0j
Phone#: -7 7 9 Z1-7
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.Cityrfown Clerk 4. Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone Ih
i
]&C placement nbo� P �Lo on L Page No. ( of / Pages
Lb L
Main Office:
7 Devens Street• P.O. Box 429 THE JUBB CO., INC. d.b.a. Northampton,
�eenfield, MA 01302 (413) 584-37116 6
(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
QOM �� C Z
STREET JOB NAME f OF
S, Fors '
CITY,STATE AND ZIP JOB LOCATION
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 Raq4Z ?Va.tevd44d 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. .
• Sun Shield Vinyl Compound (Mastic exclusive). • Energy Star approved. I
• Twin locks on double hung units 32" or wider. • Virgin vinyl. q0.7
• Twenty year manufacture guarantee on glass seal failure. L
• Lifetime transferable manufacture guarantee on vinyl window frame. SO•o
• Labor guarantee as required by CT, A, NH, VT contractor regulations.
Color: XLinen White ❑ Almond' (*extra charges apply for this colors) a
TOTAL UNITS REPLACED: `� l f,bl�1-lv�►�us 1 P►�,t-��� (Aw0ow I,dr4WAA
❑ Grids Na (Note: Grids are beveled)
A'S �� � strnm.Wndbw Removal
.Low "E" Glass�� ❑ Argon ,�( Insulation (into weight pockets) JS�' ,o,rtS
Of Aluminum Clad Exterior Castings ( A Full ❑ Partial )iDE o e O r+k DR s iv R oc
OTHER/ NOTE: SLDEIR�' lMese Yo 9IC- xN rr-tLtRD f7kcgn j'XTE 1 aiz
IG
rorv+- L0100011J
SECTION 8t 4CONSTRUCTIO,N .;-SER ICES' "
y,'M.[r?!t J.+ y„c..rA .y.;k..•L2*f J,l, a,,:.�
8.1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder: Lk �,�� Y't. ,J ( jh�,r-J 1' 1�GS • d 5��
License Number
l
� 1 n I /V1 A D 0 Z- o -7
Address -.�' Expiration
Signature Telephone
:.Reg sfe edfNome°I]mprovemeri;ontra s. , 7c .kr_na�u ! Not Applicable .❑
000o J
Company Name Registration Number
Address Expir do Date
Poo �J FAX I �'r1�£ Telephone Z
j
! !
SECTION�10',kWORKERS',COMPENSATION':.INSIJRANCE�AFFIDAVIT(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...... ❑
0�wrier. in—W pflolnl
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 therc
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 buildine 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 persont
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
����nlK��FI�� I�$��d�l�lllll��1�l�IIIIlN'1M'��,IY t��r�i'n1� 11 lefl IV 1 J' Al
SECTIONxS�IDESCRIPTIONtOF�PROPPOSEDIWORFSt(ctieck�all ap lic'able o raj
•ot,e1^dVre;asdl ws.r•. r An+ qr+,7r +!a.n•.r l�..r ..•fin
NITTS�F"nits}uP•�'x"h'!NIIf,IP MM,1'1".klffl'MT d../r.,.!LI.Y�IMJ1. 4y.:I.R'lr�d-/r�<Y'd.Y.,rM lt1.f1..N..1UA'IS)i•i1 RF".."1R.N...r. ..•...' -.. � ...J V^t.! ..,.,
f �NN:I.:iIY, 7 J..d:;n Y{h J.• .;:n+.v,pl':14Yii'b Id":"II.'.'e kl I AIM, ?.A ,1+,'p'I.0.,'^r r,,r:V C`:n Aynl"Y..2'.:i'7•.n',.;.
New House ❑ Addition ❑ Replacena t Windows Alterations) ❑ [Roofing ❑
Or Door s9
Accessory Bldg. ❑ Demolition[] New Signs [ ] Decks [ ] Siding[ ] Other [ ]
Brief Description of Proposed Work: I J
Alteration of existing bedroom Yes No Adding new bedroom Yes No
Attached Narrative❑ Renovating unfinished basement Yes No
Plans Attached Roll O- Sheet O
aIfNeirvhouse"and:"or. ""addition tosexisfinghousing complee�tFie`fol(owin :
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?
I. 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
SECTION 7a;DOWNER AUTHOR,IZATION,t�TO�:BEgCOMPLETED WHEN
�OWNNErRSY'gG �VTOnRFCONTRACTOR'ApPLI ES?F013iBUI LDI NG'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.
LAJ
Signature of Owner T F Date
as Owner/Authorized Agent
hereby declare that the statements and ' forma ion on the foregoing application are true and accurate, to the best of my
knowledge and belief.
Signed under the pains and penalties of perjury.
1 A a A� hem a —J1
J t� f->✓S
Print Name 51
Signature of Owner/Agent Date
City of Northampton S a s r.
Building Department
212 Main Street S r S Ic a
'.Room 100. a e
A04hampton, MA 01060 > w Sets o e a a
phone 413-587.1240 Fax 413.587.1272J,oS*e P
ri
APPLICATION TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 =;SITE INFORMQIION,:
111 "A'A' be'=com 'I At d;iblx�fice"
1.1 Property Address: (. , ./�
L✓,c;'Is C�iy, 15 ✓ , rylap a rr-„ , Lot ? ,: t. t,,
r tir/cc.
>S:Ov�e„rlav' istrict
Elm StDietnct ,r{CBttU-�r�� ftr: J3
SECTION'i2 PROP,,,ERTY;,QWNERSHIP/AUTHORIZED AGENT'
2.1 Owner of Record: L
Name( int) Current Mailing Address:
Telephone
Signature `�
2.2 Authorized Agent: _
/
L...rx_.uJ r'(� Lrr e l—t . _.��._ J l . �✓� l��z L/P�ti. `L 11?0 12 tau_ 4-2—
Name(Print),. Current Mailing Address:
7 '72 - LIJ _7
Signature Telephone
SECT�OtJ 3='"ESTIMATEb��CONS7RUCTlON COSTS :'
Item Estimated Cost(Dollars)to be OffIc al Use Only
completed by ermit applicant
1. Building (a) Building Permit iFee {
r.�
I
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) p Check Number U --
,,
This Section For Official Use'Onl
Bull al 'giR1 ,e fr IVI I I�h14I!
Date Issued
l I at
I,+III++I.�y�xl�,ltlli��}C�,",��7i�`1!1i.q�ppw^'11j4j7tnn�,ah'UI�II�lll t'f'�;tl��,l'll
SlgngttarPlr���= t�,i P 4y r,
uildilig Cotrimissiotier,(Inspector of Bui)dings
' - BP-2007-1134
GIS#: COMMONWEALTH OF MASSACHUSETTS
' l'MM CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL 042A)
Category: BUILDING PERMIT
Permit# BP-2007-1134
Project# JS-2007-001807
Est.Cost: $3925.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: THE JUBB CO INC 100001
Lot Size(sq. ft.): 14766.84 Owner: BOMBARD RAYMOND A&JANET R
Zoning:URA Applicant: THE JUBB CO INC
AT: 58 FOREST GLEN DR
Applicant Address: Phone: Insurance:
P O Box 429 (413) 772-6217 Workers
Compensation
GREENFIELDMA01302 ISSUED ON.511812007 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 si nature:
FeeType: Date Paid: Amount:
Building 5/18/2007 0:00:00 $25.009902
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Building Commissioner-Anthony Patillo
�Rep[acement inboW Propont Page No. 1 of Pages
Main Office:
7 Devens Street• P.O. Box 429 THE JUBB CO., INC. d.b.a. Northampton, MA:
__-C-4eenfield, MA 01302 (413)584-3716
(413) 772-6217 LARRY JUBB'S Brattleboro, VT& Keene, NH
18 North Hatfield Road TM 1-888-639-JUBB
I'IOME
Hatfield, MA 01038 Email:JubbCompanyinc@aol.com
PROPOSAL SUBMITTED TO PHONE DATE
RKY Q O (VA +A� S"? — t' Z
_h
STREET JOB NAME
�
CITY,STATE AND ZIP JOB LOCATION NJ
TENTATIVE JOB SCHEDULE(Weather Permitting) MA Registration 100001
Approximately 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 R*#4e Watenoid 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. .
• Sun Shield Vinyl Compound (Mastic exclusive). Energy Star approved.
• Twin locks on double hung units 32" or wider. • Virgin vinyl. 5/( 4-10`7
• Twenty year manufacture guarantee on glass seal failure.
• Lifetime transferable manufacture guarantee on vinyl window frame. f S O•o
• Labor guarantee as required by CT, A, NH, VT contractor regulations. G C
Color: XLinen White ❑ Almond' (*extra charges apply for this colors) a
TOTAL UNITS REPLACED: ko- �l CQOC�-lwk m% — 1 Qlc, u f, htNoow Wul WAA Sl t' I , q F/iqM
❑ Grids No (Note: Grids are beveled)
AS tje e4s gi
WnLow E Glass ❑ Ar g on k Insulation into weight 3omldbw Removal
Aluminum Clad Exterior Castingover
Full ❑ Partial ) 0 n+�G -- s N11V Poa
OTHER/NOTE: SuvER_V (Mesa t, i i =N T-r1t4LcS0 l=ieem
to",
rorvi- t,U i O DOLJ
C0ve�r
a s So% a5 0
02
SERVICE FEE: $125.00 (includes permit and disposal of all job related refuse.)
[service fee not included in total amount below, and will be billed separately.]
CONTRACT SERVICE CHARGE:An interest charge of 2%per month(24%per annum)will be added to outstanding balances over 30 days,
plus all costs,including reasonable attorney's fees,incurred in collecting any sums owed.
We jpropo5e hereby to furnish material and labor—compifi4ein accordance with above speciffiications, for the sum of:
dollars ($ 3,1 O-) p ).
Payment to be made as follows: D
1/3 DOWN PAYMENT UPON ACCEPTANCE Make checks payable to:The J bb Co.,Inc. (Our installers will collect final
balance upon completion).
All material is guaranteed to be as specified.All work to be completed in a workmanlike
manner according to standard practices.Any alteration or deviation from above specifica• Authorized
tions involving extra costs will be executed only upon written orders,and will become an extra Signature 6L
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.Our Note:This propoVn=,
may Cl
workers are fully covered by Workmen's Compensation Insurance. withdrawn by us cepted within TH I RTY days.
F nce of J)ro.po,ar—The above prices,specifications and
e satisfactory and are hereby accepted.You are authorized to do Signa ecified.Payment will be made as outlined above.
ptance: .2 —02 Signature
WHITE-Remittance Copy YELLOW-Customer copy PINK-Office Copy