36-179 (7) Page No.� of Pages
FFMain Office:
7Devens Stre et• P.O. Box 429 THE JUBB CO., INC. d.b.a. Northampton, MA:
nfield, MA 01302 LARRY J U B B (413) 584-3716
(413) 772-6217 Brattleboro, VT& Keene, NH
18 North Hatfield Road I M P R O V E-A-HOME 1-888-639-JUBB
Hatfield, MA 01038 Email: JubbCompanyinc@aol.com
PR O DATE
SAL SUBMITTED TO PHONE
"-s > ��' > c — �L� 1 yl l�3
REET JOB NAME
-7 —
CITY,STATE AND ZIP JOB LOCATION
1"4,,
TENTATIVE JOB W H ULE(Weather Permitting)
MA Registration 100001
Approximately 5,"- S-" 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 TRULOK2 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.
• Block & Tackle 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. ���4-(4 { ��
• Lifetime transferable manufacture guarantee on vinyl window frame. ` 0
• Twenty year manufacture guarantee on-glass seal failure. f..//2_�/v-Y
• Labor guarantee as required by CT, KWNH, VT contractor regulations. /
Color: ❑ Linen White ❑ Almond* ❑ Brown* ("extra charges apply for these colors) x9tyo
TOTAL UNITS REPLACED: ll t�torm Window Removal I-4-f 'A --
Grids 7,0'e E' ,6 eTbv✓, (Note: Grids are beveled)
G ,<o'w "E" Glass 1`x-5 ❑ Argon: 4b
• Insulation (into weight pockets)
• Aluminum Clad Exterior Castings: add L.�ilnr�(�� f Y _ (❑ Full U--Partial )
OTHER / NOTE: r
�A� cG>Mv
/') i / i
COMMONNNEAL'I'll OIL IVIASS1WHUSll TTS
DEVAICITYL1✓N'I' 01" INDUSTRIAL /1CCIDL NTS
600 WASHINGTON S'l'1LKV 1'
BOSTON, NIASSACIIUSE I"I'S 02111
W01UMItS' COMFENSA'L'LON INSURANCE AL FIDAVIT
j� Tne Jubb Co, Inc. d.b.a. Larry Jubb's Improve-A-home _
(l icc►tscc/perluiltce)
with a principal place or bus iness/resideice at:
7 Deverls Street; P.O. Box 129 Greenfield, hitr. 01302-0.,129
City/state/Zile
do hereby certify, uudet' lilt; pains and penalties of pee jury, litat:
m 1 .1111 an ulnl,luyer providing lire 11011uwing workers' cmilpen.natiun cuvuragu fur my elllpluycus
workirtl; urt this job.
GUAM JUWC905794
Insurance Company Policy Number
O I alit a sole pruprietur and have no true wurking For ►nc.
( ) 1 .wt .t sole pruprielur, general aularaclur ur lwrncuwner (circle unu) a►►d Have (tired the euntracturs
listed below wlto have lire folluwing workers' compenratiun insurance policies:
Naiiie of Contractor Insurance Cumpauy/lIolicy Number
Name of Contractor Insurance Cuntpany/Policy Number
Name of Contractor hismance Cumpauy/Pulley Number
( ) I a/n a homeowner performing all the work myself.
NOTE: Please be aware that while howcowners who employ persons to do mahutenauce, construction or repair work
on a dwelilug of not more Qtatt three units in which the homcowaer also resides or oil the grounds appurtenant thereto are trot
generally considered to be employers uudcr [lie Workers' Contpcnsatiwt Act (GL C. 152, sect. 1(5), application by a
houleowner for a Memo or permit may evidcuce the legal status of au employer uudcr the Worker's Compensation Act.
1 wtderstaud that a copy of tins statetucut will be forwarded to the Department of Industrial Accidents' Office or insurance for
coverage verification arid, that failure to secure coverage as required under Section 25A of MCL 152 call lead to the impusition
of crimhtal penalties cousisting of a fine of up to $15W.W and/or imprisonntcut of up to ouc year and civil penalties ht the funs
of a Stop Work Order and a fhue of$100.00 a day against me.
Sighed this clay of Ma,20
LicenseelPermittee Licensor/P • nut r
�,.�•`.�.''.,;'_. ��ie -�o-»L��LO=�zc�e�,zr/C�- o������.�1cr,�;fucaeC>yd
Board ol` BUI1ding RCblt1atlOI1S and Standards
Q . . One Asllbl.l,l1011 PlaCC - /Zoom 130 1
Boston. MaSSZICII .ISctts 02108
I- onic Invrovenient Contractor Reg0stration
Registration: 100001
Type: Private Corporation
Expiration: 6/8/04
The Jubb Company, Inc.
Larry Jubb, Jr.
PO Box 429/ 7 DEVENS ST - -
Greenfield, MA 01302 - - - - --- --- --
Ululate Address and return card. Mark reason for change.
I I Address I I Renewal I' I Employment I—I Lust Card
i
677—/ie eow&maytwea�Yi, o- ✓GCai.L1 _
Board of Building ReVations
J •%� One Ashburton Place, 1301
Boston, Ma 02108-1618
License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 05/21/1961
Number: CS 055333 Expires:05/21/2004 Restricted To: 00
LAWRENCE A JUBB JR
PO BOX 429
GREENFIELD, MA 01302
Tr.no: .22343
Keep top for receipt and change of address notification.
ti
SECTION 8 ,CONSTRUCTION_SERVICESz k
8 1 Licensed Construction Supervisor: Not Applicable ❑
Name of License Holder Tula 1'to; 'y �—' 3
Po —6-0 X � al License Number
`I &kiUA-s .S+ 63V-e ec-U 7 e<( c[
Address Expiration Date
wtiy�— ..7`7 2-4—7
Signature Telephone
�Re teredRo�m rnarovemeffla, tractor . Not Applicable .❑
Company Name Registration Number
PC) P<Iox
Address Expiration Date
AV 4 Telephone —1-7 2-- 7
SECTION 1,0-WORKERS' COMPENSATION INSUaRANCE A,FFli)AVIT(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 o the building permit.
Signed Affidavit Attached Yes....... No...... ❑
. some-Darr M-0-1
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 tv--o 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 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
gg
SECTION 5' DES SCRIPT. -ON'O��PROPOSEDWORK`c ecli all a tic"able
�� gy m . ,
rzb�a,v. # �ka"lia''.t'� 't sue'-»'� ' t1`' � � �5 ',�'a,J#'
New House ❑ Addition ❑ Replacement Windows Alteration(s) ❑ Roofing ❑
Or Doors
Accessory Bldg. ❑ Demolition❑ New Signs [ ] Decks [ ] Siding[ ] Other[ )
Brief Description of Proposed Work:
Alteration of existing bedroom Yes No Adding new edroom Yes No
Attached Narrative 0 Renovating unfinished basement Yes No
Plans Attached Roll 0• Sheet 0
��tf�Ne hou e`"�and o"raddition toe iste�n�"" >to sing:comp'leteth'e�follow.in�;
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 'OWNER AUTH.ORIZATI,ON �TOJBE COMPLETED 1NHEN:
OWNEf2S AGENT OR CONTRACTO IE RING'PERMiT; j
j < 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
CC as Owner/Authorized Agent
hereby declare that the statements and information 6n 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
1
t
Section 4.
ALL INFORMATION MUST BE COMPLETED, or PERMIT CAN BE ,
DENIED DUE TO LACK OF 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 %
Open Space Footage %
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DON'T KNOW YES
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO DON'T KNOW YES
IF YES: enter Book Page and/or Document #
B. Does the site contain a brook,body of water or wetlands? NO DON'T KNOW
YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 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
IF YES, describe size, type and location:
a, City of Northampton a
-- Building Department
n L 212 Main Street 'S ►
Room 100
a t
Northampton, MA 01060
phone 413-587.1240 Fax 413.587-1272
v�
APPLICATION'TO CONSTRUCT,ALTER, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION1-SITE INFORMATION
d bte ce Th
1.1 Property Address: #,V, �
;.Map
CBD�str�ct ' - " •'
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
1 4 e-c.+c>,-
Name(Print) Current Mailing Addre s: S S +4-4
Telephone
Signature
2.2 Authorized Agent:: �;
) L.. J iA�� o•
Name(P;W� Current Mailing Address:
Signature Telephone
SECTION 3 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by ermit applicant
1. Building (a) Building Permit Fee
OCU
2. Electrical (b) Estimated Total Cost of
Construction,from: 6
3. Plumbing Building Permit Fee
4. Mechanical (HVAC)
5. Fire Protection
6. Total =(I + 2 + 3 +4+ 5) Check Number
This Section For Official Use:Only
Building-,Permt-Number: Date lssued:
Signature
f3uiJdmg Commissioner%Inspector of Buildings, „ Date„
87 Dt1NPHY DR BP-2003-0958
G1S#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 36- 178 CITY OF NORTHAMPTON
Lot:-001
Permit: Building
Category: BUILDING PERMIT
Permit# BP-2003-0958
Pro..ject# JS-2003-1546
Est.Cost: $2695.00
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: THE JUBB CO INC 100001
Lot Size(sq; ft.): 14984.64 Owner: SANTOS HECTOR L
Zoning SR Applicant: THE JUBB CO INC
AT.• 87 DUNPHY DR
Applicant Address: Phone: Insurance:
P 0 Box 429 (413) 772-6217 Workers
Compensation
GREEN FIELDMA01302 ISSUED ON:516103 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 Occupangy Occupancy si nature:
FeeType• Receipt No: Date Paid: Check No: Amount:
Building 5/6/03 0:00:00 6367 $25.00
212 Main Street,Phone(413)587-1240,Fax: (413) 587-1272
Building Commissioner-Anthony Patillo