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Home My WebLink About0047 CANTERBURY CIRCLE /�'� ��r�a. /z G��/z - - - = Town of Barnstable 11 in Post.This•Gard So That rt is U�s1ble Frorn the Street-Ap;roved Plans,Must be RetamerJl on Job and°this Gard Must,be Kept_, �, ; gas Posted UntilFina)tnspection Has Been Made �+ a Where a Certificate'of Occupancy�s Required,such Buldirig shall Not;be Occupied un#ilk Final Inspection has been made emit ,. x ,...,. ,. . ......: x.4..... _ . Permit No. B-18-3294 Applicant Name: DIXON HOME IMPROVEMENT LLC. Approvals Date Issued: 10/23/2018 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 04/23/2019 Foundation: Residential Map/Lot: 249-115 Zoning District: RB Sheathing: Location: 47 CANTERBURY:CIRCLE,HYANNIS Con tractor',Name:: DIXON HOME IMPROVEMENT Framing: 1 5= Owner on Record: MULLANE,,BARBARA J LLC. ' 2 Address: 18 OLD SNAKE POND ROAD Contracto;r,License 179522 FORESTDALE„MA 02644 .:t Chimney: Est. Project Cost: $18,000.00 Description: replace stairs&partition wall`'due to rot.replace attic ladder in Permit Fee: $141.80 Insulation: same location . replace undersized header with IWs over-:same span I' Fee Paid: $141.80 Final: 3/4". reposition wall location for bathroom. re rotted subfloor where required. HVAC-forced hot air-gas f Date:= 10/23J2018 replace existing smoke detectors j, Plumbing/Gas Rough Plumbing: Project Review Req: s. ; Building Official Final Plumbing: x Rough Gas: Final Gas: Electrical This permit shall be deemed abandoned and invalid unless the work authorized by this within six months after issuance. All work authorized by this permit shall conform to the approved application a"rid the approved construction documents fo which this permit has been granted. Service: All construction,alterations and changes of use of any building and structures shall be in eompfarice with the local zoning by=laws and codes. Rough: s x , This permit shall be displayed in a location clearly visible from access street orroad and shall be maintained openfor public inspection for the entire duration of the work until the completion of the same. FinaC: >, Y. The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Low Voltage Rough: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Final: 2.Sheathing Inspection - Low Voltage Fi I: 3.All Fireplaces must be inspected at the throat level before firest flue lini g—is—imtalled „ Health 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspecti n 5.Prior to Covering Structural Members(Frame Inspection) fi Final' 6.Insulations 7.Final Inspection before Occupancy - Fire Department Final: Where applicable,separate permits are required for.Electrical,Plumbing,and Mechani I Installations: Work shall not proceed until the Inspector has approved the various stages of constructio . J 0 ApplicadonN=ber....-e--.. --- . ...... too .�. ` STD • BUILDING DEB P=cF=............/�:��d...........o�F�........................ OCTO C; 2018 Total Fee Paid............................................. TOWN OF BARNSTARYA 'N`sa P�Approval by..M k.............01L eO ;a 3.1.? BUILDING PERMIT /J� per* APPLICATION // Section 1 —Owner's Information and Project Location Project Address Village L7 y ti'o --r T Owners Name i also, Owners Legal Address A? old ISA,11-A. s_ City r�� wit State zip�` -=- cell# ' .3.3 E-mail Owners / �� C� 7 Section 2—Use'of Structure Use Crroup [f .Commercial Structure over 35,000 cubic feet ❑ ze Structure under 35,000 cubic feet S /Two Family Dwelling Section 3—Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑..'Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ElDeck Apartment ❑ Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar _ NJ Renovation ❑ Pool ❑ Insulation Other—Specify Section 4-Work Description S; `1-s a Z- V Z- � Q t` �. Si r - Iu 47 N4fo p k4 1C e e, v , a T Act nndsrtrd 2/9/201 S /`C�p ace✓ +�..�'iSJ ��c��C=��1�=��5 } ApplicationNumber.................................................... Section 5—Detail Cost of Proposed Construction Square Footage of Project -aT) Se7C ' Age of Structure Dig Safe Number # Of Bedrooms Existing 3 Total# Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design ?' Section 6—Project Specifics [� Wiring ❑ Oil Tank Storage ❑ Smoke Detectors dPlumbing ❑ Gas .❑ Fire Suppression [JHeating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply Public ❑ Private Sewage Disposal ❑ Municipal Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility. I am using a crane ❑ Yes ET-No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last tmdated 7J92019 Application Number........................................... Section 9—.Construction Supervisor Name Telephone Number Address City State Tip License Number License Type Expiration Date Contractors Email T Cell# I tmdeistand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date Section"10—Home Improvement Contractor Name Th 't o v►��n,,orvue �'�LTelephone Number _7�7. . ac Qj / Address l9 %( cna,LCOn&=UCity �54� .w�c,G- State zip 06�6Y-Y Registration Number 7 Q S 2-2- Expiration Date L 2 ) I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Budding Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your IUC... Signature -Date , Section 11—Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signaturer2X Date /oAl//;P Print Name Telephone Number o� �_j E-mail permit to: t;i(r` O C_a i V) .; y T e.w....,.i..._.s.n InP1nt-o i Section 12—Department Sign-Offs Health Department ® Zoning Board Cif regvired) ❑ Historic District ❑ Site Plan Review Cif required) ❑ Fire Department ❑ Conserva tion For commercial work;please take your plans direcdy to the, re deparbnent for approval Section 13—Owner's Authorization I, _3��Ly l Xd�) , as Owner of the-subject property hereby authorize-%>i xKaj r1oNr� LL( to act on my behalf, in all matters relative to work authorized by this building permit application for: Cp (Address of job) ' Si a of Owner date F> �1XDA) Print Name Last wdatt&2/9/201 a The Commonwealth of Massachusetts Department of Industrial Accidents -__ Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organizadon/Individual): Address: 16 oL® SM k ynob �n City/State/Zip: W P"Phone #: `( 1 Are you an employer?Check the appropriate b : Type of project(required): 1.❑ I am a employer with 4. 91am a`general contractor and I * have hired the sub-contractors 6. ❑ w construction employees(full and/or part-time). _ 2.El I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity, employees and have workers' [No workers' comp.insurance comp.insurance.: 9. ❑Building addition required.] 5. ❑ We are a corporation and its 10. Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.ErPlumbingjRRairs or additions myself [No workers'comp. right of exemption per MGL 12.❑Ro repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' • 13.20ther}� 9 1� ( 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 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Bel the policy and job site I tion. Insurance Corn ame: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the work ompensation policy declaration page s the policy number and expiration date). Failure to secure co ge as required,6der Section 25A of MGL c. 152 can lead to osition of criminal penalties of a fine up to!; 0 and/or one-year imprisonment,as well as civil penalties in the form of a WORK ORDER and a fine. of u 50.00 a day against the violator. Be advised that a copy of this statement may be forwarde e Office of estigations of the DIA for insurance coverage verification. I do hereby ce fy under the p Qnd penalties of perjury that the information provided above is true and correct Signature:' R Date: tf 3 nv Phone 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. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Massachusetts Workers' Compensation insurance Plan R I BerkleyNet Acadia Insurance Co I NCCI Carder Code 33391 J°Berkley GOmperw' Administered by BerkleyNet Assigned Risk INFORMATION SCHEDULE anewal Of No.MAARP301240 The insured: Policy Number: MAARP301240 Risk ID:"001:026922 Dixon Home mprovement LLC Tax1D#: 044371869 18'01&8nake Pond Road Policy Period: From: 04128/2018 Forestdale;MA 02644 To: 04/28/2019 Endorsement Date.04128/2010 Date of Mailing'.041261201'8 Changesas set forth below are hereby made,with respect to the:estimated remuneration,premium and/or rates. PREMIUM BASIS RATE PER$100 ESTIMATED ESTIMATED TOTAL OF ANNUAL CODE NO. CLASSIFICATIONS ANNUAL RENUMERATION RENUMERATION PREMIUM State: MA Premium.Period: 04/28/2018-04/2812019 . Location: #1 'Dixon:Home Improvement; 0. I.8 Old'Snake:Pond.Road, Forestdale, MA 02644 5403 CARPENTRY-NOC $0 11 $0.00 5645 CARPENTRY-DETACHED 1 OR 2 $0 8.11 $0.00 FAMILY DWELL 565:1_. CARPENTRY-DWELL NOT EXCEED 3 $0 8.11 $0.00 r x STORIES Total Manual Premium $0.00 �9812 Employers Liability Increased Limits 0.02 $0.00 9848 Employers Liability Increased Limits $75.00 Balance to Minimum Premium Subject Premium $75.00 Total Modified Premium $75.00 Total Standard Premium $75.00 0032 Loss Constant $50.00 0900 Expense Constant $159.00 9740 Terrorism 0.03 $0.00 0990 Balance to Policy Minimum Premium $291.00 Massachusetts Department of Industrial 0.0456 $0.00 Accident Assessment Reported Policy Minimum Premium $500.00 WC990001A P.O.Box 591431 Minneapolis,Minnesota 55459-01431 Toll Free(088)548-7431 1 Fax(866)215-8118 www.berkleyassigneddsic corn I assignedrisk@berkleynetcom Massachusetts Workers' Compensation Insurance Plan • I dfl:" 16y Nmer Code-33391 k I e Berkley company Administered by BerkleyNet Assigned'Risk INFORMATION SCHEDULE ULE Renewal OfNo.MAARP301240 The Insured: Policy Number: MAARP301240 Risk ID: 001026922 Dixon Home Improvement LLC Tax lb#: 043371869 1.8 Old Snake Pond Road Policy Period: From;`04/28/2018 Forestdale,MA 026" To 0412812019 Endorsement Date 0412812018 Date of Mailing: 0412612018 Changes asset forth:below are.here4y;rnade,with:respect to the.estimated remuneration,premium and/or rates. Estimated Annual Premium $575.00 Total Amount Due $575.00 Polley Summary 04/28/2018 -04/28/2019 Total Manual Premium $0.00 z $0.00 Employers Llabiiity Increased Limits Employers Liability increased Limits Balance to Minimum:Premium $75:00 Subject Premium $75:00 Total Modified Premium $75 00 Total=Standard Premium $75o0 Loss-Constant $5000 Expense Constant $159.00 Terrorism $0.00 Balance to Policy Minimum Premium $291.00 Estimated Annual Premium $575.00 Massachusetts Department of Industrial Accident Assessment $0.00 Total.Amount Due $575.00 Reported Policy Minimum Premium $500.00 Net Deposit Premium Required $575.00 Premium Paid to,,Date ($575.00) Total Premium Due $0.00 AA other terms and conditions of this policy remain unchanged. Agency Name and Address Murray&MacDonald Ins 550 MacArthur Blvd Bourne,MA 02532 WC990001A P.O.Box 591431 Minmapoils,Minnesota W5.9-0143 I Toll Free(888)548-7431 I Fax(888)215-8118 www.berldoyassigneddsk.com I assignedrisk@berkleyneLcom -� — �e� �- _i`" � ��d4m C� �. � � ` - �. -�,, �, . � � � .� � - •� L � ....f7 1 '� Y > � .. � � `. _ Mass. Corporations, external master page Page 1 of 2 a Corporations Division Business Entity summary ' ............__..... ID Number: 001286789 Request certificate New search Summary for: DIXON FOX DESIGN BUILD, LLC The exact name of the Domestic Limited Liability Company (LLC): DIXON FOX DESIGN BUILD, LLC Entity type: Domestic Limited Liability Company (LLC) Identification Number: 001286789 Date of Organization in Massachusetts: 08-16-2017 Last date certain: The location or address where the records are maintained (A PO box is not a valid location or address): Address: 18 OLD SNAKE POND RD. City or town, State, Zip code, FORESTDALE, MA 02644 USA Country: The name and address of the Resident Agent: Name: JOHN DIXON Address: 18 OLD SNAKE POND RD. City or town, State, Zip code, FORESTDALE, MA 02644 USA Country: The name and business address of each Manager: Title Individual name Address MANAGER JOHN DIXON' 18 OLD SNAKE POND RD. FORESTDALE, MA 02644 USA MANAGER A KATHY FOX ALFANO 160 JEFFERSON RD BOURNE, MA 02532 USA In addition to the manager(s), the name and business address of the person(s) authorized to execute documents to be filed with the Corporations Division: Title Individual name Address SOC SIGNATORY JOHN P. DIXON 18 OLD SNAKE POND RD. FORESTDALE, MA 02644 USA SOC SIGNATORY KATHY FOX ALFANO 160 JEFFERSON RD BOURNE, MA 02532 US http://Corp.see.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=001286789&... 10/4/2018 Mass. Corporations, external master page Page 2 of 2 The name and business address of the person(s) authorized to execute, acknowledge, deliver, and record any recordable instrument purporting to affect an interest in real property: Title Individual name Address REAL PROPERTY JOHN P. DIXON 18 OLD SNAKE POND RD. FORESTDALE, MA 02644 USA REAL PROPERTY I KATHY FOX ALFANO 160 JEFFERSON RD BOURNE, MA 02532 US ❑ ❑Confidential ❑Merger ❑ Consent Data Allowed Manufacturing View filings for this business entity_ ALL FILINGS Annual Report Annual Report - Professional Articles of Entity Conversion Certificate of Amendment V View...filings Comments Comments or notes associated with this business entity: _....._.._............_._.. New search P http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=001286789&... 10/4/2018 Crill co { Massachusetts-Department of Public Safety Board of.Building Regulations and StaradarodJ., Liaefise "CSLio& 6 JOHly DIXON Fof estdale MA dim p Oil i.. Expiration -i Commissioner 10/14/2018 �B�po�n��anxueea•�t/t o�C-l�aaurclziGtef�c t O(Hee of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:LLC Rog! gMufflon 179522 08/10/2020 DDCON HOME IMPROVEMENT LLC. 18 OLD SNAia=POfdQ°131U.. :. FORESTDALE,MA 02644° Underse"etary Application number .-/7 .3 0 �, 7.S 23 �,!`.'S Fee .............../............................o • � • .. OCT tl 4 Building Inspectors Initials...... .. ........................... .' Cl�l��r fjd 44 1 6/4ff1� � Date Issued....... .��S...f.f�..................................... . m Map/Parcel......... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: NUMBER STREET VILLAGE 'Owner's Name: . , 4, /-a X•L-)eS q.. /3"- 4� Phone Number "7f/ 576,_-� 6 3`3 11 Email Address: k-C-0 1 Xo n�X d •co MCell Phone Number ' Proj ect cost$ 45 A 5 D bt 0 0 Check one Residential V/ Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize _ to make application kor a buildin ArTn4t in accordance with 780 CMR Owner Signature: Date: E OF WORK ZL 'din Windows o e # Insulation/Weatherization g („n header.chang ) f.7el SJDoors(no header change)# "0; Commercial Doors require an inspector's review E9 Roof(not applying more than 1 layer of shingles) Construction Debris will be going to ��`✓y�py ` ,%k_ CONTRACTOR'S INFORMATION Contractor's name_n 1Y-0 1r1 Home Improvement Contractors Registration'(if applicable)# .y¢ �95 (attach copy) L/ Construction Supervisor's License (attach copy) t r Email of Contractor _ 0lI10A 0` Q` number 74 N(3I 6 ALL PROPERTIES THA AVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s) will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each.Tent X. X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent Fuel source being used LP tank 20 lbs. or> Yes No ,if yes;a gas permit is required. Natural Gas Yes No , if yes, a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3.30 pm-4.30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific,inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date /0--q Z019 All permit applic 'ons a subject to a buildin o icial's approval prior to issuance. t Massachusetts,-Department of Pubilc Safety j� Board of 8ui(ding Regulations and Standards , I � JOHN DIXON49 ' � r Fotestdale MA QU 4 y Y 6 00 Expiration o 1 Commissioner 0/14/2018�, �� i C��'e,. cpan�m2anure�e��o�G�taat�uaefll Office of consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:LLC Re oi%E9a fbnN Coiration 119522-- 08/10/2020 DIXON HOME IMPROV.E7VIENT LC. {i YTy lzg 1a JOHN P.DIXON 1:$OLD SNAKE POND.RD, ' FORESTDALE,MA 02644" Undersecretary j M� as a husetts ;Department of Publlc Sa#ety Sort!of,St.afding Regulations and Stantlards �.;� . �s",�°^��-Gdhstrel�h[►ri 5tpei�tsisr ` �,•��' � ;� �. e�:a war jam_ JOHN DIXON ` ' 4 18'OID`SNAICE Forestdale MA 0644 Expiratign CoRim' nersslcl r4 10N4/201$ Vlte (Ggnrinao�uoeul�o�C�i!a�ac�u�el�i x office of Consumer Affairs&Business Regulation ' HOME'IMPROVEMENT CONTRACTOR TYPE,LLC Rgggistrat 6\ Expiration 1,79522 08/10/2020 DIXON HOME IMPROVEMENT L.C. ^k JOHN P.DIXON � �" 18 OLD SNAKE POND.RD,- FORESTDALE,MA 026"4 Undersecretary I t --� S�� n �, r -ter r'a Y� � .�. _ ,, , � «. ,- � —� � � f a � � ; -Z Berkle Net Massachusetts Workers' Compensation insurance Plan Acadia Insurance Co I NCCI Carrier Code 33391 1 a Berkley Company Administered by BerkleyNet Assigned R[sk INFORMATION SCHEDULE enewal Of No.MAARP301240 The Insured: Policy Number: MAARP301240 Risk ID: 001.026922 Dixon Home improvement,LLC Tax ID#: 04.3371.868 18,0I0 Snake Pond;Road Policy Period: From: 04128/2018 Forestdale,,MA 02644 To: 04/2812019 Endorsement Date 04/28/2018 Date of Mailing: 04/26/2018 Changes asset forth below are.hereby,made,with respect to::the estimated.remuneration, premium and/or rates. PREMIUM BASIS RATE PER$100 ESTIMATED ESTIMATED TOTAL OF ANNUAL CODE NO. CLASSIFICATIQNS ANNUAL RENLIMERATION RENUMERATION PREMIUM State: MA Premium Period:. 04128/20181-04/2812019 Location: #1 Dixoq,Home Improvement LLC, 18 Old.Snal(O Pond Road, Forestdale, MA 02644 5403 CARPENTRY-NOC $0 11 $0.00 5645 CARPENTRY-DETACHED 1 OR 2 $0 8.11 $0.00 FAMILY.DWELL: 5651 CARPENTRY-DWELL NOT EXCEED 3 $0 8.11 $0.00 STORIES Total Manual Premium $0.00 •981 Z Employers Liability Increased Limits ' 0.02 $0.00 9848 ::Employers Liability Increased Limits $75.00 Balance to Minimum Premium Subject Premium $75.00 Total Modified Premium $75.00 Total Standard Premium $75.00 0032 Loss Constant $50.00 0900 Expense Constant $159.00 9740 Terrorism 0.03 $0.00 0990 Balance to Policy.Minimum Premium $291.00 Massachusetts Department of Industrial 0.0456 $0.00 Accident Assessment Reported Policy Minimum Premium $500.00 WC990001A P.O.Box.59143,I Minneapolis,Minnesota 55459-0143[Toll Free(888)54844311 Fax(866)215-8118 www.berldeyas4gneddsk.com l assignedrisk@berkleynetcom s .y ^y IMassachusetts Workers'Compensation Insurance Plan Be' rkleyNet Acadia Insurance Co I NGCI Carrier Code 33391 i n eerkiOY comaanY Administered by BerkleyNet Assigned Risk INFORMATION SCHEDULE Renewal Of No.MAARP301240., The insured: Policy Numbers MAARP301240 Risk ID=!001026922 Dixon Home Improvement LLC Tax ID#:r 043371869 18 Old Snake Pond Road Policy Period: From:04/28/2016 Forestdale,MA 02G" To 04128120.19 Endorsement Date 0412812018 Date of Mailing: 04/281201.8 Changes as set forth below arebereby made. wtth,l espect to the estimated remuneration,premium and/or rates. Estimated Annual,.Premium $575:00 Total Amount Due $575.00 Policy Summary £� ,04l28/2018 04/28/2019 Total Manual Premium $0.00 Employers',Liability Increased Limits $0.00 Employers•Liability increased Limits'Balance to Minimum Premium $15 00 Subject Premium $75s00 Total`Modified Premium $75.00 Total Standard.Premium $75.00 Loss.Constant $50.00 Expense Constant $159.00 Terrorism $0.00 Balance to Poltcy'Minlmum Premium $291.00 Estimated Annuat Premium` $575.00 Massachusetts 0l partrr ent of Industrial Accident Assessment $0.00 Total Amount Due $575.00 Reported Policy Minimum Premium $500.00 Net Deposit Premium Required $575.00 Premium Paid to Date ($575.00) Total Premium Due $0.00 All other terms and conditions of this policy remain unchanged. Agency Name and Address Murray&MacDonald Ins 550 MacArthur Blvd Bourne,MA 02532 WC990001A P.O.Box.59143 I Minneapolis,Minnesota 55459-0143 1 Toll Free(888)548-7431 1 Fax(888)215-8118 www.beridoyassigneddsk.com I assignedrisk@berkleynet.00m Mass. Corporations, external master page Page 1 of 2 Jb y' Y r rw J Corporations Division Business Entity Summary ID Number: 001286789 1 Request certificate New search Summary for: DIXON FOX DESIGN BUILD, LLC The exact name of the Domestic Limited Liability Company (LLC): DIXON FOX DESIGN BUILD, LLC Entity type: Domestic Limited Liability Company (LLC) Identification Number: 001286789 Date of Organization in Massachusetts: 08-16-2017 Last date certain: The location or address where the records are maintained (A PO box is not a valid location or address): Address: 18 OLD SNAKE POND RD. City or town, State, Zip code, FORESTDALE, MA 02644 USA Country: The name and address of the Resident Agent: Name: JOHN DIXON Address: 18 OLD SNAKE POND RD. City or town, State, Zip code, FORESTDALE, MA 02644 USA Country: The name and business address of each Manager: Title Individual name Address MANAGER JOHN DIXON 18 OLD SNAKE POND RD. FORESTDALE, MA 02644 USA MANAGER I KATHY FOX ALFANO 160 JEFFERSON RD BOURNE, MA 02532 USA In addition to the manager(s), the name and business address of the person(s) authorized to execute documents to be filed with the Corporations Division: Title Individual name Address SOC SIGNATORY JOHN P. DIXON 18 OLD SNAKE POND RD. FORESTDALE, MA 02644 USA SOC SIGNATORY KATHY FOX ALFANO 160 JEFFERSON RD BOURNE, MA 02532 US http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=001286789&... 10/4/2018 I Mass. Corporations, external master page Page 2 of 2 The name-end business address of the person(s) authorized to execute, acknbwledge, deliver, and record any recordable instrument purporting to affect an interest in real property: Title Individual name Address REAL PROPERTY JOHN P. DIXON 18 OLD SNAKE POND RD. FORESTDALE, MA 02644 USA REAL PROPERTY KATHY FOX ALFANO 160 JEFFERSON RD BOURNE, MA 02532 US ❑ ❑Confidential ❑Merger ❑ Consent Data Allowed Manufacturing View filings for this business entity: ALL FILINGS Annual Report Annual Report -Professional Articles of Entity Conversion Certificate of Amendment v lView filings i Comments or notes associated with this business entity: I � i New search http://corp.sec.state.ma.us/CorpWeb/CorpSearch/CorpSummary.aspx?FEIN=001286789&... 10/4/2018 r's,_r`.�Qp and lot number . ........... . ............Assess6 THEr Sewage :Permit number . LAC' �y Z 33AR338TADLE, House number .........L... 7...:.......:.... .....:.................:.... :.... 9 a . �O 1639• TOWN OF BARNSTABLE BUILDING INSPECTOR APP LIGATION FOR PERMIT TO .� .t.�I L�....... . ................................................................. TYPE OF CONSTRUCTION ..... J..l..�t :.:..........................:......................................................................... ...... .......f�,�..................19�✓ TO THE INSPECTOR OF BUILDINGS: The-undersigned hereby applies for a permit according to the following information: Location .(�... ........ ,. N '� ProposedUse ...P�2 ............................................................................................................................... I� c!...Fire District �I/7'e/��fIF Zoning District nA........... ..... ..........�-. 7 ............... Name of Owner��Ny/`4L . r ...................Address ...L.../..... �1/T/�2. �. .... .i.. 0 " Name of Builder � ! ... .,�/,�Y 3�. ddress m - Name of Architect ...5:`.�.. ..................................:.........:....Address .................................................................................... /U � �c�� d c Number of Rooms ..............:�........................................:.......Foundation �.......................................:!'S~.................................... i g � Exterior ..�L..�..:..�..�Jtf..��,'. er<.......:.......................: Roofing .�!''� /��f �??i . ..... .. .............. .......... ..................................................... Floorst% .Interior .... P-ell A' . ....:............................................ Heating g Fireplace ...Approximate. Cost 4 ...................................................... Definitive Plan Approved by Planning Board -------------------_-----------19_______. Area .........Z.S- ................... Diagram of Lot and Building with Dimensions Fee -SUBJECT TO APPROVAL OF BOARD OF HEALTH _ 1ZS � ILL 18 � i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ' Name .. .t..d�� Construction Supervisor's Licensef ,��, .......... 26841" ADDITION " No ............. Permit for ...................... ............. Location ..42..Canterbury..--i•re1•e. ................ ............... dI1T?15...................................... ... �i 4,1 ; ; �✓ r ^+/ i'1 ' I � Daniel DiY.................................;; Owner ..................... . '� • �J' �. ,rJ J s Type of Construction ....F ........................... Var e r Plot Lot ................ ......... � r ^- j�+ ,! ` Permit Granted ...Au 19.. 84 `�- >4 Date.*ofr Inspection•................................I419 [�! Date Completed .,.... .�ivt :......... 19 Sf'�5 Ass�sor's map and lot number .............:.. ............. ........ .. .: py�%THE tp�♦ Sewage Permit number .�/.�....:......!Y!�........... .yl.s,... .:...... � � /� ! Z HAHHSTADLE, i House number d TOWN OF BARNSTABLE f BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....................................................L � A-)................................................................. TYPE OF CONSTRUCTION ..... 1 i!?? ................:...................................................................................... U ....... ... ................19®Gf TO THE INSPECTOR OF BUILDINGS: The underrss�ign�ed hereby applies for a permit according to the following information: Location ../...7....Cd Ad t-' ' iV R .......C'�� :... �l�......................... . ........................ Proposed Use . -c ✓........ ........ ........................................................... ...,.. .... ....... .. .. ..... -- v .Fire District Zoning District .......................................... ....................... .............................................................. ............ } Name of Owner��'�../v .`.......................Address `T�/ /V7�C/Z ,.7U✓.. / r/ .. .....�...........................L. .. ..................... .� Name of Builder ` . . .../1:.e/4/**fs7pAddress ,,/ �...HAv., Nameof Architect ...��s'9rY1............................................ .................................................................................... Number of Rooms ..... '' ...............................................Foundation �X.e��..�` c b....�:......................... ........ ....................... Exterior .......>..A.X. C?,,!/ ......................................Roofing .. �i�'"e /!taw° ............................................. Floors ... .Interior T l ti Heating ..........r : .............................................Plumbing Fireplace /L'G ..........:.............Approximate. Cost ....! w: ®e ..................................:...... _ Definitive Plan Approved by Planning Board -----------_-------_-----------19 ------. Area .........Z.5� 4dF.........:.. Diagram of Lot and Building with Dimensions Fee D ............ .. ................................. SUBJECT`TO APPROVAL OF BOARD OF HEALTH I 0 2 ice----- 1 urz { OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS (. I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. %l Name ... ..l, %d444 -�-%............ Construction Supervisor's License /.✓... [ACEY' [D\NIEL . A7-34S-ll5 26841 ADDITION --.--- Parmkfor -----------... ' . 8ingle Family Dwellin .-_----~.�------'�--------. � 47 Location --.�o�/ .��_______ Hyannis ----'--~--_----------------' Daniel ��e%- Owner Daniel ' " Type of Construction -�7��.---------. . ' ----------------------.�---. . ' . ^ Plot --------- Lot ----'�------ ' ' ' � Permit Granted - �l5^-'�---j� 84 , . - ~ Date of Inspection .....................................1p � Dote Completed ........................................lg Avg . . . � � / . . . - . . . . ' / ^ ' ^ ' ^ � . . r °~ ^ , . . ' TOWN OF BARNSTABLE 22 . i BASBSTABL& i 0 "6 9. BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION ................... ................ - ................................................ ................7�-. ..........,9. TO THE INSPECTOR OF BUILDINGS: The undersigned ereby applies fora permit er it according to the following information: Location ...... .......� ..... ...�- �� '� Proposed Use .......... .1.�{,: rr .1 .. ................................. ........... ................................... ....................... .............................:..... v ZoningDistrict ....................................................................:...Fire District .............................................................................. Name of Owner rg? .�,..� , .li",L. �. -�f�Address � '' ... ��.. J...Address ......................... .� 'J✓d ................................. Name of Builder Nameof Architect ..................................................................Address ........... ................................................. L Number of Rooms .................. ... .................................Foundation ........� � t!�./�� . . �............,................. Exterior .......W. '1.�:..... e ....Roofing ........ Floors ............Interior . ,. ..................................... , Heating ........!' 4-/. .�?d!' .....� .. .l.—rPlumbing ................. c ..... .W . ............. Fireplace ...................... .:........................................Approximate Cost .................................................................... Definitive Plan Approved gIF by Planning Board -----------------------------�9-------• r Diagram of Lot and Building with Dimensions' /� 7 SUBJECT TO APPROVAL OF BOARD OF HEALTH / Ul - , ar > dz � co O 1 �i LL i, fl u' u jz o d z aCL- �n Lij -D � Uj - LL z r I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. �f Name .`. .. ' •zzG-kko . d d'`- r Cedar Acres Realty Trust No ...!53 ... Permit for ....one...story_........... .........single, family...dwelling..................... Location I.....Cgnterbur5r Circle ........................Hyaru?is...................................:.. Owner Cedar Acres Realty. ..Trust. y .............. ............. ........ .... ........... Type of Construction frame .......................................... ................................................................................ Plot ............................ Lot ................ ............ Permit Granted .........: ?guPtA.............19 72 Date of Inspection ...................................19 Date Completed ..: y....rl.3.....19 PERMIT REFUSED ................................................................ 19 ................................................................................ ............................................................................... Approved ................................................ 19 ............................................................................... r i . ... ,. _..__,._.._ ..,....._.. .__ ram! ... _ ._. _. .... . . ._.,. ...... ... _. . .. _ .. t i r TJ . B l Dll nFR _ OCT 19 2010 TOWN B S � T4 OF F3�V - } i I , p_� r 5 _ f A a . ( r It I -�y � _ f S j Barnstable Bldg. Dept..: _ • � � Z d Approvby; Permit #: 9 c 117- ZC?t TO : , • 4 ' - • p I ev ------------ rx�s I • r y 11i v � l i r i ® Pk-7 J' kJ - f t 09L_ C( , I� C7 r3 �d. FROArl p : i : 1 • i , C�P7r�jTO 1. 4 r#u ----- y � r : : ,