HomeMy WebLinkAboutBuilding Permit Application - 2/5/2026 2/5/26,9:38 AM 84246
16 Town of North Andover,MA February 5,2026
Record No: 84246 Primary Location Applicant
*Building Permit 123 BRENTWOOD CIRCLE iii111 Penilton DaSilva
g NORTH ANDOVER MA 01845 781-484-7209
Status:Stopped Owner penhomebuilders@gmail.com
Submitted On:4/14/2025 514 Water Street
BLAIN, RICHARD R, KATHLEEN Wakefield, MA 01880
M BLAIN
123 BRENTWOOD CIRCLE
NORTH ANDOVER, MA 01845
Application Submission
Are you submitting this application as the Homeowner?*
NO
Primary Contractor
Firm(Business)Name Licensee*
MASTER GENERAL CONSTRUCTION
CORP.
License#* License Expiration Date*
183643 05/12/2026
License Type* License Active
Home Improvement Contractor
License Status* Mailing Address*
Current 514 WATER ST WAKEFI ELD MA 01880
Preferred Telephone#:* Alternate Phone#
7814847209
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Email I certify,under the pains and penalties of perjury,that the
Penhomebuilders@gmail.com information on this application is true and complete.*
Project Information
Type of Project* Type of Improvement*
Construction of Addition,Alteration, and Addition
Remodeling
Proposed Use* Description of Work to be Performed*
Accessory Building Existing House : Refinish hardwood floor/
Renovate Kitchen/ remove 2 walls between
dining room and kitchen and install new
structural beam/ remove existing garage roof
and built a new office space on top of the
existing garage ceiling/ install new force air
HVAC IN-Law : Built a new 1200sf in-law
addition per plan
Is property on Town water* Is property on Town sewer*
Yes Yes
Project Cost(if new construction base on$125 per square Does this project require a temporary construction
foot and if addition/alteration/renovation base on actual dumpster?*
contract price)*
Yes
565542.85
Does this project require a temporary construction trailer?* Does this project require a temporary construction sign?*
NO NO
Danger Zone Literature(MGL CHapter 166 Section 21A-F
and G min.$100-$1,000 fine)
NO
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Registered Design Professional
Architect/Engineer Name Architect/Engineer Address
SOULVEPLUS 67 WILLOW AVE HYANNIS MA 02601
Architect/Engineer Phone Number Architect/Engineer Reg.#
9787597799
Construction Dumpster Permit Application
Name of Dumpster Company(if applicable)* Dumpster Arrival Date*
G Mello Disposal 05/01/2025
State clearly purpose for which the Construction Dumpster Permit is requested*
Demolition
*** The same project has already been started under a different permit (issued to start
Bathroom Project). Please do not charge 2nd dumpster fee. There already is a
dumpster at the jobsite
Insurance
have a current liability insurance policy or its substantial If yes,indicate the type of coverage*
equivalent.*
Liability
Yes
If other,specify
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Worker's Compensation Insurance Affidavit:
Bu i Iders/Contractors/Electricians/PI u m bers
Are you an employer?Select the appropriate type.Any Type of project
applicant that selects#1 must also fill out the section
below showingtheir workers'compensationpolicy10 Building addition
p
information.*
1. 1 am an employer with employees (full
and/or part-time)
am an employer that is providing workers' compensation insurance for my
employees. Below is the policy and job site information.
Insurance Company Name(Attach a copy of workers' Policy#or Self-Ins.License#*
compensation policy declaration page showing the policy
expiration date)*
6S60U B 1 W 16833324
number and ex
p )
Hartford underwriters INS CO
Expiration Date*
09/26/2025
Workers' Compensation Affidavit Signature
I do hereby certify under the pains and penalties of perjury
that the information provided above is true and correct.*
Z
Attachments
H IC_eReg istration_Card.pdf
HIC eRe istration Card. df
Uploaded by Penilton DaSilva on Mar 24, 2025 at 4:50 PM
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2/5/26,9:38 AM 84246
WORKERS COMP TOWN OF NORTH ANDOVER.pdf
° WORKERS COMP TOWN OF NORTH ANDOVER.pdf
Uploaded by Penilton DaSilva on Mar 24, 2025 at 5:01 PM
Photo Copy of H.I.C. And C.S.L. Licenses REQUIRED
P E N I LTO N CS L.pdf
Uploaded by Penilton DaSilva on Mar 24, 2025 at 4:35 PM
Set of Plans
04.09.25-STAMPED PERMIT SET- 123 BRENTWOOD CIRCLE- NORTH ANDOVER- MA.pdf
Uploaded by Penilton DaSilva on Apr 14, 2025 at 5:12 PM
Certified Surveyed Plot plan
03-250081-00-PP 11 X17C.pdf
Uploaded by Penilton DaSilva on Apr 22, 2025 at 10:17 AM
Copy of signed contract REQUIRED
Add Signed.pdf
Uploaded by Penilton DaSilva on Apr 14, 2025 at 5:12 PM
Stamped engineered documents (if applicable)
° 123 Brentwood Circle North Andover- MA Structural STAMPED R1 04-11-25.pdf
Uploaded by Penilton DaSilva on Apr 14, 2025 at 5:13 PM
Massachusetts Workers Comp Affidavit REQUIRED
P D F.pdf
Uploaded by Penilton DaSilva on Mar 24, 2025 at 4:48 PM
Copy of Certificate of Liability Insurance REQUIRED
° LIABILITY TOWN-OF-NORTH-AN DOVER.pdf
Uploaded by Penilton DaSilva on Mar 24, 2025 at 5:02 PM
Timeline
Due
Label Activated Completed Assignee Date Status
4/14/2025,
4/15/2025, Paul ected
IIIIIIIIIIII✓ Building Department Review 5:15:03 - Re 1
7:06:13 AM Hutchins
PM
✓ Fire Department Review - - _ _ Inactive
✓„ Treasurer Review _ Inactive
✓„ Conservation Review - - _ _ Inactive
✓ Planning Review - - _ _ Inactive
✓„ Health Review Inactive- - - -
✓, DPW Engineering Review - - -
Inactive
✓, DPW Operations Review _ Inactive
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Due
Label Activated Completed Assignee Date Status
eBuilding Inspector Approval _ Inactive
c11
Penilton Inactive
Additions/Alterations/Remodeling - - -
DaSilva
Building Permit Fees
1I Building Permit Issued - - _ _ Inactive
D, Temporary Dumpster Permit Inactive
Issued
111111111
1, Building Inspection - - - - Inactive
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