HomeMy WebLinkAboutBLDE-23-15893 , � Commonwealth of Massachusetts _do v44
* hil
� ; Town of Yarmouth
ELECTRICAL ELECTRICAL PERMIT , ��
Job Address: 5 PEREGRINE LN Unit:
Owner Name: CRIVELLI ANDREW H CRIVELLI JANICE G
Owner's Address: P.O. BOX 681 Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-15893
Existing Service Amps/Volts Overhead ❑ Underground❑ No.of Meters: 7
New Service Amps/Volts Overhead 0 Underground 0 Z .S•Nflo.of Meter$ �"/
Description of Proposed Electrical Installation: Replacement boiler&water heater. .
No.of Receptacle Outlets: No.of Switches: Generator KW Rating: Type. F 3
No. Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating:
No.Appliances: KW: No.Water Heaters: 1 KW: No.Transformers: Total KVA:
Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Total KW: ,✓ J_
No. Heat Pumps: Total KW: Total Tons: Fire Alarm System 0 No.of Devices:
Swimming Pool: In-Grnd.0 Above-Grnd.0 Hot Tub 0 No.of Self-Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: 1 Video System ❑ No.of Devices:
No.Air Conditioners: Total Tons: Telecom System ❑ No.of Outlets:
No. Energy Storage Systems: KWH Storage Rating: Security System ❑ No.of Devices:
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment:
No.of Modules: Roof-Mount❑ Ground-Mount 0 Level 1 0 Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1 Work to Start: May 19, 2023
FIRM NAME: License Number:
Master/System and/or Journeyman Licensee: ERIC W DREW License Number: 13118
Security System Business requires a Division of Occupational Licensure
"S" LIC. License Number:
Address: W YARMOUTH, MA, 026732588 W YARMOUTH MA 026732588
Email: info@ewdrewelectrical.com Business Telephone: 508-778-0723
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the
licensee provides proof of liability insurance including "completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office.
INSURANCE:
• ~~ l..ommotuvea&ofl rr/aeeach.uealla Official Use Only
n 1ii r ccyy Permit No. —3—(SsE9 3
w V 2Lparimenl al gine�ervicee —
tj Occupancy and Fee Checked _
,r BOARD OF FIRE PREVENTION REGULATIONS [Rev.1:07] peace blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in acccrdance with the Massachusetts Electrical Code(MEC).527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL IVFOR ATION) Date: S—l S—e)3
City or Town of: -0 YWLO U To the Inspector of Wires:
By this application the undersigned g es notice pf his or her intention to perform the electrical work described below.
Location(Street&Number)5-Mil K B (a-ytk SO-] (j�'
Owner or Tenant _ Telephone No. Q 4 i(
Owner's Address — �` C'L7TVA
Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters __
New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters __
Number of Feeders and Ampacity I, •, QL
Location and Nature of Proposed Electrical Work: (.f)(Ye vat tG(/ 4 W i
Completion of the followbt$table mar be}rained by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil.Susp.(Paddle)Fans No.or Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above In- 0 No.o Emergency rg mg
15 grnd. grnd. Battery f Units
Q 5No.If Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones
L.]I lib. f Switches No.of Gas Burners 1No.of Detection and
ca r initiating Devices
Total
m N NO. f Ranges No.of Air Cond. Tons No.of Alerting Devices
°O Heat Pump Number Tons KW No.of Self-Contained
Ll] .-. No f Waste Disposers
Totals:
V Q i�c7 Detection/Alerting Devices
n. f Dishwashers Space/Area Heating KW Local❑Municipal 0 Other
g u — Connection
. f Dryers Heating Appliances KW Security Systems:*
' f WaterNo.of Devices or Equivalent
No.of No.of
Heaters KW Data Wiring:
Signs Ballasts No.of Devices or Equivalent
No.H,r'dromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Equivalent
OTHER:
Attach additional detail if desi ed.or as required by the inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10.and upon completion.
INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force.and has exhibited proof of same/. to the permi ssui goffice.
CHE ONE: INSURANCEpBOND 0 OTHER 0 (Specify:) ttftG/ Gt�VI (J�[ -ai`i •-a3
I certi ,under the ains and n ies of erl ry,that the information on this application is true and complete.
FIRM NAME: * I IYe bt) (C _ LIC.NO.: 135(I 6j A
Licensee: -Eye I c .t'ii Signature LIC.NO.: a- a
(If applicable.ent�{'"rrenrp('In ih.e ens n tber lire.)
Address: `f j 1-) min -in(,�j tIr U) '/ Bus.Tel.No.:
'Per M.G.L.c.147,s.57-61.security work requires epartment of Public SafetyAlt.TeL No.: ol,
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent.
Owner/Agent
Signature Telephone No. (PER PERMIT FEE:$
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