HomeMy WebLinkAboutBLDE-23-15862 Commonwealth of Massachusetts o� Yg
* Town of Yarmouth 3... c
ui
ELECTRICAL PERMIT ��
Job Address: 36 DIANE AVE Unit:
Owner Name: EVERETT BARBARAATRS
Owner's Address: 36 DIANE AVE Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-15862
Existing Service Amps/Volts Overhead ❑ Underground ❑ No.of Meters:
New Service Amps/Volts Overhead❑ Underground ❑ 6.otMeters�
Description of Proposed Electrical Installation: Replacement furnace &heat pump installation
No.of Receptacle Outlets: No.of Switches: Generator KW Rating: Type: ', P
.,
No. Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating:
No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA:
Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Total KW:
No.Heat Pumps: 1 Total KW: Total Tons: Fire Alarm System❑ No.of Devices:
Swimming Pool: In-Grnd.❑ Above-Grnd.❑ Hot Tub❑ No.of Self-Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: 1 Video System 0 No.of Devices:
No.Air Conditioners: Total Tons: Telecom System 0 No.of Outlets:
No.Energy Storage Systems: KWH Storage Rating: Security System 0 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 ❑ Level 2 0 Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1 Work to Start: May 17, 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: 91 D Mid-Tech Drive West Yarmouth MA 02673
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:
- -- Commonwealth of Massachusetts Official Use only
: ifA ,)le Permit No.
. .�,f.;a Department of Fire Services
t� ? Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev.9.051 (lease blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 527('MR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMA ION) Date: ' - J (o"- �'3
City or Town of: ay 100(J(--�1 To the hispector of Wires:
By this application the undersigned giv s notice of his or her intention to perform the electrical work described below.
Location (Street& Number) 34 Di C.i Ail � o e . Q
/
L
Owner or Tenant �,rj(�NI AE1/�2 Telephone No.34j ' 5 a-b --
n_/1
Owner's Address �-- bS`
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 E Undgrd❑ No.of Meters
New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters
u'nber of Feeders and Ampacity
�""'—" ✓ eieation and Nature of Proposed Electrical Work: r�U/ �t a. X Kg�.k--
c., U44P
N Q i Coin !coon of the followin; talc roar he Waived by the Ins ector of Wires.
.NG.of Recessed Luminaires No.of Ceil:Susp.(Paddle) Fans 'o.o ota
��r"',r, i+ Transformers KVA
ti
C.��Q N of Luminaire Outlets No.of Hot Tubs Generators KVA
I Above !i>I- No. of Emergency LighTing
�� 'Q of Luminaires Swimming Pool ❑ ❑
grnd. grad. Battery Units
\
o of Receptacle Outlets No.of Oil Burners FIRE ALARMS fo. of Zones
No. of Switches No.of Gas Burners No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
g Tons
No.of Waste Disposers Heat Pump Number Tons kW No.of Self-Containca
p Totals: ,Detection/Alerting Devices
Municipal No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Other
No.of Dryers Heating Appliances KW 'Security Svstems:*
No.of Devices or Equivalent
No.of Water K`%, No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications NofDeviesor W u vg
g No.of Devices Equivalent
OTHER:
Attach additional detail,Jdesired, 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 f rce, and has exhibited proof of same to the -rmit issuing office.
CHECK ONE: INSURANCE El ( OTHER 0 (Specify:) �p�(�\ wWf5COrf f Q'a� �3
I certify,under the pains and penalties of perjury,that the information on this appli r n is true and complete.
FIRM NAME: 'iki (,t.) LIC.NO.: 13t
Licensee: Signatur LiC.NO.: 7
(If applicable, ai e "e.venr t"`in the rse r tuirt>er line) , 4/9 Bus.Tel.No.: 7 3
Address: ►J P >'/ Alt.Tel. No.:
*Security System Contractor License required for this woif applicable.enter the license number here:
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, 1 hereby waive this requirement. I am the(check one)0 owner ❑owner's agent.
Owner/Agent PERMIT FEE: $
Signature Telephone No.
/17 v a ewckeit)eiec9iCQ1, 60141