HomeMy WebLinkAboutBLDE-23-19268 7/31/23,6:39 AM about:blank
Commonwealth of Massachusetts og Y44
* Town of Yarmouth
ELECTRICAL PERMIT a Ail
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Job Address: 19 ESSEX WAY Unit:
Owner Name: GRONBERG MARK A GRONBERG KAREN T
Owner's Address: 19 ESSEX WAY Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? No Permit Number: BLDE-23-19268
Existing Service Amps/Volts Overhead ❑ Underground❑ No. of Meters:
New Service Amps/Volts Overhead❑ Underground❑ No. of Meters:
Description of Proposed Electrical Installation: service 100 OH to 200A OH
No.of Receptacle Outlets: No.of Switches: Generator KW Rating: Type:
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: 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: 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❑ Level 1 ❑ Level 2❑ Level 3❑ Rating:
Estimated Value of Electrical Work: $ 1,000 Work to Start: July 28, 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 Fee Paid: $50.00
Email: ewdrewec@comcast.net 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: Travelers Indemnity of CT
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