HomeMy WebLinkAboutBLDE-24-1279 9/5/24,5:54 AM about:blank
Commonwealth of Massachusetts of Y4*
* 1 Wo.:. ,,,
. Town of Yarmouth ��,� - .
ELECTRICAL PERMIT MATTAGNEBS[ ` ,
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Job Address: 19 ESSEX WAY Unit:
Owner Name: GRONBERG MARK A
Owner's Address: 19 ESSEX WAY Phone: Email:
Purpose of
Building Residential Utility Authorization No.:
Is this permit in conjunction with a building permit? Yes Permit Number: BLDE-24-1279
Existing Service Amps/Volts Overhead 0 Underground 0 No. of Meters:
New Service Amps/Volts Overhead 0 Underground 0 No. of Meters:
Description of Proposed Electrical Installation: Wire car charger
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: ln-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 0 Ground-Mount❑ Level 1 ❑ Level 2 0 Level 3❑ Rating:
Estimated Value of Electrical Work: $ 500 Work to Start: August 16, 2024
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: $200.00
Email: ewdrewec@comcast.net Business Telephone: 5087374924
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: The Travelers Indemnity Company
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