Work Order Application Form

Service Fee Schedule(PDF)

The asterisk (*) signifies required information.

Service Address

Customer of Record

Customer Responsible for Payment of Monthly Electric Bills (Name and address to appear on Monthly Bill)

Property Owner (if different from above)

Party Responsible for Construction costs associated with work order (if different from above)

Please Note that Articles of Incorporation are required for new commercial Eversource Customers

Type of Service Requested*

Customer Loading*

Type of Load New Connected Load in KVA
Single Phase Three Phase
Lighting
Electric Heat
Air Conditioning
Refrigeration
Cooking
Electric Dryer
Water Heater
Computer
Process Equip.
Motors/Elevators
Miscellaneous
Totals

Brief Description of Work

Number of Meters Required (Complete one or more.)*

Identification of Meter Sockets

When more than one meter is required for installation, all meter sockets need to be identified. Please list below each meter position, and how it will be labeled (i.e. Suite 100, Unit A, Apt. B etc.). For more information, please read Section 708 of

Eversource's Information & Requirements for Electric Service (PDF).

Service Characteristics

Additional Equipment

Generator:

Motors:

Over 5 HP requires locked rotor AMP current * Do not leave blank

*See Article 802 of Eversource's Information & Requirements for Electric Service (PDF) for Maximum LR current and Three Phase Protection *

Contact Information

Electrician:

Please note that by interconnecting with Eversource's distribution system the customer of record acknowledges that they have reviewed and are in compliance with the

Eversource's Information & Requirements for Electric Service (PDF).

For New Commercial Services, New Residential Developments, New 13.8 kv Two Line Station Electric Service,

please provide (2) copies of city/town approved site plans that illustrates the new facility location and the proposed location of the new utilities (electric, gas, water, sewer, telecommunications) and a one-line diagram.

For Service Increases

at existing facilities, please submit a one-line diagram if available.

For New Residential Services where a pole must be set,

please provide (2) copies of a site plan that illustrates the proposed location of the new facilities.

For Temporary Service Requests,

please provide (2) copies of a site plan illustrating service location.

You may mail any additional correspondence to:

Eversource Tech Center 247 Station Drive Westwood, MA 02090 Fax: 781-441-8721