NEW CONNECTION Heat Pump Application Form A

Transcription

1 NEW CONNECTION Heat Pump Application Form A Up to 75A per phase (compliant with EN and EN ) Please submit your completed application form to: Northern Powergrid, Network Connections, Alix House, Falcon Court, Stockton-on-Tees, TS18 3TU If you need any help to complete this form please contact us: getconnected@northernpowergrid.com Opening hours: Monday - Friday Saturday 8:00am - 8:00pm 9:00am - 5:00pm Northern Powergrid Heat Pump Form A

2 HELPING YOU FILL IN THIS FORM Help with completing the form and getting your heat pump connected If you need any more help with completing this form, please go to our help and information guidance at the back of the application form or call us on Use this form to apply to connect new or additional heat pump equipment rated up to 75A per phase that complies with two specific standards that cover power quality EN and EN For other situations see Form B or C, as appropriate. The application must be made in advance of connection. Please note that the Guaranteed Standards of Service for provision of a quotation are as follows: 5 working days for 1 single phase property with no mains extension requirement 15 working days for 1 single phase domestic property with a mains extension requirement 15 working days for a development scheme with 2 to 4 single phase domestic properties. 15 working days for 1 three phase property with no mains extension requirement 25 working days for 1 three phase property with a mains extension requirement 25 working days for a development scheme with 2 to 4 three phase domestic properties. 25 working days for a development of 5 properties or more, single or three phase Please note any reinforcement costs may be recharged to the customer. SECTION 1 - INSTALLATION ADDRESS Please provide your full installation address. SECTION 2 - INSTALLATION CUSTOMER DETAILS Please provide the full customer and contact details SECTION 3 - INSTALLER DETAILS Please provide details on the installer who is undertaking the work at the aforementioned property. SECTION 4 - EXISTING SPACE & WATER HEATING SYSTEM If there is existing space and water heating equipment please provide full details. SECTION 7 - HEAT PUMP SYSTEM Please provide full details of t he heat pump system to be installed. SECTION 8 - OPERATING VOLTAGE Please provide details of the operating voltage and maximum capacity. SECTION 9 - DECLARATIONOF CONFORMITY Please provide declaration of conformity. SECTION 10 - CONFIRMATION OF INSTALLATION Please provide signature and details of individual installer. SECTION 11- DATA PROTECTION STATEMENT SECTION 5 - EXISTING SPACE & WATER HEATING TO BE RETAINED Please provide full details of any existing equipment to be retained. SECTION 6 - NEW SPACE & WATER HEATING TO BE RETAINED Please provide full details of any new equipment to be installed. 2 Northern Powergrid Heat Pump Form A

3 * indicates mandatory field Section 1 - INSTALLATION ADDRESS* Address* Postcode* MPAN The unique identifying number for the electricity meter at the property Section 2 - INSTALLATION CUSTOMER DETAILS Name* Telephone* Address if different from the installation address Postcode Section 3 - INSTALLER DETAILS Contact Person* Telephone* Address* Postcode* address* Section 4 - Date of Installation Date of Installation of equipment* MM/YYYY 3 Northern Powergrid Heat Pump Form A

4 Section 5 - EXISTING SPACE & WATER HEATING EQUIPMENT Type: Electric/Gas/Oil/LPG/Other If Electric, please complete the following: 1. The manufacturer must verify this. 2 Direct acting heating these are directly connected to the mains (e.g. convector or panel heaters). 3 Storage heaters These retain heat inside the storage heater, are charged over night to store heat and release heat during the say. Storage heaters often use Economy 7 electricity tariff at night. Section 6 EXISTING SPACE & WATER HEATING EQUIPMENT TO BE RETAINED Section 7 NEW SPACE & WATER HEATING EQUIPMENT Section 8 HEAT PUMP SYSTEM DETAILS Manufacturer Type reference Heat pump system maximum power Note: Heaters not fitted in the heat pump unit to boost hot water or as a back-up should be recorded as new equipment above or as existing equipment to be retained below as appropriate. Section 9 OPERATING VOLTAGE (V) Phases Required Maximum Capacity for Whole Customer Installation kva Section 10 EC DECLARATION OF CONFORMITY Attach the heat pump manufacture s EC Declaration of Conformity as produced in association with the EMC Directive Attached: Yes / No 4 Northern Powergrid Heat Pump Form A

5 Section 10 CONFIRMATION OF INSTALLATION I confirm that the electrical installation noted above will be installed and commissioned as noted above and that the equipment meets the requirements of BS EN and BS EN for harmonic emissions and voltage change. The customer at the above address has been advised that commissioning of the installation may only take place when the Network Operator has completed any reinforcement works the supply network requires. Name* Date On behalf of *Installer Signature* Accreditation / Qualification Section 11 DATA PROTECTION STATEMENT Data Protection We will use the details you provide to process your connection request and to monitor the service we provide. Your details will be kept securely and will not be used for marketing purposes. We have an obligation to provide the results of customer satisfaction surveys on the services we provide to Ofgem, the electricity industry regulator. Therefore you may be contacted by our appointed Market Research Company to complete a brief satisfaction survey of our service delivery performance. If you do not wish to be contacted as part of these surveys please tick 5 Northern Powergrid Heat Pump Form A