Application for Electric Service (Copy)

$30.00

Fill out the form below. This application is a legal contract between the Responsible Billing Party and the Town of Merrimac. Application fee: $30

If you need assistance, stop by or call us at 978-346-8311 so we can help you fill it out.

Service Application

Service Installation Name and Address

Is your billing address the same as your Service address?

Service Information

Service Type
How will you heat hot water?
Type of Heat
Service will be

Installation Information

Responsible Billing Party

Party responsible for payment of fees and materials
Please be aware of, and use MMLD specifications. Upon completion of this form, MMLD will issue a meter location. Upon approval from Wiring Inspector and payment of any related fees, MMLD will connect service.
Service Agreement

These fields for MMLD office use only

Category:

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