Commercial and Instrustrial - Long Form

The undersigned hereby applies to the Fairport Municipal Commission to supply electric service and agrees to abide by the rates, rules, and regulations adopted by the Municipal Commission. 

Complete this form if you are a commerical or industrial customer and, 
  A) This is a new building; or,
  B) You are changing service requirements

You must complete all fields.

Requested Service Date:

Service Located at:


Business Type: 

Phone #:      Cell Phone Provider: 

Billing Name:    

Mailing Address (if different):
      

Taxpayer ID#: 

Sales Exempt Organziation:   No      Yes, must attach completed NYS form ST-121   
Email:  
   *Used for e-bills and notifications. Please check your spam/junk folder for your first bill.

Your Fairport Electric bill will be subject to a required Consumer Security Deposit. The security deposit will be calculated based on your anticipated service requirements. 

The deposit amount will be approximately twice your monthly invoice. The deposit will be refunded after 36 consecutive months of timely payments.

· Information requested in this form is designated to assisting us place you in the proper and
most beneficial service classification. We rely on this information in determining your service
classification.

· The cost of service may vary under different service classifications. The service classes are as
follows,
· Small-Commercial - usage less than 7,500 kWh’s or demand less than 25 kw per month
· Large-Commercial - usage more than 7,500 kWh’s and demand between 25 kw and 500 kw per month
· Industrial - demand greater than 500 kw per month

· One service class may be more beneficial than the other but it is determined based on your usage
and demand.

· Our tariff, as well as service class descriptions, can be found online here.  Our tariff may also be reviewed in our business office located at 31 S Main Street, Fairport, New York 14450. Questions about our service classifications may be discussed with our customer service representatives at (585) 223-0440.

· If your usage or equipment changes in the future, you must notify us of the changes to ensure proper billing.

· If the information provided is inaccurate or incomplete, the customer may be subject to back billing on the correct service classification, or may be precluded from receiving a refund for overcharges based on correct service classification.

Signature(enter full legal name here): 

Form A - Residential Units

 Service change type:     New Build         Service Requirement Change

 Electrical Contractor/Engineer Contact Info (name, address, phone number, e-mail):


COMPLETE IF NEW BUILD
Number of Residential Meters:    

Main Switch Information:   Amps    Voltage   Phase 

Service Type:    Overhead      Underground

Heat Source:    Gas Heat    Electric Heat    Other, Indicate Type

Building Permit Number (if applicable):

Builder's Contact Information:


COMPLETE IF SERVICE REQUIREMENT CHANGE
Existing Service Description: 

New Service Description: 

Form B-Commercial and Industrial Units

Main Switch Information:  
Amps    Voltage   Phase 

Service Type:    Overhead      Underground            Building Type:  New    Existing

Type of Service:   New   Temporary      Upgrade to Existing

Rate Class:   Small Commercial     Large Commercial     Industrial

Existing Meter(s) Number(s):       Square Footage:

Scheduled Start Date:     Scheduled Completion Date:

Jobs Created:       Building Permit Number(if applicable):  

Builder's Contact Information:


Electrical Contractor/Engineer Contact Information:


Please describe the project:


FOR LARGE COMMERCIAL OR INDUSTRIAL SERVICE APPLICATIONS, PLEASE ATTACH A ONE-LINE DIAGRAM AND A SITE PLAN OF THE REQUESTED SERVICE LOCATION

Total Connected Load:        *Estimated Peak Load: 

*Estimated annual consumption (If annual load is over 4,000 MWH please provide monthly usage and peak estimate): 

Is this load curtailable? 
Form C - Load Information

Please complete Form C and attach.
Form C.pdf




 
   
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