Forms

Combined Residential Application

Updated Fuel Pricing

EmPower Required Documents:

Workscope Submission:

• Homeowner Agreement or Rental Property Agreement
• EmPCalc
• House Diagram
• Appliance Exchange Agreement
• Energy Usage Waiver – if no bills are available
• NEC Calculation Worksheet – Required when proposing an upgrade to a panel box
• Field Change Order Form – Required for all workscope changes after approval
• ProForma – Required when financing heat pumps
• SHPO Form – if needed
• Customer Attestation (Heat Pump Information Form) – Only required for projects with ASHP/GSHP measures (previously Heat Pump Demonstration Projects) 
• National Grid Customer Self Attestation – Only required for KEDNY Pilot projects if the pilot funding amount is >$6000 OR contains custom measures on the Pilot Tab

Final Project Submission:

• EmPCalc
• Certificate of Completion
• Contractor Attestation – Only required for projects with ASHP/GSHP measures (previously Heat Pump Demonstration Projects) 

EmPower Optional Documents:

Workscope Submission:

• Initial Interview Form
• Notification of Possible Asbestos Form
• Optional Field Data Form
• Supplemental Data Collection Form
• Combustion Appliance Form

Final Project Submission:

• Clean and Tune Checklist

Assisted Home Performance with ENERGY STAR Required Documents:

Workscope Submission:

• Homeowner Agreement or Rental Property Agreement
• EmPCalc 
• House Diagram
• Energy Usage Waiver – if no bills are available
• NEC Calculation Worksheet – Required when proposing an upgrade to a panel box
• SHPO Form – if needed
• Customer Attestation (Heat Pump Information Form) – Only required for projects with ASHP/GSHP measures (previously Heat Pump Demonstration Projects) 

Final Project Submission:

• Certificate of Completion
• Contractor Attestation – Only required for projects with ASHP/GSHP measures (previously Heat Pump Demonstration Projects) 
• Field Change Order Form – Required for all workscope changes after approval