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Massachusetts Electric Company&Nantucket Electric Company(dbla National Grid) M.D.P.U. 1248
Certs{sate of Completion for Simplified Process Interconnections
Justallation Information: 0 Check if owner-installed
Interconnecting Customer: Jennifer Sowards Contact Person:
Mailing Address: 220 Spring Grove Ave
City: Florence State: MA Zip Code: 01062
Telephone(Daytime): 971-227-8444 (Evening):
Facsimile Number: 23430798 E-Mail Address: elocin200021,hotmail.com
Address of Facility Of different from above):
Electrical Contractor's Name(if appropriate): Energy Monster
Mailing Address: 125 Blackstone River Road
City: Worcester State: _MA Zip Code: 01607
Telephone(Daytime): 774-479-8897 (Evening):
Facsimile Number: E-Mail Address:
License number: 2615
Date of approval to install Facility granted by National Grid:
Application ID number:
Jnspection:
The system has been installed and inspected in compliance with the local Building/Electrical Code of
(City/County):
Aim 4k4inckriciri
Signed(Local Electrical Wi ' g Inspector,or attach signed electrical inspection):
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Name(printed): ,F o� �r >'n o Jo Date: 2. -
License fi: tic Lk, CL^-amu• co./
As a condition of interconnection you are required to sendle-mail a copy of this form along with a copy of the
signed electrical permit to National Grid:
National Grid
Attn: Distributed Generation
40 Sylvan Rd
Waltham, MA 02451
E-mail:distri.used._•nera 'on'national_rid.com
Massachusetts:htta''%www nationaltridas tomhnasselectnehomefenengyeff d,sIr huted eeneration,am
Nantucket:hi +'www.national Irid.s.com'lento et home'energyefrdistribwedd genemtion.asp Page 1 of 1