Residential Service Request

Review and Submit Your Application

Review the information below. To correct any errors, click "Edit this Information" under the section subhead. If you need to complete your application later, click "SAVE DRAFT" below. When you have verified that the information above is correct, click "SUBMIT" below.

Note: Editing any information may require you to repeat steps in this process.

Have a question?

Northern Countries call 1-800-722-0256

Bergen, Essex, Hudson, Hunterdon, Middlesex, Morris, Passaic, Somerset, and Union counties

Southern Countries call 1-800-832-0076

Burlingon, Camden, Gloucester, Mercer, Monmouth, and Ocean counties

About You ({USER_TYPE})

You are {REQUESTOR_NAME}, a {USER_TYPE}

Your email address is {CUST_EMAIL}

Your phone number is {CUST_PHONE}

This project is {CONSTRUCTION_TYPE}

New service is requested for {SERVICE_TYPE}

The project completion date is {PROJECT_COM_DATE}

{Foundation}

Gas Service

{GAS_METER_NEW} new gas meters will be installed

{GAS_METER_TOTAL} total gas meters (new + existing)

Gas meters are labeled as : {GAS_MTR_NAME}

Comments & Special Considerations:

{COMMENT}

Billing Information

Project costs will be invoiced to:

{CONSTR_BILL_NAME}

{CONSTR_PHONE}

{CONSTR_ADDRESS}, {CONSTR_CITY}, {CONSTR_STATE}

{CONSTR_ZIP}

PSE&G utility bills will be sent to:

{CONSUM_BILL_NAME}

{CONSUM_PHONE}

{CONSUM_ADDRESS}, {CONSUM_CITY}, {CONSUM_STATE}

{CONSUM_ZIP}

Contact Information

Primary Contact for this project is:

{PRIMARY_PROPERTY_NAME}

{PRIMARY_COTACT_EMAIL}

{PRIMARY_PHONE}

Contractors Contact for this project is:

{ADD_CONT1_TYPE}

{ADD_CONT1_FIRST_NAME} {ADD_CONT1_LAST_NAME}

{ADD_CONT1_EMAIL}

{ADD_CONT1_PHONE}

{ADD_CONT2_TYPE}

{ADD_CONT2_FIRST_NAME} {ADD_CONT2_LAST_NAME}

{ADD_CONT2_EMAIL}

{ADD_CONT2_PHONE}

{ADD_CONT3_TYPE}

{ADD_CONT3_FIRST_NAME} {ADD_CONT3_LAST_NAME}

{ADD_CONT3_EMAIL}

{ADD_CONT3_PHONE}

New electric service will be:

{ELE_NEW_SERVICETYPE_LOC}

{ELE_LD_NEW_PHASE} , {ELE_LD_NEW_VOLT} , {ELE_LD_NEW_AMP}

Supporting Documentation

The following documents have been uploaded:

Spec Sheet

Site Plans(required)

Additional Documentation

Review the information above. To correct any errors, click "Edit this Information" under the section subhead. If you need to complete your application later, click "SAVE DRAFT" below. When you have verified that the information above is correct, click "SUBMIT" below.