Belmont Light Interconnection Form Used to apply for a solar, battery, wind turbine, etc. authorization. (BETA VERSION) BELMONT LIGHT – Interconnection and Service Agreement Application for Behind-the-Meter InstallationsInstructions: Please fill out this application completely. The system should be designed for a power factor of 1. See Terms and Conditions for Interconnections for more information on the application process.Please read Terms and Conditions and Customer Application Checklist (links below) before proceeding.https://www.belmontlight.com/wp-content/uploads/2024/02/Interconnection-Agreement-Terms-and-Conditions.pdfhttps://www.belmontlight.com/wp-content/uploads/2021/02/2021-Belmont-Light-Interconnection-Checklist.pdfAfter installation, please download and fill out the Certificate of Completion (link below) and present it to the electrical inspector for signature during inspection.https://www.belmontlight.com/wp-content/uploads/2021/02/2021-Belmont-Light-Certificate-of-Completion.pdfBelmont Light Customer InformationCustomer Name(Required) First Last Business Name (if applicable)Electric ACCOUNT Number (on bill)(Required)Please enter a number from 00001 to 999999.Electric METER Number (on bill – begins with "RX", "RU", or "A".)(Required)Service Address of Interconnection Facility (e.g. "21 Main St, Unit 2")(Required)Customer Phone Number (e.g. "(555)444-3333")(Required)Customer Email Address(Required) Installing Contractor/Coordinating Company InformationCompany Name(Required)Company Contact Person First Last Company Mailing Address (eg. "123 Main Street, Boston, MA 02215")(Required)Company Contact Phone Number (e.g. "(555)444-3333")(Required)Company Contact Email Address(Required) Company License Number(Required)Estimated Construction Start Date(Required) Month Day Year Estimated Completion Date(Required) Month Day Year Interconnection Facility Information (Solar, Battery, Wind, Hydro, Other)Add a “System” for each Solar, Battery, Wind, Hydro, or other system proposed to be installed and/or currently installed at the facility. Start with a new proposed system for “System 1” and include existing systems later in the application. System #1Status of System #1(Required)Select from listProposedExistingRemovalType of System #1(Required)Select from listSolarBatteryCombined Solar/BatteryWindHydroOtherOther system type(Required)Production Meter Make/Model (enter "n/a" if no production meter installed)(Required)Inverter/Battery Manufacturer(Required)Model Name and Number(Required)Quantity Used (number)(Required)Please enter a number greater than or equal to 1.AC Nameplate kVA rating (per unit) (For example, enter ".290" for a 290W microinverter; enter "10" for a SolarEdge SE10000H)(Required)DC-STC Rating in kVA (solar only – enter "0" [zero] if system #1 is not solar)(Required)Please enter a number from 0 to 1001.Total System #1 AC Design Capacity (in kVA)(Required)Total Continuous System #1 AC kVA Output Available to Backfeed onto Electric Utility System (in kVA) – (Note: enter 0 if for emergency off-grid backup purposes only = no backfeed to the grid)(Required)UL Listed? (see Belmont Light Terms and Conditions for Residential & Commercial Interconnections)(Required)Select from listYesNoPhase(Required)Select from listSingleThreeContinue to System #2?Do you have a second existing or proposed system to submit?(Required) Yes No System #2Status of System #2(Required)Select from listProposedExistingRemovalType of System #2(Required)Select from listSolarBatteryCombined Solar/BatteryWindHydroOtherOther system type(Required)Production Meter Make/Model (enter "n/a" if no production meter installed)(Required)Inverter/Battery Manufacturer(Required)Model Name and Number(Required)Quantity Used(Required)Please enter a number greater than or equal to 1.AC Nameplate kVA rating (per unit)(Required)DC-STC Rating in kVA (solar only – enter "0" [zero] if system #2 is not solar)(Required)Please enter a number from 0 to 1001.Total System #2 AC Design Capacity (in kVA)(Required)Total Continuous System #2 AC kVA Output Available to Backfeed onto Electric Utility System (in kVA) – (Note: enter 0 if for emergency off-grid backup purposes only = no backfeed to the grid)(Required)UL Listed? (see Belmont Light Terms and Conditions for Residential & Commercial Interconnections)(Required)Select from listYesNoPhase(Required)Select from listSingleThreeContinue to System #3?Do you have a third existing or proposed system to submit?(Required) Yes No System #3Status of System #3(Required)Select from listProposedExistingRemovalType of System #3(Required)Select from listSolarBatteryCombined Solar/BatteryWindHydroOtherOther system type(Required)Production Meter Make/Model (enter "n/a" if no production meter installed)(Required)Inverter/Battery Manufacturer(Required)Model Name and Number(Required)Quantity Used(Required)Please enter a number greater than or equal to 1.AC Nameplate kVA rating (per unit)(Required)DC-STC Rating in kVA (solar only -enter "0" [zero] if system #3 is not solar)(Required)Please enter a number from 0 to 1001.Total System #3 AC Design Capacity (in kVA)(Required)Total Continuous System #3 AC kVA Output Available to Backfeed onto Electric Utility System (in kVA) – (Note: enter 0 if for emergency off-grid backup purposes only = no backfeed to the grid)(Required)UL Listed? (see Belmont Light Terms and Conditions for Residential & Commercial Interconnections)(Required)Select from listYesNoPhase(Required)Select from listSingleThreeCombined System Continuous kVA BackfeedPlease consider how you will use your new interconnection facility and/or pair with existing facilities (e.g. as a standalone power source, for time-of-use purposes, etc.) Total Backfeed: Based on your answers above, the maximum possible continuous kVA backfeed of all systems onto the Belmont Light grid is calculated below. (in kVA). Do NOT change this default value unless you have a special reason. (email energyresources@belmontlight.com with the reason)(Required)System's Power Factor (system must be designed for a power factor of "1")(Required)Please enter a number from 0 to 1.Documents to UploadUpload a .pdf containing each manufacturer’s document showing UL1741 listings, including ALL PROPOSED AND EXISTING SYSTEMS.(Required)Max. file size: 32 MB.Upload a .pdf of an electrical schematic/one-line diagram showing facility interconnection, main utility metering, and any premises sub-metering and including ALL PROPOSED AND EXISTING SYSTEMS.(Required)Max. file size: 32 MB.Upload a .pdf containing manufacturer spec sheets for all major equipment in ALL PROPOSED AND EXISTING SYSTEMS.(Required)Max. file size: 32 MB.Upload additional document(s). (1)Max. file size: 32 MB.Upload additional document(s). (2)Max. file size: 32 MB.Signature – contractor: you are signing on behalf of the Belmont Light customer. A copy of the form will be sent to their email address.(Required)