Electrification Questionaire and Work Request
This questionaire will help us assess how to assist you best. Feel free to fill this form out even if you are not interested in immediate work.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Municipality
*
Caroline
Cayuga Heights
Danby
Dryden Town
Dryden Village
Enfield
Freeville
Groton Town
Groton Village
Ithaca City
Ithaca Town
Lansing Town
Lansing Village
Newfield
Trumansburg
Ulysses
Type of Residence
*
Please Select
Single Family
2 Units
3 Units
4+ Units
Square Footage (approx.)
*
Year of Construction (approx.)
*
Do you have frequent electrical outages?
*
Yes
No
Existing Heating Type
*
Furnace (forced air/ductwork)
Boiler (water baseboards)
Electric baseboard
Heat Pump
Stand-alone Stove
Thermal Storage
Other
Type of Fuel
*
Fuel Oil
Propane
Natural Gas
Electric
Wood
Pellet
Coal
Other
What fossil fuel systems are in your home?
*
Space Heating
Oven/Range
Dryer
Water Heater
Gas Vehicle
No Fossil Fuels (yay!)
What investments are you considering?
*
Air Source Heat Pump (ASHP)
Dryer (Electric) Hookup
Electric Service Upgrade
EV Charger
Heat Pump Water Heater (HPWH)
Indoor Air Quality (IAQ)
Mitsubishi Cleaning
Mitsubishi Maintenance
Stove (Electric) Hookup
Power Quality (surge/brown out)
Repairs
What else would you like us to know?
*
(Timeframe, what you are initially looking for, use of the home/building, etc.)
Submit
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