Service Line Application

Service Line Information

Applicant Information

Applicant Full Name*

*required

Service Address

Street Address*

*required

City/Town*

*required

County

Located between these two intersecting roads:*

*required

Additional Directions

Mailing Information

Mailing Name

(if different than applicant)

Full Mailing Address

(if different than service address)

Building and Fuel Information

Subdivision Name

(if applicable)

NewExisting

*required

YesNo

*required

SingleDoubleMultipleManufactured Home on FoundationMobile Home

*required

Clothes DryingCookingGarage HeaterGas GeneratorGas LightGrillHeatingIndoor FireplacePatio Fireplace/FirepitPool/Spa HeaterSpace HeaterStandard Water HeaterTankless Water HeaterOther(s)

*required

If a mainline installation is necessary, it may cost more and will take longer to process.

National Fuel will backfill the new service trench with original soil. You will be responsible for surface refinishing, restoring lawns, shrubbery, driveways or walkways and the repair of damage to any privately owned underground facilities that are not accurately marked (e.g., water well lines, septic systems, etc.).

The following conditions must be satisfied before your service line can be installed:

• (PA only) You or your contractor must provide written proof to National Fuel that the building or structure passed inspections required under the uniform construction code.

• Required state/county permits must be obtained by National Fuel.

• Payment (if required) must be received.

• Proposed meter site must be marked, backfilled to rough grade and must be clear of obstruction, i.e., building material, dirt piles, scaffolding, etc.

• If this is a conversion from another fuel,

  • you must also have one appliance ready to use gas, or have proof of purchase of a furnace or boiler and

  • (NY only) you must complete a certificate verifying compliance with minimum insulation standards.

Once these conditions are met, National Fuel will contact the other utilities and direct them to locate any of their underground facilities in the area where National Fuel will be digging. This process takes approximately three days.

National Fuel’s goal is to have your service (the line from the road to the house) installed within 10 days from the time the previously stated conditions have been met.

Requested Service Line Installation Date*

*required

Meter Billing Account Information

A meter cannot be installed and turned on until the service line has been installed and your house gas piping is in place. If you are ready, we may be able to set your meter on the same day we install your service. When you are ready for your meter and to have your service turned on, call 1-800-365-3234.

Once the meter is set, who will be responsible for the billing account?

Full Name*

*required

If the applicant and ratepayer names are different, the meter will be set in the applicant’s name unless the customer calls National Fuel to verify information.

YesNo

*required

Person Applying

(if different than above)

Employed by

(voluntary)

YesNo

*required

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