The Gas distributor for the North of England

New Connection Application

Thank you for considering to have a gas supply installed by Northern Gas Networks working with United Utilities.

Firstly we suggest you read the guidance notes for completing an application. You can download these here.

Simply complete the form below and we will arrange to have a quotation sent to you in the post. You will usually receive this within 10 working days of us receiving your application.

If you are having difficulties in completing this form, or wish to apply to have a supply installed to a commercial property, a new build property or 2 or more residential properties, please contact us on 0870 300 7677 and we will be more than happy to help you.

If you require to have your meter moved you can download an application pack here or call us on 0870 300 7677 to request one.

Note:
This form is not suitable for non-residential properties or for brand new properties as scale plans are required.

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Mandatory fields are marked with a * Details of the person making this application
Name:	*
Daytime phone number: (Including area code)	*
Evening phone number:
Mobile phone number:
Email Address:
Assisted Voucher Code: (Click here for guidance notes)
Are you the owner of the property * :	Yes No
Do you rent the property?	Yes No
If you are not the owner, and do not rent the property, please state your title and whether you are the are the builder, developer, agent or other representative. Also provide us with the name of your organisation if relevant:


Property where works are to be carried out
House number or name:	*
Address:	*

City:	*
Post Code:	*

Correspondence details (if different to above)
Name:
House number or name:
Address:

City:
Post Code:
If this is a different person to the main applicant, then please state your relationship to them:

Property details
Is the property * :	Terraced Semi-Detatched Detatched Flat Maisonette Other (please specify)
If the property is a flat or maisonette please say which floor it is on:

Is the property a residential household? * :	Yes No * Note: This form is not suitable for non-residential properties. Please call us on 0870 300 7677 for an application form
Is the property a listed building? *	Yes No
How old is the property? *	Built After 1977 Built Before 1977 * Note: This form is not suitable for brand new properties, as scaled site plans are required. You can download an application pack here or call us on 0870 300 7677 and we will send one to you.
Will you be using gas central heating? *	Yes No
Permission
You must have permission to install your new gas connection across any private land that you do not own.
To install your new gas connection, will we need to lay any pipe on private land which is not in your ownership? *
	Yes No
Do you have all the official consents you require?	Yes No Does Not Apply
Meter details
Please describe where the meter is, or will be fitted.* (Click here for guidance notes)
Meter box you have chosen (Click here for guidance notes) *	Internal Meter Surface Mounted Semi-concealed Built-in
Service pipe
Will you dig and restore the trench in your private land yourself? (Click here for guidance notes) *	Yes No
Please tell us the distance (in metres) from the edge of your property to where you need the meter to be fitted. *

Site Access and Variations
There must be someone on site when we do the work.
Will you be at the property during the work?	Yes No
If no, can our contractors make changes (variations) to the work they plan to carry out at the property (and the cost of the work) without your consent?
	Yes No
If you will not be onsite during the works, please give us the details of the person you have chosen to act on your behalf.
Name:
Daytime phone number:
Evening phone number:
Mobile phone number:
Please tell us their role or relationship to you:	Rent From You Builder Landlord Developer Agent
Other Please say:
Does this person have your permission to make changes to the work we plan to carry out at the property (and the price of the work) on your behalf?
	Yes No
If no-one is available to agree any variations to our work, our contractors may not be able to continue. We may have to leave your property and set a new date for the work to take place. We may make extra charges for this.
Please include any additional information you think may be relevant.