Auxiliary Heating/Cooling Equipment Request
Instructions: Applicants must complete sections A and B. Please contact the Department of Energy Management at energy_management@stonybrook.edu with any questions.
Email address
Section A: Applicant Information
Today's Date
MM
/
DD
/
YYYY
Applicants Name (Last, First)
Your answer
Applicants Department
Your answer
Applicants Building:
Your answer
Section B: Request Information
Applicants Telephone:
Your answer
What department is requesting the unit?
Your answer
What is the equipment type?
What is the reason for the request?
Building the unit will be installed in:
Your answer
Room the unit will be installed in:
Your answer
What is the room length (FT)?
Your answer
What is the room width (FT)?
Your answer
New Unit Size? (Height x Width x Depth)
Your answer
New Unit rating? (BTUH):
Your answer
New Unit Brand and Model Number:
Your answer
Applicant Affirmation:
By checking this box, I confirm that I understand that the installation of equipment and/or any modifications to structures and/or systems will be done at the expense of the requesting department. I also understand that Campus Operations and Maintenance will provide maintenance services for this equipment on a fee basis only.
Accept Agreement
Required
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This form was created inside of Stony Brook University. Report Abuse - Terms of Service - Additional Terms