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Sede Legale
Via J.F. Kennedy, 28
20097 - San Donato (MI)
Sede Operativa
Via Angelo Moro, 109
20097 - San Donato (MI)
N.REG. Imprese
05528670960
C.S. 20.000 € I.V.
Tel: +39 02 8976 5161
Fax: +39 02 5162 1694
Fax: +39 02 3929 2226
info@myenergy.it
FILL THIS FORM
* required fields
# numeric fields
Name
Surname
E-mail
Phone
Address
C.A.P.
Town
Province
Corporate / public body
VAT or CF
Study Title
REF / CODE:
AGTE-ITA
SUBAGTE-ITA
STAG-ITA
INSTALLER
DESIGNER
Reason of contact
How did you hear about Myenergy
Myenergy's Agent
Brochure
Newspapers
Vodafone Agreement
Billboards advertising
Friends
Fairs
Link from other sites
Search Engines
Radio
Design studies
PROJECT'S DATA :
Type photovoltaic system
# Power meter [Kw]
GRID-CONNECTED
ISOLATED
Type thermal system
Hot water
# Space available
mq
Ha
Type of surface
Car Park
Flat roof
Greenhouse
Industrial shed
Land
Roof flap
shed
Shed
Shelter
sunscreens
Vaulted roof
Vertical facade
Type of surface
Flat roof
Other
Roof flap
Vaulted roof
# Any inclination of the surface:
Degrees[°]
percentage[%]
Exhibition surface
Province installation
West
Sud-West 45°
Sud-West 30°
Sud-West 15°
Sud
Sud-East 15°
Sud-East 30°
Sud-East 45°
East
~East-West
# Consumption of Energy
Reference period
€
KWh
Months
Two months
Quarter
Half
Year
1)
Preliminary Program and incentive fee request in Energy Account Energia
and
Construction of the final draft and works
2)
Installation with specialized personnel and security charges
and
Testing facility
Period of Use
All year
Only Summer
Only Winter
Spring + Summer + Autumn
# Distance panels from the local technical [m]
Current supply energy for heating
New structure/home
GPL
Methane
Diesel
HOT WATER:
# N. Persons
# N. Bathrooms
# N. Kitchens
# N. Showers
# Consumption of hot water [litres / day*person]
HEATING (Only for backup heating):
Type of heating
# [m
3
] to Heat
Radiators
Plant floor
Fan coil
Other
Description plant (boiler, kettles, etc ...)
POOL HEATING:
Coverage
# [m
3
] to Heat
exists
doesn't exist
Select the types of procedures performed or to be performed that
require energy certificate (eg. tax deduction of 55%)
Boiler Replacement (condensation or high performance)
Replacing Fixtures
Insulation of horizontal surfaces
Insulation of vertical surfaces
Works building on the external walls
Other (to be specified in the message accompanying)
Building Type
# [m
2
] building
Apartment
House 1-2 floor
House 3-4 floor
Shop
Workshop
Study
Public Place
Gym
Beauty Center
Shed
Other
Message Of Support
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