ANNEXURE

Self-Certification by The Applicant

It is certified that the following equipment & electrical fitting are fixed Ref. No. 05/06515/18
in my / our premise at Block - AA-20 Date 11/03/2018
AANAND APT
SHOP-01 , DESHBANDHU NAGAR,BAGUIHATI
KOLKATA 700059 for which I / we intend to get the supply :-

SL. NO Name of equipment No. of equipment Wattage Total wattage

1 Single Fluorescent Tube light with conventional choke 2 40.00 80.00
2 Fans 1 400.00 400.00
3 Electric Kettle 1 1000.00 1000.00
4 Vaccum Cleaner 1 400.00 400.00
5 Computer - Laptop 1 60.00 60.00
6 Hair Dryer 1 1000.00 1000.00
TOTAL (kW) 2.94
I/We further certify/confirm that:
I. The electrical wiring, as detailed above, has been done with standard/ISI marked material, through a Licensed
Electrical Contractor, and under the direct supervision of a competent person, holding necessary certificate of
competency / permit in this behalf.
II. All the above electrical installations, including connecting wiring, etc. have been inspected and tested and
found to be in order by the said Contractor, to ensure observance of safety measures, and the said Contractor
has issued necessary certificate to the above effect which I / we possess and same may be produced
immediately on demand.
III. Proper earthing has been provided by the said Contractor for effective and safe functioning in my/our
establishment.
IV. I / We shall be fully responsible for any leakage in electric current, short circuiting and / or failure / leakage of
earthing etc. in my / our electric wiring.
V. I / We will not extend the wiring and connected load to any other person or persons without prior approval of
CESC.
VI. Since my/our intending supply will be through private common passage, none of the users of this particular
private common passage has any objection, whatsoever, in the matter of providing supply to me / us through
this private common passage.
VII. In case of effecting such supply, the said private common passage is required to be disturbed in any manner
whatsoever, the same will be repaired / restored by me / us and none of the users of this particular private
common passage has any objection in the matter.
VIII. The total connected load will be properly balanced at three phases after providing me / us such three phase
supply.
IX. I/we am/are the bonafide occupier(s) of the unit for which application for power supply has been filed and I/we
further confirm that my/our said unit is not deriving supply from any source in the premises or elsewhere in any
manner.
X. All the existing consumers in the premises have agreed to shift existing meter-board position in the premises
and each one of them has also agreed to take steps towards transfer of their respective main switch(es) /
MCB(s) and related wiring from the existing meter-board position to new meter-board position.
XI. I/we have all necessary approvals, license, sanctions etc. required to operate my/our unit for which this
application is being made.
XII. I/we have no objection, if at any point of time, supply to any other person(s) is/are provided in any unit of the
premises from this source of supply.
XIII. I/we shall abide by the provisions of the Electricity Act, 2003 together with Rules, regulations, Orders,
Notifications etc. made there under as applicable from time to time.
XIV. All my/our above information / particulars including details of Bank Accounts etc. are correct and CESC
Limited will have no further liabilities in case any communication / transaction etc. is made following such
information / particulars.

The facts and statement given above is true to my / our knowledge. If any mis-information and / or wrongful statement is/are
found at any point of time, I/We shall be held responsible and my/our above supply may liable to be disconnected.

Name of the applicant(s): ARNAB BHATTACHARYA

Unique Identification No(s): - K0483081 (Passport)
(Aadhar Card / Voter Card / Driving License / Passport/ Trade License/
Association Registration No.)
Date: 11/03/2018