Please Note: This form is for routine service and mechanical issues.
If you have an emergency please call the office to schedule an appointment.

Order will be confirmed by telephone or e-mail before work begins.
Please supply the following information. Fields marked with are required.

First and Last Name:

Service Address:

City, State & Zip:	,

Telephone Number:

Billing Address: if different from service address

Billing City, State & Zip:	,


Preferred Dates and Times for Service: Appointments requested less than 4-8 weeks in advance cannot be guaranteed	Week/Day/Time:



Key Location or Realtor:

This property is currently:

If Rented, Tenants Name:

Alternate Phone Numbers:

Email:



Type of Problem:		Inspect for HVAC Service Agreement
		Inspect for Plumbing Service Agreement
		Inspect for Water Heater Agreement
		Inspect for Winterization Agreement
		HVAC Maintenance Check

Or, if those options aren't accurate, please describe your need below ...

We are proud to support our community and our industry through our membership in the following Chambers

We are also an Accredited Business with the Better Business Bureau (BBB) and members of the National

Federation of Independent Business (NFIB) and the Air Conditioning Contractors of America (ACCA).

CUSTOM MECHANICAL, INC.

PARTS & SUPPLIES

CUSTOM SHEET METAL

P.O. Box 1479, Bethany Beach, DE 19930

(302) 539-5177 & (800) 233-5177 · Fax (302) 537-5191

Office Hours 7:30-4:30 M-F, Saturdays in Season

Emergency service available 24-hours!

Daisey Road in Frankford

Phone (302) 537-1150

Fax (302) 539-9106

7:30-4:30 M-F & Sat. in Season

Daisey Road in Frankford

Phone (302) 537-5611

Toll Free (877) 537-5611

Open 7:00-3:30 M-F

Licensed and insured: DE HVAC #HM-0000111, MD HVAC #01-5841, Plumbing DE #00653, Plumbing MD #71211, Electrical DE #T1-25, Electrical MD #M725