Property Address
Post Code
Full name of owner/s
Daytime telephone number
Type of property (detached, flat, terrace etc)
Date of original construction (if known) approx 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Dates of any extensions 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Is the property in a Conservation Area or a Listed Building YesNoDon't Know
Are there any habitable outbuildings YesNo
Type of Heating Systems installed
Age if known
Type of water heating systems installed
Gas MainLPGNone
Oil YesNo
Water MainsPrivate
Electric MainsNon Mains
Where is the electricity and gas meters located
Off Peak supply provided YesNo
Has cavity wall insulation been installed after construction YesNo
Has loft insulation been installed after construction YesNo
If Yes, what depth (mm)
Has replacement double glazing been installed YesNo
Date if known 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Notes (please use this space to clarify any issues from the questions above, and let us know about any other matters that might be useful for the assessor)