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This information is for office use only.

Location:       

TYPE

AGE

CONDITION

ROOF

Is this a Flat Roof?    Yes    No

CENTRAL HEAT

PLUMBING

ELECTRICAL SERVICE

Fuses   Circuit Breakers

OVERHANGING TREES

TENANT OCCUPIED?  YES   NO

OWNER OCCUPIED?   YES   NO

Comments ________________________

_________________________________

_________________________________

STUDENT HOUSING? 

VACANT?

UNOCCUPIED?

SEASONAL?

# of APT’S/UNITS ______

YES     NO

YES     NO  If Yes,

YES     NO  If Yes,

YES     NO  If Yes,

Explain ________________

Explain ________________

Explain ________________

WATER EXPOSURE

YES    NO 

WOOD STOVE/PELLET STOVE

FIREPLACE/WOOD FURNACE

YES    NO 

OUTBUILDINGS

GARAGE  YES   NO

Used for?_______________

SHED  YES   NO

Used for?______________

BARN OR OTHER ?

Describe ______________

ANIMALS: If Dog please specify the breed: __________________

YES    NO 

AGGRESSIVE BREED?

AGGRESSIVE NATURE?

RECREATIONAL ITEMS – LIST ALL

TRAMPOLINE?

POOL?

BOATS, DOCKS, ETC.?

______________________

KEROSENE HEATERS USED

911 LOCATION ADDRESS

WHO MAINTAINS THE SIDEWALKS IN WINTER MOS?

YES      NO 

IS RISK UNDER RENOVATION?

YES   

NO, COMPLETED     READY TO RENT

COMMENTS

ATTACH  SEPARATE SHEET OF

PAPER IF NECESSARY TO LIST ALL

REQUESTED INFORMATION

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