Building Inspectors of WNY 7011 Bear Ridge Road Pendleton, NY 14120 Building Inspection Report .

• Document No.

• Client

• Location

• Telephone Number

• Client Email Address

• Real Estate Agent Name/ Number

• Conducted on

  Date

• Inspector

  Select Michael J. Poli, President NYS License # 16000005856 Member - American Society of Home Inspectors

  • Michael J. Poli, President NYS License # 16000005856 Member - American Society of Home Inspectors

• Pictures of House

  Media

• Entry Faces

  North

  South

  East

  West

• Estimated Age of House

• Stories

  Select 1 Story 1.5 Story 2 Story 3 Story Split Level Other

  • 1 Story
  • 1.5 Story
  • 2 Story
  • 3 Story
  • Split Level
  • Other

• Other

• Space below grade

  Select Full Basement Slab on Grade Crawl Space

  • Full Basement
  • Slab on Grade
  • Crawl Space

• Potable Water

  Public

  Well

• Sewage Disposal

  Public

  Septic

• Utilities

  Select All on Shutoff Gas Soil Water Electircal

  • All on
  • Shutoff
  • Gas
  • Soil
  • Water
  • Electircal

• Soil conditions:

  Select Damp Dry Frozen Snow Covered Wet

  • Damp
  • Dry
  • Frozen
  • Snow Covered
  • Wet

• How many inches of snow

• Weather

  Snow

  Rain

  Cloudy

  Clear

• Temperature

• Area

  City

  Rural

  Town

• People present

  Yes

  No

• Who is Present

  Select Buyer Owner Realtor Other

  • Buyer
  • Owner
  • Realtor
  • Other

• Other

• Garage

  Yes

  No

• Number of Cars

• Is the garage attached or detached <br>

  Attached

  Detached

• Is the house occupied

  Yes

  No

Grounds

• Does the Property Have Walkways?

  Yes

  No

• Walkway Type

  Select Asphalt Concrete Pavers Stone other

  • Asphalt
  • Concrete
  • Pavers
  • Stone
  • other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Reason why

  Select Cracked Heaved Tripping Hazard Need Sealing Uneven surface Other

  • Cracked
  • Heaved
  • Tripping Hazard
  • Need Sealing
  • Uneven surface
  • Other

• Other

• Does the Property have a Driveway?

  Yes

  No

• Driveway Type

  Select Concrete Asphalt Stone Other

  • Concrete
  • Asphalt
  • Stone
  • Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Reason why

  Select Cracked Heaved Tripping Hazard Need Sealing Uneven surface Other

  • Cracked
  • Heaved
  • Tripping Hazard
  • Need Sealing
  • Uneven surface
  • Other

• Other

• Does the Property Have a Patio?

  Yes

  No

• Patio Type

  Select Conrete Blocks Stone Other

  • Conrete
  • Blocks
  • Stone
  • Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Reason why

  Select Cracked Heaved Tripping Hazard Need Sealing Uneven surface Other

  • Cracked
  • Heaved
  • Tripping Hazard
  • Need Sealing
  • Uneven surface
  • Other

• Other

• Does Property have a Porch

  Yes

  No

• Porch

Porch

• Location

  Select North South East West

  • North
  • South
  • East
  • West

• Porch Type

  Select Concrete Covered Wood Location Front Location Rear Location Side With Railings Other

  • Concrete
  • Covered
  • Wood
  • Location Front
  • Location Rear
  • Location Side
  • With Railings
  • Other

• Type

• Condition of Porch?

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Does the Porch have a railing?

  Yes

  No

• Type of Railing

  Select Wood Metal Stone PVC Other

  • Wood
  • Metal
  • Stone
  • PVC
  • Other

• Type

• Condition of Railing

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Does Porch have Stairs?

  Yes

  No

• Type Of Stairs?

  Select Wood Concrete Trex Stone Pavers Other

  • Wood
  • Concrete
  • Trex
  • Stone
  • Pavers
  • Other

• Type of Stairs

• Condition of Stairs

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Does Porch Steps have a Railing

  Yes

  No

• Condition of Railing?

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Railing Reason if no

  Add a Railing

  Railing not Requried

• Does the Property have a Deck

  Yes

  No
Deck

• Type of Deck Material

  Select Wood Trex PVC Other

  • Wood
  • Trex
  • PVC
  • Other

• Type of Deck?

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Does Deck have Railings

  Yes

  No

• Type of Railing

  Select Wood Metal Stone PVC Other

  • Wood
  • Metal
  • Stone
  • PVC
  • Other

• Type

• Condition of Railings

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Does the Deck have Stairs?

  Yes

  No

• Deck Stair Type

  Select Wood Concrete Brick Metal Other

  • Wood
  • Concrete
  • Brick
  • Metal
  • Other

• Type

• Condition of Stairs

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Deck Stairs Have a Railing

  Yes

  No

• Condition of Railings

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Railing Reason if no

  Select Add a Railing Railing not Requried

  • Add a Railing
  • Railing not Requried

• Slope and Drainage around Building

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Trees at Building/Limbs,Wires

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Sewer Vent Pipe

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Sewer Pipe Location

  Select Not Visible Front Side Walk Front Lawn Side Lawn Rear Lawn Foundation Wall Other

  • Not Visible
  • Front Side Walk
  • Front Lawn
  • Side Lawn
  • Rear Lawn
  • Foundation Wall
  • Other

• Other

• Grounds Section Notes

• Add media

  Media

Roof and Chimney

Roof

• Roof View

  Select All Portions None Other North South East West

  • All
  • Portions
  • None
  • Other
  • North
  • South
  • East
  • West

• Because of

  Select Trees Snow Design

  • Trees
  • Snow
  • Design

• Other

• Viewed from

  Select Ladder at Eaves Binocular from Ground Walk on Roof House Window Other

  • Ladder at Eaves
  • Binocular from Ground
  • Walk on Roof
  • House
  • Window
  • Other

• Other

• Roof Style

  Select Dormer Flat Hip Gable Mansard Shed Other

  • Dormer
  • Flat
  • Hip
  • Gable
  • Mansard
  • Shed
  • Other

• Type

• Slope Type

  Select Steep Medium Shallow Other

  • Steep
  • Medium
  • Shallow
  • Other

• Type

• Roof Materials

  Select Asphalt Shingles Asphalt Roll Slate Metal Rubber Wood Shinges Other

  • Asphalt Shingles
  • Asphalt Roll
  • Slate
  • Metal
  • Rubber
  • Wood Shinges
  • Other

• Material

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Number of Layers

• Valleys

  Yes

  No

• Valley Type

  Select Asphalt Shingle Metal Other Rubber

  • Asphalt Shingle
  • Metal
  • Other
  • Rubber

• Valley Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Flashing

  Yes

  No

• Flashing Type

  Select Metal Roofing Cement Other

  • Metal
  • Roofing Cement
  • Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Ventilation

  Yes

  No

  N/A

• Type of Ventilation

  Select Box Gable Ridge Soffit Power Roof Vent Other

  • Box
  • Gable
  • Ridge
  • Soffit
  • Power Roof Vent
  • Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Gas Vent Present

  Yes

  No

• Type of Vent

  Select Asbestos Cement PVC Metal Tile Masonry Other

  • Asbestos
  • Cement
  • PVC
  • Metal
  • Tile
  • Masonry
  • Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Chimney Present

  Yes

  No

• Chimney

Chimney

• Chimney Structure

  Select Masonry Metal Other

  • Masonry
  • Metal
  • Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Chimney Cap

  Masonry

  Metal

  Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Flue

  Tile

  Metal

  Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Birds Screen Present

  Yes

  No

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Roof And Chimney Section Notes

• Add media

  Media

Exterior

• Gutters Present

  Yes

  No

• Gutters Type

  Select Galvanized Alumium Vinyl Other

  • Galvanized
  • Alumium
  • Vinyl
  • Other

• Type

• Downspouts

  Yes

  No

• Type of Down Spouts

  Select Galvanized Alumium Vinyl Other

  • Galvanized
  • Alumium
  • Vinyl
  • Other

• Type

• Down Spout Drainiage

  Select Base of Foundation Leader Pipe Underground Piped Other

  • Base of Foundation
  • Leader Pipe
  • Underground Piped
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Wall Coverings

  Select Asbestos Brick Dravit Masonry Block Metal Siding Stone Vinyl Siding Wood Siding Wood Shaker Other

  • Asbestos
  • Brick
  • Dravit
  • Masonry Block
  • Metal Siding
  • Stone
  • Vinyl Siding
  • Wood Siding
  • Wood Shaker
  • Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Soffit/Facia Present

  Yes

  No

• Type

  Select Aluminum Vinyl Wood Other

  • Aluminum
  • Vinyl
  • Wood
  • Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Caulking at Window and Doors

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Window Well Present

  Yes

  No

• Type

  Select Covered Galvanized Metal Masonry Plastic Other

  • Covered
  • Galvanized Metal
  • Masonry
  • Plastic
  • Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Basement Windows

  Yes

  No

• Type

  Select Metal Wood Vinyl Glass Block Other

  • Metal
  • Wood
  • Vinyl
  • Glass Block
  • Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Screens/Storms Present

  Yes

  No

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Foundation Wall

  Select Block Concrete Stone Spaulding Vertical Cracks Other

  • Block
  • Concrete
  • Stone
  • Spaulding
  • Vertical Cracks
  • Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible
Entry Door

• Location

  All

  Front

  Rear

  Left Side

  Right Side

• Door Type

  Select Wood Metal W/Storms W/Screens Other

  • Wood
  • Metal
  • W/Storms
  • W/Screens
  • Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Patio Door/s

  Yes

  No

• Patio Door

Patio Door

• Location

  All

  Front

  Rear

  Left Side

  Right Side

• Type

  Select Wood Metal Vinyl Slider Hinge French Insulated Glass Single Pane Glass Other

  • Wood
  • Metal
  • Vinyl
  • Slider
  • Hinge
  • French
  • Insulated Glass
  • Single Pane Glass
  • Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Reason

  Select Need Glazing Broken Seal Cracked Panes Other

  • Need Glazing
  • Broken Seal
  • Cracked Panes
  • Other

• Reason

• Windows

Window

• Type Material

  Select Metal Vinyl Wood Other

  • Metal
  • Vinyl
  • Wood
  • Other

• Material

• Window Type

  Select Casement Double Hung Fixed Glass Block Insulated Glass Slider Single Pane Vinyl Other Broken Seals

  • Casement
  • Double Hung
  • Fixed
  • Glass Block
  • Insulated Glass
  • Slider
  • Single Pane
  • Vinyl
  • Other
  • Broken Seals

• Type

• Window Location

  Select All Front Rear Left Side Right Side

  • All
  • Front
  • Rear
  • Left Side
  • Right Side

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Reason

  Select Need Glazing Broken Seal Cracked Panes Other

  • Need Glazing
  • Broken Seal
  • Cracked Panes
  • Other

• Reason

• Storms and Screens

  Yes

  No

• Type Material

  Select Wood Metal Vinyl Screens Only Combination Storm/Screen Other

  • Wood
  • Metal
  • Vinyl
  • Screens Only
  • Combination Storm/Screen
  • Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Exterior Section Notes

• Add media

  Media

Garage

• Does Property have a Garage

  Yes

  No
Garage

• Garage Attached or Detached

  Attached

  Detached

• Foundation

  Concrete

  Block

  Slab

  Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Floor

  Select Concrete Asphalt Dirt Other Cracked Heaved

  • Concrete
  • Asphalt
  • Dirt
  • Other
  • Cracked
  • Heaved

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Plumbing

  Yes

  No

• Plumbing Equipment

  Select Floor Drain Faucet Other

  • Floor Drain
  • Faucet
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Walls

  Select Block Masonry Finish Frame Other

  • Block
  • Masonry
  • Finish
  • Frame
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Fire Coating at House (Wall/Ceiling)

  Yes

  No

  NA

• Type

  Select Drywall Plaster Wood Masonry Other

  • Drywall
  • Plaster
  • Wood
  • Masonry
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Does Garage have a Man Door

  Yes

  No

• Type

  Hollow

  Metal

  Wood

  Solid

  Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Does Garage if attached have a Door Leading to Inside of house?

  Yes

  No

  N/A

• Type

  Select Hollow Metal Wood Solid Other

  • Hollow
  • Metal
  • Wood
  • Solid
  • Other

• Type

• Is the Door Fire Rated?

  Yes

  No

  N/A

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Stairs to House

  Yes

  No

• Railing

  Yes

  No

  Not Required

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Roof Structure

  Select Same as House Hip Gable Shed Flat Trusses 2x4 16" Centers 2x4 24" Centers 2x6 16" Centers 2x6 24" Centers Other

  • Same as House
  • Hip
  • Gable
  • Shed
  • Flat
  • Trusses
  • 2x4 16" Centers
  • 2x4 24" Centers
  • 2x6 16" Centers
  • 2x6 24" Centers
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Siding

  Select Asbestos Brick Dravit Masonry Block Metal Siding Stone Vinyl Siding Wood Siding Wood Shaker Other

  • Asbestos
  • Brick
  • Dravit
  • Masonry Block
  • Metal Siding
  • Stone
  • Vinyl Siding
  • Wood Siding
  • Wood Shaker
  • Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Gutters

  Yes

  No

• Type

  Galvanized

  Alumium

  Vinyl

  Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Roofing

  Select Asphalt Shingle Metal Other Rubber

  • Asphalt Shingle
  • Metal
  • Other
  • Rubber

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Electrical

  Yes

  No

• Sub Panel Amp.

• Electrical Features

  Select Lights Outlets GFCI Sub-Panel Extension Cord for Opener Other

  • Lights
  • Outlets
  • GFCI
  • Sub-Panel
  • Extension Cord for Opener
  • Other

• Others

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Vehicle Door

  Hinged

  Overhead

  Sliding

  Other

• Type

• Material

  Metal

  Plastic

  Wood

  Vinyl

  Other

• Type

• Number of Doors

  1

  2

  3

  4

  Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Garage Door Opener

  Yes

  No

• Make

• Auto Reverse

  Yes

  No

  N/A

• Safety Eyes

  Yes

  No

  N/A

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Garage Section Notes

• Add media

  Media

Interior Structural Components

• Basement

  Yes

  No

• Basement

Basement

• Type

  Select Full Partial Crawl Space

  • Full
  • Partial
  • Crawl Space

• Height of Basement Ceiling

  7'

  8'

  9'

  Other

• Height

• Foundation walls

  Block

  Concrete

  Stone

  Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Is Basement Finished

  Yes

  No

• Percentage Finished

• Wall Type

  Select Drywall Paneling Insulation Other Owners Belongings Limited Access

  • Drywall
  • Paneling
  • Insulation
  • Other
  • Owners Belongings Limited Access

• Other

• Cracks

  Yes

  No

• Check all that applies

  Select Diagonal Horizontal Vertical Not all Visible

  • Diagonal
  • Horizontal
  • Vertical
  • Not all Visible

• Floor

  Select Concrete Painted Dirt Carpeting Tile Laminate Other Cracks Heaved

  • Concrete
  • Painted
  • Dirt
  • Carpeting
  • Tile
  • Laminate
  • Other
  • Cracks
  • Heaved

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Stair to Basement Type

  Wood

  Concrete

  Other

• Type

• Does the Stairs have Railings?

  Yes

  No

  N/A

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Vapor Barrier

  Yes

  No

  N/A

• What Type

  Plastic

  Tar Paper

  Concrete

  Other

• Type

• Any sign of Water on Walls

  Yes

  No

• What type of water signs

  Select Wet Damp Stains

  • Wet
  • Damp
  • Stains

• Any sign of Water on Floor

  Yes

  No

• What type of water signs

  Select Wet Damp Stains

  • Wet
  • Damp
  • Stains

• Basement Have Insulation<br>

  Yes

  No

  N/A

• Insulation Type

  Select 3.5" Insulation 6.5" Insulation 10" Insulation 12" Insulation Cellulose Blown Insulation Fiberglass Batt Fiberglass Insulation Rock Wool Batt Other Rigid Foam

  • 3.5" Insulation
  • 6.5" Insulation
  • 10" Insulation
  • 12" Insulation
  • Cellulose Blown Insulation
  • Fiberglass Batt
  • Fiberglass Insulation
  • Rock Wool Batt
  • Other
  • Rigid Foam

• Type

• Foundation walls

  Block

  Concrete

  Stone

  Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Cracks

  Yes

  No

• Check all that applies

  Select Diagonal Horizontal Vertical Not all Visible

  • Diagonal
  • Horizontal
  • Vertical
  • Not all Visible

• Floor

  Concrete

  Dirt

  Stone

  Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Any sign of Water on Floor

  Yes

  No

• What type of Water signs

  Select Wet Damp Stains

  • Wet
  • Damp
  • Stains

• Any sign of Water on Walls

  Yes

  No

• What type of Water signs

  Select Wet Damp Stains

  • Wet
  • Damp
  • Stains

• Vapor Barrier

  Yes

  No

  N/A

• What Type

  Plastic

  Tar Paper

  Concrete

  Other

• Type

• Crawl Space Have Insulation<br>

  Yes

  No

  N/A

• Insulation Type

  Select 3.5" Insulation 6.5" Insulation 10" Insulation 12" Insulation Cellulose Blown Insulation Fiberglass Batt Fiberglass Insulation Rock Wool Batt Other Rigid Foam

  • 3.5" Insulation
  • 6.5" Insulation
  • 10" Insulation
  • 12" Insulation
  • Cellulose Blown Insulation
  • Fiberglass Batt
  • Fiberglass Insulation
  • Rock Wool Batt
  • Other
  • Rigid Foam

• Type

• Floor Joists

  Select 2x8 16"o.c. 2x10 16"o.c. Other

  • 2x8 16"o.c.
  • 2x10 16"o.c.
  • Other

• Type

• Bridging

  Yes

  No

  N/A

• Level

  Yes

  No

  N/A

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Support Column(s)

  4"Pipe

  Masonry

  Wood

  Bearing Wall

  Other

• Type

• Plumb

  Yes

  No

  N/A

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Main Beam

  Steel

  Wood

  Other

• Type

• Size of Beam

  6"

  8"

  10"

  Other

• Size

• Level

  Yes

  No

  N/A

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Flooring

  Select Boards Particle Board Plywood Other Rott Noted Evidenced Of Mold

  • Boards
  • Particle Board
  • Plywood
  • Other
  • Rott Noted
  • Evidenced Of Mold

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Interior Structural Components Notes

• Add media

  Media

Plumbing

• Sump Pump

  Yes

  No

• Type of Pump

  Select Sump Pump Submersible Upright

  • Sump Pump Submersible
  • Upright

• Backup

  Yes

  No

• Type of Backup

  Select Battery Backup Water Backup Emergency Back-up Generator

  • Battery Backup
  • Water Backup
  • Emergency Back-up Generator

• Sump Pump Discharged

  Select To Gutter underground Hub Drain Along Foundation Sewer Sanitary Sewer Covered Check Valve Other

  • To Gutter underground Hub Drain
  • Along Foundation
  • Sewer
  • Sanitary Sewer
  • Covered
  • Check Valve
  • Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Reason

  Select Repipe Sump Needs Cleaning Needs Adjustment Other

  • Repipe
  • Sump Needs Cleaning
  • Needs Adjustment
  • Other

• Reason

• Incoming Water LIne

  Select Copper Galvanized Lead Meter Plastic Pressure Reducer Well Pump Other

  • Copper
  • Galvanized
  • Lead
  • Meter
  • Plastic
  • Pressure Reducer
  • Well Pump
  • Other

• Type

• Location

  Select North South East West

  • North
  • South
  • East
  • West

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Reason

  Select Repipe Sump Needs Cleaning Needs Adjustment Other

  • Repipe
  • Sump Needs Cleaning
  • Needs Adjustment
  • Other

• Reason

• Electrical Ground Jumper around Water Meter

  Yes

  No

  N/A

• House Water Pipes

  Select Copper Steel Plastic Excessive Corrosion Other

  • Copper
  • Steel
  • Plastic
  • Excessive Corrosion
  • Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Reason

  Select Repipe Sump Needs Cleaning Needs Adjustment Other

  • Repipe
  • Sump Needs Cleaning
  • Needs Adjustment
  • Other

• Reason

• Reason

  Select Excessive Corrosion Leaks Other

  • Excessive Corrosion
  • Leaks
  • Other

• Reason

• Waste and Vent Pipes

  Select Cast Iron Copper Galvanized Plastic Lead Other Excessive Corrosion

  • Cast Iron
  • Copper
  • Galvanized
  • Plastic
  • Lead
  • Other
  • Excessive Corrosion

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Reason

  Select Repipe Sump Needs Cleaning Needs Adjustment Other

  • Repipe
  • Sump Needs Cleaning
  • Needs Adjustment
  • Other

• Reason

• Laundry Connections

  Select Yes No

  • Yes
  • No

• Location/Equipment

  Select 1st Floor 2nd Floor Basement Garage Other 220V Gas Vent Tub Stand Pipe 110 Volt

  • 1st Floor
  • 2nd Floor
  • Basement
  • Garage
  • Other
  • 220V
  • Gas
  • Vent
  • Tub
  • Stand Pipe
  • 110 Volt

• Location

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible
Water Heater

• Water Heater

  Select Gas Electrical Oil Tankless

  • Gas
  • Electrical
  • Oil
  • Tankless

• Picture

  Media

• Location

  Select Basement Crawl Space Utility Room

  • Basement
  • Crawl Space
  • Utility Room

• Brand

• Model#

• Serial Number#

• Size

• Age

• Water Heater Temp/Pressure Relief Valve

  Yes

  No

  N/A

• Extension Pipe

  Yes

  No

  N/A

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Water Heater Vent Pipe

  Select Sheet Metal Direct Sheet Metal Joins Heating PVC Induced Fan Other

  • Sheet Metal Direct
  • Sheet Metal Joins Heating
  • PVC
  • Induced Fan
  • Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Fuel Pipe

  Select Black Iron Galvanized Copper Brass Other

  • Black Iron
  • Galvanized
  • Copper
  • Brass
  • Other

• Type

• Drip Leg

  Yes

  No

  N/A

• Shut Off valve

  Yes

  No

  N/A

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Plumbing Section Notes

Heating System

Heating

• Type of Heating

  Select Baseboard Water Forced Air Steam

  • Baseboard Water
  • Forced Air
  • Steam

• Picture

  Media

• Drip Leg

  Yes

  No

  N/A

• Shut off Valve<br>

  Yes

  No

  N/A

• Furnace Brand

• Model

• KWH

• BTU/Hr

• Number of Burners

• Fuel

  Select Gas OIl Electric Wood

  • Gas
  • OIl
  • Electric
  • Wood

• Blower

  Select Direct Belt

  • Direct
  • Belt

• Piping

  Select Black Iron Galvanized Copper Flexible Gas Connection Other

  • Black Iron
  • Galvanized
  • Copper
  • Flexible Gas Connection
  • Other

• Filter Air

  Select Disposable Washable Electric

  • Disposable
  • Washable
  • Electric

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Burner Area Flame ok

  Yes

  No

  N/A

• What is wrong

  Select Lazy Heat Exchanger needs to be check for Cracks Needs Adjustment Other

  • Lazy
  • Heat Exchanger needs to be check for Cracks
  • Needs Adjustment
  • Other

• Other

• Furnace Brand

• Picture

  Media

• Model

• Btu/hr

• High Temp Degrees F

• High Pressure PSI

• Overall Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Safety Control

  Select High Limit Safety Valve

  • High Limit
  • Safety Valve

• Draft Regulator

  Select Mechanical Damper Electric Damper Draft Hood Induced Fan Other

  • Mechanical Damper
  • Electric Damper
  • Draft Hood
  • Induced Fan
  • Other

• Other

• Flue Vent Pipe

  Select Sheet Metal Asbestos PVC Other

  • Sheet Metal
  • Asbestos
  • PVC
  • Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Distribution

  Select Pipes Ducts Asbestos Sheet Metal Insulated Copper Pipes Steel Pipes Other

  • Pipes
  • Ducts
  • Asbestos
  • Sheet Metal
  • Insulated
  • Copper Pipes
  • Steel Pipes
  • Other

• Other

• Thermostat Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Humidifier

  Yes

  No

• Picture

  Media

• Auxiliary Heating System

  Yes

  No

• Type

  Select Gas Oil Electric Propane Wood Stove Other

  • Gas
  • Oil
  • Electric
  • Propane
  • Wood Stove
  • Other

• Type

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Heating Section Notes

• Add media

  Media

Cooling System

• Cooling System Present

  Yes

  No

• Cooling System

Cooling

• Type of Cooling System

  Select Electric Gas Heat Pump Other

  • Electric
  • Gas
  • Heat Pump
  • Other

• Other

• Make

• Model

• Type

• Serial Number

• Picture

  Media

• Estimate age of unit

• Outside Electrical Disconnect

  Yes

  No

  N/A

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Is system able to be Evaluated

  Yes

  No

• Reason

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Thermostat is good working condition

  Yes

  No

  N/A

• Is Cooling Distribution Common with System

  Yes

  No

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Is Cooling Electric Disconnect Mounted outside near unit

  Yes

  No

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Cooling System Notes

Electrical

• Service Size

  Select 110V 220V Other 110/220v

  • 110V
  • 220V
  • Other
  • 110/220v

• Size

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Notes

• Picture

  Media

• Wiring

  Select Romex Wiring Cloth Wiring Knob and Tube Other

  • Romex Wiring
  • Cloth Wiring
  • Knob and Tube
  • Other

• Amperage to House

  Select 30 60 100 125 150 200 Other

  • 30
  • 60
  • 100
  • 125
  • 150
  • 200
  • Other

• Size

• Electrical Service Entrance

  Select Copper Aluminum Overhead Under Ground Conduit Wire Obstructions

  • Copper
  • Aluminum
  • Overhead
  • Under Ground Conduit
  • Wire Obstructions

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Panel Type

  Select Culter Hammer Federal Pacific Siemens Square D Fuses Breakers Other

  • Culter Hammer
  • Federal Pacific
  • Siemens
  • Square D
  • Fuses
  • Breakers
  • Other

• Other Type

• Panel Location

  Select Garage Basement Outside Other

  • Garage
  • Basement
  • Outside
  • Other

• Location

• Main Breaker amps

• Ground

  Select Ground Rod Water Pipe Not Visible Other

  • Ground Rod
  • Water Pipe
  • Not Visible
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• 110v Circuit

  Select Breakers Fuses Copper Wire Aluminum Wire Other

  • Breakers
  • Fuses
  • Copper Wire
  • Aluminum Wire
  • Other

• 15amps

• 20amps

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• 220v

  Yes

  No

• 220v Circuit

  Select Breakers Fuses Copper Wire Aluminum Wire Other

  • Breakers
  • Fuses
  • Copper Wire
  • Aluminum Wire
  • Other

• Other

• Number of 20 amp Breaker

• Number of 30 amp Breaker

• Number of 40 amp Breaker

• Number of 50 amp Breaker

• Number of 60 amp Breaker

• Number of 100 amp Breaker

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Sub Panel

  Yes

  No

• Make

  Select Culter Hammer Federal Pacific Siemens Square D Fuses Breakers Other

  • Culter Hammer
  • Federal Pacific
  • Siemens
  • Square D
  • Fuses
  • Breakers
  • Other

• Other Type

• Voltage

  Select 110v 110v/220v

  • 110v
  • 110v/220v

• Wiring

  Copper

  Aluminum

• 110v 15amps

• 20 amps

• 220v 30amps

• 40 amps

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Ground Fault Interrupters?

  Yes

  No

• Ground Fault Interrupters Locations

  Select Baths kitchen Exterior Garage In Panel Other

  • Baths
  • kitchen
  • Exterior
  • Garage
  • In Panel
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Fixtures and Outlets

  Select No Visible Concerns Old Fixtures Open Boxes Loose Plugs Other Spliced Wires

  • No Visible Concerns
  • Old Fixtures
  • Open Boxes
  • Loose Plugs
  • Other
  • Spliced Wires

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Electrical Section Notes

• Add media

  Media

Attic

• Attic Present

  Yes

  No
Attic

• Access

  Select Bedroom Hatch Stairs Wall Panels Pull Stairs Not Accesssible

  • Bedroom Hatch
  • Stairs
  • Wall Panels
  • Pull Stairs
  • Not Accesssible

• Does the Attic have insulation?

  Yes

  No

  N/A

  Unable to be Determined

• Insulation

  Select 3.5" Insulation 6.5" Insulation 10" Insulation 12" Insulation Cellulose Blown Insulation Fiberglass Batt Fiberglass Insulation Rock Wool Batt Other Rigid Foam

  • 3.5" Insulation
  • 6.5" Insulation
  • 10" Insulation
  • 12" Insulation
  • Cellulose Blown Insulation
  • Fiberglass Batt
  • Fiberglass Insulation
  • Rock Wool Batt
  • Other
  • Rigid Foam

• Depth of Insulation

• Other

• Condition of Insulation.

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Roof Framing

  Select 2x6 2x8 2x10 16" on Center 24" on Center Bowed Ridge Collar Ties Jack Post Knee Walls Rafters Trusses Other

  • 2x6
  • 2x8
  • 2x10
  • 16" on Center
  • 24" on Center
  • Bowed Ridge
  • Collar Ties
  • Jack Post
  • Knee Walls
  • Rafters
  • Trusses
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Roof Sheeting

  Select Boards Particle Board Plywood Other Rott Noted Evidenced Of Mold

  • Boards
  • Particle Board
  • Plywood
  • Other
  • Rott Noted
  • Evidenced Of Mold

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Chimney

  Select Masonry Metal Other Not Visible

  • Masonry
  • Metal
  • Other
  • Not Visible

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Exhaust Fans

  Yes

  No

• Vented through Roof

  Yes

  No

  N/A

• Attic Section Notes

• Add media

  Media

Bathroom

Bathroom

• Location

• Type of Door

  Select Hollow Door 6 Panel Solid Door None Other

  • Hollow Door
  • 6 Panel
  • Solid Door
  • None
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Type of Windows

  Select Insulated Storms Other

  • Insulated
  • Storms
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Ceiling

  Select Paint Textured Tiles Wall Paper Other

  • Paint
  • Textured
  • Tiles
  • Wall Paper
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Flooring

  Select Carpet Concrete Hard Wood Laminate Tile Vinyl Linoleum Other Cracked Tile

  • Carpet
  • Concrete
  • Hard Wood
  • Laminate
  • Tile
  • Vinyl
  • Linoleum
  • Other
  • Cracked Tile

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Walls

  Select Paint Panel Tile Wall Paper Cracks Noted Other

  • Paint
  • Panel
  • Tile
  • Wall Paper
  • Cracks Noted
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Exhaust Fan

  Select None Fan Window Other

  • None
  • Fan
  • Window
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Tub Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Reason

  Select Cracked Caulking Required Slow Drain Plugged Vent

  • Cracked
  • Caulking Required
  • Slow Drain
  • Plugged Vent

• Shower Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Reason

  Select Cracked Caulking Required Slow Drain Plugged Vent

  • Cracked
  • Caulking Required
  • Slow Drain
  • Plugged Vent

• Toilet Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Fixture Conditions

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Reason

  Select Leaking Needs Replacing

  • Leaking
  • Needs Replacing

• Electrical

  Select GFCI 2 Prong Grounded None

  • GFCI
  • 2 Prong
  • Grounded
  • None

• Room Notes

• Add media

  Media

Kitchen

Kitchen

• Type of Door

  Select Hollow Door 6 Panel Solid Door None Other

  • Hollow Door
  • 6 Panel
  • Solid Door
  • None
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Type of Windows

  Select Insulated Storms Other

  • Insulated
  • Storms
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Ceiling

  Select Paint Textured Tiles Wall Paper Other

  • Paint
  • Textured
  • Tiles
  • Wall Paper
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Flooring

  Select Carpet Concrete Hard Wood Laminate Tile Vinyl Linoleum Other Cracked Tile

  • Carpet
  • Concrete
  • Hard Wood
  • Laminate
  • Tile
  • Vinyl
  • Linoleum
  • Other
  • Cracked Tile

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Walls

  Select Paint Panel Tile Wall Paper Cracks Noted Other

  • Paint
  • Panel
  • Tile
  • Wall Paper
  • Cracks Noted
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Cabinets

  Select Metal Wood Vinyl Other

  • Metal
  • Wood
  • Vinyl
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Exhaust Fan

  Yes

  No

• Type of Fan

  Vented

  Re-circulates

• Fixture Conditions

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Electrical

  Select GFCI 2 Prong Grounded None

  • GFCI
  • 2 Prong
  • Grounded
  • None

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Room Notes

• Add media

  Media

Appliances

• Range

  Yes

  No

• Range Type

  Gas

  Electrical

• Operated

  Yes

  No

  N/A

• Brand Name

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Oven

  Yes

  No

• Oven Type

  Select Gas Electrical

  • Gas
  • Electrical

• Operated

  Yes

  No

  N/A

• Brand Name

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Cook Top

  Yes

  No

• Cook Type Type

  Select Gas Electrical

  • Gas
  • Electrical

• Operated

  Yes

  No

  N/A

• Brand Name

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Exhaust Fan

  Yes

  No

• Options

  Select Light Re-circulates Vented

  • Light
  • Re-circulates
  • Vented

• Operated

  Yes

  No

  N/A

• Brand Name

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Microwave

  Yes

  No

• Operated

  Yes

  No

  N/A

• Brand Name

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Garbage Disposal

  Yes

  No

• Operated

  Yes

  No

  N/A

• Brand Name

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Dishwasher

  Yes

  No

• Operated

  Yes

  No

  N/A

• Brand Name

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Exhaust Fan

  Yes

  No

• Operated

  Yes

  No

  N/A

• Brand Name

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Appliance Section Notes

• Add media

  Media

Hall Stairs

• Does House Have Multiple Floors

  Yes

  No

• Hand Railing

  Yes

  No

  N/A

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Hall Stair Notes

• Add media

  Media

Living Room

Living Room

• Type of Door

  Select Hollow Door 6 Panel Solid Door None Other

  • Hollow Door
  • 6 Panel
  • Solid Door
  • None
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Type of Windows

  Select Insulated Storms Other

  • Insulated
  • Storms
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Ceiling

  Select Paint Textured Tiles Wall Paper Other

  • Paint
  • Textured
  • Tiles
  • Wall Paper
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Flooring

  Select Carpet Concrete Hard Wood Laminate Tile Vinyl Linoleum Other Cracked Tile

  • Carpet
  • Concrete
  • Hard Wood
  • Laminate
  • Tile
  • Vinyl
  • Linoleum
  • Other
  • Cracked Tile

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Walls

  Select Paint Panel Tile Wall Paper Cracks Noted Other

  • Paint
  • Panel
  • Tile
  • Wall Paper
  • Cracks Noted
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Fireplace

  Yes

  No

• Type

  Select Fire Box Gas Insert Wood Insert No Outside Air Vent Deteriorated Masonry Box

  • Fire Box
  • Gas Insert
  • Wood Insert
  • No Outside Air Vent
  • Deteriorated Masonry Box

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

Fire Place Components

• Flue/Damper Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Reason

  Select Flue Need Cleaning Dampener Broken Other

  • Flue Need Cleaning
  • Dampener Broken
  • Other

• Electrical

  Select GFCI 2 Prong Grounded None

  • GFCI
  • 2 Prong
  • Grounded
  • None

• Room Notes

• Add media

  Media

Family Room

• Family Room

  Yes

  No
Family Room

• Type of Door

  Select Hollow Door 6 Panel Solid Door None Other

  • Hollow Door
  • 6 Panel
  • Solid Door
  • None
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Type of Windows

  Select Insulated Storms Other

  • Insulated
  • Storms
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Ceiling

  Select Paint Textured Tiles Wall Paper Other

  • Paint
  • Textured
  • Tiles
  • Wall Paper
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Flooring

  Select Carpet Concrete Hard Wood Laminate Tile Vinyl Linoleum Other Cracked Tile

  • Carpet
  • Concrete
  • Hard Wood
  • Laminate
  • Tile
  • Vinyl
  • Linoleum
  • Other
  • Cracked Tile

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Walls

  Select Paint Panel Tile Wall Paper Cracks Noted Other

  • Paint
  • Panel
  • Tile
  • Wall Paper
  • Cracks Noted
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Fireplace

  Yes

  No

• Type

  Select Fire Box Gas Insert Wood Insert No Outside Air Vent Deteriorated Masonry Box

  • Fire Box
  • Gas Insert
  • Wood Insert
  • No Outside Air Vent
  • Deteriorated Masonry Box

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

Fire Place Components

• Flue/Damper Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Reason

  Select Flue Need Cleaning Dampener Broken Other

  • Flue Need Cleaning
  • Dampener Broken
  • Other

• Electrical

  Select GFCI 2 Prong Grounded None

  • GFCI
  • 2 Prong
  • Grounded
  • None

• Room Notes

• Add media

  Media

Other Room

• Other Room

  Yes

  No
Other Room

• Location

• Type of Door

  Select Hollow Door 6 Panel Solid Door None Other

  • Hollow Door
  • 6 Panel
  • Solid Door
  • None
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Type of Windows

  Select Insulated Storms Other

  • Insulated
  • Storms
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Ceiling

  Select Paint Textured Tiles Wall Paper Other

  • Paint
  • Textured
  • Tiles
  • Wall Paper
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Flooring

  Select Carpet Concrete Hard Wood Laminate Tile Vinyl Linoleum Other Cracked Tile

  • Carpet
  • Concrete
  • Hard Wood
  • Laminate
  • Tile
  • Vinyl
  • Linoleum
  • Other
  • Cracked Tile

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Walls

  Select Paint Panel Tile Wall Paper Cracks Noted Other

  • Paint
  • Panel
  • Tile
  • Wall Paper
  • Cracks Noted
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Fireplace

  Yes

  No

• Type

  Select Fire Box Gas Insert Wood Insert No Outside Air Vent Deteriorated Masonry Box

  • Fire Box
  • Gas Insert
  • Wood Insert
  • No Outside Air Vent
  • Deteriorated Masonry Box

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

Fire Place Components

• Flue/Damper Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Reason

  Select Flue Need Cleaning Dampener Broken Other

  • Flue Need Cleaning
  • Dampener Broken
  • Other

• Electrical

  Select GFCI 2 Prong Grounded None

  • GFCI
  • 2 Prong
  • Grounded
  • None

• Room Notes

• Add media

  Media

Bedrooms

Bedroom

• Location

• Type of Door

  Select Hollow Door 6 Panel Solid Door None Other

  • Hollow Door
  • 6 Panel
  • Solid Door
  • None
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Type of Windows

  Select Insulated Storms Other

  • Insulated
  • Storms
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Ceiling

  Select Paint Textured Tiles Wall Paper Other

  • Paint
  • Textured
  • Tiles
  • Wall Paper
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Flooring

  Select Carpet Concrete Hard Wood Laminate Tile Vinyl Linoleum Other Cracked Tile

  • Carpet
  • Concrete
  • Hard Wood
  • Laminate
  • Tile
  • Vinyl
  • Linoleum
  • Other
  • Cracked Tile

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Walls

  Select Paint Panel Tile Wall Paper Cracks Noted Other

  • Paint
  • Panel
  • Tile
  • Wall Paper
  • Cracks Noted
  • Other

• Other

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Fireplace

  Yes

  No

• Type of Insert

  Select Fire Box Gas Insert Wood Insert No Outside Air Vent Deteriorated Masonry Box

  • Fire Box
  • Gas Insert
  • Wood Insert
  • No Outside Air Vent
  • Deteriorated Masonry Box

• Condition

  Satisfactory

  Fair

  Poor

  Not Applicable

  Not Visible

• Flue Ok

  Yes

  No

  N/A

• Reason

  Select Obstructed Needs Cleaning

  • Obstructed
  • Needs Cleaning

• Damper ok

  Yes

  No

  N/A

• Electrical

  Select GFCI 2 Prong Grounded None

  • GFCI
  • 2 Prong
  • Grounded
  • None

• Room Notes

• Add media

  Media

Carbon Monoxide/Smoke Detectors

• CO Detectors

  Yes

  No

  N/A

• Location

  Select Basement 1st Floor 2nd Floor 3rd Floor Other

  • Basement
  • 1st Floor
  • 2nd Floor
  • 3rd Floor
  • Other

• Other

• Smoke Detectors

  Yes

  No

  N/A

• Location

  Select Basement 1st Floor 2nd Floor 3rd Floor Other

  • Basement
  • 1st Floor
  • 2nd Floor
  • 3rd Floor
  • Other

• Other

• Notes

• Add media

  Media

• Customer Signature

  Sign

• Inspector
  Michael Poli

• Notes

• Any Questions
  Please Contact
  Buildings Inspectors of WNY, Inc.
  (716)694-7735
  Polimj1@yahoo.com

Inspection Agreement

• Building Inspector of WNY
  7011 Bear Ridge Road
  Pendleton, NY 14120
  (716) 694-7735
  

• Select date

  Date

• Purchaser Name

• Phone Number

• Property Inspected

• Estimated Age of Home

• Design

• Sale Price

• Fee

• This Inspection is performed according the guidelines recommended by the AMERICAN SOCIETY OF HOME INSPECTORS, INC. The Purpose of this inspection is to perform visual and audible examinations of the primary structure, mechanical, and the electrical systems of the building, and give a personal opinion as to whether or not the components are performing the functions for which they were intended or are in need of repair. A standard inspection developed by Building Inspectors of WNY as followed.
  
  The scope of the inspection is limited to accessible portions of the structure and its components. Heavy furniture, installed appliances, storage boxes, permanent ceiling tiles, or permanent wall panels are not moved for the inspection. Foundations are carefully examined at the above ground levels. Below ground supports, foundation footings, piers or soil bearing areas obviously can not be checked by a visual inspection. The existing electrical system is checked without knowledge of any future demands on the system. Our Judgement of adequacy of any system (electrical, water, gas, heating or cooling) is based on standard demands.
  
  We do not specifically check a structure for various building codes compliance as this is a matter for city and/or county officials. We Do not make judgements on appraised valve, adequacy of public utilities, civil protection, flood plains, habitability, repairs and soil analysis. We DO NOT check the following items. Septic systems, Underground piping a and wiring, Swimming pools, Wells, Retaining walls, Sheds, Intercoms, Washers, Drryers, Window options, Burglar/Fire alarms, Smoke alarms, Carbon Monoxide Alarms, Water softeners, Incinerators, Termites/pests.
  
  Items for which chemical testing is necessary to confirm their existence are not induced such as. Formaldehyde foam insulation, Asbestos containing materials, Lead containing materials, Mold, and Water Quality, and Radon Gas.
  
  We are not responsible for damages to the house due to normal operation of any item inspected. Items that pertain to cosmetics, maintenance, and energy savings may not pertain to your contract. They are on the report for your benefit and in most cases, are not things which the seller should necessarily be required to do under the contract terms.
  
  THE FOREGOING REPORT IS FURNISHED AT YOUR REQUEST IN STRICT CONFIDENCE BY US AS YOUR AGENT AND EMPLOYEE FOR YOUR EXCLUSIVE USE AS AND AID IN DETERMINING THE PHYSICAL CONDITION OF THE SUBJECT PREMISES. THE EQUIPMENT THEREIN AS MAY BE EXAMINED VISUALLY; AND WE WARN YOU THAT ALTHOUGH SUCH PREMISES AND/OR EQUIPMENT MAY BE GOOD CONDITION WHEN EXAMINED, THEE CONDITION MY CHANGE THEREAFTER. FURTHERMORE, THIS REPORT IS NOT TO BE USED AS A BASIS FOR DETERMINING THE VALVE OF SUCH PREMISES OR WHETHER SAME IS OR IS NOT TO BE PURCHASED. WE DISCLAIM ALL WARRANTIES AND GUARANTEES OF THE PREMISES, EQUIPMENT OR ACCESSORIES, EXPRESSED OR IMPLIED, INCLUDING A DISCLAIMER OF ANY GUARANTEES OR WARRANTIES OR FITNESS FOR A PARTICULAR PURPOSE. THIS REPORT IS NOT TO BE CONSTRUED AS A GUARANTY OR WARRANTY OF THE PREMISES OR EQUIPMENT THEREIN O OF THEIR FITNESS FOR USE.
  
  It is understood and agreed that should Building Inspector of WNY and/or its agents or employees be found liable for and loss or damages resulting from a failure to perform and of its obligations, including but no limited to negligence, breach of contract, or otherwise, then the liability of Building Inspectors of WNY and/or its agents or employees, shall be limited to a sum equal to the amount of the fee paid by the customer for the inspection and report.

• Purchaser's signature constitutes acceptance of the terms and conditions of this agreement. Inspection fee below is due at the time of inspection.

  Sign