Title Page

  • Date of Inspection:

  • Title

  • Customer Full Name

  • COMF/COLA Scheme Ref No:

  • Customer Address
  • First Line of Address

  • Mobile Telephone No:

  • Home Telephone No:

  • Alternative Telephone No:

  • Email Address

  • Best Number to Contact & Time of Day.

  • Property Tenure

  • Leasehold or Freehold

  • Landlord Name

  • Landlord Address

  • Landlord contact Details (phone or email)

Eligibility

  • Date Of Birth

  • Benefits

  • Please List

  • Health Conditions

  • Please List

  • Household Income

  • Please ask for proof of Income, and record yearly amount.

  • No of Adults in Property

  • No of Children in Property

  • Current EPC Band (if one)

  • New EPC band & Score

  • Is the property in a Low Super Output Area (LSOA) - "check HUG website if needed" http://www.dorset-hug.co.uk/

  • Please add the LSOA post code

Property Info

  • Property Type

  • No of Bedrooms

  • Main Building Age

  • No of Floors/Storeys

  • No of External Walls

  • No of Rooms

  • How many are habitable rooms.

  • Does the property have an Extension

  • Extension Age

  • Constrution of Extension

  • Roof Type of Extension

  • Smart Meter Installed

Heating

  • Heating System Type

  • Fuel Type

  • Heating Controls in Situ

  • Heating Controls Required

  • Current Annual Electricity Use per year (kwh/£)

  • Current Annual Gas Use per year (Kwh/£)

Loft Insulation

  • Loft Insulation Less or Equal to 200mm

  • Can the loft be accessed easily

  • Photo of overall loft area (each corner)

  • Please record true loft depth (mm)

  • Photo of loft depth

  • Are all ceilings in a good state of repair

  • Please identify the areas in question and provide pictures.

Cavity Wall Insulation

  • Cavity Wall Insulation required to Main building or Extension

  • Main Building or Extension to be insulated

  • Photo of each elevation

  • Building Condition

  • Is DPC visible above 150mm above ground. (if no DPC is visible, add notes & Photos as to why)

  • Please Borescope Walls and add photos

  • Does the property have Vents

  • Which Vents are present

  • Are there any Access Issues - if yes please evidence

  • Does the property have any Party Walls

  • Can the construction of the Party Wall be identified from the loft space

  • Construction type

  • Can party wall insulation be installed if neighbouring property agrees.

Park Homes - Please advise that not all measure may be achievable

  • Client Interested in Park home Insulation

  • Is Park Home Double or Single unit

  • Photo of each Elevation of the Park Home

  • Will all elements of the Park Home require insulation

  • What is the condition of the walls

  • What is the condition of the external Ply Skin

  • is there any existing wall Insulation

  • Remedial Works required on external walls prior to instal

  • Is there access to the Floor

  • is there existing insulation.

  • Please select the Floor joints present

  • Is there access to the roof

  • is there any existing insulation

  • Are there any metal rafters

  • what is the Roof verge overhang (mm)

Solar PV

  • Client Interested in Solar PV

  • Client comfortable using mobile wireless app to monitor panel output

  • Roof Type

  • Height of Roof from Ground

  • Pitch of Roof Orientation

  • Pitch of Roof (Elevation in Degree º)

  • Roof Material

  • Dorma Windows Present

  • Any Over-Shading

  • Any Access Issues. (scaffolding/parking)

  • Photo of all Roof Elevations

  • Photo of Tile Type (close up)

  • Photo of Current Electrical System/Board

  • Photo of Potential Space in Loft for Invertor

  • Photo Inside Loft to show (roof struts/purlins/joists/rafters)

  • Any other useful photos

Air Source Heat Pump - (GFF,Terrace, or 2 bed home only + Alongside BUS Grant) https://www.ofgem.gov.uk/environmental-and-social-schemes/boiler-upgrade-scheme-bus/property-owners

  • Client interested in Air Source Heat Pump

  • Do they have the space for the outside HP unit? (Typical dimensions W 1000mm x H 1000mm x D 600mm.includes clearance required in front of unit.)

  • Can the HP Unit be housed 1 meter away from any boundaries or neighbouring properties

  • Do they have space for the hot water tank? (Typical dimensions W 1000mm x H 2000mm x D 700mm)

  • Photo of possible Location

  • Do they have space for the Internal heat exchanger, where required? (W 500mm x H 800mm x D 350mm)

  • Is there space below it to ground level for the pressure vessel & pipework? (although often these are in a loft space so less of an issue (On Smaller heat demand systems could use a "Monoblock" system that have all the heat exchanger parts in the outside unit.

  • Do they have radiators at present and if so, are they on standard pipework?

  • Photo of Radiators

  • Micro-boro pipe work not possible under scheme

  • Would the resident require extra help in setting heating controls after install?

HHR Storage Heaters

  • HHR Storage Heaters required

  • Does the Property have a Ecom-7 Supply

  • Photo of Electric Meter

  • Can meter be changed

  • Number of Pre-existing Heaters

  • Number of HHR ESH to be installed into the property

  • Will the new HHR ESH heat 100% of the Property

Other Measures

Solid Wall Insulation

  • Solid Wall Insulation

  • Photo of Each Elevation

  • Building Condition

  • is it a system build fabric

  • Photo of DPC

  • Does the Property have any Vents

  • Which vents are present

  • access Issues

Room In Roof Insulation

  • Does Property have qualifying RIR

  • Number of rooms in RIR area

  • Is there access to Residual Areas

  • Which areas require Insulating

Flat Roof Insulation

  • Flat Roof

  • Flat Roof m2

  • Flat roof Insulated

  • Photo of Flat Roof (from above & ground level)

Solar Thermal

  • Client Interested in Solar Thermal

  • Client comfortable using mobile wireless app to monitor panel output

  • Roof Type

  • Height of Roof from Ground

  • Pitch of Roof Orientation

  • Roof Material

  • Dorma Windows Present

  • Any Over-Shading

  • Any Access Issues. (scaffolding/parking)

  • Photo of all Roof Elevations

  • Photo of Tile Type (close up)

  • Photo Inside Loft to show (roof struts/purlins/joists/rafters)

  • Any other useful photos

Under Floor Insulation

  • Under Floor Insulation required

  • Is there Access to the Under Floor

  • Is there a minimum depth of 1 meter below the floor

  • Is there adequate cross flow ventilation below the floor

  • Can Access be made easily

  • Is there a minimum of 1 meter access below the floor

  • Is there adequate cross flow ventilation below the floor

Low Energy Lighting

  • LED light Bulbs Required

  • How Bulbs to be fitted & Fitting Required

Hot Water Tank Insulation

  • Hot Water Tank present

  • Dose that Hot Water Tank require new insulation jacket

Draught Proofing

  • Draught Proofing Required

  • Number of Doors to be Draught Proofed

  • Number of Windows to be Draught Proofed

Conclusion

  • Evidence on Eligibility Checked

  • COMF/COLA leave behind notice given to client

  • CUSTOMER SIGNATURE - (PLEASE READ) - I can confirm that I have given consent for my qualifying evidence to be viewed by the assessor at the time of there visit, I have received relevant Data Protection & GDPR documents. and all other procedures that are required following there visit have been explained to me regarding further visits and installations.

  • Survey Completed By

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