Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Development site is situated

Block Details

  • Number of dwellings at the address/block?

  • Number of storeys at the address block?

  • Is the dwelling occupied?

Survey Details

  • Extent of the survey

  • Is a specialist survey inspection required?

Dwelling Description

  • Form of dwelling

  • House type

  • Flat type

  • Quality assessment of building

  • Approximate age of construction

  • Has the building been refurbished and if so what is the approximate year.

  • What is the main construction type?

  • Is the building a traditional stone tenement type?

  • What is the approximate thickness of the walls

  • Is the roof pitched or flat

  • What is the percentage of pitched roof

  • What is the percentage of flat roof

  • Are there any specific notes regarding the external cladding?

Dwelling Area

  • Approximate area of the dwelling

Room by Room Record - Hallway

  • Hallway - Location

  • Hallway - Is rising damp present

  • Hallway - Is condensation present

  • Hall - What action should be taken

  • Hall - Works to be undertaken

  • Hallway - Is rot present

  • Hallway - What is the total number of radiators in this room

  • Hallway - What is the number of storage / electrical heater in this room

  • Hallway - What is the number of boilers in this room

  • Hallway - What is the number of focal fires in this room

  • Hallway - Is there mechanical extraction for ventilation in this room

  • Hallway - Are there windows in this room

  • Hallway - Do the windows provide sufficient natural light

  • Hallway - Are the windows double/ triple glazed

  • Hallway - Room dimensions

  • Hallway - Room dimension M2

Room by Room Record - Kitchen

  • Kitchen - Location

  • Kitchen - Is rising damp present

  • Kitchen - Are there signs of condensation present

  • Kitchen - What action should be taken

  • Kitchen - Works to be undertaken

  • Kitchen - Is rot present

  • Kitchen - What is the total number of radiators in this room

  • Kitchen - What is the number of storage / electrical heater in this room

  • Kitchen - What is the number of boilers in this room

  • Kitchen - What is the number of focal fires in this room

  • Kitchen - Is there mechanical extraction for ventilation in this room

  • Kitchen - Are there windows in this room

  • Kitchen - Do the windows provide sufficient natural light

  • Kitchen - Are the windows double/ triple glazed

  • Kitchen - Room dimensions

  • Kitchen - Room dimension M2

Room by Room Record - Living Room

  • Living Room - Location

  • Living Room - Is rising damp Present

  • Living Room - Are there signs of condensation present

  • Living Room - What action should be taken

  • Living Room - Works to be undertaken

  • Living Room - Is rot present

  • Living Room - What is the total number of radiators in this room

  • Living Room - What is the number of storage / electrical heater in this room

  • Living Room - What is the number of boilers in this room

  • Living Room - What is the number of Focal Fires in this room

  • Living Room - Is there mechanical extraction for ventilation in this room

  • Living Room - Are there windows in this room

  • Living Room - Do the windows provide sufficient natural light

  • Living Room - Are the windows double/ triple glazed

  • Living Room - Room dimensions

  • Living Room - Room dimension M2

Room by Room - Dining Room

  • Dining Room - Location

  • Dining Room - Is rising damp present

  • Dining Room - Are there signs of condensation present

  • Dining Room - What action should be taken

  • Dining Room - Works to be undertaken

  • Dining Room - Is rot present

  • Dining Room- What is the total number of radiators in this room

  • Dining Room- What is the number of storage / electrical heater in this room

  • Dining Room - What is the number of boilers in this room

  • Dining Room - What is the number of Focal Fires in this room

  • Dining Room - Is there mechanical extraction for ventilation in this room

  • Dining Room - Are there windows in this room

  • Dining Room - Do the windows provide sufficient natural light

  • Dining Room - Are the windows double/ triple glazed

  • Dining Room - Room dimensions

  • Dining Room - Room dimension M2

Room by Room - Bedroom One

  • Bedroom One - Location

  • Bedroom One- Is rising damp present

  • Bedroom One - Are there signs of condensation present

  • Bedroom One - What action should be taken

  • Bedroom One - Works to be undertaken

  • Bedroom One - Is rot present

  • Bedroom One - What is the total number of radiators in this room

  • Bedroom One - What is the number of storage / electrical heater in this room

  • Bedroom One - What is the number of boilers in this room

  • Bedroom One - What is the number of Focal Fires in this room

  • Bedroom One - Is there mechanical extraction for ventilation in this room

  • Bedroom One - Are there windows in this room

  • Bedroom One - Do the windows provide sufficient natural light

  • Bedroom One - Are the windows double/ triple glazed

  • Bedroom One - Room dimensions

  • Bedroom One - Room dimension M2

Room by Room - Bedroom Two

  • Bedroom Two - Location

  • Bedroom Two - Is rising damp present

  • Bedroom Two - Are there signs of condensation present

  • Bedroom Two - What action should be taken

  • Bedroom Two - Works to be undertaken

  • Bedroom Two - Is rot present

  • Bedroom Two - What is the total number of radiators in this room

  • Bedroom Two - What is the number of storage / electrical heater in this room

  • Bedroom Two - What is the number of boilers in this room

  • Bedroom Two - What is the number of Focal Fires in this room

  • Bedroom Two - Is there mechanical extraction for ventilation in this room

  • Bedroom Two - Are there windows in this room

  • Bedroom Two - Do the windows provide sufficient natural light

  • Bedroom Two - Are the windows double/ triple glazed

  • Bedroom Two - Room dimensions

  • Bedroom Two - Room dimension M2

Room by Room - Bedroom Three

  • Bedroom Three - Location

  • Bedroom Three - Is rising damp present

  • Bedroom Three - Are there signs of condensation present

  • Bedroom Three - What action should be taken

  • Bedroom Three - Works to be undertaken

  • Bedroom Three - Is rot present

  • Bedroom Three - What is the total number of radiators in this room

  • Bedroom Three - What is the number of storage / electrical heater in this room

  • Bedroom Three - What is the number of boilers in this room

  • Bedroom Three - What is the number of Focal Fires in this room

  • Bedroom Three - Is there mechanical extraction for ventilation in this room

  • Bedroom Three - Are there windows in this room

  • Bedroom Three - Do the windows provide sufficient natural light

  • Bedroom Three - Are the windows double/ triple glazed

  • Bedroom Three - Room dimensions

  • Bedroom Three - Room dimension M2

Room by Room - Bedroom Four

  • Bedroom Four - Location

  • Bedroom Four - Is rising damp present

  • Bedroom Four - Are there signs of condensation present

  • Bedroom Four - What action should be taken

  • Bedroom Four - Works to be undertaken

  • Bedroom Four - Is rot present

  • Bedroom Four - What is the total number of radiators in this room

  • Bedroom Four - What is the number of storage / electrical heater in this room

  • Bedroom Four - What is the number of boilers in this room

  • Bedroom Four - What is the number of focal fires in this room

  • Bedroom Four - Is there mechanical extraction for ventilation in this room

  • Bedroom Four - Are there windows in this room

  • Bedroom Four - Do the windows provide sufficient natural light

  • Bedroom Four - Are the windows double/ triple glazed

  • Bedroom Four - Room dimensions

  • Bedroom Four - Room dimension M2

Room by Room - Bedroom Five

  • Bedroom Five - Location

  • Bedroom Five - Is rising damp present

  • Bedroom Five - Are there signs of condensation present

  • Bedroom Five - What action should be taken

  • Bedroom Five - Works to be undertaken

  • Bedroom Five - Is rot present

  • Bedroom Five - What is the total number of radiators in this room

  • Bedroom Five - What is the number of storage / electrical heater in this room

  • Bedroom Five - What is the number of boilers in this room

  • Bedroom Five - What is the number of focal fires in this room

  • Bedroom Five - Is there mechanical extraction for ventilation in this room

  • Bedroom Five - Are there windows in this room

  • Bedroom Five - Do the windows provide sufficient natural light

  • Bedroom Five - Are the windows double/ triple glazed

  • Bedroom Five - Room dimensions

  • Bedroom Five - Room dimension M2

Room by Room - Bathroom

  • Bathroom - Location

  • Bathroom - Is rising damp present

  • Bathroom - Are there signs of condensation present

  • Bathroom - What action should be taken

  • Bathroom - Works to be undertaken

  • Bathroom - Is rot present

  • Bathroom - What is the total number of radiators in this room

  • Bathroom - What is the number of storage / electrical heater in this room

  • Bathroom - What is the number of boilers in this room

  • Bathroom - What is the number of focal fires in this room

  • Bathroom - is there mechanical extraction for ventilation in this room

  • Bathroom - Are there windows in this room

  • Bathroom - Are the windows double/ triple glazed

  • Bathroom- Room dimensions

  • Bathroom - Room dimension M2

Room by Room - Separate WC

  • Separate WC - Location

  • Separate WC - Is rising damp present

  • Separate WC- Are there signs of condensation present

  • Separate WC- What Action Should be Taken

  • Separate WC - Works to be Undertaken

  • Separate WC - Is Rot present

  • Separate WC - What is the total number of radiators in this room

  • Separate WC - What is the number of storage / electrical heater in this room

  • Separate WC - What is the number of boilers in this room

  • Separate WC - What is the number of focal Fires in this room

  • Separate WC - is there mechanical extraction for ventilation in this room

  • Separate WC - Are their windows in this room

  • Separate WC - Are the windows double/ triple glazed

  • Separate WC - Room dimensions

  • Separate WC - Room dimension M2

Room by Room - Storerooms

  • Storerooms - Location

  • Storerooms - Is rising damp present

  • Storerooms - Are there signs of condensation present

  • Storerooms - What action should be taken

  • Storerooms - Works to be undertaken

  • Storerooms - Is rot present

  • Storerooms - What is the total number of radiators in this room

  • Storerooms - What is the number of storage / electrical heater in this room

  • Storerooms - What is the number of boilers in this room

  • Storerooms - What is the number of focal fires in this room

  • Storerooms - is there mechanical extraction for ventilation in this room

  • Storerooms - is there mechanical extraction for ventilation in this room

  • Storerooms - Are there windows in this room

  • Storerooms - Are the windows double/ triple glazed

  • Storerooms - Room dimensions

  • Storerooms - Room dimension M2

Room by Room - Other

  • Other - Location

  • Other - Name of room

  • Other - Is rising damp present

  • Other - Are there signs of condensation present

  • Other - What action should be taken

  • Other - Works to be undertaken

  • Other - Is rot present

  • Other - What is the total number of radiators in this room

  • Other - What is the number of storage / electrical heater in this room

  • Other - What is the number of boilers in this room

  • Other - What is the number of focal fires in this room

  • Other - is there mechanical extraction for ventilation in this room

  • Other - is there mechanical extraction for ventilation in this room

  • Other - Are their windows in this room

  • Other - Are the windows double/ triple glazed

  • Other - Room dimensions

  • Other - Room dimension M2

Other Details

  • Are there smoke alarms fitted in the property

  • What rooms are they in (please select all that apply)

  • Is the alarm mains or battery powered - Hallway

  • Is the Alarm Mains or Battery powered - Kitchen

  • Is the Alarm Mains or Battery powered - Living Room

  • Is the Alarm Mains or Battery powered - Dining Room

  • Is the Alarm Mains or Battery powered - Bedroom One

  • Is the Alarm Mains or Battery powered - Bedroom Two

  • Is the Alarm Mains or Battery powered - Bedroom Three

  • Is the Alarm Mains or Battery powered - Bedroom Four

  • Is the Alarm Mains or Battery powered - Bedroom Five

  • Is the Alarm Mains or Battery powered - Bathroom

  • Is the Alarm Mains or Battery powered - Separate WC

  • Is the Alarm Mains or Battery powered - Storerooms

  • Is the Alarm Mains or Battery powered - Other

  • Is the roof space satisfactorily insulated

Internal Inspection - Windows

  • Element Specification/Materials - Windows

  • Element Condition - Windows

  • Element Replacement Year - Windows ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

  • Element - are the windows functioning with ease and all seals intact?

Internal Inspection - External Doors

  • Element Specification/Materials - External doors

  • Element Condition - External doors

  • Element Replacement Year - External doors ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspection - External Wall Finish

  • Element Specification/Materials - External wall finish

  • Element Condition - External wall finish

  • Element Replacement Year - External wall finish ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspection - Internal Walls

  • Element Specification/Materials - Internal walls

  • Element Condition - Internal Walls

  • Element Replacement Year - Internal walls ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspection - Wall Tiling

  • Element Specification/Materials - Wall tiling

  • Element Condition - Wall tiling

  • Element Replacement Year - Wall tiling ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspection - Ceilings

  • Element Specification/Materials - Ceiling

  • Element Condition - Ceiling

  • Element Replacement Year - Ceiling ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspection - Flooring

  • Element Specification/Materials - Flooring

  • Element Condition - Flooring

  • Element Replacement Year - Flooring ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspection - Skirting

  • Element Specification/Materials - Skirting

  • Element Condition - Skirting

  • Element Replacement Year - Skirting ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspection - Internal Doors

  • Element Specification/Materials - Internal doors

  • Element Condition - Internal doors

  • Element Replacement Year - Internal doors( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspection - Internal Door Facings

  • Element Specification/Materials - Internal door facings

  • Element Condition - Internal door facings

  • Element Replacement Year - Internal door facings ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - Kitchen Units

  • Element Specification/Materials - Kitchen units

  • Element Condition - Kitchen units

  • Element Replacement Year - Kitchen units ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - Kitchen Sink

  • Element Specification/Materials - Kitchen sink

  • Element Condition - Kitchen sink

  • Element Replacement Year - Kitchen sink ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - Bath

  • Element Specification/Materials - Bath

  • Element Condition - Bath

  • Element Replacement Year - Bath ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - Shower

  • Element Specification/Materials - Shower

  • Element Condition - Shower

  • Element Replacement Year - Shower ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - WC

  • Element Specification/Materials - WC

  • Element Condition - WC

  • Element Replacement Year - WC ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - WHB

  • Element Specification/Materials - WHB

  • Element Condition - WHB

  • Element Replacement Year - WHB ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - Cold Water Storage

  • Element Specification/Materials - Cold water storage

  • Element Condition - Cold water storage

  • Element Replacement Year - Cold water storage ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - Hot Water Storage

  • Element Specification/Materials - Hot water storage

  • Element Condition - Hot water storage

  • Element Replacement Year - Hot water storage ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - Insulation to HWT

  • Element Specification/Materials - Insulation to HWT

  • Element Condition - Insulation to HWT

  • Element Replacement Year - Insulation to HWT ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - Insulation to pipes

  • Element Specification/Materials - Insulation to pipes

  • Element Condition - Insulation to pipes

  • Element Replacement Year - Insulation to pipes ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - Radiators

  • Element Specification/Materials - Radiators

  • Element Condition - Radiators

  • Element Replacement Year - Radiators ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - Boiler/Heat Source

  • Element Specification/Materials - Boiler/Heat Source

  • Element Condition - Boiler/Heat Source

  • Element Replacement Year - Boiler/Heat Source ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - Extractor Fans

  • Element Specification/Materials - Extractor fans

  • Element Condition - Extractor fans

  • Element Replacement Year - Extractor fans ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - Consumer Unit

  • Element Specification/Materials - Consumer unit

  • Does the consumer unit have surge/ lightening protection?

  • Element Condition - Consumer unit

  • Element Replacement Year - Consumer unit ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - Switches and Sockets

  • Element Specification/Materials - Switches and sockets

  • Element Condition - Switches and sockets

  • Element Replacement Year - Switches and sockets ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - Light Fitting

  • Element Specification/Materials - Light fitting

  • Element Condition - Light fitting

  • Element Replacement Year - Light fitting ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - TV Aerial

  • Element Specification/Materials - TV aerial

  • Element Condition - TV aerial

  • Element Replacement Year - TV aerial ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - Smoke Detectors

  • Element Specification/Materials - Smoke detectors

  • Element Condition - Smoke detectors

  • Element Replacement Year - Smoke detectors ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - Door Entry Handset

  • Element Specification/Materials - Door entry handset

  • Element Condition - Door entry handset

  • Element Replacement Year - Door entry handset ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Internal Inspections - Telephone Point

  • Element Specification/Materials - Telephone point

  • Element Condition - Telephone point

  • Element Replacement Year - Telephone point ( 0 is immediate, 1 is Year 1, 2 is Year 2 etc )

Energy Efficiency Measures

  • Energy Efficiency Measures Current and improvements

What energy efficiency measures/ improvements are currently installed?

  • undefined

What energy efficiency measures/ improvements should be installed?

  • undefined

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