PIBI - EWI V1.0

Details

• Client

  Live West

  Sanctuary

  Other

• Who?

• Conducted on

  Date

• Prepared by

  Select Chris Houghton Lee Glenister Barry Griffiths Sam Barnes Lee Duncan Other

  • Chris Houghton
  • Lee Glenister
  • Barry Griffiths
  • Sam Barnes
  • Lee Duncan
  • Other

• Name of Competent Person

• Survey Type

  EWI PIBI

• First Line of Address (Or addresses if flats)

• Front Elevation Photo

  Media
• Location
  Address

• Project

  Select

Health & Safety Questions

• Is this the only energy efficiency measure for this property

  Yes

  No

• You must complete the following questions

Access Assessment

• Do you give consent for us to carry out works within your property?

  Yes

  No

• Reasoning?

• Resident Full Name and Signature

  Sign

• Is there an overhead main power cable to the property that needs sheathing before scaffold erected?

  Yes

  No

  N/A

• Photographic Evidence

  Media

• Are there any conservatories or out buildings that require a scaffold bridge for this job?

  Yes

  No

• Are there any restrictions to the property i.e. Low bridge, neighbours access required?

  No

  Yes

• Comments

• Photographic evidence

  Media

• Does the property have a main pedestrian route or a public walkway directly on one of the elevations?

  No

  Yes

• Comments

• Photographic evidence

  Media

• Is there adequate parking close to the property?

  Yes

  No

• Comments,

• Photographic evidence

  Media

• Any parking restrictions i.e. Residents parking?

  Yes

  No

  Permit Zone

• Comments

• Photographic evidence

  Media

• Will the proposed works affect neighbouring properties?

  No

  Yes

• Comments

• Photographic evidence

  Media

• Has the neighbouring property been notified of the imminent works?

  Verbal Notification

  Information Letter Posted

  Not Required - Part of Scheme

  To Be Done By Site Manager

• Date of notification given-

  Date

Occupant Assessment

• Is the property in a suitable condition for the proposed works to be carried out?

  Yes

  No

• Comments

• Photographic evidence

  Media

• Is the property highlighted as flagged or at risk?

  No

  Yes

• Comments

• Do the occupants have any physical disabilities that pose any significant risks?

  No

  Yes

• Comments

• Do the occupants have any learning difficulties or mental health issues where our activities may pose any significant risks?

  No

  Yes

• Comments

• Are there any potential risks regarding minors in the property?

  No

  Yes

• Comments

• Are there any potential risks regarding pets in the property?

  No

  Yes

• Comments

• Is there any presence of protected species (e.g., bats, birds butterflies, dormice) or plants that could be subject to special protection?

  No

  Yes

• Comments

• Is the property high risk of biological waste or vermin?

  No

  Yes

• Comments

• Photographic evidence

  Media

• Does the resident use hypodermic needles?

  No

  Yes

• Where is the sharps bin located/comments

Asbestos Assessment

• Are we in receipt of or have access to the asbestos survey or register for this property ?

  Yes

  No

  Unknown

• Asbestos Assessment Needs to be Checked

• Comments

• Has asbestos been identified ?

  No

  Yes

  See Asbestos Report

  Possible

• Comments

• Photographic evidence

  Media

• Have the health and safety questions been completed on another survey

  Yes

  No

• You may proceed to the next page

• This health and safety section must be completed

Access Assessment

• Do you give consent for us to carry out works within your property?

  Yes

  No

• Reasoning?

• Resident Full Name and Signature

  Sign

• Is there an overhead main power cable to the property that needs sheathing before scaffold erected?

  Yes

  No

  N/A

• Photographic Evidence

  Media

• Are there any conservatories or out buildings that require a scaffold bridge for this job?

  Yes

  No

• Are there any restrictions to the property i.e. Low bridge, neighbours access required?

  No

  Yes

• Comments

• Photographic evidence

  Media

• Does the property have a main pedestrian route or a public walkway directly on one of the elevations?

  No

  Yes

• Comments

• Photographic evidence

  Media

• Is there adequate parking close to the property?

  Yes

  No

• Comments,

• Photographic evidence

  Media

• Any parking restrictions i.e. Residents parking?

  Yes

  No

  Permit Zone

• Comments

• Photographic evidence

  Media

• Will the proposed works affect neighbouring properties?

  No

  Yes

• Comments

• Photographic evidence

  Media

• Has the neighbouring property been notified of the imminent works?

  Verbal Notification

  Information Letter Posted

  Not Required - Part of Scheme

  To Be Done By Site Manager

• Date of notification given-

  Date

Occupant Assessment

• Is the property in a suitable condition for the proposed works to be carried out?

  Yes

  No

• Comments

• Photographic evidence

  Media

• Is the property highlighted as flagged or at risk?

  No

  Yes

• Comments

• Do the occupants have any physical disabilities that pose any significant risks?

  No

  Yes

• Comments

• Do the occupants have any learning difficulties or mental health issues where our activities may pose any significant risks?

  No

  Yes

• Comments

• Are there any potential risks regarding minors in the property?

  No

  Yes

• Comments

• Are there any potential risks regarding pets in the property?

  No

  Yes

• Comments

• Is there any presence of protected species (e.g., bats, birds butterflies, dormice) or plants that could be subject to special protection?

  No

  Yes

• Comments

• Is the property high risk of biological waste or vermin?

  No

  Yes

• Comments

• Photographic evidence

  Media

• Does the resident use hypodermic needles?

  No

  Yes

• Where is the sharps bin located/comments

Asbestos Assessment

• Are we in receipt of or have access to the asbestos survey or register for this property ?

  Yes

  No

  Unknown

• Asbestos Assessment Needs to be Checked

• Comments

• Has asbestos been identified ?

  No

  Yes

  See Asbestos Report

  Possible

• Comments

• Photographic evidence

  Media

PAS 2035 Significance Survey

• Is the property classed as traditional or protected construction? (traditional construction is defined by PAS 2035 as 'construction consisting of solid brick or stone external walls, or pre1919 timber framed walls with any infill')

  No, modern construction

  Traditional Construction

  Protected Construction

Assessing significance of traditionally constructed buildings that are not protected

• Age of property

  Select A - Pre 1900 B - 1900 - 1929 C - 1930 - 1949 D - 1950 - 1966 E - 1967 - 1975 F - 1976 - 1982 G - 1983 - 1990 H - 1991 - 1995 I - 1996 - 2002 J -2003 - 2006 K - 2007 - 2011 L - 2012 onwards

  • A - Pre 1900
  • B - 1900 - 1929
  • C - 1930 - 1949
  • D - 1950 - 1966
  • E - 1967 - 1975
  • F - 1976 - 1982
  • G - 1983 - 1990
  • H - 1991 - 1995
  • I - 1996 - 2002
  • J -2003 - 2006
  • K - 2007 - 2011
  • L - 2012 onwards

• Listed Building / Conservation Area / Historic Environment Recorded

  Yes

  No

• Has the Council Website Been Checked at Point of Survey?

  Yes

  No

• Should the planning department be notified?

  Yes

  No

• Property Type

  Select House Bungalow Ground Floor Flat Top Floor Flat Maisonette Other

  • House
  • Bungalow
  • Ground Floor Flat
  • Top Floor Flat
  • Maisonette
  • Other

• What Type

• Attachment

  Select Semi Detached Linked Mid Terraced End Terraced Ground Floor Top Floor Mid Floor Other

  • Semi
  • Detached
  • Linked
  • Mid Terraced
  • End Terraced
  • Ground Floor
  • Top Floor
  • Mid Floor
  • Other

• What Type

• Number of Storeys

  Select 0 1 2 3 4 5 6

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6

• Building Finish

  Select Brick Painted Render Brick/Render Pebble Dash Concrete Block Recon Stone Spar UPVC Cladding Tile Hanging Limestone/Sandstone Granite/Whinstone Faced brick in a high exposure area not suitable for cavity wall insulation Other

  • Brick
  • Painted Render
  • Brick/Render
  • Pebble Dash
  • Concrete Block
  • Recon Stone
  • Spar
  • UPVC Cladding
  • Tile Hanging
  • Limestone/Sandstone
  • Granite/Whinstone
  • Faced brick in a high exposure area not suitable for cavity wall insulation
  • Other

• What Type

• Similarity to adjacent buildings (similar roof coverings or wall materials)

  Yes

  No

• Importance in townscape/landscape or associations with people/events?

  Yes

  No

Roof

• Structural Condition of Roof

  Good

  Fair

  Poor

  N/A

• Is the roof covering significant e.g. natural slate, hand-made clay tile, stone, metal thatch etc.

  Yes

  No

Walls

• Construction Type

  Select Cavity Wall Solid Brick System Built Metal Frame Other

  • Cavity Wall
  • Solid Brick
  • System Built
  • Metal Frame
  • Other

• Is the exterior wall surface significant (e.g. brick, stone, lime render)

  Yes

  No

• Are any features visible (e.g. brickwork patterns, oversailing courses, mouldings)

  Yes

  No

• Has the appearance of the wall been modified by later additions (e.g. cement render or cement repointing)

  Yes

  No

• Structural Condition of Wall

  Good

  Fair

  Poor

  N/A

Windows

• Are any of the windows of the original pattern

  Yes

  No

• Is there any historic glass present

  Yes

  No

Internal Features

• Are there any internal features of significance on external walls

  Yes

  No

• Are there any significant ground floor materials present (e.g. stone, decorative tiles or original floorboards)

  Yes

  No

Alterations

• Have there been any substantial changes to the building which have diminished or enhanced significance

  Yes

  No

• Give further details

Enhancement

• Is there potential to enhance significance (e.g. restoring windows to their original pattern)

  Yes

  No

Flooring

• Floor Construction Detail

  Select Solid Concrete Suspended Timber Suspended, Not Timber Ground Bearing Concrete Other Unknown

  • Solid Concrete
  • Suspended Timber
  • Suspended, Not Timber
  • Ground Bearing Concrete
  • Other
  • Unknown

• Is there adequate sub floor cross flow ventilation

  Yes

  No

• What measures will be undertaken to improve this

• Structural Condition of Floor

  Good

  Fair

  Poor

  N/A

Heating

• Main Heating Type?

  Select Mains Gas Oil Solid Fuel Electric Heat Pump LPG Heating not working at the time of survey Other

  • Mains Gas
  • Oil
  • Solid Fuel
  • Electric
  • Heat Pump
  • LPG
  • Heating not working at the time of survey
  • Other

• Boiler Type

  Vaillant

  Other

• Type?

• Boiler Model

  EcoTec Pro 24

  Other

• What Model?

• Boiler Location

  Kitchen

  Hallway

  Out Building

  Dining Room

  Other

• What Location?

• Heating System Photographic Evidence

  Media

• What Type

• What Type

  Select Old Storage Heaters High Heat Retention (Quantums) Panel Heaters Portable Heaters Other

  • Old Storage Heaters
  • High Heat Retention (Quantums)
  • Panel Heaters
  • Portable Heaters
  • Other

• Heat Pump Type

  Air Source Heat Pump

  Ground Source Heat Pump

  Water Source Heat Pump

  Other

• Does the appliance appear in working condition

  Yes

  No

• What is the net KW rating of the appliance

• Does the appliance flue require sleeving or safeguarding before and after EWI installation

  Yes

  No

• Secondary Heat source?

  Select No other heating present Electric Effect Fire Gas Fire with Flue Gas Fire with chimney Gas Fire Flush Fitted Open Fire with internal chimney Open Fire with external chimney Wood Burner Other

  • No other heating present
  • Electric Effect Fire
  • Gas Fire with Flue
  • Gas Fire with chimney
  • Gas Fire Flush Fitted
  • Open Fire with internal chimney
  • Open Fire with external chimney
  • Wood Burner
  • Other

• Photographic Evidence

  Media

Internal Inspection

• Internal Inspection of Building Completed

  Yes

  No

• What Condition is the Inside

  Select No Internal Issues Visible Damage to Ceiling Water Stain on Ceiling Low Level Damp Near Skirting Boards Black Mould in the Corners of the Rooms Black Mould on the Ceiling and Walls Condensation on the Windows and External Walls Other

  • No Internal Issues Visible
  • Damage to Ceiling
  • Water Stain on Ceiling
  • Low Level Damp Near Skirting Boards
  • Black Mould in the Corners of the Rooms
  • Black Mould on the Ceiling and Walls
  • Condensation on the Windows and External Walls
  • Other

• Photographic Evidence

  Media

• What Rooms?

  Select Lounge Kitchen Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Bathroom W/C Other

  • Lounge
  • Kitchen
  • Bedroom 1
  • Bedroom 2
  • Bedroom 3
  • Bedroom 4
  • Bathroom
  • W/C
  • Other

• Internal Inspection must be detailed

• If property is defined by PAS 2035 as a 'nationally designated listed building or buildings in conservation areas or world heritage site' then a full assessment should be conducted according to BS 7913.

• Age of property

  Select A - Pre 1900 B - 1900 - 1929 C - 1930 - 1949 D - 1950 - 1966 E - 1967 - 1975 F - 1976 - 1982 G - 1983 - 1990 H - 1991 - 1995 I - 1996 - 2002 J -2003 - 2006 K - 2007 - 2011 L - 2012 onwards

  • A - Pre 1900
  • B - 1900 - 1929
  • C - 1930 - 1949
  • D - 1950 - 1966
  • E - 1967 - 1975
  • F - 1976 - 1982
  • G - 1983 - 1990
  • H - 1991 - 1995
  • I - 1996 - 2002
  • J -2003 - 2006
  • K - 2007 - 2011
  • L - 2012 onwards

• Listed Building / Conservation Area / Historic Environment Recorded

  Yes

  No

• Has the Council Website Been Checked at Point of Survey?

  Yes

  No

• Should the planning department be notified?

  Yes

  No

• Property Type

  Select House Bungalow Ground Floor Flat Top Floor Flat Maisonette Other

  • House
  • Bungalow
  • Ground Floor Flat
  • Top Floor Flat
  • Maisonette
  • Other

• What Type

• Attachment

  Select Semi Detached Linked Mid Terraced End Terraced Ground Floor Top Floor Mid Floor Other

  • Semi
  • Detached
  • Linked
  • Mid Terraced
  • End Terraced
  • Ground Floor
  • Top Floor
  • Mid Floor
  • Other

• What Type

• Number of Storeys

  Select 0 1 2 3 4 5 6

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6

• Building Finish

  Select Brick Painted Render Brick/Render Pebble Dash Concrete Block Recon Stone Spar UPVC Cladding Tile Hanging Limestone/Sandstone Granite/Whinstone Faced brick in a high exposure area not suitable for cavity wall insulation Other

  • Brick
  • Painted Render
  • Brick/Render
  • Pebble Dash
  • Concrete Block
  • Recon Stone
  • Spar
  • UPVC Cladding
  • Tile Hanging
  • Limestone/Sandstone
  • Granite/Whinstone
  • Faced brick in a high exposure area not suitable for cavity wall insulation
  • Other

• What Type

• Similarity to adjacent buildings (similar roof coverings or wall materials)

  Yes

  No

Roof

• Structural Condition of Roof

  Good

  Fair

  Poor

  N/A

Walls

• Construction Type

  Select Cavity Wall Solid Brick System Built Metal Frame Other

  • Cavity Wall
  • Solid Brick
  • System Built
  • Metal Frame
  • Other

• Structural Condition of Wall

  Good

  Fair

  Poor

  N/A

Windows

• Glazing Type

  Single

  Double (Pre 2001)

  Double (2002 +)

  Triple

• Is there any historic glass present

  Yes

  No

Flooring

• Floor Construction Detail

  Select Solid Concrete Suspended Timber Suspended, Not Timber Ground Bearing Concrete Other Unknown

  • Solid Concrete
  • Suspended Timber
  • Suspended, Not Timber
  • Ground Bearing Concrete
  • Other
  • Unknown

• Is there adequate sub floor cross flow ventilation

  Yes

  No

• What measures will be undertaken to improve this

• Structural Condition of Floor

  Good

  Fair

  Poor

  N/A

Heating

• Main Heating Type?

  Select Mains Gas Oil Solid Fuel Electric Heat Pump LPG Heating not working at the time of survey Other

  • Mains Gas
  • Oil
  • Solid Fuel
  • Electric
  • Heat Pump
  • LPG
  • Heating not working at the time of survey
  • Other

• Boiler Type

  Vaillant

  Other

• Type?

• Boiler Model

  EcoTec Pro 24

  Other

• What Model?

• Boiler Location

  Kitchen

  Hallway

  Out Building

  Dining Room

  Other

• What Location?

• Heating System Photographic Evidence

  Media

• What Type

• What Type

  Select Old Storage Heaters High Heat Retention (Quantums) Panel Heaters Portable Heaters Other

  • Old Storage Heaters
  • High Heat Retention (Quantums)
  • Panel Heaters
  • Portable Heaters
  • Other

• Heat Pump Type

  Air Source Heat Pump

  Ground Source Heat Pump

  Water Source Heat Pump

  Other

• Does the appliance(s) appear in working condition

  Yes

  No

• What is the net KW rating of the appliance

• Does the appliance flue require sleeving or safeguarding before and after EWI installation

  Yes

  No

• Secondary Heat source?

  Select No other heating present Electric Effect Fire Gas Fire with Flue Gas Fire with chimney Gas Fire Flush Fitted Open Fire with internal chimney Open Fire with external chimney Wood Burner Other

  • No other heating present
  • Electric Effect Fire
  • Gas Fire with Flue
  • Gas Fire with chimney
  • Gas Fire Flush Fitted
  • Open Fire with internal chimney
  • Open Fire with external chimney
  • Wood Burner
  • Other

• Photographic Evidence

  Media

Internal Inspection

• What Condition is the Inside

  Select No Internal Issues Visible Damage to Ceiling Water Stain on Ceiling Low Level Damp Near Skirting Boards Black Mould in the Corners of the Rooms Black Mould on the Ceiling and Walls Condensation on the Windows and External Walls Other

  • No Internal Issues Visible
  • Damage to Ceiling
  • Water Stain on Ceiling
  • Low Level Damp Near Skirting Boards
  • Black Mould in the Corners of the Rooms
  • Black Mould on the Ceiling and Walls
  • Condensation on the Windows and External Walls
  • Other

• Photographic Evidence

  Media

• What Rooms?

  Select Lounge Kitchen Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Bathroom W/C Other

  • Lounge
  • Kitchen
  • Bedroom 1
  • Bedroom 2
  • Bedroom 3
  • Bedroom 4
  • Bathroom
  • W/C
  • Other

• Specify what issues are present

Ventilation Questions

• Has a ventilation PIBI been conducted

  Yes

  No

• A ventilation PIBI must be completed

• Ventilation PIBI will be provided to show:

• Wet room mechanical ventilation is working or will be replaced

• All rooms have or will have passive vents/trickle vents

• All habitable rooms have or will have the required door undercuts

• Does the property meet the minimum acceptable ventilation requirements set out in PAS 2030/2035

  Yes

  No

• Ventilation issues will be rectified as part of this project to meet PAS 2035 standard

• Does the cooker have a hood which ventilates to the outside

  Yes

  No

  N/A

• Is there an airing cupboard or drying room that is ventilated to the outside

  Yes

  No

• Is it vented to the outside

  Yes

  No

• Is there a tumble dryer

  No

  Condensing

  Vented to Outside

  Vented to Room

• Is there evidence of intermittent heating to parts of the property (e.g. TRV's being turned down too low to unused areas)

  Yes

  No

  N/A

• Are there appropriate controls in place to regulate the heating in the property (e.g. thermostat, programmer etc.)

  Yes

  No

• Is the thermostat set to a minimum of 10 Celsius in all parts of the property that are heated

  Yes

  No

• Is there evidence of clothes being dried in the property

  Yes

  No

• Has the importance of behaviour to moisture and condensation been explained to the occupants and left behind/sent a copy

  Yes

  No

Exterior

• Number of elevations to be treated

  Select 0 1 2 3 4 5 6

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6

• Does the wall have or will have cavity insulation

  Yes

  To be installed

  No

• Has the cavity been sealed at the perimeter

  Yes

  No

• Has the need for fire separation of the compartments/Boundaries been defined

  Yes

  No

  N/A

Through Wall Construction

• Internal to external surface layers

• Overall Wall Thickness (mm)

• Photo of wall thickness

  Media

• Layer 1

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Layer 2

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Layer 3

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Layer 4

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Layer 5

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Layer 6

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Layer 7

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Has a second through wall construction been identified ?

  Yes

  No

  N/A

Second through wall construction

• Overall Wall Thickness (mm)

• Photo of wall thickness

  Media

• Layer 1

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Layer 2

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Layer 3

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Layer 4

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Layer 5

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Layer 6

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Layer 7

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Has a third through wall construction been identified ?

  Yes

  No

  N/A

Third through wall construction

• Overall Wall Thickness (mm)

• Photo of wall thickness

  Media

• Layer 1

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Layer 2

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Layer 3

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Layer 4

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Layer 5

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Layer 6

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

• Layer 7

  Select Wallpaper Paint Plaster Skim Render Dense Concrete Block Lightweight Concrete Block Cavity Cavity Insulation Timber Frame Plywood Plasterboard Insulated Plasterboard Dry Dash Wet Dash Hanging Tile Brickwork Stone System built Concrete wall with cavity System built Concrete without cavity Metal Frame None

  • Wallpaper
  • Paint
  • Plaster Skim
  • Render
  • Dense Concrete Block
  • Lightweight Concrete Block
  • Cavity
  • Cavity Insulation
  • Timber Frame
  • Plywood
  • Plasterboard
  • Insulated Plasterboard
  • Dry Dash
  • Wet Dash
  • Hanging Tile
  • Brickwork
  • Stone
  • System built Concrete wall with cavity
  • System built Concrete without cavity
  • Metal Frame
  • None

Enabling Works

• Satellite Dish works (qty)

• TV Ariel (qty)

• External Lights (qty)

• Alarms (qty)

• CCTV (qty)

• Electric Cables (description and lm)

• Satellite Cables (lm)

• Electric Box (Type and qty)

• BT Box (qty)

• Gas Box (Type and qty)

• Gas Flue (position and qty)

• Gas Pipework (lm)

• Condense Pipework (lm)

• PRV (qty)

• Overflow (qty)

• External Tap (qty)

• Downpipes (Number of downpipes and lm)

• Soil and Vent Pipe (connections and lm)

• Does it go through the soffit

  Yes

  No

• Gates (Material and qty)

• Fence panels (material and qty)

• Fence posts (material and qty)

• Walls (construction type and description)

• Canopy/Porch (material and qty)

• Vegetation (day work estimation)

• Handrail (material and lm/brackets)

• Grab rails (material and qty)

• Scaffolding Bridge (qty)

• Window Cills (over or under)

• Insulated Plinth Detail (lm)

Property Elevations

• Which Elevations exist on this property

  Select Front Rear Left from front Right from front Garage and/or outbuilding Other elevations N/A

  • Front
  • Rear
  • Left from front
  • Right from front
  • Garage and/or outbuilding
  • Other elevations
  • N/A

• Specify

• Markup Property Photos with Measurements

  Media

Existing Finishes: External/Internal

• External Finishes

  Select Stone Brick Sand & Cement Render Mass Concrete Dry dash Wet Dash Concrete Block Wood paint Tile Hanging Other

  • Stone
  • Brick
  • Sand & Cement Render
  • Mass Concrete
  • Dry dash
  • Wet Dash
  • Concrete Block
  • Wood paint
  • Tile Hanging
  • Other

• Please state other type of finish

• Internal finishes

  Select Wallpaper Paint Tiles Other

  • Wallpaper
  • Paint
  • Tiles
  • Other

• Please state other type of finish

• Comments:

Vents - Combustion, Flue, Background etc.

• Are all vents (inc. combustion vents) to be safeguarded and additional vents to be installed if required

  Yes

  No

Openings - Windows/Door Materials (Timber/PVC/Other)

• Photo(s) Evidence

  Media

• Window Material Type

  Select UPVC Timber Metal Composite

  • UPVC
  • Timber
  • Metal
  • Composite

• Window Renewal

  Yes

  No

• External Door Material Type

  Select UPVC Timber Metal Composite

  • UPVC
  • Timber
  • Metal
  • Composite

• External Door Renewal

  Yes

  No

• Comments:

EXTERNAL ELECTRICAL CABLES/EQUIPMENT

• Photo(s) Evidence

  Media

• Comments:

EXTERNAL SERVICES/ATTACHMENTS TO THE WALLS e.g (Satellite dish, lights, washing lines etc.)

• Any external services/attachments to the walls

  Yes

  No

• Photo(s) Evidence

  Media

• Comments:

EWI ABUTMENT TO OTHER STRUCTURES (Conservatories extensions, garden walls, gate posts etc.)

• Any EWI abutment to other structurers

  Yes

  No

• Photo(s) Evidence

  Media

• Comments:

EWI ABUTMENT TO EAVES & ROOFS

• Photo(s) Evidence

  Media

• Comments:

STRUCTURAL DEFECTS (E.g. Cracking, subsidence, weak or cored components)

• Is there any evidence of structural defects ?

  Yes

  No

• What are the Details?

• Requires Competent Person e.g. Structural Engineer

  Yes

  No

  N/A

• Photo(s) evidence of Structural Defects

  Media

• EEM Design:

• Structural repairs included in the design before works start

  Yes

  No

• Structural repair to be carried out by others before works start

  Yes

  No

  N/A

• Site pull-out tests undertaken for mechanical fixings

  Yes

  No

• System fixing design calculated for all loading conditions (wind, system weight etc.)

  To Follow

EXISTING RENDER

• Any defects in existing render

  Select No evidence of defects Defects apparent

  • No evidence of defects
  • Defects apparent

• Comments on apparent defects

• Photo(s) Evidence

  Media

• Requires removal, partial removal, repair

  Removal

  Partial Removal

  Repair

• Render repair included in the design

  Yes

  No

• Render repair to be carried out by others prior to works

  Yes

  No

  N/A

PRESENCE OF DAMP (RISING, PENETRATING OR CONDENSATION)

• Any evidence of damp (e.g. condensation, mould or water ingress)

  No Evidence of Damp

  Evidence of Damp

• Comments on damp

• Photo(s)

  Media

• EEM Design:

• Damp treatment included in the design

  Yes

  No

  N/A

• Damp treatment measure to be carried out by others prior to works starting

  Yes

  No

  N/A

• I can confirm that at time of survey there is no evidence of existing damp present inside the property

FROST DAMAGE

• Any frost damage evident

  Select No evidence of weathering damage Evidence of weathering damage

  • No evidence of weathering damage
  • Evidence of weathering damage

• Photo(s)

  Media

• EEM Design:

• Frost repair included in the design

  Yes

  No

• Frost repair measure to be carried out before install

  Yes

  No

MOSS/LICHEN/MOULD/IVY or EFFLORESCENCE

• Is MOSS/LICHEN/MOULD/IVY or EFFLORESCENCE present

  Yes

  No

• Comments of growth

• Is there a requirement for a fungal wash application (as per system spec)

  Yes

  No

• Is an adhesive surface treatment required to promote adhesion

  Yes

  No

• Photo(s)

  Media

• Remediation included in the design

  Yes

  No

RAIN WATER AND DRAINAGE PIPES

• Photo(s):

  Media

• Can existing pipework be moved

  Yes

  No

• Comments:

DAMP PROOF COURSE(DPC) PROVISION AND LOCATION

• Photo(s) of DPC (Each elevation with tape measure from ground level)

  Media

• Design details (e.g insulated plinth below DPC) complies with requirements of PAS 2035

  Yes

  No

  N/A

• Comments (including any insulated plinth detail and location)

ARCHITECTURAL FEATURES (e.g. protruding stone work, tile sills, soldier courses)

• Any architectural features to note

  Yes

  No

• Photo(s)

  Media

• Comments:

EEM Design Questions

• Are all system designed spec/component manufacture guidance being followed and is the insulation to be carried out in accordance with the IAA technical guidance

  Yes

  No

• Which approved system will be installed (BBA or equivalent)

• Will component manufacture guidance be provided for this measure

  Yes

  No

• Are there any areas that will not be insulated

  Yes

  No

• It is mandatory for all areas to be insulated to address thermal bridging

• Comments

• Does the system design account for the Building Regulation requirements for fire

  Yes

  No

• Does the system design account for building exposure

  Yes

  No

• Interface design details (weather seals around cill, window frame etc.) comply with requirements of PAS 2035

  Yes

  No

• Design minimises Thermal bridging (partial or full continuity between wall and roof insulation)

  Yes

  No

• Design details (Penetration, fixings, weather seals etc.) comply with requirements of PAS 2035

  Yes

  No

• Design accounts for loading in service (e.g. impact)

  Yes

  No

• Comments

• Is a starter track required according to the EWI design

  Yes

  No

• Overall system design minimises thermal bridging

  Yes

  No

• Cold bridging has been addressed in the design

• Confirm that the property is suitable to receive external wall insulation and that it will not result in any non-compliance with building regs in relation to: Structural stability, materials, workmanship, fire safety and resistance to moisture

  Yes

  No

EEM Information

• Have relevant checks been undertaken to determine if asbestos containing materials are present

  Yes

• Is the nature and extent of the survey known to the customer and is it in line with their expectations

  Yes

• Are the arrangements made for site access and installation materials storage adequate and appropriate for the installation to be undertaken

  Yes

• The installation work will not result in non-compliance with the building regulations in relation to:

• Workmanship

• Materials

• Structural Stability

• Fire Safety

• Resistance to Moisture

• Any avoidable thermal bridging

• Any unsafe operation of combustion appliances

• Compromise the functionality of existing ventilation ducts/systems

• Compromise the functionality and/or safety of existing services (gas, electric, water, telephone, etc.)

• Any requirements stated by the supplier

Resident Sign Off

• House or flat

  House

  Flat

• Has the Customer been made aware of the level of disruption and is happy for the works to go ahead?

  Yes

  No

• Resident to sign

  Sign

Flat 1

• Flat 1 Address

• Has the Customer been made aware of the level of disruption and is happy for the works to go ahead?

  Yes

  No

• Resident to sign

  Sign

Flat 2

• Flat 2 Address

• Has the Customer been made aware of the level of disruption and is happy for the works to go ahead?

  Yes

  No

• Resident to sign

  Sign

Assessment Sign off

• Surveyor/Competent Person Signature and Full name

  Sign