PIBI - Loft Insulation V1.1

• Client Name.

  Live West

  Sanctuary

  Hafod Housing

  Other

• What Client

• Conducted on

  Date

• Survey Type

  Loft Insulation PIBI

• Prepared by

  Select Brian Hurren Chris Houghton Danny Montgomery Lee Glenister Mariusz Mikolajewski Simon Adolpho Surveyor Other

  • Brian Hurren
  • Chris Houghton
  • Danny Montgomery
  • Lee Glenister
  • Mariusz Mikolajewski
  • Simon Adolpho
  • Surveyor
  • Other

• Name of Competent Person

• First line of the Address.

• 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?

  No

  Yes

• 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?

  No

  Yes

• 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

Property Information

• Approx Construction age of the building

  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

• Property Type

  Select Mid-Terrace End terrace Semi-detached Detached Ground Floor Flat Middle Floor Flat Top Floor Flat Masonette Bungalow House Commercial Building

  • Mid-Terrace
  • End terrace
  • Semi-detached
  • Detached
  • Ground Floor Flat
  • Middle Floor Flat
  • Top Floor Flat
  • Masonette
  • Bungalow
  • House
  • Commercial Building

• Number of Bedrooms

  Select 1 2 3 4 5 + Other

  • 1
  • 2
  • 3
  • 4
  • 5 +
  • Other

• Floor Construction Type

  Select Solid Suspended Suspended not wood Other

  • Solid
  • Suspended
  • Suspended not wood
  • Other

• Please take a photo of the Electric and Gas meters (where applicable)

  Media

• Main Heating type, photo of appliance ID & Flue

  Mains Gas/LPG

  Oil/Solid Fuel

  Electric

  Renewable technology/Other

  None

• Photo of appliance name/make/model/rating plate

  Media

• Location of the flue

  Select External Photo Front/Rear of Property Left/Right Side of Property None

  • External Photo
  • Front/Rear of Property
  • Left/Right Side of Property
  • None

• Secondary Heat source

  Select No other heating present Electric Effect Fire Electric Downflow Portable Electric Heaters Gas Fire with Flue Gas Fire Flush Fitted Portable Gas Fire Open Fire Wood Burner Other

  • No other heating present
  • Electric Effect Fire
  • Electric Downflow
  • Portable Electric Heaters
  • Gas Fire with Flue
  • Gas Fire Flush Fitted
  • Portable Gas Fire
  • Open Fire
  • Wood Burner
  • Other

• Specify

• Safety monitors present within the property

  Select Smoke Carbon Monoxide Heat Other

  • Smoke
  • Carbon Monoxide
  • Heat
  • Other

• Internal inspection of the building completed

  Yes

  No

• Specify Findings

  Select Low level damp near the skirting boards Black mould in the corners of the rooms Black mould on the ceiling and the walls Condensation on the windows and external walls No internal issues that I can see.

  • Low level damp near the skirting boards
  • Black mould in the corners of the rooms
  • Black mould on the ceiling and the walls
  • Condensation on the windows and external walls
  • No internal issues that I can see.

Overall Condition

• I have assessed the condition on site ensuring there is adequate ventilation and no evidence of damp and no remedial works required. Unless listed below, there are no additional significant hazards observed that are not addressed in the generic risk assessment for the work to be undertaken

  None

  See Below

• Please provide details

Floorplan

• Attach photo of Floorplan (if required)

  Media

Loft Insulation Survey

• Is the Loft Accessible?

  Yes

  No

  N/A

• Is loft to be insulated or other works required

  Select Yes loft requires topping up No Loft has sufficient insulation Unable to check due to the amount of tenants belongings.

  • Yes loft requires topping up
  • No Loft has sufficient insulation
  • Unable to check due to the amount of tenants belongings.

• Photo of Access Point and Overall Loft (Multiple Angles)

  Media

• Loft Hatch Size (mm)

• Loft Height at Centre

  Select 0.80 metres 0.90 metres 1.00 metres 1.20 metres 1.40 metres 1.50 metres 1.60 metres 1.80 metres and above.

  • 0.80 metres
  • 0.90 metres
  • 1.00 metres
  • 1.20 metres
  • 1.40 metres
  • 1.50 metres
  • 1.60 metres
  • 1.80 metres and above.

• Width between rafters (mm)

• Roof covering type

  Select Clay Concrete Slate Interlocking Lapped Unknown

  • Clay
  • Concrete
  • Slate
  • Interlocking
  • Lapped
  • Unknown

• Does a steel combustion flue pass through the loft space

  Yes

  No

  N/A

• Should loft insulation be Rolled or Blown

  Rolled

  Blown

• Loft hatch needing D/P

  Yes

  No

  N/A

• Does the hatch need to be replaced

  Yes

  No

  N/A

• Approximate Total Area of Loft (m2)

• Is there more than one loft

  Yes

  No

• Area of additional loft (m2)

• Photo's (inc depth) of additional loft

  Media

• Notes

• Existing Depth

  Select 0mm 12mm 25mm 50mm 70mm 80mm 100mm 125mm 150mm 170mm 200mm 250mm 270mm 300mm plus

  • 0mm
  • 12mm
  • 25mm
  • 50mm
  • 70mm
  • 80mm
  • 100mm
  • 125mm
  • 150mm
  • 170mm
  • 200mm
  • 250mm
  • 270mm
  • 300mm plus

• Minimum depth to be achieved

  Select 270mm 300mm 350mm 400mm + Other

  • 270mm
  • 300mm
  • 350mm
  • 400mm +
  • Other

• Pipes Present

  Yes

  No

  N/A

• Any pipes to be lagged

  Yes

  No

  Already Lagged

• Details of pipes

• Number and length of pipes to be lagged

• Check on site

• Tanks Present

  Yes

  No

  N/A

• Details of tanks

• Distance from loft hatch to tank for possible walkway

• Do the tanks require insulating

  Yes

  No

• Can the tank be insulated underneath

  Yes

  No

• Check on site

• Down lights present in ceiling

  Yes

  No

• Details of down lights, how many and there current location

• Do they have halogen bulbs fitted.

  Yes

  No

• Can you see the IP rating on the casing

  Yes

  No

• Are there any existing down light covers fitted

  Yes

  No

• Are they fire rated covers

  Yes

  No

• Electrical wiring free from visual defects

  Yes

  No

  N/A

• Evidence of electric wiring trapped between insulation

  Yes

  No

  N/A

• Are there any high voltage cable's in the loft space

  Yes

  None Visible

  No

• Type of cable

  Select Cooker cable Shower cable Immersion cable PV cable Other

  • Cooker cable
  • Shower cable
  • Immersion cable
  • PV cable
  • Other

• Relay of Insulation Required

  Yes

  No

• Estimate of relaying time allocation (hours)

  Select 1 2 3 4 5 + Other

  • 1
  • 2
  • 3
  • 4
  • 5 +
  • Other

• Specify

• Cross Flow Ventilation

  Yes

  No

  Unknown

• What type

• Loft vents required

  Yes

  No

  N/A

• Is breathable felt fitted

  Yes

  No

  Eaves Only

• Is the specification available

  Yes

  No

  Unknown

• Does the loft have any boarding

  Yes

  No

  N/A

• Can we insulate at least 2/3rds of the loft space

  Yes

  No

  N/A

• Has the boarded area got insulation under it

  Yes

  No

  N/A

• If not insulated under, are the joist tunnels tightly sealed with insulation at the ends

  Yes

  No

  N/A

• Is roof eaves insulation present

  Yes

  No

  N/A

• Can the insulation be undertaken through the loft space

  Yes

  No

• How should it be installed

• Areas to be omitted

  Yes

  No

• What Areas?

• Walkway required

  Yes

  No

• Details of walkway

  Select Access to PV inverter Access cold water tank Access to storage area Required to access all areas Access to heat pump equipment Access to hot water cylinder Other

  • Access to PV inverter
  • Access cold water tank
  • Access to storage area
  • Required to access all areas
  • Access to heat pump equipment
  • Access to hot water cylinder
  • Other

• What is Required

• Loft clearance

  Yes

  No

• Details of loft clearance

• Estimate of loft clearance time allocation (hours)

  Select 1 2 3 4 5 + Other

  • 1
  • 2
  • 3
  • 4
  • 5 +
  • Other

• Remedial works required for Loft

  Yes

  No

• What remedial works are required

• What is the current insulation level

  270mm

  300mm

  350mm

  400mm +

  Other

• Is there a loft insulation conformity certificate present

  Yes

  No

  N/A

• Why?

  Select No Hatch Hatch Blocked Hatch Over Stairs (Cannot Access Safely) Resident Refused Access Other

  • No Hatch
  • Hatch Blocked
  • Hatch Over Stairs (Cannot Access Safely)
  • Resident Refused Access
  • Other

• What?

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 a non-compliance with the building regulations in relation to:

• Workmanship

• Materials

• Structural Stability

• Fire Safety

• Resistance to Moisture

• Avoidable thermal bridging

• Any unsafe operation of combustion appliances

• Functionality of existing ventilation ducts/systems

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

• Any requirements stated by the supplier

• Use of a Step ladder/ladder

• Access and Egress

• Manual Handing

• Hand Tools/Power Tools

• Vibration

• Noise

• Dust

• House Keeping

• Lone Working

Assessment Sign off

• Competent Person Signature and Full name

  Sign