Building Questionnaire

1. Owner____________________________________________________________
2. Location _________________________________ Occupancy____________________

3. Building Characteristics:
a. Age ____ b. area ____ c. # of Stories ___ d. Construction Type: _________
e. exposure and distance: right __________ left ___________ rear:________

4. Building Systems:
a. Heat: Central System _____Fuel: _____ Age:_____ Last updated _______
b. Is the heating system maintained regularly? ____ by contract? ______
c. Air Conditioning System: Describe________________________________
d. Electrical: fuse or circuit breaker type _________ Last updated ________
e. Plumbing: Last Updated ________ Type: _________
f. Roof: peaked or flat _________ Type________ Last updated__________

5. Protection:
a. Sprinkled ______ Full or Partial ________ Wet or Dry _________
b. Fire alarm ________ hard wired type _________ central station _______
c. Smoke Detectors______ Type __________ Who maintains ____________
d. Number of miles to fire station_______feet from Hydrant_________

6. Occupancy & Use: habitational only ______ # of units _______ other _______________
________________________________________________________________________

7. Tenants:
a. What % have long term lease? _______
b. What % are students without parents also occupying the unit: ________
c. Any units unoccupied? _____________
d. Do you require tenants to have tenants property/liability insurance? ______

8. Values:
a. Building: replacement cost or actual cash value _________ How
determined_________
b. Contents, if any: __________ Describe______________________________
c. Rental Income Value _______________ (annually)
d. Boiler Insurance desired Y or N (circle)

9. Mortgage:
a. Name: _____________________________________________________
b. Address:____________________________________________________

10. Parking provided: _______ fee charged _________ amount of fee ________
# of lots ________ area paved _______ Lighted? ________

11. Life Safety Protection:

a. Are their two means of egress from each unit? _________________
b. Is there a swimming pool on the premises: _____ fenced? ______
c. Do all interior steps, decks & balconies have railings? __________

12. Lead Paint:

a. Has any test for lead paint been positive? _____ Remedial Steps _________
b. Has the property been certified lead free? ______
c. Are there signs of chipping, flaking or dusting of painted surfaces? _____