Inspection Questionnaires - HTM Insurance Company

Name

First Last

Untitled

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Which Type of Inspection?(Required)

Oil Tank Information

How Many Oil Tanks Do You Have?(Required)

Please enter a number greater than or equal to 1.

Type(Required)

Year of Manufacturing

Manufacturer

Tank Location(Required)

Filter Location

Expansion Loop in Line

Overall Condition

Installed to Code?

Protection (outside tanks)

Notes:

Please upload any photo's/documents you may have:

Drop files here or

Max. file size: 50 MB.

Woodstove Information

Number of cords burnt

Please enter a number greater than or equal to 1.

Woodstove Type

Woodstove Location

Woodstove Positioning

Woodstove Chimney

Woodstove Rating

Comments

Measurements – Inches

Existing – Back

Required – Back

Existing – LHS or Corner

Required – LHS or Corner

Existing – RHS or Corner

Required – RHS or Corner

Existing – Pipe to Wall

Required – Pipe to Wall

Existing – Pipe to Ceiling

Required – Pipe to Ceiling

Existing – Hearth Protection

Required – Hearth Protection

Sheilding

Comments

Attach Any Photo's You May Have

Max. file size: 50 MB.

Building Information

Inspection Type(Required)

Both Inside and Outside

Outside Only

Year Built

Building Type

Number of Storeys

Foundation

Construction

Exterior Finish

Roof Covering

Roof Cover Age

Roof Condition

Downspouts

House Keeping

Comments