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Show b. Does roof leak around the chimney projection type:describe 4 __________y,es_________no 5. c. Year chimney last maintained d. Any history of chimney fire e. Overall condition good fair poor Rooms (If remodeled since last survey fill in a through f) a. LxWxH Room year remodeled General information No. for l20V outlets Year of last maintenance b. Insulated fully ______p, artially_______none X _______ c. Type of insulation type of material floor wall ceiling jathro om (itche n ~iving hning )edroo m III i12 ) torag e ill X 112 X Attic Wood Fu lly Bldg. )ther f. -----------------------------------------------------------------------Walls ---------------------------------------------------------Ceiling,___________________________________ g. Overall condition of rooms_X_good_____ fair_________poor____ Floors d. e. 6. o _ _ _ __ _ Attic a. Vented X yes b. present ______N_o~___ Any signs of moisture problems past No Describe signs_________________________________________________ ------~ Remarks: ---no Attic has full floor & is used for storage. a lite on N. end. .......... , -~ ....................... Has Stairway outside on S. side • -. - --- |