Ref: CR-08
What we will ask.
Please find below exemplary questions regarding your property that our assessor may ask while he’s visiting
your property.
3.0
The Type of Property
Please describe the type of property:
Please
tick one
House:
Bungalow:
Flat:
Maisonette:
Please
tick one
Please describe the level of detachment of the property.
Detached:
For flats or maisonettes, please leave blank; your Green
Deal Advisor will assess this.
Semi-detached:
Mid-terrace:
End-terrace:
Enclosed (“back-to-back”) midterrace:
Enclosed (“back-to-back”) endterrace:
What is the total floor area of the property? (m2)
OR if you do not know the floor area of your property, please complete the question below to allow us to
estimate its size.
Please indicate how many of the following types of
room there are in your property:
State no. of
each
Bedrooms:
Living/dining rooms; studies:
Bathrooms; WCs:
Kitchens; utility/store rooms:
Conservatories:
Other:
CR-08 Domestic Pre-visit Questionnaire v.1.0 Page 1 of 8
Ref: CR-08
Does your property include any extensions?
Please
tick one
0:
1:
2:
3:
4 or more:
Please indicate which of the following geographical areas and age bands your property falls into:
England/Wales
Please tick
one
Scotland
Before 1900:
Before 1919:
1900-1029:
1919-1929:
1930-1949:
1930-1949:
1950-1966:
1950-1964:
1967-1975:
1965-1975:
1976-1982:
1976-1983:
1983-1990:
1984-1991:
1991-1995:
1992-1998:
1996-2002:
1999-2002:
2003-2006:
2003-2007:
2007 onwards:
2008 onwards:
CR-08 Domestic Pre-visit Questionnaire v.1.0 Page 2 of 8
Please
tick one
Ref: CR-08
4.0
Methods of Heating
Please
tick one
Is the property…
On gas grid:
“On gas grid” means that the property has a mains gas
supply.
Off gas grid:
Please
tick one or
two
What is the main heating system in the property?
Central heating – gas boiler:
Central heating – oil boiler:
A “main” heating system is your central heating system
or, if you do not have one, the method you use to heat
the majority of your property. It will usually provide hot
water in addition to space heating.
Some properties have two main heating systems, for
example where two different boilers are used to supply
heat to different areas of the property.
Central heating – electric
boiler:
Central heating – solid fuel
boiler:
Central heating – range:
Ground source heat pump:
Please tick up to 2 options.
Air source heat pump:
Electric under floor heating:
Warm air system:
Electric storage heating:
Community heating:
Individual room heaters (please
only tick if this is the only
method of heating the
property). Specify below:
State no.
of each
Do you use any of the following to heat a single
room or rooms within your property?
Electric fire/room heater:
Gas fire/room heater:
Solid fuel fire/room heater:
(This is “Secondary heating”.) Please do not count
portable heaters, only fixed appliances.
CR-08 Domestic Pre-visit Questionnaire v.1.0 Page 3 of 8
Oil fire/room heater:
Ref: CR-08
5.0
Energy-Saving Measures
Please tick
all that
apply
Do you know if any of these energy-saving measures
have already been installed at the property?
Heating Ventilation & Air Conditioning
Condensing boiler:
Heating controls:
Underfloor heating:
Heat recovery system:
Flue gas recovery device:
Insulation/ Building Fabric Improvements
Cavity wall insulation:
Loft insulation:
Flat roof insulation:
Internal wall insulation:
External wall insulation:
Floor insulation:
Draught proofing:
Heating system insulation (hot
water cylinder, pipes):
Energy-efficient glazing or doors:
Lighting
Energy-efficient light fittings
(e.g. LEDs, CFL, linear
fluorescents):
Energy-efficient lighting controls
(presence detectors, dusk-todawn sensors, timers, dimmers,
‘smart home’ controls):
CR-08 Domestic Pre-visit Questionnaire v.1.0 Page 4 of 8
Ref: CR-08
Water Heating
Innovative hot water systems:
Water-efficient taps and showers:
Renewable Energy
Ground source heat pump:
Air source heat pump:
Solar thermal water heating:
Biomass boiler (e.g. fired by logs,
wood chips, pellets):
Solar PV panels:
Wind turbine:
6.0
Local Constraints
Please
tick all
that
apply
Listed:
As far as you are aware, is the building…
In a Conservation Area:
Subject to planning constraints:
If you have ticked any of the above, please provide
details.
CR-08 Domestic Pre-visit Questionnaire v.1.0 Page 5 of 8
Ref: CR-08
7.0
Existing Energy Performance Certificates (EPCs)
Please
tick
one
Yes:
Does your property have an existing EPC?
No:
If “Yes”: Was it produced after 1st April 2012 (in
England and Wales) or 1st October 2012 (in
Scotland)?
Yes:
If “Yes”: Have there been any major changes to the
property since the EPC was lodged?
Yes:
No:
No:
If “Yes”: Please provide details
8.0
Existing Green Deal Plans
Please
tick
one
Does your property have an existing Green Deal Plan
or Plans in place?
Yes:
No:
If “Yes”: describe which measures were installed (or
are being installed) under each Plan.
9.0
Energy Bill Information
Do you have energy bills available for at least the last
12 months?
Please
tick
one
Yes:
No:
Please note: Please make this information available prior to the assessment visit where possible; otherwise
this may affect the accuracy of your Green Deal Assessment.
CR-08 Domestic Pre-visit Questionnaire v.1.0 Page 6 of 8
Ref: CR-08
10.0
Accessibility
Please
tick
Is it currently possible to access all areas of your
property, including loft spaces, basements etc?
Yes:
No:
If “No”: Which areas are inaccessible?
Please note: We politely request that all areas are made accessible prior to the assessment visit where
possible; inaccessible areas may affect the accuracy of your Green Deal Assessment.
Would it be possible for you to make these areas
accessible?
Please describe how you can make all areas
accessible.
Please state the date by which you would be able to
make all areas accessible.
CR-08 Domestic Pre-visit Questionnaire v.1.0 Page 7 of 8
Yes:
No:
Ref: CR-08
11.0
Form of Tenure
Please
tick
one
Owner-occupier:
What is the form of tenure?
Private rented:
Social rented:
If private rented or social rented: Are you the…
Landlord*:
Tenant+:
*
Please note: If the property is rented and you are the Landlord, you must ask your Tenant to complete
Appendix 1, and return this with this Questionnaire. This provides written confirmation of their consent for all
aspects of the assessment to be carried out.
Please tick to confirm that a completed Appendix 1 has been attached.
note: If the property is rented and you are the Tenant, you do not need to obtain the property owner’s
permission to have a Green Deal Assessment carried out; however, written consent may be required from the
property owner prior to the installation of measures as part of a Green Deal Plan, depending on the terms of the
tenancy agreement.
+ Please
12.0
Other
How long have you lived at this property?
Who is the Local Authority?
Are there any hazardous materials present within
the property?
Are there any disability issues that may require
additional personnel present?
How many other adults will be present during the
inspection?
CR-08 Domestic Pre-visit Questionnaire v.1.0 Page 8 of 8