Construction

Year Built:

# of Families

# of Rooms

Frame Masonry

Market Value of Dwelling

Market Value of Land

Protection

Miles to Station:

ft to Hydrant

Protection Class:

Responding Fire Department:

Property

 Date Purchased 

 Price 

 # of Outbuildings  

Principal Heating System

Central
Space Heaters
Floor Furnace
Circulating Heater
Steam/Hot Water
Electric
Other

Age:

Principal Fuel

Gas
Wood
Oil
Electric
Coal
Other

Supplemental Heat System

Yes
No

Can house be reached any time of the year?

Yes
No

Miles from service road?:

Type of Chimney

Masonry w/ Liner
Masonry w/o Liner
Metal
None

Plumbing

Copper
Plastic
Galvanized

Electric Service

Fuse
Breaker

Size of House

Size X  

Stories   Total Area

Basement Size

Size X  

Porch Area

Size X  

Add on Room

Size X  

Type of Foundation

Solid Masonry
Block Pier    Age:

Type of Roof

Shingle
Metal
Rolled
V-Crimp
Other      Age: