Insured 1 - First Name What is your first name?
Insured 1 - Last Name What is your last name?
Insured 1 Email What is your email address?
What is the location address of the home we are evaluating? What is the location address of the home we are evaluating?
Renovations? Has this home been renovated since it was originally built?
System Updates Select the features of your home that have been updated.
Electrical update year What year was the electrical updated? (YYYY)
Plumbing update year What year was the plumbing updated? (YYYY)
Heating update year What year was the heating system updated? (YYYY)
Roof update year What year was the roof updated? (YYYY)
Windows update year What year were the windows updated? (YYYY)
Other updates? What other updates have been done to your home?
Historic registry? Is this home listed on the National Register of Historic Homes? (www.nps.gov)
Living area square footage What is the square footage of the home's living area? (Do not include a finished basement.)
Year built What year was this home built?
Other home details Please select the other features of this home. (Select all that apply)
Garage Type What type of garage does this home have?
Garage bays? How many bays does the garage have?
1 car 2 cars 3 cars 4 cars 5 cars
Garage square footage What is the square footage of the garage?
Basement / Crawlspace type What type of basement / crawl space does this home have?
Finished basement year What year was the basement finished?
Finished basement square footage? What is the square footage of the finished basement?
Unfinished basement square footage? What is the square footage of the unfinished basement?
Deck type What type of deck does this home have?
Deck year built What year was the deck built?
Deck square footage What is the square footage of the deck?
Porch type What type of porch does this home have?
Porch year built What year was the porch built?
Porch square footage What is the square footage of the porch?
Other defined areas Please select any other defined spaces at this home. (Select all that apply)
Structure Details Architectural style What is this home's architectural style?
Select 2 - Family Home 3 - Family Home 4 - Family Home A - Frame Adam Adirondack Adobe American 4 - Square Architecturally Unique Art Deco Art Moderne Arts and Crafts Style Basic Bay Region Beaux Arts Bi - Level Brownstone Brownstone - Bowfront Victorian Brownstone - Bowfront Victorian - End Unit Brownstone - End Unit Brownstone - Stand Alone Brownstone - Victorian Brownstone - Victorian - End Unit Bungalow California Ranch Cape Cod Carpenter Gothic Castle - like Chalet Charleston Chateau City House City House - Art Deco City House - Art Deco - End Unit City House - Art Moderne City House - Art Moderne - End Unit City House - Beaux Arts Classical City House - Beaux Arts Classical - End Unit City House - End Unit City House - Gothic City House - Gothic - End Unit City House - International Style City House - International Style - End Unit City House - Itallianate City House - Itallianate - End Unit City House - Neo-Classical City House - Neo-Classical - End Unit City House - Renaissance City House - Renaissance - End Unit City House - Renaissance Revival City House - Renaissance Revival - End Unit City House - Romanesque City House - Romanesque - End Unit City House - Second Empire City House - Second Empire - End Unit City House - Sullivanesque City House - Sullivanesque - End Unit Classical Revival Colonial Colonial, Custom Colonial, Dutch Colonial, Early American Colonial, Eclectic Colonial, French Colonial, German Colonial, Manor Colonial, New England Style Colonial, Plantation Colonial, Revival Eclectic Colonial, Southern Colonial, Spanish Colonial, Tract Completely Custom Conch Contemporary Contemporary, California Contemporary, English Contemporary, French Contemporary, Tudor Contractor Modern Converted Barn Cottage Country Style Craftsman Style Deconstruction Designed by a Famous Architect Duplex Earth Shelter, Bermed Earth Shelter, Hillside Earth Shelter, Underground Eastlake Eclectic, French Eclectic, Neoclassical Farmhouse Federal French Provincial French Style Georgian Georgian Revival German Stone Gingerbread Gothic Revival Greek Revival Gulf Coast Style High Ranch International Style Italian Villa Italianate Katrina Cottage Key West Style Log Mansard Mansion Mediterranean Mission Style Moderne Monterey Style Neo-Classical Neo-Colonial Neo-French Neo-Mediterranean Neo-Tudor Neo-Victorian Normandy Style Octagon One - of - a - Kind Palatial Period Post Modern Prairie Style Public Building-like Pueble Queen Anne Raised Cape Raised Ranch Rambler Rammed Earth Ranch Regency Renaissance Revival Richardsonian Romanesque Romanesque Saltbox Santa Barbara Sants Fe Style Second Empire Shaker Shingle Style Shotgun Style Soil Cement Southampton Style Spanish Mission Spanish Revival Spanish Style Split entry Split level Stick, Eastern Stick, Western Strawbale Sullivanesque Townhouse Townhouse, End Unit Townhouse, Federal Style Townhouse, Federal Style - End Unit Townhouse, Georgian Style Townhouse, Georgian Style - End Unit Tract Home Tri - Level Triplex Tudor Tuscan Usonian Vernacular/Folk Victorian Western Mountain Wrightian
Construction Type What is the construction type of this home?
Select Autoclaved Aerated Concrete Foam Form Concrete Framing, Steel Framing, Wood Framing, Wood With Elevated Slab Log Masonry, Block Masonry, Brick Masonry, Stone Modular, Wood Frame Pole Frame Poured Concrete Rammed Earth Rigid Metal Frame Soil Cement Stick Strawbale Structural Insulated Panel Stucco On Frame Stucco On Masonry Timber/post &Beam Veneer, Brick Veneer, Brick With Wood Frame Veneer, Stone
Construction quality Select the option that most accurately describes this home's construction quality.
Select Basic / Economic Modest / Fair Average / Standard Above Average / Upgraded / Expensive / Custom Very Expensive / Luxury Opulent / Museum Quality
Physical shape What is the physical shape of this home?
Select Angular (Few To No Right Angles) Complicated Contemporary Curvy (extensive Curves) H - Shaped I - Shaped L - Shaped Octagonal Rectangular Rectangular with Angled Wing Rounded Square T - Shaped U - Shaped Unique
Primary Exterior What is the primary exterior of this home?
Select Adobe Aluminum Siding Asbestos Replacement, Cement Fiber Asphalt Autoclaved Aerated Concrete, Exposed Autoclaved Aerated Concrete, Painted Board And Batten Brick Masonry Brick W/block Backup Brownstone Cedar Siding Cement Floor Clapboard Clay Tile Concrete Block Concrete Block, Painted Concrete, Reinforced Decorative Wood Shingle Drivit/EIFS Engineered Wood Siding Glass Block Glass Panels Half Log Siding Hardboard Limestone Local Stone Log (<11”diameter) Log (>11”diameter) Masonite Metal Siding Paint Plywood With Batts Precast Concret Precast Stone Rammed Earth Redwood Siding Siding, Log Solid Stone Steel Siding Stone Rubble Stucco Stucco Over Masonry Stucco With Half Timbering Stucco, Slick Finish Stucco, Smooth Coat Stucco, Tuscan Finish T1-11 Siding Tabby Siding Veneer, Common Brick Veneer, Face Brick Veneer, Rubble Veneer, Stone Veneer, Synthetic Brick Veneer, Synthetic Stone Vinyl Siding Wood Shake/shingle Wood Siding Wood Stresskin Panels
Primary Roof Cover What is the primary roof cover of this home?
Select Aluminum Architectural Shingle Asbestos Shingle Replacement Asphalt Shingle Asphalt Shingle With Solar Panels Barrel Tile Cedar Shingle/shake Cement Fiber Clay Tile Composition Roll Composition Shingle Composition, Build-up Concrete Tile Dibiten Dimensional Asphalt Shingle Earth Covered Elastomeric EPDM Membrane Fiberglass Shingle Glass Panel Glazed Tile Hail Proof Shingle Lamarite Shingle Ludowici Tile Metal Other Than Standing Seam Metal, Corrugated Metal, Ribbed Minera Shingle Polyurethane Foam Pvc Membrane Red Slate Rubber Slate Slate, Graduated Slate, Patterned Slate, Synthetic Solar Shingles Spanish Tile Standing Seam Metal Steel Steel With Solar Panels Tar And Gravel Tile With Solar Panels TPO Membrane Wood Shake Wood Shingle
Locale Describe this home's locale. (Select all that apply)
Additional Information Number of Rooms How many rooms does this home have?
Number of Bedrooms How many bedrooms does this home have?
Number of Bathrooms How many bathrooms does this home have?
Heating Type Please select the heating type for this home.
Select Electric Baseboard Forced Air Gas Furnace Geothermal Heat Pump Hot Water Radiant
Heating Fuel Type Please select the heating fuel type for this home.
Select Electric Gas Liquid Propane Natural Gas Oil
Air Conditioning Type Please select the air conditioning type for this home.
Select Heat Pump A/C Evaporative Cooler
Number of Fireplaces How many fireplaces does this home have?
Roof Configuration What is this home's roof configuration?
Select Flat Gable Gable with Dormers Gambrel Hip Hip with Gable Dormers Mansard Multi-level Contemporary Salt Box Shed
Roof Pitch What is this home's roof pitch?
Select Flat Slight Moderate Steep
Foundation Type What is this home's foundation type?
Select Brick Concrete Block Concrete Slab Fieldstone Holland Clay Tile No Permanent Foundation Pier Pier and Beam Pilings Poured Concrete Stone Stone Rubble and Mortar Treated Wood
Number of Stories How many stories does this home have?
Other Structures? Do you have any other structures on your property?
Number of Buildings How many buildings are on the property?
Other Structures Other Structure 1 Please select the type of other structure you have on this property.
Select Barn Barn, Equipment Barn, For Cows Barn, For Horses Barn, Generic Barn, Hay Barn, Milking Barn, Post and Beam Basketball Court Boathouse Cabana Caretakers House Carriage House Club House Dock, Concrete Dock, Wood Garage Gazebo Grain Silo Greenhouse Guard House Guest House Hot Tub Lap Pool Play House, Childrens Pool House Shed, Equipment Shed, General Purpose Shed, Run-in Shed, Tractor Spring House Swimming Pool, Above Ground Swimming Pool, Inground Tennis Court
Other Structure 1 Year Built What year was this structure built?
Other Structure 1 Square Footage What is the square footage of this structure?
Other Structure 1 Construction Quality What is the construction quality of this structure?
Select Basic / Economic Modest / Fair Average / Standard Above Average / Upgrade\Expensive / Custom Very Expensive / Luxury Opulent / Museum Quality
Other Structure 1 Condition What is the condition of this structure?
Select Excellent Above Average Average Below Average Poor
Pool Construction Type What is the construction type of the pool?
Select Concrete Gunite, Black Gunite, Regular Tiled Vinyl Lined
Other Structure 1 Construction Type What is the construction type of this structure?
Select A - Frame Autoclaved Aerated Concrete Foam Form Concrete Framing, Steel Framing, Wood Framing, Wood with Elevated Slab Log Masonry, Block Masonry, Brick Masonry, Stone Modular, Wood Frame Pole Frame Poured Concrete Rammed Earth Rigid Metal Frame Soil Cement Stick Strawbale Structural Insulated Panel Stucco on Frame Stucco on Masonry Timber/Post and Beam Veneer, Brick Veneer, Brick with Wood Frame Veneeer, Stone
Other structure 1 Primary Exterior What is this structure's primary exterior?
Select Adobe Aluminum Siding Asbestos Replacement, Cement Fiber Asphalt Autoclaved Aerated Concrete, Exposed Autoclaved Aerated Concrete, Painted Board And Batten Brick Masonry Brick W/block Backup Brownstone Cedar Siding Cement Floor Clapboard Clay Tile Concrete Block Concrete Block, Painted Concrete, Reinforced Decorative Wood Shingle Drivit/EIFS Engineered Wood Siding Glass Block Glass Panels Half Log Siding Hardboard Limestone Local Stone Log (<11”diameter) Log (>11”diameter) Masonite Metal Siding Paint Plywood With Batts Precast Concret Precast Stone Rammed Earth Redwood Siding Siding, Log Solid Stone Steel Siding Stone Rubble Stucco Stucco Over Masonry Stucco With Half Timbering Stucco, Slick Finish Stucco, Smooth Coat Stucco, Tuscan Finish T1-11 Siding Tabby Siding Veneer, Common Brick Veneer, Face Brick Veneer, Rubble Veneer, Stone Veneer, Synthetic Brick Veneer, Synthetic Stone Vinyl Siding Wood Shake/shingle Wood Siding Wood Stresskin Panels
Other structure 1 Primary Roof Cover What is this structure's primary roof cover?
Select Aluminum Architectural Shingle Asbestos Shingle Replacement Asphalt Shingle Asphalt Shingle With Solar Panels Barrel Tile Cedar Shingle/shake Cement Fiber Clay Tile Composition Roll Composition Shingle Composition, Build-up Concrete Tile Dibiten Dimensional Asphalt Shingle Earth Covered Elastomeric EPDM Membrane Fiberglass Shingle Glass Panel Glazed Tile Hail Proof Shingle Lamarite Shingle Ludowici Tile Metal Other Than Standing Seam Metal, Corrugated Metal, Ribbed Minera Shingle Polyurethane Foam Pvc Membrane Red Slate Rubber Slate Slate, Graduated Slate, Patterned Slate, Synthetic Solar Shingles Spanish Tile Standing Seam Metal Steel Steel With Solar Panels Tar And Gravel Tile With Solar Panels TPO Membrane Wood Shake Wood Shingle
Second Other Structure? Is there a second other structure on the property?
Other Structure 2 Please select the type of other structure you have on this property.
Select Barn Barn, Equipment Barn, For Cows Barn, For Horses Barn, Generic Barn, Hay Barn, Milking Barn, Post and Beam Basketball Court Boathouse Cabana Caretakers House Carriage House Club House Dock, Concrete Dock, Wood Garage Gazebo Grain Silo Greenhouse Guard House Guest House Hot Tub Lap Pool Play House, Childrens Pool House Shed, Equipment Shed, General Purpose Shed, Run-in Shed, Tractor Spring House Swimming Pool, Above Ground Swimming Pool, Inground Tennis Court
Other Structure 2 Year Built What year was this structure built?
Other Structure 2 Square Footage What is the square footage of this structure?
Other Structure 2 Construction Quality What is the construction quality of this structure?
Select Basic / Economic Modest / Fair Average / Standard Above Average / Upgrade\Expensive / Custom Very Expensive / Luxury Opulent / Museum Quality
Other Structure 2 Condition What is the condition of this structure?
Select Excellent Above Average Average Below Average Poor
Pool Construction Type 2 What is the construction type of the pool?
Select Concrete Gunite, Black Gunite, Regular Tiled Vinyl Lined
Other Structure 2 Construction Type What is the construction type of this structure?
Select A - Frame Autoclaved Aerated Concrete Foam Form Concrete Framing, Steel Framing, Wood Framing, Wood with Elevated Slab Log Masonry, Block Masonry, Brick Masonry, Stone Modular, Wood Frame Pole Frame Poured Concrete Rammed Earth Rigid Metal Frame Soil Cement Stick Strawbale Structural Insulated Panel Stucco on Frame Stucco on Masonry Timber/Post and Beam Veneer, Brick Veneer, Brick with Wood Frame Veneeer, Stone
Other structure 2 Primary Exterior What is this structure's primary exterior?
Please select Adobe Aluminum Siding Asbestos Replacement, Cement Fiber Asphalt Autoclaved Aerated Concrete, Exposed Autoclaved Aerated Concrete, Painted Board And Batten Brick Masonry Brick W/block Backup Brownstone Cedar Siding Cement Floor Clapboard Clay Tile Concrete Block Concrete Block, Painted Concrete, Reinforced Decorative Wood Shingle Drivit/EIFS Engineered Wood Siding Glass Block Glass Panels Half Log Siding Hardboard Limestone Local Stone Log (<11”diameter) Log (>11”diameter) Masonite Metal Siding Paint Plywood With Batts Precast Concret Precast Stone Rammed Earth Redwood Siding Siding, Log Solid Stone Steel Siding Stone Rubble Stucco Stucco Over Masonry Stucco With Half Timbering Stucco, Slick Finish Stucco, Smooth Coat Stucco, Tuscan Finish T1-11 Siding Tabby Siding Veneer, Common Brick Veneer, Face Brick Veneer, Rubble Veneer, Stone Veneer, Synthetic Brick Veneer, Synthetic Stone Vinyl Siding Wood Shake/shingle Wood Siding Wood Stresskin Panels
Other structure 2 Primary Roof Cover What is this structure's primary roof cover?
Please select Aluminum Architectural Shingle Asbestos Shingle Replacement Asphalt Shingle Asphalt Shingle With Solar Panels Barrel Tile Cedar Shingle/shake Cement Fiber Clay Tile Composition Roll Composition Shingle Composition, Build-up Concrete Tile Dibiten Dimensional Asphalt Shingle Earth Covered Elastomeric EPDM Membrane Fiberglass Shingle Glass Panel Glazed Tile Hail Proof Shingle Lamarite Shingle Ludowici Tile Metal Other Than Standing Seam Metal, Corrugated Metal, Ribbed Minera Shingle Polyurethane Foam Pvc Membrane Red Slate Rubber Slate Slate, Graduated Slate, Patterned Slate, Synthetic Solar Shingles Spanish Tile Standing Seam Metal Steel Steel With Solar Panels Tar And Gravel Tile With Solar Panels TPO Membrane Wood Shake Wood Shingle
Pictures and Comments Home Pictures Please upload current pictures of your home and other structures (maximum 10 photos)
Comments Please enter any additional comments about the specific characteristics of your home in the space below.
Consent* Disclaimer: This online questionnaire is a tool used to gather information. It is not an application for insurance. No insurance coverage will be bound or put into effect by submitting this form.
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