Name:
Address:
Do you have Central Air Conditioning?
Yes No
# of Rooms in Basement
# of Rooms on 1st Floor
# of Rooms on 2nd Floor
Total Number of Bedrooms Including Basement
Windows
Original Replacement
Year Replaced
Interior Walls
Drywall Plaster Paneled Wood Tongue & Groove
Interior Doors
Hollow Solid
Floor Covers
Foyer Wood Carpet Laminate Linoleum Vinyl Ceramic Tile
Kitchen Wood Carpet Laminate Linoleum Vinyl Ceramic Tile
Dining Wood Carpet Laminate Linoleum Vinyl Ceramic Tile
Bath #1 Wood Carpet Laminate Linoleum Vinyl Ceramic Tile
Bath #2 Wood Carpet Laminate Linoleum Vinyl Ceramic Tile
Bath #3 Wood Carpet Laminate Linoleum Vinyl Ceramic Tile
Bath #4 Wood Carpet Laminate Linoleum Vinyl Ceramic Tile
Bedrooms Wood Carpet Laminate Linoleum Vinyl Ceramic Tile
Living Rm Wood Carpet Laminate Linoleum Vinyl Ceramic Tile
Ceilings *Check all that apply
Drywall Plaster Tile Wood Suspended
Heating *Indicate type of heat
Gas Oil Electric Wood Coal Steam OTHER
House Foundation & Wall Type *Check all that apply
Full Basement No Basement Partial Basement %
Crawl Space %
Wall Type: Poured Concrete Cement Block Stone
Basement Finish
Please list the types of finished rooms in your basement
Total Basement Finish Area(SQ FT)
Basement Floor: Wood Carpet Ceramic Tile Vinyl Basement Walls: Drywall Panel Basement Ceiling: Drywall Suspended Tile Basement Ceiling Ht: # Rough In Baths Approximate year basement was finished Is your basement: Daylight Walkout
Total Number of Bathrooms *Please indicate the number of fixtures in each bathroom & if applicable, the year in which each bathroom was remodeled
Bath #1 SinksToilets Tub w/Jets Tub w/Shower Tub Only Shower YEAR REMODELED
Bath #2 SinksToilets Tub w/Jets Tub w/Shower Tub Only Shower YEAR REMODELED Bath #3 Sinks Toilets Tub w/Jets Tub w/Shower Tub Only Shower YEAR REMODELED Bath #4 Sinks Toilets Tub w/ Jets Tub w/Shower Tub Only Shower YEAR REMODELED
Fireplaces
How many openings?
How many Fireplace Chimneys? Fireplace #1 Pre-Fab Masonry 2 Sided Gas Only Location Fireplace #2 Pre-Fab Masonry 2 Sided Gas Only Location Fireplace #3 Pre-Fab Masonry 2 Sided Gas Only Location Wood Stove? Yes No If Yes, how many?
Kitchen
Type of Countertops?
Type of Cupboards? Has the Kitchen been remodeled, If so what year?
Other Amenities *Check all that apply
Utility/Laundry Sink Central Vacuum Security System
Central Stereo Wet Bar Built In Entertainment System In Ground Sprinkling Public Water Public Sewer
Electric Service
100 AMP 150 AMP 200 AMP
A representative from Alpine Township will be coming by to inspect the OUTSIDE of your home. If you have any questions please call 784-1262 M-F 8-5. Thank You for your cooperation
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