New Home Survey

Residence Type *
Will you rent this property out to others? *
Siding Material of Home *
Home Style *
Electrical Type *
Heating type *
Is there a fuel oil tank on premises? *
# of Stories *
Is there a basement? *
Is there a garage? *
Is there any custom cabinetry in home? *
Are there solar panels? *
Is there a trampoline? *
Is there a swimming pool? *
Do you need to schedule any valuable items? I.e. jewelry, furs, fine art. *
Is there an operational fire alarm? *
Is there an operational burglar alarm? *
Do you have any decks or patios? *
Was the structure originally built for any purpose other than a private residence and then converted? *
Is the property located on more than 5 acres? *
Do you have any pets? *
Will the residence be unoccupied or vacant for over 30 days after purchase date? *
Will the premium be billed to a mortgagee? *
Is there a lead paint hazard? *
Does the premises have a wood stove, coal stove, or solid fuel stove? *
First time home buyer? *
Have you had any insurance claims or losses in the past 5 years? *
Have you had any insurance coverage been declined, cancelled, or non-renewed in the past 3 years? *
During the last 5 years, have you been indicted or convicted of any degree of crime, fraud, bribery, or any other arson related crime in connection with this property? Have you had a foreclosure, repossession, bankruptcy, judgment, or lien? *
Do you have a personal automobile, umbrella, recreational vehicle, or watercraft policy that you would also like for us to quote? Note many carriers offer discounts for having multi-line policies. *
If so, please forward current policy declarations pages and drivers licenses to Kelsey Martin at