Casey Insurer Services
Exterior Only
Company:
*
DeCotis Insurance - MA
DeCotis Insurance - RI
Market Finders Insurance
Johnson & Johnson
Jencap
Jencap/Quaker Special Risk
Safety Insurance
Insured Name:
*
Policy #:
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Agency:
*
Inspector's Name:
*
William Bierce
Keith McEachern
Bill Casey
John Frank
Jim McEachern
David Morin
Nicole Messier
Ashley Freudenthal
Charles Lyons
Greg McEachern
Mark Kramer
Dick Herman
Matt Bodman
Tyler McQuade
Latania Knights
Kristian Mahaffey
Erick Hartz
Inspection Date:
*
-
Month
-
Day
Year
Date Picker Icon
Contact Information:
Enter phone numbers & email addresses
Type of Risk/Description:
*
Total Living Square Footage:
*
Owned Property:
Leave Blank if Tenant Only
Estimated Replacement Costs:
Enter Dollar Amount
Agree with Replacement Costs?
Yes
No
Other
Prior Loss:
*
Yes
No
Unknown
Prior Loss Description:
Click Here For Occupancy
Occupancy
If multi-unit, enter occupancy for each floor below.
Basement:
List basement occupancy
First Floor:
List 1st floor occupancy
Second Floor:
List 2nd floor occupancy
Third Floor:
List 3rd floor occupancy
Fourth Floor:
List 4th floor occupancy
Occupancy if above doesn't apply
Area/Type of Neighborhood
Area
Type of Neighborhood
*
Residential
Commercial
Industrial
Area
*
Urban
Suburban
Rural
Area Security/Safety
*
Good
Fair
Poor
Click Here For Construction
Construction
Age of Building:
*
120 Years Old
# of Stories:
*
1
1.5
2
2.5
3
3.5
4
4.5
5
6
7
8
9
10+
Foundation:
*
Concrete
Brick
Stone
Concrete Block
Concrete Slab
Crawl Space
Pylons
Stone Block
Other
Exterior Frame:
*
Wood Frame
Steel Frame
Concrete Block
Brick
Other
Exterior Siding:
*
Vinyl
Wood Clapboard
Wood Shingles
Cement Fiber Clapboard
Brick
Concrete Block
Aluminum
Asbestos Shingles
Asphalt Shingles
Stucco
Steel Sheathing
T1-11 Wood Siding
Other
Roof Type:
*
Flat
Gable
Hip
Mansard
Gambrel
Sloped
Other
Roof Deck:
*
Wood
Steel
Concrete
Other
Roof Covering:
*
Asphalt Shingles
Rubber Membrane
Tar & Gravel
Wood Shake
Slate
Metal
Other
Roof Age:
*
New
Less than one year
1-5 years
5-10 years
10-15 years
15-20 years
20-25 years
25 + years
Original
Unknown/Not Visible
Other
Interior Walls & Ceilings:
*
Wood Frame
Steel Frame
Concrete Block
Brick
Off Street Parking:
*
No
Yes
Other
Garage:
*
None
Attached 1 Car
Attached 2 Car
Attached 3 Car
Detached 1 Car
Detached 2 Car
Detached 3 Car
One Car Under
Two Car Under
Other
Overall Condition of Building:
*
Excellent
Good
Fair
Poor
Click Here For Utilities
Utilities
Heating/Cooling System(s):
Gas Forced Hot Water
Oil Forced Hot Water
Gas Forced Hot Air
Oil Forced Hot Air
Gas Steam
Oil Steam
Gas/Electric HVAC
Central Air Conditioning
Electric Baseboard
Electric Wall Monitor
Gas Wall Monitor
Gas Ceiling Unit
Electric Ceiling Unit
Gas on Gas Stove
Gas Parlor Stove
Wood Stove
Pellet Stove
Wood Fireplace
Gas Fireplace
Gas Radiant
Electric Split Air System
Gas Hydro-Air System
No Heat
No Access
Other
Type of Plumbing:
Copper
Cast Iron
PVC
PEX
Flex Pipe
ABS
Brass
No Access
Other
Electrical:
Breakers
Fuses
No Access
Other
Amperage:
60
100
125
200
400
No Access
Other
Utility Updates
Heating:
*
New
Within 5 Years
Within 10 Years
Within 15 Years
Within 20 Years
Within 30 Years
Original
Updating During Renovations
No Access
Unable to verify with insured
Other
Plumbing:
*
New
Within 5 Years
Within 10 Years
Within 15 Years
Within 20 Years
Within 30 Years
Original
Updating During Renovations
Partial Updates
No Access
Unable to verify with insured
Other
Electrical:
*
New
Within 5 Years
Within 10 Years
Within 15 Years
Within 20 Years
Original
Updating During Renovations
Partial Updates
No Access
Unable to verify with insured
Other
Hot Water Tank:
New
Within 5 Years
Within 10 Years
Within 15 Years
Within 20 Years
Original
Tankless
No Access
Unable to verify with insured
Other
Overall Utility Condition:
Good
Fair
Poor
N/A
Click Here For Protection
Protective Measures
Common Areas/Main Building:
Hardwired Smoke Detectors
Hardwired Carbon Monoxide Detectors
Heat Detectors
Battery Smoke Detectors
Battery Carbon Monoxide Detectors
Plug-In Carbon Monoxide Detectors
Wet Sprinkler System
Dry Sprinkler System
Emergency Lighting
Illuminated Exit Signs
Exit Bars on Doors
Strobes
Klaxons
Fire Pull Stations
Video Surveillance
Security Grates
Fire Escape
No Common Areas
No Interior Access
Other
Fire Extinguisher:
ABC
K-Class
Tagged
Other
Alarms:
Central Station Fire
Internal Fire
Fire Alarm Panel (normal operations)
Fire Alarm Panel (trouble with system)
No Access to Fire Panel
Central Station Burglar
Internal Burglar
None
Other
Fire Hydrant:
*
Within 50 Feet
Within 100 Feet
Within 200 Feet
Within 500 Feet
None
Suction Point
Other
Fire Department:
*
Paid
Volunteer
Within 500 Feet
Within 1 Mile
Within 2 Miles
Within 3 Miles
Within 5 Miles
None
Other
Additional Protective Measures:
Click Here If Vacant
Vacant, Locked & Secure:
Yes
No
Other
How Often Checked:
Daily
Multiple Times Per Week
Weekly
Bi-Weekly
Monthly
Every 2-3 Months
Other
Utilities Being Maintained:
Electric On
Plumbing On
Heating On
Electric Off
Plumbing Off
Heating Off
Winterized
Other
Under Renovation:
Yes
No
Other
Type of Renovations:
Exterior Siding
Roofing
Windows
Interior Walls/Ceilings
Flooring
Kitchen
Baths
Heating Updates
Electrical Updates
Plumbing Updates
Adding Second Story
Decks
Adding Garage
Cosmetics
Full Rehab
Other
Start Date:
Example: May 2019
Completion Date:
Example: May 2019
Plans for Risk:
Sell
Rent
Primary Residence
Not Sure
Project Costs:
Example: $25,000
Click Here For Swimming Pool
Swimming Pool:
*
Yes
No
Swimming Pool Type:
In-Ground
Above Ground
Diving Board
Water Slide
Other
Security of Area:
Secured
Fenced With Locked Gate
Not Secure
Rules/Signs Posted
Lifeguard
Other
Click Here For Exposures
Distance to Coastline:
Exposures
LEFT EXPOSURE
No. Feet:
*
Abuts
Attached
Within 5 feet
Within 15 feet
Within 25 feet
Within 50 feet
Within 100 feet
Within 200 feet
Within 300 feet
Within 500 feet
Occupancy:
*
Single Family
Two Family
Multi-Family
Apartment Building
Mixed Use
Commercial Building
Commercial Unit
Wooded Area
Vacant Land
Pond
Lake
Park
Playground
Other
RIGHT EXPOSURE
No. Feet:
*
Abuts
Attached
Within 5 feet
Within 15 feet
Within 25 feet
Within 50 feet
Within 100 feet
Within 200 feet
Within 300 feet
Within 500 feet
Occupancy:
*
Single Family
Two Family
Multi-Family
Apartment Building
Mixed Use
Commercial Building
Commercial Unit
Wooded Area
Vacant Land
Pond
Lake
Park
Playground
Other
REAR EXPOSURE
No. Feet:
*
Abuts
Attached
Within 5 feet
Within 15 feet
Within 25 feet
Within 50 feet
Within 100 feet
Within 200 feet
Within 300 feet
Within 500 feet
Occupancy:
*
Single Family
Two Family
Multi-Family
Apartment Building
Mixed Use
Commercial Building
Commercial Unit
Wooded Area
Vacant Land
Pond
Lake
Park
Playground
Other
Click Here To List Hazards
Hazards & Recommendations
HAZARDS & RECOMMENDATIONS:
*
Yes- See Below
None
Hazard 2025-01:
Recommendation:
Hazard One Photo:
Browse Files
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of
Hazard 2025-02:
Recommendation:
Hazard Two Photo:
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of
Hazard 2025-03:
Recommendation:
Hazard Three Photo:
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of
Hazard 2025-04:
Recommendation:
Hazard Four Photo
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of
Hazard 2025-05:
Recommendation:
Hazard Five Photo:
Browse Files
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of
Hazard 2025-06:
Recommendation:
Hazard Six Photo
Browse Files
Cancel
of
Additional Hazards/Concerns:
Additional Hazard Photos:
Browse Files
Cancel
of
Click Here To Add Photos:
Front Exterior Pictures:
Browse Files
Include at least one front & back photo of risk
Cancel
of
Remaining Exterior Pictures:
Browse Files
Include at least one front & back photo of risk
Cancel
of
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