Name:
Address:
Email:
Phone:
Q.1) Home Ownership Status:
Tenant Owner
Q.2) What type of house do you live in?
Detached Semi-detached Terrace Flat Other
Q.3)When was your home built?
4) How many of the following rooms do you have?
Bedrooms Living & Dining Kitchens
Hall & Stairs Bathrooms Oher
5) Are any of these loft conversions or dormer rooms?
Yes No
6)If you live in a flat, what type of building is it in?
Tower Block No. of Blocks Divided House Above shop / office
Other
Where in the property do you live?
Ground floor (basement)
Above ground with unheated space below
Partly above unheated space
Above a heated space / property
Is there a roof directly above your flat?
Yes - a pitched roof
Yes - a flat roof
Part of the flat has a roof directly above it
No, the flat is below another heated space / property
7) What type of walls do you have?
Cavity
Solid
Mixed cavity and solid
Timber frame
8) Are your walls insulated?
Yes No Don't know
If yes, what type of insulation do you have?
Internal thin EPS (expanded polystyrene) roll
Internal dry lining (e.g. with thermal board)
Cavity Fill
External
9) Do you have an attic?
If so, do you have attic insulation?
If yes, please state thickness and type:
10) Do you have floor insulation?
If yes, please state thickness:
11) Do you have any double, secondary or triple glazing?
If yes, what type do you have?
Sealed unit double glazing (replacement type)
Fixed secondary glazing
Temporary secondary glazing
Double glazing with "Low E" coating
Triple glazing
Don't know
12) What percentage of the overall glazing does this represent?
All Most (75%) Half (50%) Some (25%)
Less than 25% None Don't know
13) Are your external doors and windows draught proofed?
If yes, please estimate what proportion
Less than 25% Don't know
14) What type of heating system do you have?
Warm air system Boiler and radiators Room heaters Storage heaters
Radiant system Other system Don't know
15) How old is your heating system?
Less than 5 years 5 - 10 years Over 10 years Don't know
16) What is the main fuel that you use for heating?
Natural Gas Bottled Gas LPG (bulk) Oil
Smokeless House coal (processed) Anthracite
Peat Wood Nightsaver off peak Other off peak
On peak electricity Don't know
Do you have any of the following?
Foil behind some radiators Foil behind all radiators None / Don't know
Some radiator shelves All radiator shelves None / Don't know
17) What type of heating controls do you have?
No controls Timer / Programmer only Room Thermostat
Room Thermostat and Timer / Programmer
Thermostatic Radiator Valves (TRV's) and Programmer
Room Thermostat / Timer / Programmer / TRV's and boiler manager
Automatic charge control on storage heaters
Other (please specify)
18) How is your hot water provided?
Central Heating system Dual immersion (on and off peak) Single immersion (off peak Nightsaver)
Single immersion (on peak) Instant Electric Gas combi boiler / instantaneous
Gas, oil or solid fuel range Don't know
19) Is your hot water cylinder insulated?
No insulation 1 inch (25mm or less spray foam) 2 inches (50mm or more spray foam)
1 inch thick jacket (25mm) 2 inches thick jacket (50mm) 3 inches thick jacket (75mm)
More than 3 inches thick jacket (80mm) Not applicable / No hot water tank Don't know
20) Do you have any pipe insulation on the pipes between your boiler and your hot water cylinder?
Yes No Don't know Not applicable / No tank
21) What hot water control do you have?
Not applicable / No cylinder No control except on / off switch Programmer / Timer only
Cylinder Thermostat only Thermostat and timer Don't know
22) What are the different types of lighting that you have?
Standard Fluorescent Tubes (T12) Standard Fluorescent Tubes (T8)
High Frequency Fluorescent Tubes Compact Fluorescent Lamps
Discharge Lamps (e.g. Sodium) Tungsten Halogen Low Voltage Halogen Lamps
Normal Filament Light Bulbs Not applicable Don't know
23) Do you have many energy saving light bulbs (Compact Fluorescent Lamps [CFLs] )?
Yes (number ....) No Don't know
24) How important would you consider the improvement of energy efficiency in your home?
Very important Important Unimportant Very unimportant
25) Would the existence of a grant system influence your decision to improve the energy efficiency of your home?
26) Is there a maximum amount of money that you feel you can spend on improvement in the next year or so?
No fixed amount allocated for improvements
Maximum amount of €
27) Who might you use to carry out any improvements?
DIY Contractors or Builders Don't know
28) Have you already decided to install any particular energy efficiency measures?
If so, which ones:
29) Would you like any advice on these?
30) Would you like information on any of the following?
Domestic appliances Solar water heating Energy labelling CO2 emissions
Condensation control Handy hints
31) Where did you find out about us?
Thank you for filling out this questionnaire with details of your home. Please press the submit button below to forward your infromation to us. We will then record the information onto our computer system and produce a list of possible ways to save you money off the cost of heating, lighting and providing hot water. Suggestions will then be sent to you with any supporting information.
All data will be treated in the strictest confidence.
Mayo Energy Agency,The Quay,Ballina.
Tel: (096) 76113Fax: (096) 76119E-Mail: mayoenergy@eircom.net
