Joseph H. McGlone, Inc.
Insurance Analyst

Customer Information

     

Please choose:	Mr.,Mrs.,or Ms. Mr. Mrs. Ms.
Last name:		First name:
Address:
City, State, Zip:
E-mail address:
Home phone:		Work phone:

 

Property Information

Address:
Property type:	Single family duplex condominium-end unit condominium-center unit townhouse-end unit townhouse-center unit	owner occupied vacation/secondary rental vacant other
Construction:	frame Select (type) brick masonry other	year built
Type of:	heat (select) gas hot air gas hot water oil hot air oil hot water radiator electric other	electrical (select) circuit breakers fuses
If heated by oil: Where is the tank located?    Select (tank location) basement underground above ground other

 

Total living area:

square feet (do not include basement or garage)

Total area of foundation:

square feet (not required but helpful if available)

Is there a basement?	if yes, is it finished?
Is there a crawl space?	Is house on a SLAB?

 

Last Updated:	roof	plumbing
	electric	heating

 

Number of:

baths    1 11/2 2 21/2 3 31/2 4 4+ Select                   fireplaces none 1 2 3 3+ Select      stories  Select 1 1 1/2 2 2 1/2 3                   garages    Select none 1 attached 2 attached 3 attached 1 detached 2 detached 3 detached 1 built-in 2 built-in 3 built-in

 

Does it include:

central air ,  fire ext. ,   pool ,   deck   sq. ft. enclosed porch  ,  open porch ,  porch size (sq. ft.) fire alarm  -  central station or local burglar alarm  -  central station or local

 

If new purchase:

settlement date

purchase price