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Mainewave Home Energy Audit Questionnaire

Please fill out to the best of your ability before the scheduled audit.  If you have any questions, contact Mainewave at info@mainewave.com .

Note:  In order to conduct the audit, you should be made aware of the following.  All woodstoves must be completely extinguished.  House should have been at a normal and stable temperature for at least three hours.  Access ways to areas such as attics, basements, crawl spaces, and knee walls should be cleared.  Depressurization of the house for testing may result in possible odors from the combustion device exhaust ducts and chimneys.  All windows and doors should be closed (normal winter heating conditions).

Customer _______________________________       Date ____________________

Home Address _________________________________________________________

Occupants:    ___Adult    ___Children

Year built:   ____    Style:  _________   Stories___  square feet:  _______  basement finished ____

Foundation:      ___ full basement    ___crawlspace   ___ slab  ___other (explain) _________________

Number of    ____ bedrooms   ____ bathrooms   ____ other rooms

Temperature                 ___ Average F of house during heating season

Please indicate average yearly usage of the following heating fuels. 
Please research the last 1-3 years of utility bills. 

Energy Usage

Please indicate average yearly usage of the following heating fuels. 
Please research the last 1-3 years of utility bills. 

 ___oil               ____ units/year Comments ________________________________________

___gas             ____ units/year Comments ________________________________________ 

___wood         ____units/year  Comments ________________________________________

___propane      ____units/year  Comments ______________________________________

___electricity    ____$/year         Comments ______________________________________

Heating Systems 

Primary  _____age                   __air    __h/w  __other (explain)______________________

Explain (make, model, eff%, btu) _______________________________________________

Sec         _____age                  __air    __h/w   __other (explain)_______________________

Explain (make, model, eff%, btu) _______________________________________________

Hot water         ___ electric   ___gas   ___oil   ___solar   ___works off h/w boiler: 

Insulation (If Known)

Wall insulation              ___ inches   ____________________________ describe

 Attic insulation           ___ inches   ____________________________ describe

 Basement         `           ___ inches   ____________________________  describe

 Other                           ___ inches   ____________________________ describe

 Describe humidity during heating season:   ___dry   ___humid  ___just right

 Humidifiers       ___      Explain __________________________________________________

 Dehumidifiers ___         Explain __________________________________________________

 Moisture or water infiltration:Explain_____________________________________________

 Fans:    ___bathroom   ___kitchen   ___dryer   ___ other (explain) ______________________

 % of lights CFL:  ___%

 Appliances and year       Refrigerator ___________________________________

                                                 Freezers ________________________________________

                                                 Stove  _________________________________________

                                                 Dryer __________________________________________

                                                 Washer _________________________________________

                                                 Dishwasher ______________________________________

                                                 Dehumidifier _____________________________________

 Comments (Include any concerns, etc):