Send Form 'LI Green Request for Services'

How did you hear about the LI Green Program?

(Other):

What is your name? 

Street Address 

City 

Zip 

Phone 

Alternative_Phone_Number 

Email_Address 

Home Style:

(Other):

Approximate square footage of living space?:  

How many bedrooms?:  

Do you have a finished basement?t

When was the house built? 

When did you purchase the house? 

What is the primary heating fuel?

(Other):

What kind of heat do you have?

(Other):

Central air conditioning?

Have you made major construction changes in the house?

Have you installed new windows?

Have you added insulation? 

Have you switched to more energy efficient bulbs for lighting?

Have you upgraded the heating system?

Is the house drafty?

Are there cold spots?

Are there hot spots?

Do you have high fuel costs?

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