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Greener Homes DIY Scheme

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					“WISHLIST”
                                           Greener Homes DIY Scheme
                  DIY Application for Insulation/Energy Efficient measures

  Name.....................................................................................Address...............................................

  .........................................................................................................................................................................

  Contact no..............................................Email address...................................................................................
                                                                       (very important, if you have one)
  Please tick the appropriate box(es) below or fill in the required information. The Greener Homes
  leaflet gives more product information and links to product websites.

  LOFT INSULATION
  What is your current level of loft insulation in millimetres?                                   …………………
  What is the approximate area of your loft in square metres? …………………
  If you have less than 150mm of loft insulation you may be eligible for a top up with one of the
  following products:
  Tick below if product required (We will calculate the amount you will need)
  Recycled plastic insulation                                                    (Tick one thickness) 150mm                       200mm
  Space Blanket (plastic covered mineral fibre)                                  (Tick one thickness)       150mm                 200mm
  Sheep’s Wool insulation                                                        (Tick one thickness)         75mm               100mm                125mm
  (NB. 125mm of sheep’s wool is roughly equivalent to 160mm of other products)
  For sheep’s wool please specify either                                                   400mm wide rolls                       or 600mm wide rolls
  Hemp ‘Breathe’ (natural fibre) insulation                                          (Tick one thickness)       50mm                 75mm                100mm
  For hemp fibre insulation please specify either                                             375mm wide batts                      or 575mm wide batts

  Note: If you use part of your loft for storage you may wish to insulate the boarded areas using spaceboard.
  This will need to be overboarded with (i.e.) chipboard after installation (not provided under the scheme).
  What area of your loft do you wish to insulate with spaceboard in square metres                                                    …………………
  WALL INSULATION
  Do you have cavity walls that are unfilled?                                                              Don’t know                      Yes               No
  NB. If yes you may qualify for a Cavity Wall Insulation Voucher. If awarded to you, a money-back voucher will
  be issued for redemption after you have had the insulation installed.
  For houses without cavity walls:
  Solid wall insulation: SEMPATAP (internally fixed under wallpaper) Each roll is 12.5m x 1m
  What area of external wall do you wish to cover internally? (Square metres; up to 25 maximum) ………………
  DRAUGHT PROOFING
  Letter Box Seals (number and colour required) White ……… or in Brown ……… (please enter the number required)
  Door Seals with brush strip around door (number and colour required)  White ……… or Brown ………
  Window Seals (foam sticky-backed strips, 5m per roll) (number and colour required) White ……or Brown ………
  Chimney Balloons for blocking draughts when flues not in use (No.) Small …….. Medium …….Large ……..
  HOT WATER AND HEATING MEASURES
  What type of heating do you have?                             Central                  Storage Heaters                   Other               …………………
  What fuel do you use for heating?                            Mains Gas                Oil         Electricity              LPG            Solid Fuel
  I would like: Hot Water Cylinder Jacket
  Heating Pipe Insulation – how many metres of each pipe size? 15mm ……… 22mm ……… 28mm………
  Reflective radiator panels                        How many radiators are on outside walls?                                 …………………
  OTHER:           Waterbutt Kit (incl. stand and diverter)
 Conditions of Applications
 All applications must be in writing on this form, and returned to Suffolk Coastal District Council (SCDC)
 by Friday 31 December 2010 Forms received after this date may not be accepted.

 Goods will be allocated to households according to household income, the potential for carbon/energy
 savings and the availability of funds. You will be notified of the date goods will be available for collection.
 This will normally be at least 3 weeks after the closing date. Failure to collect at the specified time may lead
 to forfeit of goods. All applicants agree to follow the manufacturer’s instructions when installing the goods
 and carry out a home risk assessment
 In completing this form I understand that:
        • I may not be eligible for all the products selected and that I will be responsible for fitting them in my
            own home.
        • Checks will be made on a proportion of properties and if I have not installed the products in my
            property and are found to have disposed of them I may be charged their full cost.
        • My details will be held by SCDC as managing agent for the scheme. SCDC is registered under the
            Data Protection Act 1998. The information provided will be used to determine my eligibility under
            this and other current insulation schemes. I will be contacted and advised of the outcome of this
            assessment and my consent will be obtained prior to my details being forwarded to any other party.

 I consent to details contained in this form to be used for statistical purposes in reporting the outcomes of the
 project.
 If I apply for an Ipswich and Suffolk Credit Union (ISCU) loan I consent to this information being shared with
 the ISCU.
 I agree with the above terms and conditions (please tick)

 Details of your financial circumstances (details of your financial circumstances will not be seen by
 anyone but SCDC who will destroy all financial information at the end of the process)

 Total household income (after tax and NI deducted) £..........................per week/month/annum
 If you do not wish to disclose your financial details you can only be offered up to £50 of free goods. If you
 choose not to disclose this information please be realistic with your selections overleaf; as a guide, loft
 insulation is priced between at between £4 and £9 per square metre depending on thickness. Disclosing
 financial details could entitle you to more goods. The average value of free goods to date is £175 (approx).

 What is your total spend on home energy costs? (electricity/gas/oil) £…………….month /annum

 Who lives in your house?                  No of adults......................... No of children under 18............................
 Do you own or rent your property? Owner occupied                                     Private rented

 Does anyone in your household receive any of the following benefits? This information is needed to see if
 you qualify for other related schemes.

 Attendance Allowance                   Housing Benefit                   Income Based Job Seekers Allowance

 Working Tax Credit                     Income Support                    Income Related Employment & Support Allowance
(income less than £16,040)
 Council Tax Benefit                    Pension Credit                     Disability Living Allowance

 Child Tax Credit                       War Disablement Pension
(income less than £16,040)


 Are you and any partner over 60?                     Yes                            No
 Are you and any partner over 70?                     Yes                            No


 Signed................................................... Full name.................................................... Date...........................

 If you have any questions about the products/scheme, please contact Kirsty Wilmot, Suffolk Energy
 Action Link, Suffolk Coastal District Council, Melton Hill, Woodbridge, Suffolk, IP12 1AU or call the
 Suffolk Climate & Energy Helpline 0800 02 88 938, or e-mail kirsty.wilmot@suffolkcoastal.gov.uk

				
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