House Check Form
Your house will be checked on a daily basis, when other HPD responsibilities allow. Please provide as much detail as you can when filling out this form. Please submit this form at least 5 days in advance of your departure date.
****Please make sure to notify the station at 508-497-3401 when you return******
Name *
Your answer
Address *
Your answer
Date you will be leaving *
MM
/
DD
/
YYYY
Date you will be returning *
MM
/
DD
/
YYYY
Condition of property on departure *
Yes
No
Open or broken windows
Windows closed and locked?
Lights on timers
If not on timers, are there lights on?
Alarm
Animals in the house
Will there be any vehicles on the property? If so please list make, color and license plate
Your answer
Are there any hazards on the property that we should be aware of (construction, pond, clothes line, etc.)?
Your answer
Anyone with a key who may be visiting the property?
Your answer
Emergency contact information *
Your answer
Submit
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