Owner
Agent
Yes
No
Owner
Agent
Witness
Tenant
Does this unit have a fire extinguisher, visible & accessible, with current agency inspection tag? NFPA 1-13.6.
Does each sleeping room have an egress window? Easily opened, at least 20” wide & 24” tall and provide an opening of at least 5 sq. Ft, less than 44” from bottom above the floor. NFPA 101-24.2.2.1.
Please take the time to perform this basic safety inspection of your rental unit. If you are unable to complete the inspection yourself, you may appoint an agent.
Is there an exception applied on the unobstructed exits?
Does the property comply with the Brandon Street Naming and Addressing Ordinance? Address number posted near the entrance, visible from the road, and of the proper size and coloring?
Does this unit have access to at least two separate unobstructed exits? NFPA101-31.2.4.1.
Is it Owner or Agent Signature?
Is it Witness or Tenant Signature?
Is there compliance with Housing Health Code Sections, such as proper lighting, ventilation, wiring, heating, sanitation, and structural conditions?
Signature
Does the property comply with the Vermont Lead Law? Has an EMP been filed with the Vt DOH within the past 12 months? (required for all rentals built before 1978) Notice to Tenants been provided? 18 VSA Chapter 38, ss 1759.
Does this unit have working smoke alarm(s), on each level of the dwelling, including basements, and within each bedroom or room used for sleeping? Hardwired with battery backup, Photoelectric type. NFPA 101-31.3.4.5.
Does this unit have a working Carbon Monoxide Alarm, in the immediate vicinity of each sleeping room? A CO alarm is also required in each sleeping room that contains a fuel burning appliance. NFPA 101-31.3.4.6.
Has a wood or solid fuel appliance been installed since the Certificate of Occupancy was issued?
Signature
If yes, please explain
Annual Statement of Compliance Details
Who completed the inspection?