Application Form


Tipperary Energy Agency are looking for leaders and innovators to take part in the deep energy retrofit pilot project

Name*:

Address*:

Eircode*:

Telephone*:


Email Address*:

What type of construction is your house?:

If other please state type of construction:

Year of Construction?*:

Approximate house size?*:

Why are you interested in taking part in the project?*:

Current Energy Use*:
Cost Usage(Litres/Kgs etc)
Oil
Electricity
Coal/Turf/Other

Current BER Rating, if known:

Do you know what sustainable energy measures you would like to make to your home:
Item Status
Attic insulation:
Cavity wall insulation:
External wall insulation:
Heat pump:
Biomass boiler:
Full window replacement:
Glazing replacement:
Front door replacement:
Back door replacement:
LED lighting:
Heat recovery ventilation:
Demand control ventilation:
Wood log stove:
Flat roof insulation:
Hot water tank replacement:

How did you hear about this project?*:

If other please state:

We would now like to ask you some questions for research purposes

1. Please list below the main drivers of carrying out a substantial energy performance (deep retrofit ) improvement retrofit of your home:*

2. Please list below the main barriers to carrying out a deep retrofit of your home:*

3. If you consider all the costs of carrying out deep retrofit of your home, how much would you expect the costs be?:*

4. What would you expect the energy savings to be if you would carry out deep retrofit:*

5. What would you find an acceptable payback time if you would carry out deep retrofit:*

6. How would you finance the investment in deep retrofit?*

7. If you plan to take out a loan for the finance of the project, what % of the net costs do you intend to finance from the loan:*

8. How should the financial package be designed to encourage you to invest in the improvement of the energy performance of your home?*

Finally, we would like to ask a few general questions about you.

What is your gender:

malefemale

What is your age:


Don’t want to say

What is the highest education that you finished?:

What is the annual, gross income in your household?:

What does your household look like?:


Applicant Declaration

I understand that;
  • SEAI and Tipperary Energy Agency are collecting my personal data as a result of my application for the 2016 Super Homes Scheme.
  • Both SEAI and Tipperary Energy Agency are jointly responsible for managing my personal data.

My personal data is being collected to:
  • to administer and deliver the 2016 Super Homes Scheme and other related schemes
  • determine and verify grant eligibility
  • assist in the calculation of credits of energy suppliers and use for audit and anti-fraud detection purposes
  • my data may be shared with third parties where necessary to assist achieving the above purposes

I consent to the use of my personal data in this way

I agree with the terms & conditions