PROPERTY DISCLOSURE -RESIDENTIAL ONLY 0 No ...
PROPERTY DISCLOSURE - RESIDENTIAL ONLY New Hampshire Association
of REAL TORS® Standard Form
TO BE COMPLETED BY SELLER The following answers and explanations are true and complete to the best of SELLER'S knowledge. This statement has been prepared to assist prospective BUYERS in evaluating SELLER'S property. This disclosure is not a warranty of any kind by the SELLER, or any real estate FIRM representing the SELLER, and is not a substitute for any inspection by the BUYER. SELLERS authorize FIRM in this transaction to disclose the information in this statement to other real estate agents and to prospective buyers of this property. NOTICE TO SELLER(S): COMPLETE ALL INFORMATION AND STATE NOT APPLICABLE OR UNKNOWN AS APPROPRIATE. IF ANY OF THE INFORMATION IN THIS PROPERTY DISCLOSURE FORM CHANGES FROM THE DATE OF COMPLETION, YOU ARE TO NOTIFY THE LISTING FIRM PROMPTLY IN WRITING.
1. SELLER:~Pe=t=er~H=a=ru=e~y~S=r. 2. 3. 4. 5.
_ PROPERTY LOCATION: 18StumpfieldRoad,EastKingstonNH CONDOMINIUM, CO-OP, PUD DISCLOSURE RIDER OR MULTIFAMILY DISCLOSURE RIDER ATTACHED? 0 Yes 0 No SELLER: 0 has 0 has not occupied the property for 24 years. WATER SUPPLY Please answer all questions regardless of type of water supply. a. TYPE OF SYSTEM: D Public 0 Private D Seasonal 0 Unknown Drilled 0 Dug 0 Other _ b. INSTAL~TION: Location:~SO~~~~S=ID=E~OF~LO~T~ ~ Installed By:UNKNOWN Date of Installation::::.19:..:9..;:cl _ What is the source of your information? _FIR----'-ST"'-HAND-'-'_ c. USE: Number of persons currently using the system: =.2 __ -==-Does system supply water for more than one household? DYes 0 No d. MALFUNCTIONS: Are you aware of or have you experienced any malfunctions with the (public/private/other) water systems? Pump: DYes 0 No 0 N/A Quantity: 0 Yes 0 No Quality: DYes 0 No 0 Unknown If YES to any question, please explain in Comments below or with attachment. e. WATER TEST: Have you had the water tested? 0 Yes D No Date of most recent test NOTRECENTLY DATEUNK IF YES to any question, please explain in Comments below or with attachment. Are you aware of any test results reported as unsatisfactory or satisfactory with notations? DYes 0 No IF YES, are test results available? DYes 0 No What steps were taken to remedy the problem?
o
=-
COMMENTS: 6.
----------------------------------------------------------------------------
SEWAGE DISPOSAL SYSTEM a. TYPE OF SYSTEM: Public: DYes Private: 0Yes b.
c.
d.
_
0 No D No
Community/Shared:
o Unknown
D? Yes 0 No
Septic Design Available: 0 Yes 0 No IF PUBLIC OR COMMUNITY/SHARED Have you experienced any problems such as line or other malfunctions? DYes 0 No What steps were taken to remedy the problem? _ IF PRIVATE: TANK: 0 Septic Tank 0 Holding Tank 0 Cesspool 0 Unknown 0 Other ------------------Tank Size Gal. 0 Unknown 0 Other --~~-------------------------------------Tank Type 0Concrete DMetal DUnknown D Other _ =.=2_ Location: WESTSIDELOT 0 Location Unknown Date of Installation:1991 Date of Last Servicing: NOV2013 Name of Company Servicing Tank:_PE_T_E-'-'S_S_EWE R _ Have you experienced any malfunctions? 0 Yes 0 No Comments: __ ~=-----~----~------------------------------------_---------------------~ LEACH FIELD: Ii]Yes D No 0 Other IF YES, Location: WESTSIDE Size Ii]Unknown Date of installation of leach field: 1991 0 Installed By:UNKNOWN ~~~~-------------------Have you experienced any malfunctions? 0 Yes 0 No Comments:
SELLER(S) INITIALSrJ =O~~""l'7"'S=;-['d===;L--------------S-U-y-ER-(S-)-IN-IT-IA-LS-Jr='=='L,'J===;[-8:47PM
EDT
© 2014 NEW HAMPSHIRE ASSOCIATION
OF REAL TORS®, INC. ALL RIGHTS RESERVED. FOR USE BY NHAR REAL TOR® MEMBERS ONLY. ALL OTHER USE PROHIBITED Page 1 of 4
12.2014
PROPERTY DISCLOSURE - RESIDENTIAL ONLY New Hampshire Association of REALTORS® Standard Form TO BE COMPLETED BY SELLER PROPERTY LOCATION: 18 Stumpfield Road, East Kingston NH e.
121No 0 Unknown
IS SYSTEM LOCATED ON "DEVELOPED WATERFRONT" as described in RSA 485-A? DYes IF YES, has a site assessment been done? 0 Yes 0 No O? Unknown Source of Information:
_
Comments::~~~~~~~~~_=~~~~~~~~~~~~~~~_=-~~----------FOR ADDITIONAL INFORMATION THE BUYER IS ENCOURAGED TO CONTACT THE NH DEPARTMENT OF ENVIRONMENTAL SERVICES SUBSURFACE SYSTEMS BUREAU LOCATION Attic or Cap Crawl Space Exterior Walls Floors
7. INSULATION
8.
Yes
No
Unknown
121 0 121 0 0
0 121 0
0 0 0 121 0
D D
If YES, Type FG
R30
Amount
0 0
FG
R19
D D D
HAZARDOUS MATERIAL a. UNDERGROUND STORAGE TANKS - Current or previously existing: Are you aware of any past or present underground storage tanks on your property? IF YES: Are tanks currently in use? DYes D No IF NO: How long have tank(s) been out of service? What materials are, or were, stored in the tank(s)? ---:---:-:Age of tank(s): Size of tank(s): Location: -:Are you aware of any past or present problems such as leakage, etc? DYes D No
b.
c.
d.
e.
Unknown
121No
DYes
D Unknown _ _ _ _
Comments:
----------------
Iftanks are no longer in use, have the tanks been removed? D? Yes DNa D Unknown ASBESTOS - Current or previously existing: As insulation on the heating system pipes or ducts? DYes 121No 0 Unknown In the siding? 0 Yes 121No 0 Unknown In the roofing shingles? DYes In flooring tiles? DYes 0 No D Unknown Other _ DYes If YES, Sourceofin~rmation:
0No DNo
DUnknown Unknown
o
~
Comments: ---:-__ -:- __ ~:__----------------------------------------------------RADON/AIR - Current or previously existing: Has the property been tested? DYes D No D Unknown If YES: Date: By: -------------------------------------------Results: If applicable, what remedial steps were taken? _ Has the property been tested since remedial steps? DYes D No Are test results available? DYes DNa Comments: _ RADONIWATER - Current or previously existing: Has the property been tested? DYes 0 No D Unknown If YES: Date: By: _ Results: If applicable, what remedial steps were taken? _ Has the property been tested since remedial steps? DYes D No Are test results available? DYes D No Comments: _ LEAD-BASED PAINT - Current or previously existing: Are you aware of lead-based paint on this property? DYes 0 No If YES: Sourceofin~rmation: _ Are you aware of any cracking, peeling, or flaking lead-based paint? Comments:
SELLER(S)
INITIALS
J
o~
© 2014 NEW HAMPSHIRE Assd8A¥/l5"N
Ld
L
DYes
ONo _ BUYER(S)
INITIALS
J
Ld
OF REAL TORS®, INC. ALL RIGHTS RESERVED. FOR USE BY NHAR REAL TOR® MEMBERS ONLY. ALL OTHER USE PROHIBITED Page 2 of 4
L 12.2014
PROPERTY DISCLOSURE - RESIDENTIAL ONLY New Hampshire TO BE COMPLETED
Association
of REAL TORS® Standard
Form
BY SELLER
PROPERTY LOCATION: 18 Stumpfield Road, East Kingston NH f. Are you aware of any other hazardous materials? If YES: Source of information: Comments:
0 Yes
121No
-------------------------------------------------------------------
_
9. GENERAL INFORMATION a.
b.
Is this property subject to liens, encroachments, easements, rights-of-way, estates, or right of first refusal? 121Yes []? No 0 Unknown If YES, Explain: "'-pe::.::rc...::d=-=e..:;ed=-~~isyoursou~eclinfurmation? Is this property subject to special assessments, betterment DYes 0? No 0 Unknown If YES, Explain: ~~isyoursou~eclinfurm~on?
fees, association
leases, restrictive
covenants,
attachments,
life _ _
fees, or any other transferable
fees? _ _
c.
Are you aware of any onsite landfills or any other factors, such as soil, flooding,
d. e.
OY~ ~No ~YES,&~ain: ~--~-------------Are you aware of any problems with other buildings on the property? DYes 121No If YES, Explain: ---------------Are you receiving a tax exemption or reduction for this property for any reason including but not limited to current use, land conservation, etc.? 0 YES 121NO 0 UNKNOWN If YES, Explain:
drainage,
etc?
----------
f. g. h.
i. j.
Is any part of this property in Current Use? DYes 121No OUnknown If YES, Explain: --------------------Is this property located in a Federally Designated Flood Zone? 0 Yes 121No 0 Unknown Has the property been surveyed? !2IYes ONo 0 Unknown If YES, By:.::.UNKN::..:..:..::..:..O:::...W:.:...:;:N _ If YES, is survey available? 0 Yes 0 No 0 Unknown Howisthepropertyzoned?~Re::.::s..:;id::.::e=n.::.tiill=_ _ Tank/Location: BASEMENT Heating System Age:24years Type:FoRcED HOT WATER Fuel: OIL FIRED Owner of Tank: HOMEOWNER ----------------------------------------------------------------------------Annual Fuel Consumption:..:..UN:..;.KN::.:::..;.O..:..W----'-N Price: Gallons:
~==~~------_
k.
Comments: ----------------~------------------------------------------------------------Roof Age: VARIES Type of Roof Covering: F:::...G:::.....:;SH:.::IN::..:..::G:.::L=ES:::....:..:Wl.::.:·th=IC::.::E=-=&:..:.W.:...:A..:;TE=Rc..:S..:;HI:.::E=L= _ Moisture or leakage::..:N.=.o..:;NE=_
I.
Comments: GARAGE2 years old ,MAIN HOUSE4 years old Foundation/Basement: 0Full 0 Partial 0 Other: Moisture or leakage: ..:;SEA=Sc..:0..:;N..:;AL=-
m. n.
Comments: Chimney(s) Plumbing Comments:
o. p. q.
r. s.
t.
-------------------
0 Type:
POUREDCONCRETE _
------------------------------------------------------------------------------How Many?.::.2 Type: COPPER
Lined?Lye.:..:s'--
Last Cleaned::::...20:..::1c::.4 Problems?~N..:;O Age: 24 years
_ _
Gallons: TANKLESS Domestic Hot Water: Age: .::.24"-"yLe:..::ac:.;rs'--Type: DEMAND Electrical System Amps: 200 !21Circuit Breakers 0 Fuses Comments: ----------------------------------------------------------------~----~------Modifications: Are you aware of any modifications or repairs made without the necessary permits? 0 Yes !21No If Yes, please explain: -==-- __ -==-_ Pest Infestation: Are you aware of any past or present pest infestations? 0 Yes 0 No Type: -----------------Comments: --~------~--------~--~--~--------------~--------------------------------Methamphetamine Production: Do you have knowledge of methamphetamine production ever occurring on the property? (Per RSA477:4-g) DYes I2INo If YES, pleaseexplain: _ Other (e. g. Alarm System,
SELLER(S)
INITIALS
J
06~5
© 2014 NEW HAMPSHIRE ASS~:cjA~f8N
Irrigation System, etc.) _IN_A_C_TI..:..VE-"'-'AL-=-ARM S'-'y'-"S-"-TE_M
lID
_
BUYER(S)
INITIALS
OJ
OF REALTORS®, INC. ALL RIGHTS RESERVED. FOR USE BY NHAR REALTOR® MEMBERS ONLY. ALL OTHER USE PROHIBITED Page 3 of 4
L 12.2014
PROPERTY DISCLOSURE - RESIDENTIAL ONLY New Hampshire Association
of REAL TORS® Standard Form
TO BE COMPLETED BY SELLER PROPERTY LOCATION: 18 Sturnpfield Road, East Kingston NH NOTICE TO PURCHASER(S): PRIOR TO SETTLEMENT YOU SHOULD EXERCISE WHATEVER DUE DILIGENCE YOU DEEM NECESSARY WITH RESPECT TO ADJACENT PARCELS IN ACCORDANCE WITH THE TERMS AND CONDITIONS AS MAY BE CONTAINED IN PURCHASE AND SALES AGREEMENT AND DEPOSIT RECEIPT. YOU SHOULD EXERCISE WHATEVER DUE DILIGENCE YOU DEEM NECESSARY WITH RESPECT TO INFORMATION ON ANY SEXUAL OFFENDERS REGISTERED UNDER NH RSA CHAPTER 651-B. SUCH INFORMATION MAY BE OBTAINED BY CONTACTING THE LOCAL POLICE DEPARTMENT. 10. ADDITIONAL INFORMATION a. ATTACHMENT EXPLAINING CURRENT PROBLEMS, PAST REPAIRS, OR ADDITIONAL INFORMATION? DYes !ZINo b. ADDITIONAL COMMENTS:
ACKNOWLEDGEMENTS: SELLER ACKNOWLEDGES THAT HE/SHE HAS PROVIDED THE ABOVE INFORMATION AND THAT SUCH INFORMATION IS ACCURATE, TRUE AND COMPLETE TO THE BEST OF HIS/HER KNOWLEDGE. SELLER AUTHORIZES THE LISTING BROKER TO DISCLOSE THE INFORMATION CONTAINED HEREIN TO OTHER BROKERS AND PROSPECTIVE PURCHASERS.
SELLER(S) MAY BE RESPONSIBLE AND LIABLE FOR ANY FAILURE TO PROVIDE KNOWN INFORMATION TO BUYER(S). dotloop verified 06113115 8:47PM EDT
~~~ SELLER
I
HUXZ-UION-M5QZ-ZIVB
DATE
~S~E~L~LE~R~--------------------~D~A~T=E~--------
BUYER ACKNOWLEDGES RECEIPT OF THIS PROPERTY DISCLOSURE RIDER AND HEREBY UNDERSTANDS THE PRECEDING INFORMATION WAS PROVIDED BY SELLER AND IS NOT GUARANTEED BY BROKER/AGENT. THIS DISCLOSURE STATEMENT IS NOT A REPRESENTATION, WARRANTY OR GUARANTY AS TO THE CONDITION OF THE PROPERTY BY EITHER SELLER OR BROKER. BUYER IS ENCOURAGED TO UNDERTAKE HIS/HER OWN INSPECTIONS AND INVESTIGATIONS VIA LEGAL COUNSEL, HOME, STRUCTURAL OR OTHER PROFESSIONAL AND QUALIFIED ADVISORS AND TO INDEPENDENTLY VERIFY INFORMATION DIRECTLY WITH THE TOWN OR MUNICIPALITY.
I
~B~U7Y~E~R~--------------------~D7A~TE~--------
I I
~B~U~Y=E~R--------------------~D~A~T=E~----------
© 2014 NEW HAMPSHIRE ASSOCIATION OF REALTORS®, INC. ALL RIGHTS RESERVED. FOR USE BY NHAR REALTOR® MEMBERS ONLY. ALL OTHER USE PROHIBITED Page 4 of 4
12.2014
of REAL TORS® Standard Form
TO BE COMPLETED BY SELLER The following answers and explanations are true and complete to the best of SELLER'S knowledge. This statement has been prepared to assist prospective BUYERS in evaluating SELLER'S property. This disclosure is not a warranty of any kind by the SELLER, or any real estate FIRM representing the SELLER, and is not a substitute for any inspection by the BUYER. SELLERS authorize FIRM in this transaction to disclose the information in this statement to other real estate agents and to prospective buyers of this property. NOTICE TO SELLER(S): COMPLETE ALL INFORMATION AND STATE NOT APPLICABLE OR UNKNOWN AS APPROPRIATE. IF ANY OF THE INFORMATION IN THIS PROPERTY DISCLOSURE FORM CHANGES FROM THE DATE OF COMPLETION, YOU ARE TO NOTIFY THE LISTING FIRM PROMPTLY IN WRITING.
1. SELLER:~Pe=t=er~H=a=ru=e~y~S=r. 2. 3. 4. 5.
_ PROPERTY LOCATION: 18StumpfieldRoad,EastKingstonNH CONDOMINIUM, CO-OP, PUD DISCLOSURE RIDER OR MULTIFAMILY DISCLOSURE RIDER ATTACHED? 0 Yes 0 No SELLER: 0 has 0 has not occupied the property for 24 years. WATER SUPPLY Please answer all questions regardless of type of water supply. a. TYPE OF SYSTEM: D Public 0 Private D Seasonal 0 Unknown Drilled 0 Dug 0 Other _ b. INSTAL~TION: Location:~SO~~~~S=ID=E~OF~LO~T~ ~ Installed By:UNKNOWN Date of Installation::::.19:..:9..;:cl _ What is the source of your information? _FIR----'-ST"'-HAND-'-'_ c. USE: Number of persons currently using the system: =.2 __ -==-Does system supply water for more than one household? DYes 0 No d. MALFUNCTIONS: Are you aware of or have you experienced any malfunctions with the (public/private/other) water systems? Pump: DYes 0 No 0 N/A Quantity: 0 Yes 0 No Quality: DYes 0 No 0 Unknown If YES to any question, please explain in Comments below or with attachment. e. WATER TEST: Have you had the water tested? 0 Yes D No Date of most recent test NOTRECENTLY DATEUNK IF YES to any question, please explain in Comments below or with attachment. Are you aware of any test results reported as unsatisfactory or satisfactory with notations? DYes 0 No IF YES, are test results available? DYes 0 No What steps were taken to remedy the problem?
o
=-
COMMENTS: 6.
----------------------------------------------------------------------------
SEWAGE DISPOSAL SYSTEM a. TYPE OF SYSTEM: Public: DYes Private: 0Yes b.
c.
d.
_
0 No D No
Community/Shared:
o Unknown
D? Yes 0 No
Septic Design Available: 0 Yes 0 No IF PUBLIC OR COMMUNITY/SHARED Have you experienced any problems such as line or other malfunctions? DYes 0 No What steps were taken to remedy the problem? _ IF PRIVATE: TANK: 0 Septic Tank 0 Holding Tank 0 Cesspool 0 Unknown 0 Other ------------------Tank Size Gal. 0 Unknown 0 Other --~~-------------------------------------Tank Type 0Concrete DMetal DUnknown D Other _ =.=2_ Location: WESTSIDELOT 0 Location Unknown Date of Installation:1991 Date of Last Servicing: NOV2013 Name of Company Servicing Tank:_PE_T_E-'-'S_S_EWE R _ Have you experienced any malfunctions? 0 Yes 0 No Comments: __ ~=-----~----~------------------------------------_---------------------~ LEACH FIELD: Ii]Yes D No 0 Other IF YES, Location: WESTSIDE Size Ii]Unknown Date of installation of leach field: 1991 0 Installed By:UNKNOWN ~~~~-------------------Have you experienced any malfunctions? 0 Yes 0 No Comments:
SELLER(S) INITIALSrJ =O~~""l'7"'S=;-['d===;L--------------S-U-y-ER-(S-)-IN-IT-IA-LS-Jr='=='L,'J===;[-8:47PM
EDT
© 2014 NEW HAMPSHIRE ASSOCIATION
OF REAL TORS®, INC. ALL RIGHTS RESERVED. FOR USE BY NHAR REAL TOR® MEMBERS ONLY. ALL OTHER USE PROHIBITED Page 1 of 4
12.2014
PROPERTY DISCLOSURE - RESIDENTIAL ONLY New Hampshire Association of REALTORS® Standard Form TO BE COMPLETED BY SELLER PROPERTY LOCATION: 18 Stumpfield Road, East Kingston NH e.
121No 0 Unknown
IS SYSTEM LOCATED ON "DEVELOPED WATERFRONT" as described in RSA 485-A? DYes IF YES, has a site assessment been done? 0 Yes 0 No O? Unknown Source of Information:
_
Comments::~~~~~~~~~_=~~~~~~~~~~~~~~~_=-~~----------FOR ADDITIONAL INFORMATION THE BUYER IS ENCOURAGED TO CONTACT THE NH DEPARTMENT OF ENVIRONMENTAL SERVICES SUBSURFACE SYSTEMS BUREAU LOCATION Attic or Cap Crawl Space Exterior Walls Floors
7. INSULATION
8.
Yes
No
Unknown
121 0 121 0 0
0 121 0
0 0 0 121 0
D D
If YES, Type FG
R30
Amount
0 0
FG
R19
D D D
HAZARDOUS MATERIAL a. UNDERGROUND STORAGE TANKS - Current or previously existing: Are you aware of any past or present underground storage tanks on your property? IF YES: Are tanks currently in use? DYes D No IF NO: How long have tank(s) been out of service? What materials are, or were, stored in the tank(s)? ---:---:-:Age of tank(s): Size of tank(s): Location: -:Are you aware of any past or present problems such as leakage, etc? DYes D No
b.
c.
d.
e.
Unknown
121No
DYes
D Unknown _ _ _ _
Comments:
----------------
Iftanks are no longer in use, have the tanks been removed? D? Yes DNa D Unknown ASBESTOS - Current or previously existing: As insulation on the heating system pipes or ducts? DYes 121No 0 Unknown In the siding? 0 Yes 121No 0 Unknown In the roofing shingles? DYes In flooring tiles? DYes 0 No D Unknown Other _ DYes If YES, Sourceofin~rmation:
0No DNo
DUnknown Unknown
o
~
Comments: ---:-__ -:- __ ~:__----------------------------------------------------RADON/AIR - Current or previously existing: Has the property been tested? DYes D No D Unknown If YES: Date: By: -------------------------------------------Results: If applicable, what remedial steps were taken? _ Has the property been tested since remedial steps? DYes D No Are test results available? DYes DNa Comments: _ RADONIWATER - Current or previously existing: Has the property been tested? DYes 0 No D Unknown If YES: Date: By: _ Results: If applicable, what remedial steps were taken? _ Has the property been tested since remedial steps? DYes D No Are test results available? DYes D No Comments: _ LEAD-BASED PAINT - Current or previously existing: Are you aware of lead-based paint on this property? DYes 0 No If YES: Sourceofin~rmation: _ Are you aware of any cracking, peeling, or flaking lead-based paint? Comments:
SELLER(S)
INITIALS
J
o~
© 2014 NEW HAMPSHIRE Assd8A¥/l5"N
Ld
L
DYes
ONo _ BUYER(S)
INITIALS
J
Ld
OF REAL TORS®, INC. ALL RIGHTS RESERVED. FOR USE BY NHAR REAL TOR® MEMBERS ONLY. ALL OTHER USE PROHIBITED Page 2 of 4
L 12.2014
PROPERTY DISCLOSURE - RESIDENTIAL ONLY New Hampshire TO BE COMPLETED
Association
of REAL TORS® Standard
Form
BY SELLER
PROPERTY LOCATION: 18 Stumpfield Road, East Kingston NH f. Are you aware of any other hazardous materials? If YES: Source of information: Comments:
0 Yes
121No
-------------------------------------------------------------------
_
9. GENERAL INFORMATION a.
b.
Is this property subject to liens, encroachments, easements, rights-of-way, estates, or right of first refusal? 121Yes []? No 0 Unknown If YES, Explain: "'-pe::.::rc...::d=-=e..:;ed=-~~isyoursou~eclinfurmation? Is this property subject to special assessments, betterment DYes 0? No 0 Unknown If YES, Explain: ~~isyoursou~eclinfurm~on?
fees, association
leases, restrictive
covenants,
attachments,
life _ _
fees, or any other transferable
fees? _ _
c.
Are you aware of any onsite landfills or any other factors, such as soil, flooding,
d. e.
OY~ ~No ~YES,&~ain: ~--~-------------Are you aware of any problems with other buildings on the property? DYes 121No If YES, Explain: ---------------Are you receiving a tax exemption or reduction for this property for any reason including but not limited to current use, land conservation, etc.? 0 YES 121NO 0 UNKNOWN If YES, Explain:
drainage,
etc?
----------
f. g. h.
i. j.
Is any part of this property in Current Use? DYes 121No OUnknown If YES, Explain: --------------------Is this property located in a Federally Designated Flood Zone? 0 Yes 121No 0 Unknown Has the property been surveyed? !2IYes ONo 0 Unknown If YES, By:.::.UNKN::..:..:..::..:..O:::...W:.:...:;:N _ If YES, is survey available? 0 Yes 0 No 0 Unknown Howisthepropertyzoned?~Re::.::s..:;id::.::e=n.::.tiill=_ _ Tank/Location: BASEMENT Heating System Age:24years Type:FoRcED HOT WATER Fuel: OIL FIRED Owner of Tank: HOMEOWNER ----------------------------------------------------------------------------Annual Fuel Consumption:..:..UN:..;.KN::.:::..;.O..:..W----'-N Price: Gallons:
~==~~------_
k.
Comments: ----------------~------------------------------------------------------------Roof Age: VARIES Type of Roof Covering: F:::...G:::.....:;SH:.::IN::..:..::G:.::L=ES:::....:..:Wl.::.:·th=IC::.::E=-=&:..:.W.:...:A..:;TE=Rc..:S..:;HI:.::E=L= _ Moisture or leakage::..:N.=.o..:;NE=_
I.
Comments: GARAGE2 years old ,MAIN HOUSE4 years old Foundation/Basement: 0Full 0 Partial 0 Other: Moisture or leakage: ..:;SEA=Sc..:0..:;N..:;AL=-
m. n.
Comments: Chimney(s) Plumbing Comments:
o. p. q.
r. s.
t.
-------------------
0 Type:
POUREDCONCRETE _
------------------------------------------------------------------------------How Many?.::.2 Type: COPPER
Lined?Lye.:..:s'--
Last Cleaned::::...20:..::1c::.4 Problems?~N..:;O Age: 24 years
_ _
Gallons: TANKLESS Domestic Hot Water: Age: .::.24"-"yLe:..::ac:.;rs'--Type: DEMAND Electrical System Amps: 200 !21Circuit Breakers 0 Fuses Comments: ----------------------------------------------------------------~----~------Modifications: Are you aware of any modifications or repairs made without the necessary permits? 0 Yes !21No If Yes, please explain: -==-- __ -==-_ Pest Infestation: Are you aware of any past or present pest infestations? 0 Yes 0 No Type: -----------------Comments: --~------~--------~--~--~--------------~--------------------------------Methamphetamine Production: Do you have knowledge of methamphetamine production ever occurring on the property? (Per RSA477:4-g) DYes I2INo If YES, pleaseexplain: _ Other (e. g. Alarm System,
SELLER(S)
INITIALS
J
06~5
© 2014 NEW HAMPSHIRE ASS~:cjA~f8N
Irrigation System, etc.) _IN_A_C_TI..:..VE-"'-'AL-=-ARM S'-'y'-"S-"-TE_M
lID
_
BUYER(S)
INITIALS
OJ
OF REALTORS®, INC. ALL RIGHTS RESERVED. FOR USE BY NHAR REALTOR® MEMBERS ONLY. ALL OTHER USE PROHIBITED Page 3 of 4
L 12.2014
PROPERTY DISCLOSURE - RESIDENTIAL ONLY New Hampshire Association
of REAL TORS® Standard Form
TO BE COMPLETED BY SELLER PROPERTY LOCATION: 18 Sturnpfield Road, East Kingston NH NOTICE TO PURCHASER(S): PRIOR TO SETTLEMENT YOU SHOULD EXERCISE WHATEVER DUE DILIGENCE YOU DEEM NECESSARY WITH RESPECT TO ADJACENT PARCELS IN ACCORDANCE WITH THE TERMS AND CONDITIONS AS MAY BE CONTAINED IN PURCHASE AND SALES AGREEMENT AND DEPOSIT RECEIPT. YOU SHOULD EXERCISE WHATEVER DUE DILIGENCE YOU DEEM NECESSARY WITH RESPECT TO INFORMATION ON ANY SEXUAL OFFENDERS REGISTERED UNDER NH RSA CHAPTER 651-B. SUCH INFORMATION MAY BE OBTAINED BY CONTACTING THE LOCAL POLICE DEPARTMENT. 10. ADDITIONAL INFORMATION a. ATTACHMENT EXPLAINING CURRENT PROBLEMS, PAST REPAIRS, OR ADDITIONAL INFORMATION? DYes !ZINo b. ADDITIONAL COMMENTS:
ACKNOWLEDGEMENTS: SELLER ACKNOWLEDGES THAT HE/SHE HAS PROVIDED THE ABOVE INFORMATION AND THAT SUCH INFORMATION IS ACCURATE, TRUE AND COMPLETE TO THE BEST OF HIS/HER KNOWLEDGE. SELLER AUTHORIZES THE LISTING BROKER TO DISCLOSE THE INFORMATION CONTAINED HEREIN TO OTHER BROKERS AND PROSPECTIVE PURCHASERS.
SELLER(S) MAY BE RESPONSIBLE AND LIABLE FOR ANY FAILURE TO PROVIDE KNOWN INFORMATION TO BUYER(S). dotloop verified 06113115 8:47PM EDT
~~~ SELLER
I
HUXZ-UION-M5QZ-ZIVB
DATE
~S~E~L~LE~R~--------------------~D~A~T=E~--------
BUYER ACKNOWLEDGES RECEIPT OF THIS PROPERTY DISCLOSURE RIDER AND HEREBY UNDERSTANDS THE PRECEDING INFORMATION WAS PROVIDED BY SELLER AND IS NOT GUARANTEED BY BROKER/AGENT. THIS DISCLOSURE STATEMENT IS NOT A REPRESENTATION, WARRANTY OR GUARANTY AS TO THE CONDITION OF THE PROPERTY BY EITHER SELLER OR BROKER. BUYER IS ENCOURAGED TO UNDERTAKE HIS/HER OWN INSPECTIONS AND INVESTIGATIONS VIA LEGAL COUNSEL, HOME, STRUCTURAL OR OTHER PROFESSIONAL AND QUALIFIED ADVISORS AND TO INDEPENDENTLY VERIFY INFORMATION DIRECTLY WITH THE TOWN OR MUNICIPALITY.
I
~B~U7Y~E~R~--------------------~D7A~TE~--------
I I
~B~U~Y=E~R--------------------~D~A~T=E~----------
© 2014 NEW HAMPSHIRE ASSOCIATION OF REALTORS®, INC. ALL RIGHTS RESERVED. FOR USE BY NHAR REALTOR® MEMBERS ONLY. ALL OTHER USE PROHIBITED Page 4 of 4
12.2014
