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DocuSign Envelope ID: E45CCD45-DC6C-44C9-BE0C-E28B0DDC9A76PROPERTY LOCATED AT: 796 Main Road, Holden , ME 04429PROPERTY DISCLOSUREUnder Maine Law, certain information must be made available to buyers prior to or during preparation of an offer.This statement has been prepared to assist prospective buyers in evaluating this property. This disclosure is not awarranty of the condition of the property and is not part of any contract between Seller and any Buyer. Sellerauthorizes the disclosure of the information in this statement to other real estate licensees and to prospectivebuyers of this property. The Seller agrees to provide prompt notice of any changes in the information and thisform will be appropriately changed with an amendment date. Inspections are highly recommended.DO NOT LEAVE ANY QUESTIONS BLANK. WRITE N/A OR UNKNOWN IF NEEDED.SECTION I WATER SUPPLYTYPE OF SYSTEM:PublicX DrilledX PrivateDugSeasonalOtherUnknownMALFUNCTIONS: Are you aware of or have you experienced any malfunctions with the(public/private/other) water system?Pump: .Yes X NoN/AQuantity: .Yes X NoUnknownQuality: .Yes X NoUnknownIf Yes to any question, please explain in the comment section below or with attachment.WATER TEST:Have you had the water tested? . XIf Yes, Date of most recent test: 2018Are test results available? . XTo your knowledge, have any test results ever been reported as unsatisfactoryor satisfactory with notation? .If Yes, are test results available? . XWhat steps were taken to remedy the problem?YesYesNoNoYesYesX NoNoIF PRIVATE:INSTALLATION: Location: Left front of the buildingInstalled by: UnknownDate of Installation: 1997USE:Number of persons currently using system: VariesDoes system supply water for more than one household?Comments: Previous business tested water annually without any problemsYes X NoUnknownSource of Section I information: OwnerSeller InitialsPage 1 of 7Buyer InitialsERA Dawson Bradford Company, 417 Main Street Bangor ME 4401Phone: (207)992-4090Patricia QuirkProduced with zipForm by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 www.zipLogix.comFax:796 Main Road
DocuSign Envelope ID: E45CCD45-DC6C-44C9-BE0C-E28B0DDC9A76PROPERTY LOCATED AT: 796 Main Road, Holden , ME 04429SECTION II WASTE WATER DISPOSALTYPE OF SYSTEM:Public X PrivateQuasi-PublicUnknownIF PUBLIC OR QUASI-PUBLIC:Have you had the sewer line inspected?.If Yes, what results:Have you experienced any problems such as line or other malfunctions? .What steps were taken to remedy the problem?YesNoYesNoIF PRIVATE:Tank:Holding TankCesspoolOther:X Septic TankTank Size:500 GallonUnknownOther:X 1000 GallonTank Type: X ConcreteMetalUnknownOther:Location: Right side of buildingORUnknownDate installed: 1997Date last pumped: 2018Name of pumping company: Berry's SepticHave you experienced any malfunctions? .Yes X NoIf Yes, give the date and describe the problem:Date of last servicing of tank:Name of company servicing tank:Leach Field: . X YesIf Yes, Location: Right side of parking lotDate of installation of leach field: 1997Installed by:NoDate of last servicing of leach field:Company servicing leach field:Have you experienced any malfunctions? .If Yes, give the date and describe the problem and what steps were taken to remedy:Do you have records of the design indicating the # of bedrooms the system was designed for?If Yes, are they available? .Is System located in a Shoreland Zone? .Yes X NoIs System located in a Coastal Shoreland Zone?.Yes X NoComments:Source of Section II information: OwnerSeller InitialsPage 2 of 7UnknownYesYesNoYesNoUnknownUnknownBuyer InitialsProduced with zipForm by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026www.zipLogix.comNo796 Main Road
DocuSign Envelope ID: E45CCD45-DC6C-44C9-BE0C-E28B0DDC9A76PROPERTY LOCATED AT: 796 Main Road, Holden , ME 04429SECTION III HEATING SYSTEM(S)/HEATING SOURCES(S)Heating System(s) or Source(s)SYSTEM 1HWBBTYPE(S)1997Age of system(s) or source(s)Name of company that servicesDead Riversystem(s) or source(s)Fall 2018Date of most recent service callAnnual consumption per system orsource (i.e., gallons, kilowatt hours,cords)Malfunction per system(s) orsource(s) within past 2 yearsOther pertinent informationSYSTEM 2SYSTEM 3Are there fuel supply lines? . XAre any buried? .Are all sleeved? . XChimney(s): .If Yes, are they lined: .Is more than one heat source vented through one flue? .Had a chimney fire: .Has chimney been inspected? .If Yes, when:Date chimney last cleaned:Direct/Power Vent: . XComments:Source of Section III information: OwnerSYSTEM 4YesYesYesYesYesYesYesYesNoX NoNoX UnknownUnknownUnknownSECTION IV HAZARDOUS MATERIALThe licensee is disclosing that the Seller is making representations contained herein.A. UNDERGROUND STORAGE TANKS - Are there now, or have there ever been, any undergroundstorage tanks on the property? .If Yes, are tanks in current use? .If no longer in use, how long have they been out of service?If tanks are no longer in use, have tanks been abandoned according to DEP?Are tanks registered with DEP? .Age of tank(s):Size of tank(s):Location:Seller InitialsPage 3 of 7YesYesX NoNoUnknownUnknownYesYesNoNoUnknownUnknownBuyer InitialsProduced with zipForm by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026www.zipLogix.com796 Main Road
DocuSign Envelope ID: E45CCD45-DC6C-44C9-BE0C-E28B0DDC9A76PROPERTY LOCATED AT: 796 Main Road, Holden , ME 04429What materials are, or were, stored in the tank(s)?Have you experienced any problems such as leakage: .Comments:Source of information:B. ASBESTOS Is there now or has there been asbestos:YesNoUnknownAs insulation on the heating system pipes or duct work? .In the ceilings? .In the siding? .In the roofing shingles? .In flooring tiles? .Other:Comments:Source of information:C. RADON/AIR - Current or previously wnUnknownUnknownUnknownUnknownUnknownHas the property been tested? .If Yes: Date:By:Results:If applicable, what remedial steps were taken?Has the property been tested since remedial steps? .Are test results available? .Results/Comments:Source of information:D. RADON/WATER - Current or previously existing:YesX NoUnknownYesYesNoNoUnknownHas the property been tested? .If Yes: Date:By:Results:If applicable, What remedial steps were taken?Has the property been tested since remedial steps? .Are test results available? .Results/Comments:Source of information: OwnerYesX NoUnknownYesYesNoNoUnknownSeller InitialsPage 4 of 7Buyer InitialsProduced with zipForm by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026www.zipLogix.com796 Main Road
DocuSign Envelope ID: E45CCD45-DC6C-44C9-BE0C-E28B0DDC9A76PROPERTY LOCATED AT: 796 Main Road, Holden , ME 04429E. LEAD-BASED PAINT/PAINT HAZARDS (Note: Lead-based paint is most commonly found in homesconstructed prior to 1978)Is there now or has there ever been lead-based paint and/or lead-based paint hazards on the property? .YesUnknownUnknown (but possible due to age)X NoIf Yes, describe location and basis for determination:Do you know of any records/reports pertaining to such lead-based paint/lead-based paint hazards:YesNoIf Yes, describe:Are you aware of any cracking, peeling or flaking paint? .YesNoComments:Source of information:F. OTHER HAZARDOUS MATERIALS - Current or previously existing:TOXIC MATERIAL: .YesX NoX NoX NoUnknownLAND FILL: .YesUnknownRADIOACTIVE MATERIAL: .YesUnknownOther:Source of information:Buyers are encouraged to seek information from professionals regarding any specific issue or concern.SECTION V GENERAL INFORMATIONIs the property subject to or have the benefit of any encroachments, easements, rights-of-way, leases, rights offirst refusal, life estates, private ways, trails, private road/homeowner associations (including condominiumsand PUD's) or restrictive covenants? .YesUnknownX NoIf Yes, explain:Source of information:Answer only one of the following sets of questions depending on the type of property:If the subject property consists of at least one, but not more than four, residential dwelling units:Is access by means of a way owned and maintained by the State, a county, or a municipalityover which the public has a right to pass? .YesUnknownX NoIf No, who is responsible for maintenance?For all other properties:Are there any abandoned or discontinued town ways, any public easements or any private roads locatedon the property or abutting the property? .YesUnknownX NoIf Yes, describe:If Yes, who is responsible for maintenance (including road association, if any):Seller InitialsPage 5 of 7Buyer InitialsProduced with zipForm by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026www.zipLogix.com796 Main Road
DocuSign Envelope ID: E45CCD45-DC6C-44C9-BE0C-E28B0DDC9A76PROPERTY LOCATED AT: 796 Main Road, Holden , ME 04429Are there any tax exemptions or reductions for this property for any reason including but not limited to:Tree Growth, Open Space and Farmland, Veteran's, Homestead Exemption, Blind, Working Waterfront?.YesUnknownX NoIf Yes, explain:Is a Forest Management and Harvest Plan available?.YesUnknownX NoIs house now covered by flood insurance policy (not a determination of flood zone)YesUnknownX NoEquipment leased or not owned (e.g., propane tank, hot water heater, satellite dish): Type:1997Year Principal Structure Built:1997What year did Seller acquire property?2016Roof: Year Shingles/Other Installed:Water, moisture or leakage: None knownComments: Architectural long life shingles installedFoundation/Basement:Is there a Sump Pump? .YesUnknownX NoWater, moisture or leakage since you owned the property: .YesUnknownX NoPrior water, moisture or leakage? .YesUnknownX NoComments:Mold: Has the property ever been tested for mold? .YesUnknownX NoIf Yes, are test results available? .YesNoElectrical:Fuses X Circuit BreakerOther:UnknownHas all or a portion of the property been surveyed? .NoUnknownX YesIf Yes, is the survey available? .NoUnknownX YesManufactured Housing ‒ Is the residence a:Mobile Home .YesUnknownX NoModular .YesUnknownX NoKNOWN MATERIAL DEFECTS about Physical Condition and/or value of Property, including those that mayhave an adverse impact on health/safety: None KnownSource of Section V information: OwnerSeller InitialsPage 6 of 7Buyer InitialsProduced with zipForm by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026www.zipLogix.com796 Main Road
DocuSign Envelope ID: E45CCD45-DC6C-44C9-BE0C-E28B0DDC9A76PROPERTY LOCATED AT: 796 Main Road, Holden , ME 04429SECTION VI ADDITIONAL INFORMATIONATTACHMENTS EXPLAINING CURRENT PROBLEMS, PAST REPAIRS OR ADDITIONALINFORMATION IN ANY SECTION IN DISCLOSURE: .YesNoSeller shall be responsible and liable for any failure to provide known information regarding known materialdefects to the Buyer.Neither Seller nor any Broker makes any representations as to the applicability of, or compliance with, any codesof any sort, whether state, municipal, federal or any other, including but not limited to fire, life safety, building,electrical or plumbing.As Sellers, we have provided the above information and represent that all information is correct. To the best ofour knowledge, all systems and equipment, unless otherwise noted on this form, are in operational condition.6/7/2019SELLERAshley GallantDATESELLERDATESELLERDATESELLERDATEI/We have read and received a copy of this disclosure, the arsenic in wood fact sheet, the arsenic in waterbrochure, and understand that I/we should seek information from qualified professionals if I/we have questionsor concerns.BUYERDATEBUYERDATEBUYERDATEBUYERDATEPage 7 of 7Maine Association of REALTORS /Copyright 2019.All Rights Reserved. Revised 2019.Produced with zipForm by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026www.zipLogix.com796 Main Road
Produced with zipForm by zipLogix 18070 Fifteen Mile Road, Fraser, Michigan 48026 www.zipLogix.com 796 Main Road, Holden , ME 04429 X X X X Right side of building 1997 2018 Berry's Septic X X Right side of parking lot 1997 X X Owner 796 Main Road DocuSign Envelope ID: E45CCD45-DC6C-44C9-BE0C-E28B0DDC9A76
