Fill and Sign the Maine Residential Real Estate Sales Disclosure Statement Form

Property Disclosure Statement – Page 1 of 2 MAINE PROPERTY DISCLOSURE STATEMENT Property Located At: WATER SUPPLY: Public Private (If private Please answer 1 thru 6) 1. Type of System: 2. Location: 3. Malfunctions: Yes No (If Yes, please explain when, and type of malfunction and if repaired, & by whom) 4. Date of Installation: 5. Date of most Recent Water Test: 6. Have you experienced any problem such as an “Unsatisfactory Water Test” and/or a “Water Test with Notation?” Yes No (If Yes, please explain) INSULATION: Type of Insulation in: 1. Attic: 2. Crawl Space: 3. Exterior Walls: HEATING SYSTEM OR HEATING SOURCE: 1. The type of heating system or source: 2. The age of the heating system or source: 3. The name of the company that services the heating system or source: 4. The date of the most recent service call on the heating system or source: 5. The annual fuel consumption per heating system or source: 6. Any malfunctions per heating system or source within the past 2 years: WASTE DISPOSAL SYSTEM: Public: Private (If Private, please Answer 1 thru 11) 1. Type of System: 2. Size of Tank: 3. Type of Tank: 4. Location of Tank: 5. Malfunctions of Tank: Yes No (If Yes, please explain when, type of malfunction & if repaired) 6. Date of Tank Installation: 7. Location of Leach Field: Property Disclosure Statement – Page 2 of 2 8. Malfunctions of Leach Field: Yes No (If Yes, please explain malfunction & if repaired) 9. Date of Leach Field Installation: 10. Date of Most Recent Servicing: 11. Name of Service Contractor: B. Has Seller Experienced any system and/or line malfunctions with the Sewer? Yes No C. Sump Pump Yes No Has Seller any water problems in the Basement? Yes No (If Yes, explain) D. Is the Property located in a Flood Zone? Yes No HAZARDOUS MATERIAL: Do you have any knowledge of the current existence or prior existence of known Hazardous Materials on and/or in the real estate including, but not limited to: Asbestos: Yes No Lead Paint for pre-1978 homes: Yes No Radon: Yes No Unknown: Underground Tanks: Yes No Unknown: (If yes, please explain) KNOWN DEFECTS: Other than noted above, are you aware of any defects in the property? Yes No (If yes, please explain) Notice: Buyer(s) are encouraged to seek information from professionals regarding any specific issues or concerns. To the best of my knowledge and belief, the information provided herein is accurate and true. Seller Signature Seller Name Date By signing below, Purchaser indicates receipt and review of this document and any attached disclosures. Purchaser Signature Purchaser Name Date About half of all Maine homes have a deck, or playground or some other structure that is made of wood treated with arsenic. This wood is called “CCA pressure-treated wood” or just “pressure-treated” wood. The wood was treated with arsenic to protect against rot and insects. Too much arsenic can cause cancer. So it is good to prevent arsenic getting into your body when you can. When you touch wood treated with arsenic, you can get arsenic on your hands. The arsenic on your hands can get into your mouth if you are not careful about washing be- fore eating. Young children are most at risk be- cause they are more likely to put their hands in their mouths. The good news is that there are simple things you can do to protect yourself and your family from arsenic treated wood. This fact sheet will tell you how. Children touching unsealed treated wood, and then putting their hands in their mouths is the biggest concern. Does Your New Home Have Arsenic (CCA) Treated Wood? Fact Sheet: Arsenic Treated Wood Maine CDC Environmental and Occupational Health Program Common Questions What is CCA wood? CCA wood is made by dipping the wood in a mixture of chemi- cals. These chemicals include chromium, copper, and arsenic. This protects the wood against insects and rot. This wood is known as CCA wood or “pressure treated” wood. Most pressure treated wood in the U.S. is CCA wood. After December 31, 2003, no more CCA wood will be made for use around homes. CCA wood may still be sold for home use until April 1, 2004 in the state of Maine. What is Arsenic? Arsenic is found in soil and rocks. Most people get a little arsenic every day from the food they eat. Also, some people have arsenic in their private wells, which is why it is impor- tant that anyone with a well have it tested for arsenic. People who are exposed to too much arsenic over many years are more likely to get cancer. First: Does your house have arsenic treated (CCA) wood? When arsenic treated wood is new, it tends to have a greenish tint. When CCA wood is older, it is harder to tell. Ask your realtor if the seller knows whether CCA wood was used. You can also test the wood to find out if it contains arsenic. Call us to find out how. Second: If so, reduce contact with the arsenic. You can lower the amount of arsenic on the surface of the wood by applying a coating on the wood every 1-2 years. Oil-based sealants, varnishes, or polyurethane work best for sealing arse- nic in the wood. Be sure to wash your children’s hands when they finish playing on or near CCA wood. Third: If you have any questions, call us toll-free in Maine: 866-292-3474 IF YOU WORK WITH CCA WOOD
NEVER burn CCA wood.
Wear gloves when handling CCA wood
Wear a dust mask when sanding or cutting CCA wood
Don’t work with CCA wood in an enclosed area (like a garage) Apply a coating to seal the wood every 1-2 years TO LEARN MORE Eric Frohmberg Environmental and Occupational Health Program Maine CDC Toll-free in Maine 866- 292-3474 TTY: 207-287-8066 www.maine.gov/dhhs/ eohp Department of Health and Human Services 11 State House Station Augusta, ME 04333 Toll Free in Maine: 866-292-3474 Fax: 207-287-3981 TTY: 207-287-8066 Email: ehu@maine.gov How to Test Your Well Water 1. Call a lab.• Call a certified lab and ask for an arsenic test kit for your well water. You can find a lab at this website: wellwater.maine.gov. Or call the Maine Lab Certification Officer at 207-287-1929. • If you have never tested your well water for bacteria, nitrites and nitrates, or other chemicals like radon, uranium and f louride, ask your lab for a test kit for all of these. 2. Do the test. • Your test kit will arrive in the mail. It will have empty bottles, directions and forms to fill out. • Follow the directions and mail the bottles back to the lab with the forms. • Watch a video on how to do a water test: youtube.com/user/MainePublicHealth 3. Get your results. • Your test results will come to you in the mail. • If you have too much arsenic in your water, or if you are not sure you understand your test results, call 866-292-3474 (toll-free in Maine) or 207-287- 4311 to speak to an expert. Why Arsenic is Bad People who drink water with too much arsenic for many years are more likely to get cancer. Arsenic can cause skin, bladder and lung cancers. It may cause low birthweight and affect brain development in babies if pregnant women drink water with too much arsenic in it. Arsenic can also affect brain development in young children. Other problems from drinking water with very high arsenic levels include: stomach pain, nausea, diarrhea, numbness or tingling in the hands and feet and changes in skin. Your chance of having any of these health problems depends on: • how much arsenic is in your water; • how much water you drink; • how long you have been drinking the water. Solving Arsenic Problems There are actions you can take to protect your family if your water has too much arsenic. First, you can switch to bottled water for drinking and making drinks. This will allow you time to decide if you want to install a water treatment system. Call us at 866-292-3474 (toll-free in Maine) or 207- 287-4311 if you have high arsenic. We can help you decide how to solve the problem. Your water looks, smells and tastes fine. So why do you need to test it? It is hard to believe that water that looks, smells and tastes fine may not be safe to drink. But the truth is that 1 in 10 wells in Maine has water that is high in arsenic. There are wells high in arsenic in all parts of Maine. Protect your family. Test your well for arsenic every 3 to 5 years. Have you tested your well water for arsenic? Protect your family. Test your well. • For more information: wellwater.maine.gov • Call for advice: 866-292-3474 • TTY: Call Maine Relay 711 April 2015 If the property is a shoreland property as described below, use this additional shoreland disclosure. 30-A Maine Revised Statutes § 4216 Disclosure for transfer of shoreland property with subsurface waste water disposal system. 1. Shoreland areas. Any person transferring property on which a subsurface waste water disposal system is located within a s horeland area, as described in Maine Revised Statutes Title 38, section 435 (appended), shall provide the transferee with a written statement by the transferor as to whether the system has malfunctioned during the 180 days preceding the date of transfer. Has the abovementioned subsurface waste water disposal system malfunctioned during the 180 days preceding the date of transfer? Yes __ No __ 2. Coastal shoreland areas. In addition to the requirements of subsection 1, the following provisions apply to the transfer of property within a coastal shorel and area as described in Title 38, section 435. A. A person purchasing property on which a subs urface waste water disposal system is located within a coasta l shoreland area, as described in Title 38, section 435, shall prior to purchase have the system inspected by a person certified by the department except that if it is impossible due to weather conditions to pe rform an inspection of the system prior to the purchase, the inspection mu st be performed within 9 months after transfer of the property. If the inspection finds that the system is malfunctioning, the system must be repaired or replaced within one year after tran sfer of the property. For purposes of this paragraph only, indications of a malfunctioni ng system are limited to the indications specified in the definition of "malfunctioning system" in the department's rules regulating subsurface waste water disposal that are in effect on the effective date of this paragraph. B. A subsurface waste water disposal system that has been installed pursuant to section 4211 and rules adopted under Title 22, section 42 within 3 years prior to the closing date of the transfer of property is not subject to the inspection requirements of paragraph A. C. If the seller of the shoreland property ha s a written inspection report for an inspection of the subsurface waste water disposal system that was performed within 3 years prior to the date of the transfer of property by a pe rson certified by the department, then the seller shall provide the inspection results to the purch aser, and the purchaser is not required to have the system inspected pursuant to paragraph A. D. The inspection described in paragraph A is not required if the purchaser certifies to the local plumbing inspector that the purchas er will replace the subsurface waste water disposal system within one year of the transfer of property. ______________________________ _________________________________ Signature of Seller Signature of Purchaser Title 38: WATERS AND NAVIGATION Chapter 3: PROTECTION AND IMPROVEMENT OF WATERS Subchapter 1: ENVIRONMENTAL PROTECTION BOARD Article 2-B: MANDATORY SHORELAND ZONING HEADING: PL 1991, C. 346, §1 (RPR) §435. Shoreland areas To aid in the fulfillment of the State's role as tr ustee of its waters and to promote public health, safety and the general welfare, it is declared to be in the public interest th at shoreland areas be subject to zoning and land use controls. Shorelan d areas include those areas within 250 feet of the normal high-water line of any great pond, rive r or saltwater body, within 250 feet of the upland edge of a coastal wetland, within 250 feet of the upland edge of a freshwater wetland except as otherwise provided in section 438-A, s ubsection 2, or within 75 feet of the high-water line of a stream. The purposes of these controls are to further the maintenance of safe and healthful conditions; to prevent and control water pollution; to protect fish spawning grounds, aquatic life, bird and other w ildlife habitat; to protect buildings and lands from flooding and accelerated erosion; to protect archaeological and historic resources; to protect commercial fishing and maritime industries; to protect freshw ater and coastal wetlands; to control building sites, placement of structures and land uses; to conserve shore cove r, and visual as well as actual points of access to inland and co astal waters; to conserve natural beauty and open space; and to anticipate and respond to the impacts of development in shoreland areas. [1995, c. 625, Pt. B, §15 (AMD) .] It is further declared that, in accordance w ith Title 12, section 402, certain river and stream segments, as identified in the Department of Conservation's 1982 Maine Rivers Study and as specifically delineated in section 437, are sign ificant river segments and deserve special shoreland zoning controls desi gned to protect their natural and recreational features. [1987, c. 815, §§1,11 (RPR) .] Zoning ordinances adopted pursuant to this article need not depend upon the existence of a zoning ordinance for all of the land and water ar eas within a municipality, notwithstanding Title 30-A, section 4503, as it is the intention of the Legislature to recognize that it is reasonable for municipalities to treat shorela nd areas specially and immediat ely to zone around water bodies rather than to wait until such time as zoning ordina nces may be enacted for all of the land within municipal boundaries. [1989, c. 403, §3 (AMD) .] All existing municipal ordinances dealing with subjects of this section currently in effect and operational on April 18, 1986, are declared to be valid and shall continue in effect until rescinded, amended or changed according to m unicipal ordinance, charter or state law. [1987, c. 815, §§1,11 (RPR) .] SECTION HISTORY 1985, c. 481, §A89 (NEW) . 1985, c. 737, §A110 (AMD) . 1987, c. 94, §§1,2 (AMD) . 1987, c. 815, §§1,11 (RPR) . 1989, c. 403, §3 (AMD) . 1993, c. 196, §1 (AMD) . 1995, c. 625, §B15 (AMD) . If there are underground oil storage tanks on the property, use the following disclosure. DISCLOSURE per Maine Revised Statutes Title 38, Chapter 3 Subchapter 2-B: OIL STORAGE FACILITIES AND GROUND WA TER PROTECTION, §563. Registration and inspection of underground oil storage tanks and piping (statute appended) Providing notice. Prior to the sale or transfer of any real estate where an underground oil storage facility is located, the owner of the real estate shall file a written notice with the purchaser or transferee. The notice must disc lose the existence of the underground oil storage facility, its registration number or numbers, the real estate where the facility is located, whether or not the facility has been abandoned in pl ace pursuant to section 566-A and th at the facility is subject to regulation, including registration requirements, by the department under this subchapter. Supplier notification requirement. Any person who sells a tank intended to be used as an underground oil storage tank shall notify the purchaser in writing of the purchaser's obligations under this section. By signing below, the Purchaser indicates that Purchaser has received from Seller a satisfactory notice per the first paragraph above, and a satisfactory notice under the second paragraph, above. ______________________________ Date: _____________ Signature of Purchaser Title 38: WATERS AND NAVIGATION Chapter 3: PROTECTION AND IMPROVEMENT OF WATERS Subchapter 2-B: OIL STORAGE FACILITIES AND GR OUND WATER PROTECTION §563. Registration and inspection of underground oil storage tanks and piping 1. Prohibition on unregistered tanks. The following prohibition on unregistered tanks applies. A. A person may not install, or cause to be installed, a new or replacement underground oil storage facility unless the facility is regist ered in accordance with subsection 2 at least 10 business days but no more than 2 years prior to installation and the registration fee is paid in accordance with subsection 4. If co mpliance with this time requirement is impossible due to an emergency situation, the owner or operator of the facility at which the new or replacement facility is to be installed sh all inform the commissioner as soon as the emergency becomes known. The owner or operator shall make available a copy of the facility's registration at that facility for inspection by the commissioner and authorized municipal officials. [2011, c. 206, §14 (AMD) .] B. No person may operate, maintain or store oil in an underground oil storage facility after May 1, 1986, unless each underground oil storage tank at that facility is registered with the commissioner. [1989, c. 890, Pt. A, §40 (AFF) ; 1989, c. 890, Pt. B, §132 (AMD) .] [ 2011, c. 206, §14 (AMD) .] 2. Information required for registration. The owner or operator of an underground oil storage facility shall provide the commi ssioner with the following information on a form in triplicate to be developed and provided by the commissioner; one copy to be submitted to the commissioner, one copy to be promptly submitted upon completi on to the municipality and one copy to be retained by the owner or operator: A. The name, address and telephone number of th e owner of the underground oil storage tank to be registered; [1991, c. 66, Pt. A, §22 (RPR) .] B. The name, address and telephone number of the person having responsibility for the operation of the tank to be registered; [1991, c. 66, Pt. A, §22 (RPR) .] C. The location of the facility; [2005, c. 491, §1 (AMD) .] D. [2001, c. 626, §13 (RP) .] E. The size of the tank to be registered; [1991, c. 66, Pt. A, §22 (RPR) .] F. The type of tank or tanks and piping at the fac ility and the type of product stored or contained in the tank or tanks and piping; [1991, c. 66, Pt. A, §22 (RPR) .] G. For new, replacement or retrofit ted facilities, the name of the installer, the expected date of installation or retrofit, the natu re of any emergency pursuant to subsection 1, paragraph A, if applicable, and a description or pl an showing the layout of the facility or tank, including the form of secondary containment, other forms of leak de tection or equipment to be installed pursuant to section 564, subsection 1, paragraph A and, when applicable, the method of retrofitting leak detection pursuant to sec tion 564, subsection 1 or 1-A; [1991, c. 66, Pt. A, §22 (RPR) .] H. For existing facilities and tanks, the best estim ate of the age and type of tank or tanks and underground piping at the facility; and [2005, c. 491, §1 (AMD) .] I. For underground oil storage tanks, the expirati on date of tank manufacturer's warranty. [2005, c. 491, §1 (AMD) .] [ 2005, c. 491, §1 (AMD) .] 3. Amended registration required. The owner or operator of an underground oil storage facility shall file an amended registration form with the commissioner immediately upon any change in the information required pursuant to subsection 2, including any modifications to the facility or a change of ownership. The board may establish, by rule, a late registration period not to exceed 10 business days in duration. A fee may not be charged for filing an amended registration. [ 1991, c. 66, Pt. A, §23 (RPR) .] 4. Registration fees. The owner or operator of an underground oil storage facility shall pay a fee to the department of $100 for each tank register ed under this section located at the facility, except that single family homeowne rs are not required to pay a fee for a tank at their personal residence. The fee must be paid at the time the ta nk is first registered and every 3 years thereafter upon receipt of a bill from the department. The department may prorate the fee as appropriate. [ 2009, c. 121, §10 (AMD) .] 5. Penalty for failure to submit amended registration. Any person who has not submitted an amended registration form in accordance with su bsection 3 shall pay a late fee of $100. This does not preclude the commissioner from seeking civil penalties from any person who fails to register a facility or tank. [ 1991, c. 66, Pt. A, §24 (RPR) .] 6. Providing notice. Prior to the sale or transfer of any real esta te where an underground oil storage facility is located, the owner of the r eal estate shall file a written notice with the purchaser or transferee. The notice must disclo se the existence of the underground oil storage facility, its registration number or numbers, the r eal estate where the facility is located, whether or not the facility has been aba ndoned in place pursuant to section 566-A and that the facility is subject to regulation, including registration requirements, by the department under this subchapter. [ 2005, c. 491, §1 (AMD) .] 7. Supplier notification requirement. Any person who sells a tank intended to be used as an underground oil storage tank shall notify the purchaser in writing of the purchaser's obligations under this section. [ 1989, c. 865, §7 (NEW) .] 8. Certification of proper installation. Owners of new and replacement facilities shall ensure that the installer provides certification to the co mmissioner, within 30 days of completion of installation, that the materials and methods used comply with the applicable installation standards of this subchapter. [ 1989, c. 865, §7 (NEW) .] 9. Annual compliance inspection. The owner of an undergr ound oil storage facility is responsible for ensuring that e ach underground oil storage tank and associated piping at the facility are inspected annually for compliance with the requirement s of this subchapter and any rules adopted under this subchapt er and the requirements for gasoline vapor control in rules adopted under section 585-A. The owner shal l correct or arrange for correction of any deficiencies detected during the in spection as necessary to bring the facility into compliance with these requirements. A. The owner of an underground oil storage facility shall submit annual inspection results to the department on or before July 1, 2003 and on or be fore July 1st annually thereafter. The results must be recorded on a form provided by the department and must include a certification statement, signed by an underground oil storag e tank inspector or underground oil storage tank installer certified by the Board of Underground Oil Tank In stallers under Title 32, chapter 104- A, that each tank and associated piping have been inspected and any deficiencies discovered during the inspection have been corrected. The owner shall submit the completed form to the department no more than 30 days after the date on which the inspection was completed. [2007, c. 534, §1 (AMD) .] B. [2007, c. 534, §1 (RP) .] C. [2007, c. 534, §1 (RP) .] D. [2007, c. 534, §1 (RP) .] E. Beginning July 1, 2010 and at least once ever y 3 years thereafter, the annual inspection of each tank must be performed by a certified underground oil storage tank inspector or underground oil storage tank installer who is not the tank owner or operator, an employee of the tank owner or operator or a person having dail y on-site responsibility for the operation and maintenance of the tank. [2007, c. 534, §1 (NEW) .] [ 2007, c. 534, §1 (AMD) .] 10. Aboveground oil storage tanks with underground piping. An owner of an aboveground oil storage tank with underground piping is subject to the requirements of this subsection. A. Effective January 1, 2007, a person may not store motor fuel in an aboveground oil storage facility that has underground pi ping without first having registered the facility with the commissioner in the same manner as is requi red of underground oil storage facilities under subsections 2 to 5. [2005, c. 491, §1 (NEW) .] B. Prior to the sale or transfer of an above ground oil storage tank that has underground piping, the owner shall notify the purchas er or transferee in writing of the existence of the underground piping and the requirement that the tank be regist ered with the commissioner if the tank will be used to store motor fuel. [2005, c. 491, §1 (NEW) .] C. The owner of an aboveground oil storage tank used to store motor fuel shall ensure that, within 30 days after completion of installation of underground piping associated with the tank, the installer certifies in writing to the commissioner that the mate rials and methods used comply with the applicable installation standards of this subchapter. [2005, c. 491, §1 (NEW) .] D. The owner of an aboveground oil storage tank used to store motor fuel shall ensure that underground piping associated with the tank is inspected annually for compliance with the requirements of this subchapter and the requirem ents for gasoline vapor control in rules adopted under section 585-A. The owner shall submit annual inspection results to the department on or before July 1, 2007 and on or before July 1st annua lly thereafter. The results must be recorded on a form provided by the department and must in clude a certification statement, signed by an underground oil storage tank insp ector or an underground oil storage tank installer certified by the Board of Underground Oil Tank Installers und er Title 32, chapter 104-A that the piping has been inspected and any deficiencies discovered during the inspection have been corrected. The owner shall submit the completed form to the depa rtment no more than 30 days after the date on which the inspection was completed. The requirement s of this paragraph may be enforced in the same manner as is provided for underground oil storage facilities under subsection 9. [2007, c. 534, §2 (AMD) .] This subsection does not apply to tanks or piping at an oil terminal facility as defined in section 542, subsection 7. Until July 1, 2009, this subsection does not apply to tanks or piping at a facility used to store diesel fuel. [ 2007, c. 534, §2 (AMD) .] SECTION HISTORY 1985, c. 496, §A14 (NEW) . 1985, c. 626, §2 (AMD) . 1987, c. 402, §A199 (AMD) . 1987, c. 491, §§6-9 (AMD) . 1989, c. 865, §§3-7 (AMD) . 1989, c. 890, §§A40,B131- 135 (AMD) . 1991, c. 66, §§A22-24 (AMD) . 2001, c. 231, §17 (AMD) . 2001, c. 626, §§12,13 (AMD) . 2005, c. 491, §1 (AMD) . 2007, c. 534, §§1, 2 (AMD) . 2007, c. 655, §4 (AMD) . 2009, c. 121, §10 (AMD) . 2011, c. 206, §14 (AMD) .