3 Evergreen Lane Meredith, NH by LAKE LIFE REALTY- Brie Stephens

Sitting atop 156’ of Lake Winnipesaukee shoreline, the southwest facing home is perfectly positioned to embrace the long sunset views down the cove, optimizing the sun year-round, with a floor plan that creates a natural interaction between the home and the outdoors. The heart of the home, a large sun filled great room is open to the kitchen and dining area, allowing free-flowing informality amongst the spaces accented by walls of windows. The expansive lakeside deck is perfect for morning coffees or watching family swim and play below. A secluded owners suite on the top story includes a loft, walkin closet and full bathroom with jacuzzi. The lower level offers a spacious family room off a large bedroom overlooking the lake. Lakeside enjoy deep water off your U-shaped docking system with boat lift and canopy as well as a seasonal jet ski dock. A shoreline bluestone patio provides for entertainment right along the lakes edge. Enjoy being close by boat to all the destination boating yet you get calmer waters with the protection from Stonedam Island across the way, which is mostly all protected, undeveloped land. With a two-car detached garage with an unfinished space above, you have great storage space or future living space. This home embraces the lake from so many venues and affords its owners a lifestyle that is truly special.

Protected cove location Protected Island across the way – Stonedam Island Centered location to destination boating

L AKE L IFE R EALTY . NET

PROPERTY DISCLOSURE . RESIDENTIAL ONLY New Hampshire Association of REALTORS@ Standard Form

HF.*-

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 FlRl\4 representing the SELLER, and is not a substitute for any inspection by the BUYER. SELLERS authorize FIRIV 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 NG FIRM PROMPTLY IN WRITING

COMPLETION, YOU ARE TO NOTIFY THE 1.

o tl

SELLER:

2. 3.

col{DoMlNtuM, co-oP,

R MULTIFAM

-tr

4. sir-len' ![ has I has not occupied the property tor ] 3 5. WATERSUPPLY questions regardless of type of water supply. P1""." "**"r "ll g Public a Private I Seasonal a. TYPE OF SYSTEITI: tr Drilled fl Dug E Other e b. INSTALLATION: Location: ^d,e. lnstalled By: c. d.

years.

Unknown

lnstallation u11 rtow What is the source of your i USE: Number of persons currently using the system No Does system supply water for more than one household? [Yes MALFUNCTIONS: Are you aware of or have you experienced any malfunctions with the (public/private/other) water systems?

Pump: ElYes

Quality: EYes

.E E[

No No

E N/A

Quantity: fiYes

ErNo

Unknown

lf YES to any question, plelase explain in Comments below or with attachment.

Date of most recent test WATER TEST: Have you had the water tested? E Yes lF YES to any question, please explain in Comments below oi with attachment. Are you aware of any test results reported as unsatisfactory or satisfactory with notations? [ Yes -E No lF YES, are test results available? E Yes E No What steps were taken to remedy the problem?

tsUo

COIVIVENTS 6.

TYPE OF SYSTEIM

Public: Private:

b. c.

fiYes BNo $Yes ANo

flYes fl No IYes ![No

5l Unknown Septic Design Available:

IF PUBLIC OR COTMTUUNITY/SHARED Have you experienced any problems such as line or other malfunctions? E Yes # No What steps were taken to remedy the problem? lF PRIVATE: Other Unknown Cesspool Septic Tank I Holding Tank TANK: Unknown Gal. Tank Size aOther 6[

I I

trt IVletal

Tank Type

Location: Date of Last Servi ng: Have you experienced any nnalTunctions?

Community/Shared:

Comments: LEACH FIELD---EYes EL lF YES, Location: 7a Date of i Have you experienced anY Comments:

.ELLER(.)rNrrALS

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o 2014 NEW HAMpsHtRE ASSoctATtoN oF REALTGIkS

Unknown EI Oth",

plocation

Unknowffi:

trtarne of Company Servicing Trnk,

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BUYER(S) INITIALS

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9, INC. ALL RTGHTS RESERVED. FOR USE BY NHAR REALTOR@ MEMBERS ONLY. ALL OTHER USE PROHIBITED 07.2018

Page 1 of 4

PROPERTY DISCLOSURE . RESIDENTIAL ONLY New Hampshire Association of REALTORS@ Standard Form TO BE COMPLETED BY SELLER

PROPERTY LOCATION:

[Yes ElNo !

lS SYSTEM LOCATED ON "DEVELOPED WATERFRONT" as described in RSA 485-A? lF YES, has a site assessment been El Unknown Source of lnformation:

$Yes E No

done?

Unknown

Comments:

FOR ADDI ENVI RON M

ENTAL SERVI CES SU BSU RFACE SYSTEMS

7. INSULATION

LOCATION

Yes

E tr tr

Attic or Cap Crawl Space Exterior Walls

Floors

REAU

Unknown E

lf YES.

Unknown

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HAZARDOUS MATERIAL UNDERGROUND STORAGE TANKS - Current or previously existing: Are you aware of any past or present underground storage tanks on your lF YES: Are tanks currently in EL No out of service? lF NO: How long have tank(s) been in the tank(s)? What materials are, or of tank(s): Age of tank(s):

use?

Amount

ltl

Tyoe

/6 ,'

tr_

SVes

property? SlYes

Il No !

Unknown

f] I

Unknown Unknown

Location

problems

Are you aware of any past

I zoz(

IfYES:

No Comments:

-tr No E- Unknown

I Unknown shingles?

Date:

SNo

lfa Results: Has the property been tested since remedial steps?

available? pYes E- No

EYes E[ EYes a

No No

IUnknown BY:

whaf remedial steps were taken?

flYes fLNo

Comments: RADON/VVATER - Current or previously ex.isting: Has the property been tested? AYes EL Unknown

Are test results

IfYES:

*o E '

Date:

Results: Has the property been tested since remedial

[Yes

frYes

tanks been removed? E Yes have previously existing: or Current ASBESTOS As insulation on the heating system pipes or ducts? ELYes E[ No ln the flYes fil No Unknown ln the roofrng Other Unknown ln flooring tiles? @ No lf YES, Source of information: Comments: ng: or RADO

Hasthepropertybeentested? fi,Yes

etc?

lf tanks are no longer in

siding? [Yes

BY:

what remedial steps were taken?

steps?

EL Yes Comments:

flNo

Are test results available? ELEAD-BASED PAINT - Current or previously Yes fif No Are you aware of lead-based paint on this property? lf YES: Source of information Are you aware of any cracking, peeling, orflaking lead-based paint?

existing: g

-Et

1{tlo

Comments: SELLER(S) @

TNTTTALS

2014 NEW HAMPSHIRE ASSOCIATION OF

BUYER(S) INITIALS

l-l

PROPERTY DISCLOSURE . RESIDENTIAL ONLY

New Hampshire Association of REALTORS@ Standard Form TO BE COMPLETED BY SELLER

he, 3 Ewrorcen mterials? tr

PROPERTY LOCATION: Are you aware of any other hazardous lf YES: Source of information: Comments:

Yes

/her"r/,I|,

-[No

FIEALTOFIC

rI o f);

GENERAL INFORMATION

ls this property subject to liens, encroachments, easements, rights-of-way, leases, restrictive covenants, aftachments, life estates, or right of first refusal? Yes Xt No Unknown lf YES, Explain: -What is fo*ur rour"" of information? ls this property subject to special assessments, betterment fees, association fees, or any other transferable fees? No Unknown lf YES, E^plain' ELYES What is yourr source of information? ng, nage, Are you aware of any onsite landfills or any er SU AS IYes **o lf YES, Explain No lf YES, Explain Are you aware of any problems with other buildings on the property? E Yes Are you receiving a tax exemption or reduction foy this property for any reason including but not limitedlo current use, land tr vrs lf YES, Explain:_ ruon_ uNKNowN conservation, etc.?

n b.

c. d. e.

f. s.

!Yes ffiNo llUnknown lf YES, Explain FloodZone? EYes -[ No E Unknown Yes I No E_ Unknown lf YES, By: ma'-t+

lsanypartof thispropertyinCurrentUse?

ls this property located in a Federally Designated

n No

Tank/Location:

el: Type: Heating System Age Owner of Tank: Price: Annual Fuel Consumption: by whom? a Date system was last Leased EOwned lf leased, explain terms of ag Solar Panels: Comments: Type of Roof Covering RoofAge Moisture or leakage: Comments:

Gallons:

l.Foundation/Basement:gFullx3]eartiatEother:-EType Moisture or leakage Comments: Problems? Last Cleaned Lined? m. Chimney(s) How Many? Age: n. Plumbing Type Comments; Gallons Type Domestic Hot Water: it Breakers -tr Electrical System Amps: Comments: q. Modifications: Are you aware of any modifications or repairs made without the necessary permits? tr lf Yes, please explain: YesE No you aware of or present pest i r. Pest lnfestation:

o. p.

Comments:

you have knowledge lf YES, please explain: (Per RSA 477:4-g) aYes Other (e.g . Alarm System, lrrigation System, etc.)

SELLER(S)

Type: lltr<

VNo

phetamine production ever occurring on the propefty?

p No

BUYER(S) INITIALS

TNTTTALS

O 2014 NEW HAMPSHIRE ASSOCIATION OF

Page 3 of 4

PROPERTY DISCLOSURE - RESIDENTIAL ONLY New Hampshire Association of REALTORS@ Standard Form TO BE COMPLETED BY SELLER PROPERTY LOCATION

fH,

NOTIGE 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 651-8. SUCH INFORMATION MAY BE OBTAINED BY CONTACTING THE LOCAL POLICE DEPARTMENT.

10. ADDITIONAL INFORMATION

a. b.

ATTACHIVENT EXPLAINING CURRENT PROBLETVIS, PAST REPAIRS, OR ADDITIONAL INFORI\4ATION?

BYes

-EL

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 RESPO

BLE AND LIABLE FOR ANY FAI

TroN TO BUYER(S).

BUYER ACKNOWLEDGES RECEIPT OF THIS PROPERry 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 TNVESTIGATIONS VIA LEGAL COUNSEL, HOME, STRUCTURAL OR OTHER PROFESSIONAL AND QUALIFIED

ADVISORS AND TO INDEPENDENTLY VERIFY INFORMATION DIRECTLY WITH THE TOWN OR MUNICIPALITY.

DISCLOSURE OF INFORMATION ON LEAD-BASED PAINT

AND/OR LEAD-BASED HAZARDS FOR HOUSING

lrl H

SALES

This Disclosure Form isfrom the NationalLead lnformation Center underthe United States EnvironmentalProtection

Agency. This is not a New Hampshire Association of Property Address:3 Evgrgreen

REALTORS@

form.

Lane, Meredith, NH 03253

tead Warning Statement Every purchoser of any interest in residentiol property on which a residentiol dwelling was built prior to 1978 is notified that such property may present exposure to lead from lead-bosed point thot moy ploce young children ot risk of developing leod poisoning. Leod poisoning in young children moy produce permonent neurologicol domage, including learning disabilities, reduced intelligence

quotient, behaviorol problems, ond impoired memory. Lead poisoning also poses o porticulor risk to pregnont wamen. The seller ot' any interest in residentiol reol property is required to provide the buyer with any information on leod-based paint hozords from risk ossessments or inspections in the seller's possession ond notify the buyer of ony known lead-bosed point hazards. A risk ossessment or inspection for possible lead-based paint hozards is recommended prior to purchose.

Seller's Disclosure

(a)

Presence of lead-based paint and/ot lead-based paint hazards (check (i) or (ii) below):

(i)

E Known lead-based paint and/or lead-based paint

(ii) Eseller (b)

hazards are present in the housing (explain)

has no knowledge of lead-based paint and/or lead-based paint hazards in the housing

Records and reports available to the seller (check (i) or (ii) below):

(i) Eseller

has provided the purchaser with all available records and reports pertaining

to lead-based paint and/or

lead-based paint hazards in the housing (list documents below). (ii)

Fseller

has no reports or records pertaining

to lead-based paint and/or lead-based paint hazards in the

housing.

Purchase/s Acknowledgement (initial)

It II It (e) c)

Purchaser has received copies of all information listed above.

Purchaser has received the pamphlel Protect Your Family from Leod in Your Home. Purchaser has (check (i) or (ii) below):

(i)

Elreceived a 10-day opportunity (or mutually agreed upon period) to conduct a risk assessment or inspection for the presence of lead-based paint and/or lead-based paint hazards; or (ii) flwaived the opportunity to conduct a risk assessment or inspection for the presence of lead-based paint and/or lead-based paint hazards. Agent's Acknowledgement (initial) has informed the seller of the seller's obligations under 42 U.S.c. 4852d and is aware of his/her $l

,ffiagent

o+espdnsibility to ensure compliance.

Certification of Accuracy The following parties have reviewed the information above and information they have

,tIrahAsPr

the

their knowledge, that the

true and accurate.

)at dotloop verified

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03127121 12:34 PMEDr HSOD]2GO-gBOX-HTV(

2009

itEw

HAMPSHTRE ASSOCIATION

OF REAr-TORSo, rNC.

ALt RIGHTS RESERVED. FOR USE BY NHAR REAI-TOR. MEMBERS ONLY. ALL OTHER USE PROH|B|TED. 01.2009

Waterfront Site As ses s ment To comply with RSA:485-A:39

Prepared by: www.va rneyeng i neeri ng llc. com

EI\TGII\TEEFI,IhTG LLC 93 POVVD=FE TVIIL-L FRt) ALTC}I\, NH O38O9 tvwarney@td

603-475-71

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fFacffi Bhceffi EB Hazen Drive, Concord, New Hampshire

NEITIIAMPSEIRB

$erviees

0gEO1 o [608] p71-BEOB o www.des.nh

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201.6

Selling Developed Waterfront Froperty Sife Assessm ent Study Required Relevant laws: RSA 4:40-A,4g5-A:2,485-A:89, RSA 4g3-B;4 Relevant NHDES Acjministrative Rulel Env-Wq 1025

Statutorv Requirennents Prior to executing a purchase and sale agreement for any .,developed waterftont proper!y', using a septic disposal system, an owner shall, at his or her expense, engage a perrnitted subsurfiace sewer or waste disposal designertO perform an on-she assessrnent stucly.

ty*"*

o'Oeueloped

waEerfrant propertf means any parcel of land upon which stands a structure suitable for either seasonal or year-round human occupancy, where such parcel of land is contiguous to, or within, 200 feet of the

ietl*;rr;;:;-;1.t,3 of all waterbodies protected under RSA 493-8, the {Shoreland Water euality protection Act}. Waterbodies protected under RSA483-8 includes: All lakes and ponds greaterthan 10 acres, all 4s.order and greater sffeams and rivers, all designated rivers and river segments under RSA 493-A (The hivers Management and Protection Act) and all waters subiect to the ebb and flow of the tide tincluding tidal marshes, rivers and

estuaries). The !+iS:'liCa.;aj,_js';,sl:rje.iE-:.;;-!.,is-;:.:s-.,jf-_=?. .--:_-;.;;.i_.+=.:=,:_ii_=d.;e:_kai=: is a comprehensive list off all freshwater bodies protected under RSA 493-8. please note: A Site Assessrnent Sfudy must be conducted whenever anv part of the property is within 200 feet of the reference line, not merely when the structurs or septic disposal system is within 200 feet oi the reference line.

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The Site Assessment Study is a form prepared by a _,,:l.i;- - !: :i that you, as the seller, hire to determine if your site meets the curent standards for septic disposal systems established by NHDES. .The Site Assessment Study form is not submitted to NHDES. The compteted Site Aisessment Study form is transfefred frorn the sellerto the buyerand becomes part of the purchase and sales agreement.

ln instances where a subsequent sale of a developed waterfront propefcy occurs for which a She Assessment Study has already been conducted for a previous sale, if no changes occurred to'the information required.on the original Site Asse'ssment Study, the property owner and assessor may certifil that no change in the informatiorr required has changed in lieu of conducting a new she assessment Srudy. The site assessment study tu35 originally required priorto listing or offering a waterfront property for sale but, since L993, it has beeir required priorto executing a purchase and sale agreement and must,include an on-site inspedion. The site assessment form may be obtained from the Subsurlace Systems Bureau, or on-line at: _

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lnfonnratio-n lf you have anV questions concerning septic systems,:contact the NHDES Subsurface Systems Bureau at (603) 271-3501, or 29 Hazen Drive, PO Box 95, Concord, NH 03302-0095; Fax; {603} 271-6683;

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FaGffi Shecu 29 Hazen Drive, Concord, New Hampshine 03301

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271-3503 o

DEPAR?MENTOF

Services www.des.nh.gov

WD-SS8-6

2010

Buyiag

a X{ome or Business? Questions You Slzould Ask An Sewage Disposal When purchasing a home or business it is important to inquire about the sewags disposai system on the properly. The following are suggested questions to ask the owner before you buy.

" o

o "o e o o o n , e '.

What type of sewage disposal system serves the property, a municipal sewer system or a septic system? (Ifthere is running water in the sfruchrq it must have one or the other.) Note: If the property is served by a municipal sewer systexo, you usually don't need to inguire fi:rther. Is the lot part ofa state approved subdivision? Ifso, try to get the subdivision approval number. If the lot was created prior to 1967 , there will be no.state approval for the subdivision since the state approval program was not imptemented until July i, 1967. This may affect the marketability and development potentiai of a lot. For previously developed lots, it may prohibit firrther expansion or

coaversion

Has the septic system received both state approvals for consmrcfion and operation? If so, does the owner have a copy ofthe approved plans, or the constrrrction approval and approval for operation numbers? Flease note: Ifthe lot has questionable characteristics such as ledge outcrops or steep siopes, it is stongly advised to have a site assessment performed by a permitted septic system designer. Does the numba' of bedrooms on the approval match the number of bedroorns in the house? (There is no problem if there is less than the approved number of bedrooms.) Where the system located is, in parlicular, where is the tank clean-out located? How old is the septic system? When was the last time the tank was pumped? (This becomes particularly important if a garbage disposai has been used.) Do you have a maiatenance record for the system? (W'hile a maintenance record is not required, it is a good idea to get one if possible.) l{as the system ever failed, or are there signs offaiiure like soggy grass or odor? What tytrre'of water supply serves the structtue, municipal water supply or weil? If tlere is a well, whele is it located? Is the well a dug well or a drilled weli? ls the well properly sealed? t{as the weli water ever been tested? If so, when? What wsre the results? Has the well ever been disinfected? If so, when?

For Further Information

If you have any questions concerning se,ptic systems, contact DES Subsur&ce at (603) 271-35AL or 29 Hazen Drivq PO Box 95, Concord, NH 03302-0095; Fa.x: (603) 271-6683; http;l/&s.nf1. gavlat gani"ali on/di r is i Ers/'#arer/ss-b/in dex. irlin.

WATERFRONT PROPERTY SITE ASSESSMENT FORM Water Division/ Subsuface Systems Bureau

Env-wq

1025 Land ReSOurCes Management

Prior to executing a purchase and sale agreement for any "developed waterfront property" using a septic disposal system, an owner shall, at his or her expense, engage a permitted subsurface sewer or to perform an "On-Site Assessment Study". This form is NOT submitted to NHDES. This form is transferred from the seller to the buyer and becomes part of the purchase and sales agreement. For more

. :

1. SELLER

NAI\ilE: Benjamin P. Bassi Jr. and Rebecca Coburn MAILING ADDRESS: 3 Evergreen Lane

TOWN/CITY: Meredith

STATE: NH

ZIPCODE: 03253

2. AGENT

NAME: The Lake Life Realty Team I Keller Williams Lakes & Mountains Realty, Brianna Stephens MAILING ADDRESS: 87 Whittier Highway

TOWN: Moultonborough

STATE NH

ZIPCODE: 0325a

3. SITE ASSESSOR (DESTGNER) DESIGNER NAME: May A. Varney

DESIGNER PERMIT NUMBER: 1838

P.E. NAME (ISDS over 2500GPD):

P.E. NUMBER:

ADDRESS: 93 Powder Mill Road TOWN/CITY:Alton

STATE: NH

ZIPCODE:03809

4. LOT LOGATION TAX MAP: U32

LOT NUMBER: 10H

SUBDIVISION NAI\4E:

TOWN/CIW: Meredith

STREETADDRESS: 3 Evergreen Lane 5. LOT DESCRIPTION STRUCTURES: Existing House NUMBER OF BEDROOMS: Four(4) Bedrooms (600 gallons per day)

6. ABUTTERS rF KNOWN (ATTACH ADDTTTONAL SHEET lF NECESSARY) NAME: Allen Family Realty Trust

ADDRESS: 5 Allenhurst Street, Billeric, MA 01821

NAME: Kenneth Kaulbach

ADDRESS: 43 Richardson Road, Boxborough, MA 01719

NAME

ADDRESS:

7. LOT CHARACTERISTICS LOT SIZE: 19,070 +/- square feet or so

SLOPE:

LOADING CAPACITY: 196 Gallons per day after

15-25o/o

deducting well radius

WATER SUPPLY; Well on Lot

dawn. buker@des. nh. gov or (603) 27 1 -3501 NHDES Subsurface Systems Bureau, PO Box 95, Concord NH 03302-0095 urww.des,nh.gov

Site Assessment Form

Revised 0110112016

Page 3 of 3

SOIL TYPE* Group 4 (soil web suruey) * From U$ Natural Resources Conservation Service maps or actual data if available *: ESTIMATED SEASONAL HIGH WATER TABLE*: Two(2')feet +/SCOPE OF REVIEW (Materials reviewed, if any): On-site investigation, Varney Engineering LLG files, Town Files DATE OF ON SITE INVESTIGATION: March 31,2021 DESIGNER'S ASSESSMENT OF SITE FOR CURRENT USE AND IF THE SITE CAN SUPPORT A SYSTEM MEETING CURRENT STANDARDS (attach a separate sheet for additional comments): NHDES will not allow an increase in

number of bedrooms. lf the current septic system does go into failure NHDES will only approve a two(2)bedroom

septic design for this property. 8. PRESENT SEWAGE DISPOSAL SYSTEM A. DOES THE PROPERry CURRENTLY HAVE ANY SEWAGE DISPOSAL SYSTEM? B. IF YES, IS THE SYSTEM STATE APPROVED?

E VES tr

X YCS U

NOTE: Env-Ws 1022.03 provides that "Holding tanks shall not be approved except as a replacement for an existing system in failure when no other means of disposal is practical." Holding tanks are not approved for new construction or for expansion of existing structures. lf YES, a copy of the approved plan, construction approval, and operational approval must be attached to the original of

this form. Also, an 8112"

x 11" sketch to scale orwith dimensions shown of the lot, approximate propefi lines

and

locations of abutter's septic systems and wells (within 75'well radius), if known, must be attached.

lf NO, supply all available information on the type, capacity, age, and location of the system, and include an 8

112"

11"

sketch to scale or with dimensions shown of the property and the location of the system. Also, an 8 112" x 11" sketch to

scale or with dimensions shown of the lot, approximate property lines, and approximate locations of abuttefs septic systems and wells (within 75'well radius), or if known, must be attached.

9. DESIGNER (SITE ASSESSOR) STAMP AND DATE (** Required)

re"#;::"Cr of Subsurface

ASSESSMENT DATE: March 31,2021

dawn.buker@des.nh.qov or (603) 271-3501 NHDES Subsurface Systems Bureau, PO Box 95, Concord NH 03302-0095 www.des.nh.gov Site Assessment Form

Revised 0110112016

Page 3 of 3

(**Required) The undersigned certify that we have reviewed this Site Assessment Form and understand the information contained that have a of form BUYER: DATE:

SELLER:

DArE:

or (603) 271-3S01 NHDES Subsurface Systems Bureau. pO eox ConcorO

3 of 3

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SURVEYOR

Shoreland Water Quality Prstection.Act [!WQ,F$ A Summary of the Stsndsrds The Protected Shoreland: All lands within 250 feet of the following waterbodies are subject to the SWQPA: All Lakes and ponds greater than 10 acres in size.

. i: :l

All 4th Order and greater streams and rivers

- see the Protgcted Rivers and Streams interactive v,/eb map-. Most designated rivers, including sections less than 4th Order - see the Designated Rir.rers interactive v,re-b map.

All waterbodies subject to the ebb and flow of the tide.

,li

Primary Structures: Primary strustures are typically the residential dwelling and include all attached decks and porches. The primary structure setback is 50 feet from the reference line.

Accessory Structures: Accessory structures include parking areas, patios, sheds, gazebos and retaining walls. Accessory structures must be setback at least 20 feet from the reieience line, When planning to construct a new accessory structure, alwayS refer to the Accessoi'y Sti-ucture fact slreet.

Septic Systems: Septic system setbacks are based on soil types. At a minimum, all new septic systems must achieve at least a 75 foot setback from the referei:ce line, Replacement septic systems must meet the septic system setback requirements to the greatest extent practicable. For more information, review the specific seotlc svstenr setbacirs or contact the NHDES Subsurface Systems Bureau at (603J 27!-35A1,.

lmpervious sur=iaces are modified surfaces that cannot effectively absorb or inflltrate water. lmpervious surface .include, but are not limited to: the roofs of structures, deck, patios and paved, gravel or crushed stone driveway and parking areas. Because impervious surfaces have the tendency to concentrate stormwater flows to waterbodies, when a project proposal exceeds certain impervious area thresholds, installing stormwater management systems is required.

|,-'

increase stormwater from the development.

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Any waterfront buffer grid segment that does not meet the minimum required tree and sapling point score must be planted with additional vegetation so that it, at least, meets the minimum required point score' Points are awarded for planting ground covers, shrubs and saplings.

:::

Most new constructionl, excavationz and filling3 within the protected shoreland requires a Shoreland Permit. Smaller scale projects that propose no greater than 1,500 square feet of impact area and no Sreater than a 900 square foot increase in impervious area mqy.qualify for the streamlined 'Shorqiaed Permit bt: Notiftcatien Process.

':'Many rnunicipalities have more stringent setback requirements. Always determine the lqcal regulations as well.

lajatedrent Euffel' Area: Within 50 feet from the refei'ence lir-re. except for a 5 foot wide walkway to the water, all natural ground covers must remain intact. Shrubs can be trimmed and pruned to a minimum height of 3 feet. With limitations, trees and saplings can be removed based on a 25 foot x 50 grid segment tree and sapling point score.

tiilr*diai1ei Etlf&q:1rca: Between 50 feet and 150 feet from the reierence line. 25% of this area must be maintained as natural woodland. Natural woodland means an area consisting of various species of trees, saplings, shrubs and ground covers in any combination and at any stage of growth. *Before removing vegetation, always refer to the V€Eetatioi'l ivianaaefient for Water Qualitv fact sheet.

>30% lrnpervious Area: When a project pioposes a net increase in impervious area that results in the area of lot

being composed of greater than 30% impervious area, a stormwater management system must be designed and certified licensed engineer; and

Fertilizerl Chemicals: Only low phosphorous, slow release nitrogen fertilizers can be appiied beyond 25 feet from the reference line. Pesticide and herbicides can be applied greater than 50 feet from the ieference line by a licensed applicator only.

2O-3O% lmpervious Area: When a project proposes a net increase in impervious area that results in the area of the lot being composed of between ZA-30% impervious area, a stormwater management plan is required to infiltrate the

ManV low-impact projects are exempt from the permitting process and they're identified within the Frequently Asked Questions (FAQs).

Definitions: "tcONSfRUCnOHq Erectin& reconstructing or altering any structure{s) that result in an increese in impervious area. - To dig, remove, orform a mechanized equipment,

"2EXCAVATION"

cvity

or hole wlthin the grouBd with

']FILL" - To place or deposit materials such as roEks,goil, gravel sand or othersuch materials.

Services We Offer For Your Ullaterfnont Froperty varneyeng i neering I lc. com

Septic System Desion

Do you need to update your current septic system or have a new one designed? Over 30 years experience of septic design in the lakes region!

Shoreland Permits

Are you thinking of making improvements to your property within 250 feet of the lake? To build a deck, patio, or addition to your home requires a shoreland permit.

Wetland Ferm[ts Work along the shoreline, such as the building or replacement of retaining walls, steps, and beach improvements(perched beach) requires a wetland perrnit. Do you have wetlands on your property? We can determine the wetland boundaries for you.

Elevation Certificate Are you required to buy flood insurance? An elevation certificate could verify. to your insurance company, that your house ls above the 100 year flood elevation of the lake. (F,E.M.A., L.O.M.A)

Waterfromt SEte Assessment When you are ready to sell your waterfront home call us to prepare a new or update your existing waterfront site assessment!

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net

603-875-711C.

E-E-C

3 EVERGREEN LN

Location Acct#

Assessment PID

3 EVERGREEN LN

MBLU

U32/ 10/H / /

30980

Owner

BASSI, BENJAMIN P JR & REBECCA COBURN

$1,128,400

Appraisal

5099

Building Count

$1,128,400 1

Current Value Appraisal Valuation Year

Improvements

Land

2020

$334,200

Total $794,200

$1,128,400

Assessment Valuation Year

Improvements

Land

2020

$334,200

Total $794,200

$1,128,400

Owner of Record Owner

BASSI, BENJAMIN P JR & REBECCA COBURN

Co-Owner

Sale Price

Certificate Book & Page

3159/ 296

Sale Date

03/07/2018

Instrument

Ownership History Ownership History Owner

Sale Price

Certificate

Book & Page

Instrument

Sale Date

BASSI, BENJAMIN P JR & REBECCA COBURN

3159/ 296

03/07/2018

BASSI, MARSHA A REVOCABLE TRUST

2622/0643

01/27/2010

BASSI, MARSHA A REVOCABLE TRUST

2489/0791

04/29/2008

BASSI, MARSHA A

1531/ 420

05/21/1999

BASSI, MARSHA A

1482/ 129

07/28/1998

Building Information Building 1 : Section 1

Building Photo

Year Built:

1960

Living Area:

2,246

Replacement Cost:

$328,113

Building Percent Good:

Replacement Cost Less Depreciation:

$275,600 Building Attributes

Field

Description

Style

Modern/Contemp

Model

Residential

Grade:

Average +20

Stories:

Occupancy

(http://images.vgsi.com/photos/MeredithNHPhotos//\00\00\04/28.jpg)

Exterior Wall 1

Vinyl Shingle

Building Layout

Exterior Wall 2 Roof Structure:

Gable/Hip

Roof Cover

Asphalt

Interior Wall 1

Drywall

Interior Wall 2 Interior Flr 1

Carpet

Interior Flr 2

Ceram Clay Til

Heat Fuel

Gas

Heat Type:

Hot Water

AC Type:

None

Total Bedrooms:

4 Bedrooms

Total Bthrms:

(http://images.vgsi.com/photos/MeredithNHPhotos//Sketches/5099_5196.jp

Building Sub-Areas (sq ft)

Total Half Baths:

Code

Total Xtra Fixtrs:

Total Rooms:

Bath Style:

Average/Modern

Kitchen Style:

Average/Modern

MH Park

Description

BAS

First Floor

FHS

Legend Gross

Living

Area

1,568

Half Story, Finished

816

408

TQS

Three Quarter Story

360

270

CRL

Crawl Space

696

CTH

Cathedral Ceiling

392

FOP

Porch, Open

SFB

Basement,Raised Finished

872

WDK

Deck, Wood

510

5,232

2,246

Extra Features Extra Features Code FPL

Description FIREPLACE

Legend Size

Value 1 UNITS

Bldg # $2,500

WHL

WHIRLPOOL TUB

1 UNITS

$2,100

Land Land Use

Land Line Valuation

Use Code

1013

Size (Acres)

0.44

Description

SFR WATER

Depth

Zone

Assessed Value

$794,200

Neighborhood

W04

Appraised Value

$794,200

Alt Land Appr