STATE OF CONNECTICUT
DEPARTMENT OF CONSUMER PROTECTION
450 Columbus Blvd, Suite 901 ♦ Hartford, CT 06103
RESIDENTIAL PROPERTY CONDITION REPORT
The Uniform Property Condition Disclosure Act (Connecticut General Statutes Section 20-327b) requires the seller of residential property to provide this report to the prospective purchaser prior to the prospective purchaser’s execution of any binder, contract to purchase, option, or lease containing a purchase option. These provisions apply to the transfer of residential real property of four dwelling units or less, including cooperatives and condominiums, made with or without the assistance of a licensed broker or salesperson. The seller will be required to credit the purchaser with the sum of $500 at closing if the seller fails to furnish this report (Connecticut General Statutes Section 20-327c).
INSTRUCTIONS TO SELLERS:
1. You must answer all questions to the best of your knowledge.
2. You are required to identify and disclose any problems regarding the subject property.
3. Your real estate licensee cannot complete this form on your behalf.
4. “UNK” means Unknown, “N/A” means Not Applicable.
5. If you need additional space to complete any answer or explanation, attach additional page(s) to this form. Include subject property address, seller’s name and the date.
Pursuant to the Uniform Property Condition Disclosure Act, the seller is obligated to answer the following questions and to disclose herein any knowledge of any problem regarding the following:
A. SUBJECT PROPERTY
1) Name of seller(s):
2) Street address, municipality, zip code:
3) What year was the structure built?
7) Is the property in a flood hazard area or an inland wetlands area? If yes, explain: Klas and Christine Holm
3 Cove Road, Old Greenwich 1898 22 years
4) How long have you occupied the property? _______________ If not applicable, indicate with N/A.
5) Does anyone else claim to own any part of your property, including, but not limited to, any encroachments? If yes, explain:
6) Does anyone other than you have or claim to have any right to use any part of your property, including, but not limited to, any easement or right of way? If yes, explain:
8) Are you aware of the presence of a dam on the property that has been or is required to be registered with the Department of Energy and Environmental Protection? If yes, explain:
9) Do you have any reason to believe that the municipality in which the subject property is located may impose any assessment for purposes such as sewer installation, sewer improvements, water main installation, water main improvements, sidewalks or other improvements? If yes, explain:
10) Is the property located in a municipally designated village district, municipally designated historic district, or listed on the National Register of Historic Places? If yes, explain:
Note: Information concerning village districts and historic districts may be obtained from the municipality’s village district commission, if applicable.
11) Is the property located in a special tax district? If yes, explain:
12) Is the property subject to any type of land use restrictions, other than those contained within the property’s chain of title or that are necessary to comply with state laws or municipal zoning? If yes, explain:
13) Is the property located in a common interest community? If yes, is it subject to any community or association dues or fees? Please explain:
14) Do you have any knowledge of prior or pending litigation, government agency or administrative actions, orders or liens on the property related to the release of any hazardous substance? If yes, explain:
15) Does the property include any leased or rented equipment that would necessitate or oblige either of the following: the assignment or transfer of the lease or rental agreement(s) to the buyer or the replacement or substitution of the equipment by the buyer? If yes, indicate by checking all items that apply:
Propane fuel tank
Water heater
Security alarm system
Fire alarm system
Satellite dish antenna
Water treatment system
Solar devices
Major appliances
Other:
16) Fuel types? _____________________ Are you aware of any heating system problems? If yes, explain:
17) Hot water heater type? __________________________ Age: __________ Are you aware of any hot water problems? If yes, explain:
18) Is there an underground storage tank? If yes, list the age of tank ___________ and location:
19) Are you aware of any problems with the underground storage tank? If yes, explain:
20) During the time you have owned the property, has there ever been an underground storage tank located on the property? If yes, has it been removed? Yes No If yes, what was the date of removal and what was the name and address of the person or business who removed such underground storage tank?
Provide any and all written documentation of such removal within your control or possession by attaching a copy of such documentation to this form.
21) Air conditioning type: Central; Window; Other:
Are you aware of any air conditioning problems? If yes, explain:
22) Plumbing system problems? If yes, explain:
master bathroom shower head drips
23) Electrical system problems? If yes, explain:
24) Electronic security system problems? If yes, explain:
25) Are there carbon monoxide or smoke detectors located in the dwelling on the property? If yes, state the number of detectors _____ and whether there have been problems with such detectors:
there is wiring for smoke detectors in the mudroom and the aupair suite which are not
26) Fire sprinkler system problems? If yes, explain:
27) Domestic water system type: Public; Private well; Other:
28) If public water:
a) Is there a separate expense/fee for water usage? If yes, is the expense/fee for water usage flat or metered? ________ Provide the amount of the expense/fee and explain:
b) Are there unpaid water charges? If yes, state amount unpaid:
29) If private well:
Has the well water been tested for contaminants/volatile organic compounds? If yes, attach a copy of the report. If no report is available, provide name of entity that performed testing and describe results of such testing:
31) Sewage disposal system type: Public; Septic; Cesspool; Other: downstairs deck lighting needs to be repaired
30) If public water or private well: Are you aware of any problems with the well or with the water quality, quantity, recovery, or pressure? If yes, explain:
32) If public sewer:
a) Is there a separate charge made for sewer use? If yes, is it flat or metered?
greenwich mill rate
b) If it is a flat amount, state amount __________________ and due dates:
c) Are there any unpaid sewer charges? If yes, state the amount:
33) If private:
a) Name of service company:
b) Date last pumped: _________________________ Frequency of pumping during ownership:
c) For any sewage system, are there problems? If yes, explain:
34) Are asbestos insulation or building materials present? If yes, location:
35) Is lead paint present? If yes, location:
36) Is lead plumbing present? If yes, location:
37) Is the foundation made of concrete? If no, explain:
38) Foundation/slab problems or settling? If yes, explain:
39) Basement water seepage/dampness? If yes, explain amount, frequency and location:
40) Sump pump problems? If yes, explain: flat
Basement is extremely dry but water can penetrate temporarily during big storms at Sump pumps are installed but disconnected
41) Do you have knowledge of any testing or inspection done by a licensed professional related to a foundation on the property? If yes, disclose the testing or inspection method, the areas or locations that were tested or inspected, the results of such testing or inspection and attach a copy of the report concerning such testing or inspection. If no report is available, provide name of entity that performed testing and describe results of such testing:
42) Do you have knowledge of any repairs related to a foundation on the property? If yes, describe such repairs, disclose the areas repaired and attach a copy of the report concerning such repairs:
43) Do you have any knowledge related to the presence of pyrrhotite in a foundation on the property? If yes, explain:
44) Roof type: ________________________________; Age:
Asphalt shingle
45) Roof leaks? If yes, explain:
46) Exterior siding problems? If yes, explain:
47) Chimney, fireplace, wood or coal stove problems? If yes, explain:
48) Patio/deck problems? If yes, explain:
49) If patio/deck is constructed of wood, is the wood treated or untreated?
Installed 2011, updated 2020 Ipe wood
50) Driveway problems? If yes, explain:
51) Water drainage problems? If yes, explain:
Front lawn may flood temporarily during big storms with heavy rain at high tide
52) Interior floor, wall and/or ceiling problems? If yes, explain:
53) Fire and/or smoke damage? If yes, explain:
54) Termite, insect, rodent or pest infestation problems? If yes, explain:
55) Rot or water damage problems? If yes, explain:
56) Is(Are) the structure(s) insulated? If yes, type: _______________________; location:
57) Has a test for radon been performed? If yes, attach copy of the report. If no report is available, provide the name of entity that performed the testing and describe the results of such testing:
58) Is there a radon control system in place? If yes, explain:
59) Has a radon control system been in place in the previous 12 months? If yes, explain:
RISK AWARENESS
60) Is the property located in a Federal Emergency Management Agency designated floodplain? If yes, which zone:
61) During the time that the seller has owned the property, has the seller received assistance or is the seller aware of any previous owners receiving assistance from the Federal Emergency Management Agency, the United States Small Business Administration or any other federal or state disaster assistance program for flood damage to the property?
We received payments from FEMA for hurricaines in 2010, 2011, and 2012
62) Is there a current flood insurance policy in effect on the property?
63) Is a Federal Emergency Management Agency elevation certificate available?
64) Has the seller ever filed a claim for flood damage to the property? [to come]
65) If there is a structure on the property, has the structure experienced any water penetration or damage due to seepage or a natural flood event?
Basement may get wet temporarily during big storms with heavy rain at high tide
The seller should attach additional pages, if necessary, to further explain any item(s) above. Indicate here the number of additional pages attached: ______
Questions or Comments? Consumer Problems? Visit the Department of Consumer Protection website at: www.ct.gov/dcp
IMPORTANT INFORMATION
(A) Responsibilities of Real Estate Brokers
This report in no way relieves a real estate broker of his or her obligation under the provisions of section 20-328-5a of the Regulations of Connecticut State Agencies to disclose any material facts. Failure to do so could result in punitive action taken against the broker, such as fines, suspension or revocation of license.
(B) Statements Not to Constitute a Warranty
Any representations made by the seller on the written residential property condition report shall not constitute a warranty to the buyer.
(C) Nature of Report
This Residential Property Condition Report is not a substitute for inspections, tests, and other methods of determining the physical condition of the property.
(D) Information on the Residence of Convicted Felons
Information concerning the residence address of a person convicted of a crime may be available from law enforcement agencies or the Department of Public Safety.
(E) Building Permits and Certificates of Occupancy
Prospective buyers should consult with the municipal building official in the municipality in which the property is located to confirm that building permits and certificates of occupancy have been issued for work on the property.
(F) Home Inspection
Buyers should have the property inspected by a licensed home inspector.
(G) Concrete Foundation
Prospective buyers may have a concrete foundation inspected by a licensed professional engineer who is a structural engineer for deterioration of the foundation due to the presence of pyrrhotite.
(H) Dam
Information concerning the registration and categorization of a dam on the property may be obtained from the Department of Energy and Environmental Protection.
(I) Flood Insurance, Flood Maps and Flood Risk
Federal law requires owners to obtain and maintain flood insurance for properties financed with a federally regulated or insured mortgage in a Special Flood Hazard Area, also known as a high-risk zone on FEMA’s flood insurance rate maps. In addition, for properties that have previously received federal disaster assistance, owners are required to obtain and maintain flood insurance as a condition to be eligible for future assistance. This requirement affixes to the property and applies to all future owners. FEMA flood maps are not designed, nor intended to be, a reliable tool for buyers to assess a property’s flood risk. A property does not have to be near water or in a flood zone to flood. For additional information on obtaining important flood insurance, contact an insurance professional.
Buyer’s Certification
The buyer is urged to carefully inspect the property and, if desired, to have the property inspected by an expert. The buyer understands that there are areas of the property for which the seller has no knowledge and that this report does not encompass those areas. The buyer also acknowledges that the buyer has read and received a signed copy of this report from the seller or seller’s agent.
Date Buyer
Date
Seller’s Certification
To the extent of the seller ’s knowledge as a property owner, the seller acknowledges that the information contained above is true and accurate for those areas of the property listed. In the event a real estate broker or salesperson is utilized, the seller authorizes the brokers or salespersons to provide the above information to prospective buyers, selling agents or buyers’ agents.
Date
DEPARTMENT OF CONSUMER PROTECTION
450 Columbus Blvd, Suite 901 ♦ Hartford, CT 06103
RESIDENTIAL FOUNDATION CONDITION REPORT
This report must be filled out for the transfer of residential property located in a town determined by the Capitol Region Council of Governments to be affected, or potentially affected, by crumbling foundations and that was acquired by: (1) a political subdivision of this state; (2) a judgment of strict foreclosure; (3) foreclosure by sale; or (4) a deed in lieu of foreclosure. The owner or political subdivision shall make the disclosures below to the prospective purchaser of such property prior to the prospective purchaser’s execution of any binder, contract to purchase, option, or lease containing a purchase option. The seller is required to credit the purchaser with the sum of $500 at closing if the seller fails to furnish this report (C.G.S. Section 20-327c).
A list of affected or potentially affected towns may be found at https://crcog.org/municipal-services/crumbling-foundations/.
INSTRUCTIONS TO SELLERS:
1.You must answer all questions to the best of your knowledge.
2. You are not required to undertake investigations or inspections of the foundation to verify your answers.
3. Your real estate licensee cannot complete this form on your behalf.
4. “UNK” means Unknown, “N/A” means Not Applicable.
5.If you need additional space to complete any answer or explanation, attach additional page(s) to this form. Include the subject property address, seller’s name and the date on all additional pages.
Pursuant to the Uniform Property Condition Disclosure Act, the seller is obligated to answer the following questions and to disclose herein any knowledge of any problem regarding the following:
A. SUBJECT PROPERTY
1) Name of seller(s):
Klas and Christine Holm
2) Street address, municipality, zip code:
3 Cove Road, Old Greenwich
3) Do you have any knowledge related to the presence of pyrrhotite in any concrete foundation on the subject property? If yes, explain:
4) Are you aware of any damage or deterioration in any concrete foundation on the subject property, including, but not limited to, any damage or deterioration caused by the presence of pyrrhotite in any concrete foundation on the property? If yes, explain: 5) Are you aware of any repairs or remediation to any concrete foundation on the subject property? If yes, explain:
The seller should attach additional pages, if necessary, to further explain any item(s) above. Indicate here the number of additional pages attached: ______
Questions? Visit the Department of Consumer Protection website at: www.ct.gov/dcp
IMPORTANT INFORMATION
(A) Responsibilities of Real Estate Brokers
This report in no way relieves a real estate broker of the broker’s obligation under the provisions of section 20-328-5a of the Regulations of Connecticut State Agencies to disclose any material facts. Failure to do so could result in punitive action taken against the broker, such as fines, suspension or revocation of license.
(B) Statements Not to Constitute a Warranty
Any representations made by the seller on this residential foundation condition report shall not constitute a warranty to the buyer.
(C) Nature of Report
This report is not a substitute for inspections, tests, and other methods of determining the physical condition of the foundation. Prospective buyers may have a concrete foundation inspected by a licensed professional engineer who is a structural engineer for deterioration of the foundation due to the presence of pyrrhotite.
Buyer’s Certification
The buyer is urged to carefully inspect the property and, if desired, to have the property inspected by an expert. The buyer understands that there are parts of the property for which the seller has no knowledge and that this report does not encompass those parts The buyer also acknowledges that the buyer has read and received a signed copy of this report from the seller or seller’s agent.
Date
Date
Seller’s Certification
To the extent of the seller ’s knowledge as an owner of a property acquired through foreclosure or deed in lieu of foreclosure, the seller acknowledges that the information contained above is true and accurate. In the event a real estate broker or salesperson is utilized, the seller authorizes the broker or salesperson to provide the above information to prospective buyers, selling agents or buyers’ agents.
Date Seller
Date
10/13/2025
10/13/2025
Christine Holm
Christine Holm
Klas Holm
Klas Holm
