Application General Information
4. .6-DAVTax Parcel ID Number: (�. l " Z' (,Z �
Zoning District: V\C:\C . /0 M lAW
3EP 0 2 2015
Detailed Description of Project [includes current& prop ed usej
xci
� h1 i VI,C TOWN OF QUEENSBURY
�� P tyliyZONING OFFICE
(Cr-rtf
t( Aca„fi edvreL)
Location of protect:
VSe\7\tZtA\ Ccs ws \IL\ 1\01)
ift,111-'!yi-
Applicant Name: N6kilA 130gk 411_ Address: -10 Li' 1,$)i)iL LI CApk, Of
Home Phone Cell: sQY,�,tie I
\)R I-1 211 `0l�J 31 g-a_I� t r
Work Phone Fax '7 g'„1
VA-Z4-4,121-1
E-Mail:
. 4-c 5 VnplcA0\.,caw,
!Dike,6) mar l.tkr*,com
Agent's Name: l Address:
1,,6 %5 0 c 17K CZ Cv,aet '0 Qefik5Aluii,
Home Phone Cell: 5I6-1(1U 01 0 , 131
Work Phone \\ R Fax
IM
E-mail
Owner's Name Address
4:N1°C5\1911 Glft'S5(&) \\4
Home Phone Cell
Work Phone Fax
E-mail
1,
1
Area Variance Revised March 2014
Town of Queensbury•Zoning Office•742 Bay Road• Queensbury, NY 12804 •518-761-8238
i-Submission Conference Form [179r-4-0401
1. Tax Map ID .26G &• 1 - d-C ll
1
2. Zoning Classification gRsk
3. Reason for Review: •k lr( c tiOA sy+l
Li c n atifYYt, d
`'7
4. Zoning Section#: t —S—c U Se Q\C
5. Pre-Submission Meeting Notes; Outstanding Items To Be Addressed Include:
Deed Yes No
General Information complete /Yes No
Site Development Data Complete K V'Yes No
Setback Requirements Complete Yes No
Additional Project Information Complete - Yes No
FAR addressed TThYes No
Compliance with Zoning Ordinance tic- VYes No
Checklist items addressed V'Yes No
Environmental Form completed /JA' Yes JVo
Signature Page completed Yes ✓No
e?,t u, ^ eco dots. ry) -ef -e,�hct Ac ()vi
,Q,U i`e L . )f?(' �l c�c cil Al al e r i ct( a.-)C'� arc u c rt �-
c, � rtnI ceS Ser.1 (1 u kc�. F c (,V,ve(06 rto, ;1-
t' �� t �
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hei
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L., �-.i-e c j cic k(c% 1- (A s�f t'-e &c1 ,�l//ci c li
Si.cI,1c4 ( () ri
7 c.,_: :L . ,. i-,„ __ ,f ,, ,l 1 I ,
1 , , i r ` t t( tX
Staff Representative: it a U a (`t)C't,
Applicant/Agent: \C''\..-„
Date: �Ig f 1('� 1
6
Area Variance Revised March 2014
Town of Queensbury•Zoning Office•742 Bay Road•Queensbury, NY 12804.518-761-8238
I I
I
I
Site Development Data
Area/Type Existing sq. ft. Proposed Total sq. ft.
Addition sq.ft.
A. Building footprint
\-co Vi4Ati q
B. Detached Garage 7 Cc
C. Accessory Structure(s)
D. Paved, gravel or other hard surfaced area
000
E. Porches/ Decks
F. Other
G. Total Non-Permeable [Add A-F] 2
H. Parcel Area [43,560 sq. ft. /acre]
I. Percentage of Impermeable Area of Site [I=G/H] (r3
7 Co Gl, o
Setback Requirements
Area Required Existing Proposed
(ILti)
Front [1] i
\OCA b
Front [2]
Shoreline
Side Yard [1] ---AC
Side Yard [2] c-,
Rear Yard [1] Ocp\ � 9 Zi
Rear Yard [2]
Travel Corridor
Height [max]
Permeability —\Set q y f 0
No. of parking spaces
2
Area Variance Revised March 2014
Town of Queensbury•Zoning Office•742 Bay Road• Queensbury, NY 12804•518-761-8238
Compliance with Zoning Ordinance
Requesting relief from SECTION:
Need relief from the re�Uirement(s) listed below which can not be met by the project as proposed.
(Check all that apply] ® Setback ❑ Buffer Zone ❑ Lot Width ❑ Other
The following questions reflect the criteria for granting this type of variance. Please complete them; use additional
sheets if needed.
1. Whether an undesirable change will be produced in the character of the neighborhood or a detriment to
nearby propertyl•
r{ �� will be created by,the ran dng of this area variance2
1`+O ).4a.xq70 t'. ran
c Tho J1 Iry 3 V1 t k Yu,'Q to
L)i I c>L c SPi- Ak b1^', v 11) Nfec kec
2. Whether the benefit sought by the applicant can be achieved by some method, feasible for the applicant to
pursue, other than an arezs
variance? i
\ O { .Ux \ > Iry \ c \Nki
3. Whether the requested area variance is substantial?
c -?_c c\ 'CZ\tA VA6C. k \ L
4. Whether the proposed variance will have an adverse effect or impact on the physical or environmental
conditions in the neighborhood or dist(gt?
Rio � ►�► \� ��� \tr �vx, V
r‘wA •
5. Whether the alleged difficult was self-cre ted? \
. \ c C��O � Vivi -0 -2(i)4)hi0
4
Area Variance Revised March 2014
Town of Queensbury•Zoning Office• 742 Bay Road• Queensbury, NY 12804•518-761-8238
Additional Project Information ,
1. Will the proposal require a Septic Variance from the Town Board of Health? '{e ( \\ va
2. If the parcel has previous approvals, list application number(s):
3. Does this project require coverage under the NYS DEC Stormwater Pollution Prevention Program?
Yes VNo
4. Estimated project duration: Start Date C\ End Date 'I\`l ,
5. Estimated total cost of project:
6. Total area of land disturbance for project: \"\�(
Floor Area Ratio Worksheet
FLOOR AREA RATIO (FAR) --The relationship of building size to lot size, derived by dividing the total building
floor area by the lot size in square feet, yielding a percentage.
Zoning District Symbol Floor Area Ratio [FAR]
Waterfront Residential WR 0.22
Commercial Moderate/Commercial Intensive CM /CI 0.3
Main Street MS 0.3
A. The combined area of all square footage, as measure from exterior walls of all structures on the property, including all
floors of the structures, garages, basements and attics with more than five (5) feet of ceiling height and covered
porches. Building square footage does not include: Open deck, docks and that portion of covered docks extending
over water and one storage shed of one hundred twenty (120) square feet or less. Any additional sheds will be
included. (See"FLOOR AREA RATIO").
B. Commercial or industrial: the total area in square feet as measured from the exterior of the outside walls of a building
or structure, and when applicable, the sum total of all floor areas of the principal and accessory buildings or structures
on the project site.
A. Parcel Area sq. ft.
B. Existing Floor Area _ sq. ft.jsee above definition]
C. Proposed Additional Floor Area sq. ft.
D. Proposed Total Floor Area sq. ft.
E. Total Allowable Floor Area (Area x ) [see above table]
*if E is larger than D, a variance or revisions to your plan may be needed. Please consult
w/Staff.
3
Area Variance Revised March 2014
Town of Queensbury•Zoning Office•742 Bay Road •Queensbury, NY 12804•518-761-8238
•
Submittal of a stamped and signed SURVEY MAP depicting existing and proposed conditions shall
include the items as noted below.
A. GENERAL SHEET#
1 Title, Name,Address of applicant&person responsible for preparation of drawing 3 u:
2 Deed �
1AV%-c.
3 North arrow,Tax Map ID,date prepared and scale[minimum 11n. =40 ft.]
4 Boundaries of the property plotted to scale,zoning boundary c\_)i�
5 Principal structures, accessory structures with exterior dimensions t��
6 Site improvements incl. outdoor storage areas,driveways,parking areas,etc.: existing&proposed 3't‘)z1
7 Setbacks for all structures and improvements: existing&proposed
' 13UNij
8 Elevations and floor plans of all proposed and affected structures
B. WATER&SEWER SHEET#
1 Project sewage disposal facilities, design details, construction details, flow rates, and number of bedrooms
proposed
2 Water supply [i.e. well] & septic on adjoining lots with separation distances to existing or proposed on-site We.`1
water supply and septic �a 1[VII"C.
3 Separation distances for proposed sewage disposal system to well and water bodies
4 Existing public or private water supply[well, lake, etc.]. Method of securing public or private water, location,
design and construction of water supply including daily water usage
5 Percolation test location and results
C. PARKING/PERMEABLE AREAS SHEET# _
1 Number of spaces required for project including calculations and justification: existing&proposed
2 No. of existing parking spaces, number to be removed, number to maintain and type of surfacing material
[e.g.,gravel,paved]
3 Provision for pedestrian and handicap access and parking: existing&proposed
4 Design details of ingress,egress,loading areas and cutting: existing&proposed
5 Location and character of green areas [existing and proposed], modification to green area, buffer zone to
remain undisturbed
6 Lighting, location and design of all existing and proposed outdoor lighting
D. ADDITIONAL SITE DEVELOPMENT AND MISCELLANEOUS SHEET#
1 On-site&adjacent watercourses,streams, rivers, lake and wetlands
2 Utility/energy distribution system[gas, electric,solar,telephone]: existing&proposed
3 Location, design and construction details of all existing and proposed site improvements including: drains,
culverts, retaining walls,fences,fire&emergency zones and hydrants, etc.
4 Square footage of bldg. area proposed for office, manufacturing, retail sales or other commercial activities:
existing&proposed
e Signage: Location, size,type,design and setback: existing&proposed
f Waiver Request: provide letter with application requesting any waivers: please reference specific items
g Commercial/Industrial Development requires submission of Landscaping, Stormwater Management, Grading
& Lighting Plans
h Identification of Federal, State or County permits required for the project together with a record of application
for all necessary permits
5
Area Variance Revised March 2014
Town of Queensbury•Zoning Office•742 Bay Road•Queensbury, NY 12804•518-761-8238
Signature Page
This page includes the 1.) Authorization to Act as Agent Form: 2.) Engineering Fee Disclosure; 3.) Authorization for Site
Visits; 4.) Other Permit Responsibilities; 6.) Official Meeting Disclosure and 6.) Agreement to provide documentation
required.
OWNER'S AGENT FORM:
Complete the following if the OWNER of the pro,�etty is molt the �n�e as the applicant
Owner: „g . 1, ; M
Designates: i � I'uLi 0144 Ci�c
As agent regarding: Variance Site Plan Subdivision
For Tax Map No.: Section Block Lot
Deed Reference: Book Page Date
Z.
OWNER SIGNATURE: Rf •, _.._. DATE: I ) i
APPLICANT'S AGENT FORM: 60
Complete the following if the APPLICANT is unable to attend the meeting or wishes to be represented by another parry:
Owner:
Designates:
As agent regarding: Variance Site Plan__Subdivision
For lax Map No,: Section Block Lot
Deed Reference: Book Page Date
APPLICANT SIGNATURE: DATE:
2.) ENGINEERING FEE DISCLOSURE: Applications may be referred to the Town consulting engineer for review of septic design,
storm drainage, etc, as determined by the Zoning or Planning Department. Fees for engineering review services wilt be charged
directly to the applicant. Fees for engineering review will not exceed$1,000 without notification to the applicant.
3.) AUTHORIZATION FOR SITE VISITS: By signing this page and submitting the application materials attached herein, the Owner,
Applicant, and hislherlthcir agent(s) hereby authorize the Zoning Board or Planning Board and Town Staff to enter the subject
properties for the purpose of reviewing the application submitted.
4.) OTHER PERMIT RESPONSIBILITIES: Other permits may be required for construction or alteration activity subsequent to approval
by the Zoning Board or Planning Board. It Is the applicant's responsibility to obtain any additional permits.
5.) OFFICIAL MEETING MiNUTES DISCLOSURE: Itis the practice of the Community Development Department to have a designated
stenographer tape record the proceedings of meetings resulting from application,and minutes transcribed from those tapes constitutes
the official record of all proceedings.
B.) AGREEMENT TO PROVIDE DOCUMENTATION REQUIRED: I, the undersigned, have thoroughly read and understand the
instructions for submission and agree to the submission requirements, I acknowledge no construction activities shall be commenced
prior to issuance of a valid permit. i certify that the application, plans and supporting materials are a true and complete
statement/description of the existing conditions and the work proposed, and that all work will be performed in accordance with the
approved plans and in conformance with local zoning regulations. t acknowledge that prior to occupying the facilities proposed, I or my
agents,will obtain a certificate of occupancy as necessary. I also understand that I/we may be required to provide en Pas-built survey by
a Licensed land surveyor of all newly constructed facilities prior to issuance of a certificate of occupancy
l have read and agree to the above.
\ \\Q\v‘i\
hH
Signature[Applicant] \ Print Name[Applic nt] Date sig d
Signature[Agent] Print Name[Agent] Date signed
Area Variance Revised March 2014
Town of Queensbury•Zoning Office•742 Bay Road•Queensbury, NY 12804•518-751-8238
Se e ; Vye 1
Morning Star Excavating & Septic Invoice
107 Jewell Road
•
Gansevoort, NY 12831-2154
7,27;2015 ms 15-0`22 3
101) As
1
els
Mike Yurdiga
Sunset Trail
Queensbury, NY 12804
1),,:
20 -3Soil Test with backhoe work and engineer -50(W 750.00
report.
i
g
Subtotal $750.00
Sales Tax (7.0%) $0.00
Total $750.00
Phone# Fax# Payments/Credits -$750.00
Balance Due $0.00
5I 8-'93-2290 518-793-211;
Stf
G. Peter Jensen
17 West Road
South Glens Falls
New York 12803
(518) 798—3859
July 26,2015
To Whom It May Concern:
On July 24,2015, at the request of Michael Yurdiga, I investigated the property on
the west side of Sunset Trail between#6 and# 20, Town of Queensbury, Warren County
New York. The purpose of this investigation was to determine the suitability of the site
for the installation of a septic system. A test pit dug to a depth of 74"indicated the soil
profile, in the area investigated,to be as follows:
• 0 - 6"top soil/forest duff.
• 6"- 38"medium coarse yellow brown sand.
• 38" - 62"yellow brown coarse sandy gravel.
• 62"- 74 hardpan.
• There was no evidence of mottling observed.
The stabilized percolation rate was determined to be one(1)minute fifty two(52)
seconds.
Based on the above,the lot between#6 and#20 Sunset Trail in the area
investigated; is adequate for the installation of a residential septic system.
Sincerely,,
G. Peter ensen 4EpE0 AgCh
47
t
7t t.
Lie +
.444
III
BK: 548 PG: 31 02/28/1972 DEED Image: 1 of 3
- T-o S.3X N.Y•"-S1r —+RARhANY'Y..k%U..C.... . .... ,..................,....,.... y.
elTY7Y4ANR...re..mM....R...w.
arni0 S ..` *Ili' It i II. il‘ . 'VITO 1..Vol 0.0.4 1‘.....1...../.•v..M.
, . . - . - 'P&p...A. . . .I* : 1.E.: :::
{; .dads the l 0 !� day of y/ild�t� _ r..
:,s: ` AYnetoe l Ilundred and Seventy-two ci •
$rt:ustn EDWARD W.,GRANT and•ELSIE H. GRANT, his'wife, both•of the-•.
•
Town of Queensbury, Warren'County., New-York1. •- -
parties of the J1rit.part,..and` .. . • ',
• RICHARD C. MERRILL and MARY M. MERRILL, his wife, bath of 46 Sherman.
r Avenue; City of Glens Jalls,•Werren•County, New York,;as tenants by '
the entirety,'
•
: • •'•,port-' tee of••the second part,
, that the part its of theft's!part,-in consideration of : • •
• ONE • Dollar (;.1.0o )
lawful money of the United Statei,and other good and-valuable-consideration
i paid by the parties of the second part,do .' hereby eranL and release unto the - ' • :i;..:
rt iea of the second part, their heirs:
and assijns forever,all that certain piece or parcel of land situate, lying `;i"r.:'
and being in the Town of Queensbury, Warren County, New York, more par- • ; •,
Ypoint ;,'.
• ticularl bounded and described as follows: BEGINNING at a in the ;;;,4.
t westerly bounds of Sunset Trail which marks the southeasterly corner-of Gi'i��f!
Lot 2, as set forth on a map of Section One of Pickle Hill •Acres filed :;-?
in the Warren County Clerk's Office on January 20, 1972; running thence ••;=J;'
N. 5 '7' E. along the westerly bounds of said Sunset Trail a distance , • -y';7%';
' of 175.08 feet to a point; running thence on a curve to the left, having ;V! F
_ a radius of. 24.75 feet, a distance of 39.12 feet to a point; running .
thence N. 85' 27' W. a distance of 175.01 feet to a point which marks • • J1<<:'
the northwest corner of said Lot 2; running.thence S. 5' 7' W. n dis- ': -
• tance of 198.10 feat to a point which marks' the southwest corner of,said +,F .
Lot 2; running thence S. 84' 53' E.'a distance of 200.00 feet to the ' ..,!..-,..!,i
point or place of beginning. .' . •
• Bearings refer to•the magnetic meridian as of August 17,-1964. . . :,i
' Together with all right, title and interest of the.parties .of the first
part•herein, if any, in and to lands lying between the northerly boy'nde-.-
of the above•described premises and center of Pickle.Hill Road.:..
Being a portion of the premises conveyed to the-parties of the first .per t •
herein by Michael Sinto by deed dated Jury 27,••1964.and recordedlathe
•
•
Warren County Clerk's Office on July 28,` 1964-in Book 444. of Deeds •a_t ,
• Pa• ges 147 and' 148,. • ,
Subject to whatever an accurate survey.May. obi* -
• Subject to the following covenants and restrictions which shall run•with
• the land: _ . . .
1. No lot shall be subdivided. ' � -
CO
-r
2.•No structure other than ane single dwelling house not more
E ' then two stoiries•high,with'a privatekarage for not more than three--:- . . -
cars for use in connection therewith ,and one tool abaci:of not over •106.•
psq. ft. area shall be constructed or maintained upon any one lot.•
1
BK: 548 PG: 31 02/28/1972 DEED Image: 2 of 3
" if� ;
,, 1 r.
3. No manufacturing, mercantile, service or'commercial business • ,:,, ,;:
XV
+.,...
or activity of any kind or nature shall be conducted thereon. :;-e:g3}&
4. No horses, cows,,hogs, goats, poultry or other livestock ^'e ,:.Citi
shall be kept or raised on 'the lot herein described;.Chic covenant shall . . .^ .
not be deemed to prohibit keeping of cats or dogs as household pets. F:a ;s1l
N
5. No structure shall be hazer than 35 feet from the lot line•, rf;p
w adjoining. a road, nor nearer than 25 feet to any other lot line. Siii.V
Is 6. No dwelling shall be permitted on any_ lot unless the main' l3Sr{.
orches, l'• •'`i,'
floor area of the structure. exclusive of garage, car port, p L�rl
CID etc. shall be at least 950 sq. ft. and unless the plans, specification' �A'•i '
and location shall be approved in writing by the grantors herein. On- _ $ sa,
and after January 1, 1973, approval in writing'by a majority of owners, . f
f„ of lots in the subdivision shall be deemed to be approval by the grant= • ,iimi
^ li
t%1 ors. f
7. No'structure shall be erected upon other than a•.continual • r;fix
masonry, concrete or tile foundation. , - .�wx�`
8. No fence or hedge exceeding 4 feet in height shall be erect • vA.
NV;
ed or'permitted to remain between the street and the front setback line `W
of any lot. i>."'7
Y4
34.
9. No trailer or'other preconatructed unit housing basement, .• i- %;,
la
FSd;
tent, shack, barn, garage or other outbuilding erected on a lot Shall• ' ';
at any time be used as a residence, temporarily or permanently, and no. '.ii.,
trailers of any description shell be parked in the front yard at any'
time. - • ;i��-`�*'iti',
10. That all houses shall be completed within one year from th• y FhL's;
.u,,.},;
date the excavation begins. :,,'
ll.. The foregoing covenants anil
d restrictions herein shall run ry .
with the land and shall'be binding for a period of ten years from the kgs
date hereof, unless at the expiration of said ten-year period all 0f :-,, .
3,
the owners of the property affected by these covenants and restriction. cy`;`;
shall agree to alter, amend or eliminate said restrictions in an agree ; :
mant in writing in form sufficient to be recorded in the same manner a••• ,;;,:f;:
a dead in the State of New York. .' ' • '`'�``:
• a.t .2.•
Illi:•sa�:�t 1u.aa ,.3Jau
-
•
,,, artF 1.Atl-Minn�,,7 mild.'%'tn;a �a .V.
• a :'.V. 't' •. -..•. •-'...,:: '`:,
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�- • ice ,.- "y, .,t-'• •-'- y
it,:\},:%1;•
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._.. ,-. - __ __, s . x.13':
1:••••••;,,,,,01,,,
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A
BE: 548 PG: 31 02/28/1972 DEED Image: 3 of 3
• ,{ r�',, T;,,`e ij �r ,il 19 4t-.�•rlio,vr-tilt i �—, 'l,,, e� •, f .. f ,r, ,
0,4V:•=7-•'..••••';'0.,T-St i�q.,,0.ka ± �*>>r{1 .1•5-44 i, ��1 3,
�tJ,li V?r.h
datalflsr with the appurtenances and all the estate and rights of the part ies 1.-0T,
i:r
't* of the first part in and to said premises, •
1 s .. :' .
• ,
ria Iwo keit to kith the premises herein granted unto the part ies • • o/the-
- second part; their heirs . , and assigns forever.' - "
i
iA`said p
• .Iarties'of:the first part • • •
• eavenant• •:•as follows:
diet,That the part les of the second part shall quietly e'rfoy-the said premises;`.•
*trona, That said parties of the first part • •-
will forever illaraui the title to said premises. .. - ' _ •
•
ifyttb, That, its Compliance'with Sec. 13 of the Lien•Law,•ihe grantors`. will'::.
-receive the consideration for this conveyance and will Bold the right•to'reoeive such-:. .
consideration as a trust fund to be applied flrat•for the purpose of paying the cost•of: ••-•
the improvement and will apply.the same first to the payment of the.cost oo-the•'
improvement before using any part of the total of the same for any other purpose. :'; ;
• 3n litturse Illberrof, the part ies of•thr first port ha ve hereunto set their
hand a and scale the day and year first above written. •
.
lttilresrnrt ofgrt t:-.dC.).:;tt•
•
LQward W. Grant by :'•
• A. .nt�, ••tto nenein Fact.', ,
•
IMO of Nye link 1 s.. Om this 0.7.5-.1-- '"day of 96r<d• y'
of Warren ( Nineteen.'Hundred and Seven EEEy-two (f
• before me , the subscriber,personally appeared , •• - • •'
EDWARD W. GRANT, by Daniel A. Grams, Attorney-in-Fact, and . .
ELSIE H. GRANT - ,
• to Me personally known and known to me to be the sante persons •described iia unit. •
who executed the within Instrument, and 'the y ;Gstt,i,4 acknowledged.
to me that they executed the same. • ! ;
• - •, •, 'Notary Public''. ..
• wOD "•Fflae-`9.550}1 7? '
•. DEEDS
Co..) • .. .,,,,..,•'31 •3fiCi YLNs. _
wngtN W.,:,.-li,a
vrikEt vrs,{ "
___,,z
, .R.., , ,.,.,,,, ,..,-,. ,. ,
r ,), , �� Veal `tum
. WARREN COUNTY MULTIPLE LISTING SERVICE, INC.
RESIDENTIAL REAL ESTATE CONTRACT CV,A 1
vi
This form was approved August 2013 by the Warren County Bar Association and
Warren County Association of Realtors and Warren County Multiple Listing Service
THIS IS A LEGALLY BINDING CONTRACT.
WE RECOMMEND ALL PARTIES TO THE CONTRACT CONSULT AN ATTORNEY.
THIS CONTRACT MAY ONLY BE MODIFIED BY WRITTEN ADDENDUM.
RESIDENTIAL REAL ESTATE CONTRACT
Dated: July 24, 2015
Seller: Mary Merrill Buyer: Michael Yurdiqa
FULL LEGAL NAME AS STATED ON THE DEED OF RECORD FULL LEGAL NAME AS WILL APPEAR ON THE DEED
Address: 168 Magnolia Dr. Address: 30 Edwards Ave.
,Greeneville, TN 34473 Sayville, NY 11782
Attorney: Robert Hafner Attorney: Timothy Alden
1. PROPERTY TO BE SOLD
Seller agrees to sell and Buyer agrees to purchase the property known as Sunset Trail _
located in the City, Village or Town of Queensbury in Warren
County, State of New York. The property includes all of Seller's transferable rights, privileges, and easements, if any,
related to the property. The lot size is approximately .75 Acres (165 x 190) and is described more fully
in Seller's deed, a copy of which must be annexed hereto, and incorporated herein.
Tax Map Number(s): 266.1-2-62
2. PURCHASE PRICE
a. The purchase price is Forty-Five Thousand dollars
($45,000.00 )
b. Plus a Seller's contribution of dollars
($ )
c. This equals the gross purchase price of Forty-Five Thousand and 00/100 dollars
($45,000.00 )
All parties to this contract shall sign the HUD 1 Settlement Statement and thereby certify to the accuracy of the financial
terms of the transaction. In accordance with 18 U.S. Code Section 1001 and Section 1010 (dealing with Fraud and False
Statements), the parties hereby agree that the Seller's Contribution amount specified in 2(b) above is an "amount certain"
that is added to the Purchase Price to yield the Gross Purchase Price in 2(c) above. In the event the Buyer's lender disallows
any portion of the agreed upon Seller's Contribution, the parties understand and agree that the lender is relying upon the
Gross Purchase Price in 2(c) as an essential term of this contract that will not change and the Buyer must deliver the full
Gross Purchase Price to Seller as reported on the HUD 1 Settlement Statement. The result of a disallowance of a portion of
the Seller's Contribution is an unexpected increase in the amount of available funds required to be brought to closing by the
Buyer, and an increase in the amount due Seller at closing. It is recommended that Buyers consult with an attorney during
attorney review when utilizing a Seller's Contribution in a purchase offer.
9
Buyer's Initials
'Farren County MLS,296 Bayroad Queensbury,NY 12804 Pae 1 of 7
Phone:518744-0101 Sunset Trail offer
'dra Poulos Produced with zipForm®by zipLogix 18070 Fifteen Mile Road,Fraser,Michigan 48026 www.zioLogix.com Seller's Initials
Fax:518-795-3287
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both The buyer and seller that the agent is acting for the of the real estate broker. With the informed consent of
other party as well. The agent should also explain the the buyer and the seller in writing, the designated sales
possible effects of dual representation, including that by agent for the buyer will function as the buyer's agent
consenting to the dual agency relationship the buyer and representing the interests of and advocating on behalf of
seller are giving up their right to undivided loyalty.A buyer the buyer and the. designated sales agent for the seller 1
or seller should carefully consider the possible con- will function as the seller's agent representing the
sequences of a dual agency relationship before agreeing interests of and advocating on behalf of the seller in the
to such representation. A seller or buyer may provide ad- negotiations between the buyer and seller. A designated
vance informed consent to dual agency by indicating the sales agent cannot provide the full range of fiduciary
same on this form. duties to the buyer or seller. The designated sales agent
must explain that like the dual agent under whose
Dual Agent with Designated Sales Agents supervision they function, they cannot provide undivided
If the buyer and seller provide their informed consent in loyalty. A buyer or seller should carefully consider the
writing, the principals and the real estate broker who possible consequences of a dual agency relationship
represents both parties as a dual agent may designate a with designated sales agents before agreeing to such
sales agent to represent the buyer and another sales agent representation. A seller or buyer may provide advance
to represent the seller to negotiate the purchase and sale of informed consent to dual agency with designated sales
real estate. A sales agent works under the supervision agents by indicating the same on this form.
This form wa rovid?d to m by Q361.1) a G-"LJ (print name of licensee) of
Jf -�(print name of company, firm or brokerage), a licensed eal
estate broker actin in th in rest of the:
( ) Seller as a (check relationship below) ( $uyer as a (check relationship below)
( ) Seller's agentuyer's agent
( ) Broker's agent • Broker's agent
( ) Dual agent
Dual agent with designated sales agent
For advance informed consent to either dual agency or dual agency with designated sales agents complete section below:
( )Advance informed consent dual agency
( )Advance informed consent to dual agency with designated sales agents
Y
If duA agpilt with d Hated gents is checked Cir is appointed to represent the buyer;
and h t,pI (' 10 • - is appoin ed to represent the seller in this transaction.
(1)(We) acknowledge receipt of a copy of this disclosure form: signature of,24 Buyer(s) and/or Seller(s):
Date: Date:
DOS 1736(Rev.11/10) Page 2 of 2
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