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L 13059 P 976
SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED Recorded: 6/2/2020 Number of Pages: 4 At: 7 :02 :33 PM Receipt Number: 20-0079638 *ELECTRONICALLY RECORDED* Transfer Tax Number: 19-30321 LIBER: D00013059 PAGE: 976 District: Section: Block: Lot: 1000 115 .00 16.00 016.000 EXAMINED AND CHARGED AS FOLLOWS Deed Amount $0 . 00 Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $20 . 00 NO Handling $20 . 00 NO COE $5. 00 NO NYS SRCHG $15. 00 NO Notation $0 . 00 NO Cert.Copies $0 . 00 NO RPT $200 . 00 NO Mansion Tax $0 . 00 NO EA-CTY $5. 00 NO EA-STATE $125. 00 NO TP-584 $5. 00 NO Comm.Pres $0 . 00 NO Transfer Tax $0 . 00 NO Transfer Tax Number: 19-30321 Fees Paid $395. 00 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL Judith A. Pascale County Clerk, Suffolk County RECORDED Number of pages 4 6/2/2020 7:02:35 PM JUDITH A. PASCALE CLERK OF This document will be public SUFFOLK COUNTY record. Please remove all L D00013059 Social Security Numbers P 976 prior to recording. 19-30321 Deed 1 Mortgage Instrument Deed 1 Mortgage Tax Stamp Recording 1 Filing Stamps 31 FEES Page 1 Filing Fee 20.00 Mortgage Amt. 1. Basic Tax Handling 20. 00 2. Additional Tax TP-584 5.00 Sub Total Notation 0.00 Spec./Assit. or EA-52 17(County) 5.00 Sub Total 50.00 Spec./Add. EA-5217(State) 125.00 TOT.MTG.TAX 200.00 CIO., Dual Town Dual County — Held Held for Appointment Comm.of Ed. 5. 00 Transfer Tax 0.00 ' _� Mansion Tax 0.00 Affidavit 4�" The property covered by this mortgage is Certified Copy 0.00 or will be improved by a one or two NYS Surcharge 15. 00 345.00 family dwelling only. Sub Total YES or NO Other 395.00 Grand Total If NO,see appropriate tax clause on page# of this instrument. 4 1 Dist. Section Block Lot 5 Community Preservation Fund 2DO1835B 1000-115.00-16.00-016.000 0.0 0 Real Property Consideration Amount $ Tax Service P r s Agency �5r2sri�2� CPF Tax Due $ 0.00 Verification Improved X 6 Satisfactions/Discharges/Releases List Property Owners Mailing Address RECORD&RETURN TO: Vacant Land Freedom Land Title Agency TD 10 999 Walt Whitman Rd Ste 201 Melville NY 11747 TD TD Mail to: Judith A. Pascale, Suffolk County Clerk 7 Title Comwny Information 310 Center Drive, Riverhead, NY 11901 Co.Name www.suffolkcountyny.gov/clerk Title# g Suffolk County Recording & Endorsement Page This page forms part of the attached DEED made by: (SPECIFY TYPE OF INSTRUMENT) The premises herein is situated in SUFFOLK COUNTY,NEW YORK. TO In the TOWN of SOUTHOLD In the VILLAGE or HAMLET of BOXES 6 THRU S MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. 12-0104..10MId, over Standard N,Y,B.T,U,Form 8002-20M -Bargain and Sale Deed,with Covenants against Grantor's Acts-Individual or Corporation(single Sheet) CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT - THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY THIS INDENTURE,made the day of May,Two Thousand Twenty BETWEEN SCOTT CZUJKO and /KIM MARIE CZUJKO residing at 3215 Deep Hole Drive,Mattituck,NY 11952 parry of the fast part,and KIM MARIE CZUJKO residing at 3215 Deep Hole Drive,Mattituck,NY 11952 parry of the second part, WITNESSETH, that the party of the first part, in consideration of ten ($10.00) dollars and other valuable consideration paid by the party of the second part,does hereby grant and release unto the party of the second part,the heirs or successors and assigns of the party of the second part forever, ALL that certain plot,piece or parcel of land,with the buildings and improvements thereon erected, situate,lying and being in the DISTRICT 1000 SEE SCHEDULE"A"ATTACHED HERETO AND MADE PART HEREOF. SECTION: Being the same premises described in deed dated October 21, 1999 recorded in the Office of the Clerk of Suffolk County 115.00 on November 12,1999 at LIBER 12000 PAGE 514. BLOCK: 16.00 LOT: 016.000 TOGETHER with all right,title and interest,if any,of the party of the first part in and to any streets and roads abutting the above described premises to the center lines thereof;TOGETHER with the appurtenances and all the estate and rights of the party of the first part in and to said premises;TO HAVE AND TO HOLD the premises herein granted unto the party of the second part,the heirs or successors and assigns of the party of the second part forever. AND the party of the first part covenants that the party of the first part has not done or suffered anything whereby the said premises have been encumbered in any way whatever,except as aforesaid. AND the parry of the first part,in compliance with Section 13 of the Lien Law,covenants that the party of the first part will receive the consideration for this conveyance and will hold the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply the same first to the payment of the cost of the improvement before using any part of the total of the same for any other purpose. The word"parry"shall be construed as if it read"parties"whenever the sense of this indenture so requires. IN WITNESS WHEREOF,the party of the first part has duly executed this deed)1>e day and year first above written. IN PRESENCE OF: i OTT CZUJKO 41.yw KIM MARIE CZUJKO STATE OF NEW YORK STATE OF NEW YORK COUNTY OF SUFFOLK ss: COUNTY OF ss: On May 7 ,2020 before me,the undersigned, On before me, the undersigned nally appeared personally appeared SCOTT CZUJKO and to personally known,who,being by me duly sworn,did depose KIM MARIE CZUJKO personally known to and say that he/she resides at No. me or proved to me on the basis of satisfactory evidence to be the individuals whose names are that he/she is theof subscribed to the within instrument and I the corporation acknowledged to me that they executed the described in and which executed the foregoing same in their capacities, and that by their instrument; that he/she knows the seal of said signatures on the instrument, the individuals, corporation; that the seat affixed to said instrument is or the person upon behalf of which the such corporate seal;that it was so affixed by order of the individuals acted,executed the instrument. board of directors of said corporation, and that he/she signed his/her name thereto by like order. otary Public Notary.Public JOSEPH A.FARIA Notary Public,State of New York No.02FA5024548 Oualified in Suffolk County Commission Expires March 14,20 Z2— STATE OF NEW YORK COUNTY OF ss: On before me, the undersigned personally STATE OF NEW YORK appeared to me known, COUNTY OF ss: who,being by me duly sworn,did depose and say that On before me,the undersigned, he/she resides at No. personally appeared that he/she is theof personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose the corporation name(s)is(are)subscribed to the within instrument and described in and which executed the foregoing acknowledged to me that he/she/they executed the same instrument; that he/she knows the seal of said in his/her/their capacity(ies), and that by his/her/their corporation;that the seal affixed to said instrument is signature(s)on the instrument,the individual(s),or the such corporate seal;that it was so affixed by order of person upon behalf of which the individual(s) acted, the board of directors of said corporation, and that executed the instrument. he/she signed his/her name thereto by like order. Notary Public Notary Public DISTRICT: 1000 BARGAIN AND SALE DEED WITH COVENANT AGAINST RESTRICTIONS SECTION: 115.00 Title No. BLOCK: 16.00 LOT: 016.000 CZUJKO COUNTY OR TOWN: SUFFOLK TO CZUJKO Recorded at Request of Standard Form of New York Board of Tifle Underwriters Distributed by FIDELITY NATIONAL TITLE INSURANCE COMPANY RETURN BY MAIL TO Kim Marie Czujko 3215 Deep Hole Drive Mattituck,NY 11952 FIDELITY NATIONAL TITLE INSURANCE COMPANY Title Number:FLT-44189 SCHEDULE A DESCRIPTION OF PREMISES ALL that certain plot,piece or parcel of land,situate,lying and being at Mattituck,Town of Southold,County of Suffolk,State of New York,known and designated as Lot No.58 on a certain map entitled,"Map of Deep Hole Creek Estates,"filed in the Suffolk County Clerk's Office on January 28,1965 as Map No.4256. FOR INFORMATION ONLY:Said premises being more commonly known and designated by the street address 3215 Deep Hole Drive,Mattituck,NY, 11952;tax map designation District 1000 Section 115.00 Block 16.00 Lot 016.000. l FDR COUNTY USE ONLY )F-INS):www-orps"state_ny"vs Ci_ SaiS Cade 14 . 7 . 3 . 8 . 8 . 9 1 Neer York State Department of Ca_ Date Deed Recorded 16 / 2 / 20201 Taxation and Finance afonth nay rear Office of Real Property Tex Services C3_ nook 11,3,p ,5, g 1 C4_ Page 1 , ,9 , 7, 6 1 � RP- 5217-PDF ReaI Property Transfer Report(8110) PROPERTY INFDRltATIDNI ' `i.Property 321.5 C]e )'. 1'1G]"C-' 0-ive Location -------------.".. •srreEe-r Nuvw�re •sT;3EEr NWdn MaLLa..L c:k 1xa�;z -. _. __ •CFT`%On TOW.1Y V i..cf.Cl.' -IFf+C:Uf]E 2.Buyer CZ1jjK0 T.KTM �LUF RIF Name .-- 't.R5'd�A+hE.Cnr-sPRNv FFPS7 L"T."MMICO-PAFQY FlRiT NAME"------------------------------------------------------------........ $L Tax lridEGaFe Where future d"ax 8',fs are 10 be sena Billing i€other t€san toyer addres at bottom of corm) ________ Address RRsT NMFE: ......................................................................................................................... STRC ET NJ DCR ANDNAME C,r OR TGVN .•'::.TF. ZIP COr..E 4.Indicate the num bar of Assessme rK 1. Part of o Parcel (An IY if Ra rt of a Parcel)Check as they apply, Roll parcels transferred on the deep 4A, of P,arceis OR 4A.Y13rFnirFg i3d6rr1 WiGi SupdiVlsiQn AuthOrdty ExdSt3 5.Deed X OR 0.61 Oat S.ndivision Approval was Required for Transfer Propertyf••E:E:T •f3W1'M 'RC9 EG Size 4C.Parcel Approved for Subdivision with Map Provided ❑ 6.5elFer 'LRSrNfNVGOVnANY FlrinTNAraE V. ):'lrytrie ... ----------- .asr r+.n�eccraoRNy ri>Zsr r+nr e '7•Select the descr€ption which most accurately describes the Check floe boxes belowas,they appFy-, use of the property at the time of sale: Il.Ownership Type is Conderhimurn A, One.Family Re.sideritial 9.New Construction on a Vacant Land G 90A,Pmpeay Located wit h.in an Fig nculturhi DislriCt I Oe,Buyer received a di stio�um rn]tice m JiCaiinS that the prrperty is in an i P,griqulkural f,]i stria[ �-"_"• SA!_E. 3NFQF"RATION tg.Check one or more of these conditions as applicable to transfer: A"Sale Between Relatives or Former RaSatdves 11.Sala contraot Date B"Sales between Related Companies or Part ria m Susiness" C"One of the Buyers is also a scllerr "92.Date of salearansfer 05/07/2020 £l,Buyer or 9oSjer is Government.Agency or lending:nstitufon E-Deed Type not vdarranty or Bawa€n and Sale(Specify aelow) F.Sa4e Of Frscliona?or Less than Fee Interest(Specdfy Below) "•13-Full safe Price 0 .00 G.Signdfecent Chariga in Property Betmean Taxable Status and Sale Dates ---•••--• t-3"Sale of Busl peas is 11 icluded in$ale Price 'Fu13 Sala pr6CG'is tfl,3 totB(aiM1piFrlL paid SCF the property inGUciiM1g perzonal proppr'ty. I" Other Unusuai Factors Affecting Saie Price[Spec[fy Below) This pa ymcnk may bE in the Form of Cn3Slt,of har prop er;y or goods,or the ass:i nip;ion o° J"None mpngaRu5 crr otti tr PFaa-se round to the nearest wtaoie dollar ai a nf. - 'Commerrt(s)do coodkiom 14.ind€cate the value of persorkW property included in the sale 00 ..F....a......o..i..l_.y Tna �c= - ------------------------ A 79 F 9 SM ENT -----------------------ASSF9SMENT -----' INF OR MAT -Data ShCLAid reflect the latest Final Assessrnent Roil and Tax Bill ie,Year of Assessment(toll from which information taken(YYI 20 -------------------'-------------------------------------------------------------------------------------.. 'TB.Property Class 210 199,Scti ooi District.Name Vc L L.i.t:i:eCk C,-t.clh CquCI:au.YC. '20.Tax Map Fdentifier(s)IRalF identifier(s)(If more than four,attach sheet with addition at identifier(s)) r-� 3 :i. .-.GO B 1.is,.0❑ 'C, D-i C ER71 F ICAT 10 N F Certify that all of the items of information enterad nn this form are true and corract(to the best of my xnowFadge and beh"and t understand that the in aki ng of any wiitfu€ false statement of materlal fact herein suhject me to fheprovdslons of Lha"R>F.na.l fa:,y_r_rel ative to the making and filing of false dnstrum ants. ;7 SELLER--*I.NA 19 .. 15VY-ER —OfMATI_0-61 (Fi.ever=niPrt:igleon TO'1n*t]OVQ4-HOIC 1`DuYEr iS d..LC.AaCiP:y.aJ`3aSi M ion,oox pt'k1i4rt.do:rte SIOCec cafe"ny.-"two or l s FnFiy th]r is RGt w indJ iduai agi)nd or adudary,thou.a oAmo orad eo.n:ad-nfo reefs,,ar an,r+diVid�$EIrES.(,OrtS:U1G fiery W."C 0 rVi 9rdinil Tht!ral. fF V must bo antartd.Typo or print Clearly-i - ,y� SFA.I"FR S:GNAT.IRE pa"c BUYER S€C�NAT[J"RE. L zu._•kc K:i"m Marr e 1 '[R F3R 3T NAhdE ""."_""."""""_"""""-------- "...1_"vw _�".... .. �". "__w".......".... "... ^^_fr' 'ARC\GO DF - ©ATF" 32�5 E-Ia]_e �•S::Hn i q nFL3RAFlEi s'rf+ T NN4F. Mat_t_1"i_uck N 11952 ........................................................................................................... .---..„..„ I'✓O.^OVPi•.• ;,rRT� •,2:.R c4i,F: BUYER'S ATTORNEY L! F 3 .1 S 1 f �,fj Z 3F ` fi ••�•�••..��F.R CC]- TEI.�F^r=4*rE uuMBEP”(fix:92`)799?: