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Home My WebLink AboutL 13119 P 913 SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED WITH LIFE ESTATE Recorded: 09/15/2021 Number of Pages : 3 At: 09 :56 : 37 AM Receipt Number : 21-0162867 TRANSFER TAX NUMBER: 21-04569 LIBER: D00013119 PAGE : 913 District: Section: Block: Lot: 1000 066 . 00 02 . 00 058 . 000 EXAMINED AND CHARGED AS FOLLOWS Deed Amount: $0 . 00 Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $15 . 00 NO Handling $20 .00 NO COE $5 . 00 NO NYS SRCHG $15 .00 NO EA-CTY $5 . 00 NO EA-STATE $250 . 00 NO TP-584 $5 . 00 NO Notation $0 . 00 NO Cert.Copies $0 . 00 NO RPT $200 . 00 NO Transfer tax $0 . 00 NO Comm.Pres $0 . 00 NO Fees Paid $515 . 00 TRANSFER TAX NUMBER: 21-04569 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County Number of pages RECORDED 2021 Sep 15 09[56:3' AM .JUDITH A. PASCALE This document will be public CLERK OF SUFFOLK COUNTY record.Please remove all L D00013119 Social Security Numbers P 913 prior to recording. DT# 21-04565 Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps 3 FEES Page/Filing Fee /7 + Mortgage Amt. 1.Basic Tax Handling 20. 00 2. Additional Tax TP-584 IS Sub Tota I Notation Spec./Assit. r- or EA-52 17(County) J5 SubTotal `� Spec./Add. EA-5217(State) TOT.MTG.TAX D Dual Town Dual County R.P.T.S.A. Held forAppointment Comm.of Ed. 5. 00 Transfer Tax Affidavit � ao + R Mansion Tax The property covered by this mortgage is SCRCertifieclCopy or will be improved by a one or two NYS Surcharge 15. 00 [� family dwelling only. Sub Total I YES orNO Other Grand Total If NO, see appropriate tax clause on page ofthis instrument. J14 IJ 30 4 Dist.1C 210492531000 06600 0200 058000 5 Community Preservation Fund Real Property P T S Consideration Amount$Tax Service R Verification 10-SEP-21�i II��IIIIIIIIIIIIIIIIII Illllllllilllllllllllllllll! CP Tait Due $ .� Improved Satisfactions/Discharges Releases List Property Owners Mailing Address 6 WORD&RETURN TO: Vacant Land William C.Goggins, Esq. TD P.O. Box 65, 13235 Main Road TD Mattituck, New York 11952 TD Mail to:Judith A.Pascale,Suffolk County Clerk 7 Title Company Information 310 Center Drive, Riverhead, NY 11901 Co.Name A+ — MAJA www.suffolkcountyny.gov/clerk 1 Titlefi I qlDI 8 Suffolk County Recording & Endorsement Page This page forms part of the attached Bargain and Sale Deed with Life Estate made by: (SPECIFYTYPE OF INSTRUMENT) John J. Nickles The premises herein is situated in SUFFOLK COUNTY,NEW YORK. TO In the TOWN of Southold Kathleen M.Goggins-Nickles In the VILLAGE or HAMLET of Southold BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. over COUWsy 1401 A NY 005-Bargain and Sale Deed with Covenant against Grantor's Acts Individual or Corporation(Single Sheet)(NYBTU 8002) CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY THIS INDENTURE,made the �Jd day of October in the year 2020 BETWEEN John J.Nickles,residing at 1605 Arshamomaque Avenue,Southold,New York.11971 party of the first part,and Kathleen M.Goggins Nickles,residing at 1605 Arshamomaque Avenue,Southold,New York 11971 party of the second part, WITNESSETH,that the party of the first part,in consideration of Ten Dollars and other valuable consideration paid by the party of the second part,does hereby grant and release unto the party of the second pact,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 Hamlet of Southold,Town of Southold,County of Suffolk,State of New York,shown and designated as Lot 15 on the "Map of Beixedon Estates,Town of Southold,Suffolk County,NY, Property of Grace R.Nickles,formerly Grace Rogers DeBeixedon,Made by Otto W.Van Tuyl, Licensed Surveyor,and riled in the Suffolk County Clerk's Office on March 16,1946,as Map No.1472. SCTM No.1000-066.00-02.00-058.00 containing.33 acres Known as 80 Orchard Road,Southold,New York GRANTOR hereby retains a life estate in the within premises. TOGETHER with all right,title and interest,if any,of the party of the first part of,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 party of the first pan,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"party"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 the day and year first above written. IN PRESENCE OF: �4- JOHN,Y,NICKLES UBEACKNOWLEDGMENTFORMBELOWWFTHINNEwYORKSTAmONI.Y: USIiAG'KY014'Ih'IJGME'NTFORhIHh.'/.OWW/THINNEWYORKSTATFONLY, . Stateo`fj NewYork,County ofSulfolk Iss.: State of New York,CountynfSuffolk }ss.: On thet/" day ofOCtober in the year202O On the day of in the year before me,the undersigned,personally appeared before me,the undersigned,personally appeared John J.Nickles personally known to me or proved to me on the basis of satisfactory personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s)whose namc(s)is(are)subscriNcd to the evidence to be the individual(s)whose name(s)is(are)subscribed to the within instrument and acknowledged to me that heJshe/they executed within instrument and acknowledged to me that hc/she/they executed the same in his/her/their capacity(ies), and that by his/her/their the same in his/her/their capacuy(ics), and that by his/herdtheir signature(s)on the instrument, the individual(s).or the person upon signatur:(s)on the instrument, the mdividual(s),or the person upon hch��w al(s)acted,executed the instrument. behalf of which the individual(s)acted.executed the instrument. DMA T JennJzzl LI J.TANNUi I LIC,STATE OF NSW YORKf.C-_ion I.Io.02JAGOSZSSS ed in Sufielk County pVU-4 in SAA 60rxpires February 13, Kumm11 exP Z�Ii3 ACKNOWLEIIrAfENTFORMFOR-UsL, SATE ONLY: ACKNOWIXDGME'NT OW FOR USF.OUTSIDP.NEW YORK STA TF ONLY: f—York Suhsrrihing Wilne.re Arkr,nwledgmeru Cerlitirnh'! 10w al'Srnre or F,rrrign..G- dt Arknolrledgmenl Cenifirared State of New York,County ofIss.: ................................................. .Iss: (Cnnq,We Vrnrrr n ill,Slaw.C-awv,Prariare or Munirilndily) On the day of in the year before me,the undersigned,personally appeared On the day of in the year helore.me•the undersigned,personally appeared the subscribing witness to the foregoing instrument.with whom 1 am personally acquainted,who,being by me duly swum,did depose and personally known to me or proved to me on the basis of satisfactory say that he/she/they reside(s)in evidence to he the individual(s)whose names)is(are)subscribed to the within instrument and acknowledged to me that he/she/they executed (ifthe place of residence is ill a city,include rhestreet and sweet number, the same in his/Iter/their capacity(ies).that by his/her/their signature(s) ifa n,thereof):that he/she/they know(s) on the instrument.the indiv(dual(s),or the person upon bchalfof which the individuals)acted,executed the instrument,and that such individual to be the individual described in and who executed the foregoing made such appearance before the undersigned in the instrument:that said subscribing witness was present and saw said execute the same: and that said witness at the same time suhscribcd (Insert the cin or other political subdivision and the,'tate or countn'or his/her/their name(s)as a witness thereto. other place the acknowlcidgrnenl was taken). BARGAIN&SALE DEED W—COVIiNANINA(:A[N.\'r(ilU IOR'\ACIN TITTLE NO. Dl STR ICT SECrioN' BLOCK LOT COUNTY Ok TOWN Suffolk TO RECORDED AT REQUEYT OF Fidelity National Title Insurance Company RFTURN RY MA1L TO FIDELITY NATIONAL TITLE William C.Goggins,Esq. INSURANCE COMPANY P.O.Box 65 tna,Rw,xnn:o tylg Mattituck,New York 11948 Fidelity moi" dl—d,,—V—Y,.l.Gnu Lu,d TW,A.r„e inline W U C 0 O Cf Z n tL O U W tL LL O W In n tL O W W U Q a N ISn F IrW D W W N W Q INSTRUCTIONSCRP-5217-PDF-INS)!www.orps.stete ny.us FOR COUNTY USE ONLY I Now York Bide Doperbylent of C1.*vies*cede Ly 7 ,�J Taxation and Finance CZ Date Deed Recorded * / , 011ce of Real Property Tax SerVioLs C3.Book RP-5277-PDF f;4.Papa Real Properly Transfer Report(8110) PROPERTY INFORMATION 1.properly H0 LOra110M1 Orchard Road •fi1N!I:YJrara •910111 11.1 Southold Southold li4S•' •[T 7r I PMI Yl1ADF •:In CanE 2.Sullen, Goggins Nickles Kal. Leen �. Name •LAST wMFJC0117M1, Fl4*1 RWa [AS'"E OWAN- 1-s'tiIME a.Tax Indiana whoa Nlum Tax Bills ars to be sent aBtltlnling a If other than buyer am selat bottom m form) tiMrr . S1.1 l T ilisse ,l rlRlx [rrd.r'oa•. -yrwTF Do a%1h 4.Indleate the number of Assessment p� a parcal (only If Part or a ParceO Check as they apply: Roll parcels transferred on me dead_ of Parcels OR 4A.Planning Board with Subdwlskan Aut ionly Exists a.Deed Properly •r,MArT aEE1 \ ()R 7•.i 40.Subdivision Approval was Required ml Transfer SW •114P11 •upEg 4C.Portal Approved for Subdivision with Map Provided Nickles :ohs j. 5.Seller •Ik*-tixesJKa"wr — --- Name h nsr wall: est rNw.rccapwv ——"— FOS:haaE —'— —•-- •7.Select the description which most accurately describes the Check the boxes below as they apply: use of the property at the ams of gale: 6.Owrlemhlp Type is Condominium El C.Residential Kuant Land B.New Construction On a Vacant Land I OA.Pmpery Locama within an Agricultural Dlshkt I__I IDS.Buyer received a(fisdoalra nockit Indicating that the proporty,is in on Agricultural Diabrcl SALE INFORMATION 15.Cheek one or mom o1 these conditions as applicable to transfer. A.Salo Between Relatives or Former Removes 11.sale Contract Dau B Sola between Related Companies or Partners in Business C.One Orate Buyem Is also a Seller •12.Date or tfalalrronsfer 10/30/2020 D Buyer or Seger Is Govemmenf Agency or Lending Inaeuhon - C'Deed Type riot Wmlanry or Bargain and Sala ISpeoly Below) F.Sale o1 I'maional o Lea Nan Fee Interest(Specify adow) `7�.Full Sam Peke C IJQ G.Significant Change in Properly Behroen Taxable Status and Soto Data. (rue Selo Price Is eve IuW amount paid lot eve Properly includingH Sala d Business Is Irldllaotl to Sam Peke Trus Paymenl may be In the Item d rash,never personal al prmcnY I.Othm Unumal Factors Afibcin bale Pere ISpeay Below) P0Parb11 or goods.a the emoursaan or g mortgages m cher obligations 1 Please Alam m fes Muee1 wank dbderaapunt J.None Comment(*)an Condition: 14.Indicate the value of personal properly included In the sale .VO ASSESSMENT INFORMATION-Data should reflect the leftist Final Assessment Roll and Tax Bill 16.Year olAssessment roll from which Information takan(YY) 10 •17.Tocol Assessed Value — ?DO 116.PropsrtyCmss 311 _ •76.School District Name SJt:':Ielr; 120.Tea Map M*ntifiegeyRoll Iderdllfer(s)(M more than four•etmeh chest with additional Identifier(s)) 1003-066.30-02.00-055.000 CERTIFICATION I Cw11y plat all of the hems of Information entered on this form 2 i true Orbit eomcI(to the best of my knowledge and began and I understand Met the making of any wifllu( false statement of material fact hsmin subject m.to the Mvkiona-el th"Tial.law relative to the making and filing of false Instruments. SELLER 5LS1NAT.VRE BUYER CONTA.rL INFORMATION Ierew mMr's—fr ire buyer Are II buys a LLC,eooay....dale..ralpWg_corn stork o"Mary slew of n snip M-1a rot 1a Indalxal ROAM or.durary I—P Neva ale moan ala -.1 r,o daduarmp.nwk /IV IIwM who ai reser quseaxa mom-dra Te aAs'er mss)et rdered Type or prim crony.) b FA 110"Tuin- DAIS BUYER SIGNATURE Go Ira IV 'lel Kathleen ^'/��/�/(t //)�/_/ �`/J .y .aSl I POT rrwL' I/�1 akf d 3Y urrac •M I'PhOfPhW3ER.P -- r 9YK9 BxxM Nee 'S1:L dux —�. eiwxal -!605 Arshamrmaque Avenu •—FE —aL. - •Srl•Irrfew. Southold NY 1'471 -I-•aTale. -arwTE •/a CODF BUYEWISATTORNEY WrWM •R8-V. AREA;iCP -—• :ELrPII[Y(RIr4eER;r•rarrw: I