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L 13135 P 593
SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED Recorded: 12/27/2021 Number of Pages: 4 At: 7 :25 : 11 PM Receipt Number: 21-0218711 *ELECTRONICALLY RECORDED* Transfer Tax Number: 21-17742 LIBER: D00013135 PAGE: 593 District: Section: Block: Lot: 1000 066.00 02 .00 058 .000 EXAMINED AND CHARGED AS FOLLOWS Deed Amount $300,000 . 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 $250 . 00 NO TP-584 $5. 00 NO Comm.Pres $4,500 . 00 NO Transfer Tax $1,200 . 00 NO Transfer Tax Number: 21-17742 Fees Paid $6,220 . 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 12/27/2021 7:25:11 PM JUDITH A. PASCALE CLERK OF This document will be public SUFFOLK COUNTY record. Please remove all L D00013135 Social Security Numbers P 593 prior to recording. 21-17742 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) 250.00 TOT.MTG.TAX 200.00 CIO., Dual Town Dual County — Held Held for Appointment Comm.of Ed. 5. 00 Transfer Tax 1,200.00 ' _� 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. 00 470.00 family dwelling only. Sub Total YES or NO Other 520.00 Grand Total If NO,see appropriate tax clause on page# of this instrument. 4 1 Dist. Section Block Lot 5 Community Preservation Fund Real Property 27062723 1000-066.00-02.00-058.000 Consideration Amount $30 0,0 0 0.0 0 Tax Service P r s Agency €t DTr n CPF Tax Due $ 4,500.00 g }' Verification 77179!2[727 Improved 6 Satisfactions/Discharges/Releases List Property Owners Mailing Address RECORD&RETURN TO: Vacant Land X Hamlet Title Agency Inc TD 10 601 Portion Rd Ste 207 Lake Ronkonkoma NY 11779 TD TD !Nail 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 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 MDENTIJRlVVV le the ( day of OJ&I*W �B♦fQNv1�Z( in the year ar BETWEEN l ei , ttr�1r�C N0V'Crr�q,2_C2-, Kathleen M.Goggins Nickles,residing at 1605 Arshamomaque Avenue,Southold,New York. 11971 party of the first part,and Christopher T.Crozier,residing at 1050 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 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 Hamlet of Southold,Town of Southold,Couuty 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 filed in the Suffolk County Clerk's Office on March 16,1946,as Map No.1472. SCTM No.1000-066.00-02.00-058.000containing.33 acres Known as 80 Orchard Road,Southold,New York _A�\(:) �d t�ltect y U ai� Oared C� 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 incumbered in any way whatever,except as aforesaid. AND the party 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"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: KATHLEEN Ay.GOGYINS NICKLES First American Title Insurance Company Title Number: HTA-7735-S Page 1 SCHEDULE A DESCRIPTION AMENDED ALL that certain plot, piece or parcel of land, 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 filed in the Suffolk County Clerk's Office on March 16, 1946, as Map No. 1472, being more particularly bounded and described as follows: BEGINNING at a point on the Northerly side of Orchard Road distant 89.02 feet Westerly from the corner formed by the intersection of the Northerly side of Orchard Road with the Westerly side of Arshamomaque Avenue; RUNNING THENCE along the Northerly side of Orchard Road South 73 degrees 44 minutes 50 seconds West 88.00 feet; RUNNING THENCE North 03 degrees 39 minutes 50 seconds West 173.73 feet(actual) 173.95 feet(map); RUNNING THENCE North 83 degrees 20 minutes 10 seconds East 86.00 feet; RUNNING THENCE South 03 degrees 39 minutes 50 seconds East 159.05 feet to the Northerly side of Orchard Road at the point or place of BEGINNING. 1 USEACKNOWLEDGMENTFORMBELOWWITHINNEWYORKSTATEONLY: USEACKNOWLEDGMENTFORMBELOWwrrHINNEWYORKSTATEONLY.• State of New York,CountyofSuffolk }ss,: State of New York,County of Suffolk }Ss.: A4 w On the day of 4ft4m*r OVCw1�2C in the year2021 On the day of in the year before me,the undersigned.personally appeared before me,the undersigned,personally appeared Kathleen M.Goggins 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 name(s)is(are)subscribed to the evidence to be the individual(s)whose name(s)is(are)subscribed to the within instrument and acknowledged to me that he/she/they executed within instrument and acknowledged to me that he/shelthey executed the same in his/her/their capacay(ies). and that by his/her/their Elie same in his/her/their capacty(ies), and that by his/hedtheir signature(s)on the instrument,the individual(s),or the person upon signature(s)on the instrument,the individual(s),or the person upon behalf of which the individual(s)acted,executed the instrument, behalf of which the individual(s)acted.executed the instrument. MICHAEL HARRISON NOTARY PUBLIC.STATE OF NEW YORK Registration No,OIHA5026220 Qualified In Suffolk County Commisslon Expires March 21,20 2 ACKNOWLEDGMENT FORM FOR USE WTTHINNEW YORK STATE ONLY.• ACKNOWLEDGMENT FORMFOR USE OUTSIDE NEW YORK STATE ONLY.• (New York Subscribing Wimevs Ac•krtowledgment Certificate/ (Out of State or Foreign General Acknowledgment Certificate) State of New York,County of }ss.: .......................................}SS.: (Conylle[e Venue with Stnte,Country,Province or Municipality) On the day of in the year before me,the undersigned,personally appeared On the day of in the year before me,the undersigned,personally appeared the subscribing witness to the foregoing instrument,with wham I am , personally acquainted,who.being by me duly sworn,did depose and personally known to me or proved to me on the basis of satisfactory say drat be/she/they reside(s)in evidence to he the individual(s)whose name(s)is(arc)subscribed to the Within instrument and acknowledged to me that hc/shchhey executed (if the place of residence is in a city,include the street and street number, the same in hi slher/their capacity(ies).that by his/her/their signature(s) ifany,thereof);that he/she/they know(s) on the instrument,die individual(s),or the person upon behalfof which the individual(s)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 subscribed (Insert the city or other political subdivision and the state or country or his/her/their name(s)as a witness thereto. other place the acknowledgment was taken). BARGAIN&SALE DEED Win COVENANTS AGAINST GRANTOR'S ACOS TITLE NO. DISTRICT 0900 SECTION 205.00 Linda Bandrowski BLOCK 03.00 LOT 048.000 COUNTY OR TOWN Suffolk TO Doniella Brown RECORDED ATREQUEST OF Fidelity National Title Insurance Company RETURNBYMAILTO FIDELITY NATIONAL TITLE ViOu"C INSURANCE COMPANY bCrlHYnlNif_n 1928 �, e2►n �t � carT�t� Fidelity-a Member New bkS..L-d 77ne Asancln,ion U LL LL O 0 Z 2 O U w LL W N 7 R O LL W V 6 a w S2 F W W N W R -INS):vwuw.orps_sta3e.ny,us FOR COUNTY USE ONLY Now York State Department of Cl- S4IIS Code 1 4 F 7 F 3 F S F S F 9 i Taxation and Finance C2_ nate need Recorded 1 12 / 27 20211 Office of Real Property Tax Services Manth nay Year RP- 5277-PDF C3_ Book 111 3,1 ,3, _5J C4_ Page I 1 15 1 91 3 I Rea[Property Transfer Report(8/10)1 PROPERTY INFORMATIONI 1.Property 80 Or<-hard 131r-eet Location •STREET NAME Southold 11971 •C17Y aR Tawe ..................... _____..... 'car'CIXJE 2,Buyer Ch_rist=c);pher T, Name _.__. .......... ----- iR 'EAS,'NAMklC©I�RNY � 5T NNW- LA$T'NAME+cOMFANY........... ____ flRS'r NAbW .......................... .......................... 3.Tax Indicate where future Tax Bills are to be sent Billing if other than€]Ehler address(at bottom of form} EAST NAMFJC:OI�.�A3JY •�•� FFRST PW ph[ •••••• ..........•"•"•"•"•". . Address ST EE I'NUMBER AND NAME •••••••••••••••••• CITY aR TOM .1.1..,.,,.,.,.,.,.,.,.,.,.,.,.,. S7A3-E 7W CGI7E 4.Indicate the number of Assessment 1 Part of a Parcel (Only If Bart of a Parcel)Check as they apply: Roll parcels transferred on the deed #of Parcels OR 4A.Planning Sea rd with Subdivision Authority Exists S.DeedX OR 0.33 Prop48,Subdivision APP 4 Approval was Required for Transfer size ty 'FRF)NTF 'c'{' 'DEPTH 'ACHES Size 40.Parcel Approved for Subdivision with Map Prov€cied GoggIns Nickles Kathleen €;. 6.Seiler .iAaT RAMI GOWANY _ """" "".. Name NRST NAME ._._......_.�... .""""""""""."" ............ FAST K MEkG&WI NY MRST NAMU "7.Select the description which most accurately describes the Check the boxes below as they apply: use of the property at the ti ne of sale: 8.Ownership Type is Condominium C. ResScleratzal Vacant Latad 9.Now Construction on a Vacant Land IDA.Property Located within an Agricultural District 1nB,Buyer received a disclosure notice indicating that the praparty is in an Agriou.itural District SALE I N>~URMATIO t 15.Check one or more Of these conditions as a pp€ICabW to transfer: 06/30/21 I A.Sal*Between Re€atives or Fortner Relatives 11.Sala Contract Date B.Sale between Related Companies or Partners in Business- - C One of the Buyers is also a Seller '12.Fate of SaEle/Transfarf I l� D•Buyer or Se€ler is Government Agency or Len dir D institution """". ------ E-Deed Type not Warra My or Bargain and Sate(Specify Seiow) '100,000 F-Sale of Fractlorta€or Less that?Fee Interest(Specify Se€ow) "13.Full Bala Pride ,00 G.Significant Change In Property Between Taxab;o Status and Sale Dates H-Sale of Busloess Is Inc€uded in Sale Price? ( Full Sale Price is the total amount paid for the property including personal property. I. Cather Unusual Factors Affecting Sale Price(Specify Below) This paymart may be in the farm of cash,other property or goods,or the assumption of J.Norm mortgages or other oh€€ga;Igoe)plass®round 1p the nearest whole dollar&M8L1rit. Comment(s)on Condition: 14.indicate the value of personal property Included in the sale '00 ~ ASSESSMENT$INFORMATION-Data should refect the latest Pinal Assessment Roll and Tax Blll 18.Year of Assossment Roll from which Information taken(YY) 20 '17'.Total Assessed Value C' •, -------- '18.Property Class 4 I } "1 s.School District Name S O u t hn l d 1 .........__....---- --------- '20.Tax Map identifter(s)1i2o€€Identifiers;(€f more than four,attach she®!with additional identifier(s))............. .........................�,,,J.ter`�� ..._....-�... CERTIFICATI©N I Certify that all of the items of information entered on this form are true and Correct(to the best of my knowledge and belief)and l understand that the making of any willful faire statement of material fact herein subject me to the,prgylgior�g 4fs,hpxaeX]pI.JRkM.ralative to the making and filing of false Instruments. ..rte.. E 1 CR 1-fa.l €.T41.13 WY ONTACTINFO RMAT.ION (Enter inror livn for the buyer Now€r buyet is LE.C,society,assU lotion,carp—,14 r.,i6rsl stock company,asbata or I c"' entsn ity that is dol an Indbvldua€ast or fiduc ary,men a[flame and c nlon act Inlormalbof an individualrea poo bl* pasty Who caro answer qu�stions regarding the trenater must be entered Type or print ties") 9ELF,F.R SiCiNA"ri1RE �� Il F7AT[ �i 1� r �� i3iJYL�Ft x'�l.4 NATUR.F_ L�_gaA_...... --------� i�i J`? t � t "LAFlY r'f•A1•M1E rFRSF NRA4(w _v�_.3_S Z-E�14_iL�� .•�."�.t,.�l,V�.... !i �� Cj •AF:EA coE]E -,E.l.riPHPMC t-0l�Ir�ER(Ex:P9a9999) 'STREET Nup.$f)Ert 'BTriFET iY4ME I 1 + � � I 1 k C:diY.tlIt.7oWPt �d---_ 'STATE •2ER Coen I I l I I IJ+I + I .......... CMSTNAME RRST NA MP ---------------19_Q� tp 0 0 ARA COOP ••- TELEPFio�3�Nr19l;R[fix:USiP9899)