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- IIIIIIIIIIIIIIIIIIIIIIIII -
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEED Recorded: 02/07/2022
Number of Pages : 5 At: 02 :53 : 37 PM
Receipt Number : 22-0020831
TRANSFER TAX NUMBER: 21-22873 LIBER: D00013141
PAGE : 692 '
District: Section: Block: Lot:
1000 006. 00 02 . 00 003 . 010
EXAMINED AND CHARGED AS FOLLOWS
Deed Amount: $200, 000 . 00
Received the Following Fees For Above Instrument
Exempt Exempt
Page/Filing $25 . 00 NO Handling � -
$20 . 00', NO
COE $5 . 00 NO NYS SRCHG $15 . 00 ; NO 1
EA-CTY $5 . 00 NO EA-STATE $125 . 00• „ . NO
TP-584 $5 . 00 NO Notation $0 . 00 NO
Cert.Copies $0 . 00 NO RPT $200 . 00 NO
Transfer tax $800 . 00 NO Comm.Pres $1, 000 . 00 NO
Fees Paid $2;-200 .`00 ...
TRANSFER TAX NUMBER: 21-22873
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
JUDITH A. PASCALE
County Clerk, Suffolk County
rt r• -
1❑❑z
Number of pages
RECORDED
2022 Feb 07 02:53:37 PM
This document will be public JUDITH A. PASCALE
CLERK OF
record.Please remove all SUFFOLK COUNTY
Social Security Numbers L D00013141
prior to recording. P 692
DT# 21-22873
Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps
3 G FEES
Page/Filing Fee T 1- 13 Mortgage Amt,
1.Basic Tax
Handling 110 Ik 00 2. Additional Tax
TP-584 17— Sub Total
Notation Spec./Assit.
or
EA-52 17(County) 5 Sub Total '515— Spec./Add.
EA-5217(State) TOT.MTG.TAX
Dual Town Dual County
R.P.T.S.A. Held for Appointment
cccppp. �c� i
Comm.of Ed. 5. 00 1 Transfer Tax U�
Affidavit + �. Mansion Tax
The property covered by this mortgage is
Certified Copy or will be improved by a one or two
NYS Surcharge 15. 00 family dwelling only,
Sub Total YES or NO
Other
Grand Total If NO, see appropriate tax clause on
(� page# of this instrume t.
4 Dist. 22001881 1000 00600 0200 003010 )3.010 5 Community Preservation Fund
Real Propert P T S Consideration Amount$
Tax Service R SMI 111111111111111111111111111 _
Agency 11-JAN CPF Due $
Verification. _ __
---- - -- � T Improved
6 Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD&RETURN TO: / Vacant Land
MICHAEL ROBERTS ESQ TD tC)
THE ADVOCATE LAW FIRM
805 THIRD AVENUE SUITE 2030 TD
NEW YORK,NEW YORK 10022 TD
Mail to:Judith A.Pascale,Suffolk County Clerk 7 Title Company Information
310 Center Drive, Riverhead, NY 11901 Co.Name "
www,suffolkcountyny.gov/clerk Title# 413 016451
8 Suffolk County Recording & Endorsement Page
This page forms part of the attached DEED made
by: (SPECIFY TYPE OF INSTRUMENT)
)MAL-,H PARK BENEVOLENT CORPORATION The premises herein is situated in
SUFFOLK COUNTY,NEW YORK.
TO In the TOWN of SOT ITHOT.D
MICHAFT.P SIMONCTNI In the VILLAGE
K ARFN R RIMOMCINT or HAMLET of
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
over
DEED
WALSH PARK BENEVOLENT CORPORATION,
A DELAWARE NOT-FOR-PROFIT CORPORATION
TO
MICHAEL P. SIMONCINI AND KAREN R. SIMONCINI
TAX LOT NUMBERED: DISTRICT 1000
SECTION 006.00
BLOCK 02.00
LOT 003.010
TOWN OF SOUTHOLD
COUNTY OF SUFFOLK
STATE OF NEW YORK
RECORD & RETURN BY MAIL TO:
MICHAEL ROBERTS, ESQ.
THE ADVOCATE LAW FIRM
805 THIRD AVENUE
SUITE 2030
NEW YORK, NEW YORK 10022
12861612 4.doc
12861612v.4
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DEED
THIS INDENTURE, made as of the I" day of December, 2021, between,
WALSH PARK BENEVOLENT CORPORATION, a Delaware not-for-profit corporation,
having an address c/o Jean-Claude Lanza, Esq., Patterson Belknap Webb & Tyler LLP, 1133
Avenue of the Americas, New York, New York 10036, party of the first part, and MICHAEL P.
SIMONCINI and KAREN R. SIMONCINI, husband and wife, having an address at 700 Peter's
Way (flkla 8 Peter's Way), Fishers Island, New York 06390.
WITNESSETH:
That the party of the first part, in consideration of ten dollars ($10.00) lawful
money of the United States and other good and valuable-consideration paid by party of the
second part, does hereby grant, bargain, sell, assign and release unto the party of the second part,
the heirs or successors and assigns of the party of the second part forever, that dwelling unit (the
"Unit") above the plane defined by the top of the concrete foundation located on that certain plot,
piece or parcel of land situate, lying and being in the Town of Southold, County of Suffolk, State
of New York, described as:
Lot 8 according to the major subdivision plan
prepared for Walsh Park Benevolent Corporation
d06 and filed in the Office of the Clerk of the County of
3 + �� Suffolk, State of New York, as Map No. 8871, on
December 22, 1989,
L� 003 01C) SUBJECT TO the Declaration of Covenants and Restrictions recorded in the
Office of the Clerk of the County of Suffolk, State of New York, in Liber 10969 at Page 329 on
November 20, 1989;
FURTHER SUBJECT TO the Declaration of Covenant for Road Maintenance
recorded in the Office of the Clerk of the County of Suffolk, State of New York, in Liber 11068
at Page 479 on May 16, 1990;
FURTHER SUBJECT TO the Declaration of Covenant for Utility Easement
recorded in the Office of the Clerk of the County of Suffolk, State of New York, in Liber 11107
at Page 494 on July 24, 1990; and
TOGETHER with the appurtenances and all the estate and rights of the party of
the first part in and to the Unit;
TO HAVE AND TO HOLD the Unit herein granted unto the party of the second
part, the heirs or successors and assigns of the party of the second part forever.
'J.Ud lLC� fd Q 3 Cdv�znr�n��.S Co /o �, oo' / aU/aiv/ f
Q�Lrci9.A/34a ul�o�
Ji
w �c% .ate �vevt� '� Cos, °�°'fa�r, ♦
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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 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.
IN WITNESS WHEREOF, the party of the first part has duly executed this deed
as of the day and year first written above.
WALSH PARK BENEVOLENT CORPORATION
By: `V
Name: kndrew Burr
Title: Ce—ener,do
STATE OF CONNECTICUT,COUNTY OF F&14A ss:
On the 16 day of November, in the year 2021, before me, the undersigned, personally appeared
Andrew Burr, personally known to me or proved to me on the basis of satisfactory evidence to be
the individual whose name is subscribed to the within instrument and acknowledged to me that
he executed the same in his capacity, and that by his signature on the instrument, the individual
or the person upon behalf of which the individual acted, executed the instrument, and that such
individual made such appearance before the undersigned in the r . {Insert the
city or political subdivision and the state or country or other place the acknowledgement was
taken},
ZACHARY MILLER f
NOTARY PUBLIC•CT 183702 �-
IIly Commission Expires Apr•34,2026 4 x
Notary Public y "
� ,' ^r• Opti
!rl .
2
1266 i 612_4.doc
128661612v.4
First American Title Insurance Company
Title Number: 478-016451S
Page 1
SCHEDULE A DESCRIPTION
AS TO FEE
The dwelling unit above the plane defined by the top of the concrete foundation located on
that certain plot, piece or parcel of land, situate, lying and being in the Town of Southold,
County of Suffolk, State of New York, described as:
Lot 8 according to the major subdivision plan prepared for Walsh Park Benevolent
Corporation and filed in the Office of the Clerk of the County of Suffolk, State of New York,
as Map No. 8871, on December 22, 1989.
AS TO LEASEHOLD
All that certain plot, piece or parcel of land situate lying and being at Fishers Island, Town of
Southold, County Of Suffolk being more known and designated as Lot 8 according to the
major subdivision plan prepared for Walsh Park Benevolent Corporation and filed in the
Office of the Clerk of the County of Suffolk, State of New York, as Map No. 8871, on
December 22, 1989.
FOR INFORMATION ONLY: Premises known as 700 Peter's Way (f/k/a 8 Peter's Way),
Fishers Island, NY. 06390.
1
• INSTRUCTIONS(RP-5217-PDF-INS):www.orps.state.ny.us
FOR COUNTY USE ONLY Now York State Department of
C1.sins Cede Taxation and Finance
C2.Date Dood Rocorded I /67
I Office of Real Property Tax Services
(� �'° "T RP-5217-PDF
09.Book 3 T C4_Page L-1— I C) L_I I Real Property Transfer Report(8110)
PROPERTY INFORMATION
1.Property 70C PETER'S WAY
Locaton _.... ---.. ...
•aTRFFi h.�•W.Fa � "Si=F-F-N4lE '
F:SH-ERS =SLAKI) 06390
•cl:r;::lawn . vx..;.a "- -sir GdpF
2.Buyer SIMONC1?:_ MICHAEL P.
Nems ... ..-.; -- — - --
•MSI NAN�A:r1Y�'ANr xwF
9;1NO:JC:'i_ KAREN E.
I AS•NAN X.7jrNY FROh 11
7.Tax indicate where future Tac 9114;aro to be sem
&Iltng II other than buyer address(st bottom of form) _4T NAYF..W';'NT' rIRST NAN:
Addmaa
V.RMTh W7GP N]M1AM_ :7-raA Te.WN - _ STATE tPC
1.Indicate the number of Assessment - p ply Percale OR �Part d a Parcel (Only If Part of a Parcel)Check as they appy:
Roll parcels tronsforred on the dead 4A.Planning Board with Subdivision Avlhorhy Exists
6.Deed \ Olt 46.Subdwsron Approval was Required for Transfer
Propery •Iwwl:¢r �C.,-,. ACRLs
six 4C.Pared Approved for Subdivision with Map Provided
wAI.S•r' FA:tiK B ENEVOIENT CCRF0FA7TCN --
6.Seller •cast YAM--aRCY+AY+ =ria:hAYE
Name
IAS-RAMEW10-NY -_• •_ - RRIST NAVF
•7.89but the description which most accurately describes the Check the boxes below as they appy:
use of the property at the time of sale: S.Ownership Type is Condominium
A.One tarnily Residential 9.New Construction an a Vacant Land r'
10A.Property Located within an Agricultural District
106.Buyer received a disclosure notice indicating that the property is In an -I
Agncultural District IJ
SALE INFORMATION 15.Check one or mora of these conditions as applicable to transfer.
IA Sala Between Relatives or Former Relatives
11.Sale Contract Date 12/1/21 B.Sale between Related Companies w Partners in Business.
I C One of the Buyers is also a Seller
- 1 D Buyer or Seller is Government Agency or Lending Insa:uban
12.Date et Satarrmnster 1211/21 -„ JE Deed Type not Warranty or Bargain and Sorb(Specify Below)
F Sae of Fract anal or Less than Fee Interest(Specify Below)
•17.Full Sala Price
200,C00
.(w G Signiunt Change In Property Between Taxable Suuus and Sala Dates
-- - I H Sae of Business is Included In Sale Pira
(Fill Sale Price is the total amour.pard for the property including persona property �' I.Other Unusual Factors AReeLng Sale Prim 15pesi!y,Below)
Tres payment may be in the form at cash,other property or goods or the assumption of 1_
I J None
mortgages or other obllga'uons)Presse round to the neared whole dose amount.
CommeM(a)an Condition:
14.indicate the value of personal 00
properly included In the solo
ASSESSMENT INFORMATION-Data should reflect the latest Fina(Assessment Roll and Tax Bill
IL Year of Amazement Roll from which information token(YY) 2.. 117.Total Assessed Value 5,210
'15.Prop"Clean 210 _ _-, '19.School District Name 04-FISHERS ISTAND
k 7�ao Map Identiflerts)fRoll Identterjej(If mom than four,attach shoot wdh additional IdamlMrjsl)
336.11C, C2.30, 0C'..010
CERTIFICATION
1 CerUly
that all of the home of infoml Won entered on this form are We and correct Ito the best of my knowiadgps and bellef)and I understand that the making of any willful
false 1orriem of material fact herein subject me to the provisions of the penal law rslstve to the making and flung of false instrwnonts.
SELLER SIGNATURE BUYER CONTACT INFORMATION
ICPmr IIYar•Nben m•!ne buyer hate d buyer it L:.0 radalY.p•NW:wI,cory0'a:on,IxI.Y.elan tpRpenY.eS'Jm ar
YJIy'_'al Y nor ,amid wauat agent a reu9ary,hmn a mane sne rJel m rrew-r n..ion at an int vla.aaaapom bat party
ICA A ��/� WrO rY aneae'71NSeae mgaCl'la:'re.9•rYirmuelbesourd Taps or prim clearly)
SELLEP 9IG L 4JZ� V� COrS:ONC IN MICHAEL P.
UYE zYES)GN/-TUBE/�+ AF —
I �IIa•vw: i ravr M1AUL
,a S •+wiFA:Of.P •__• -IL I L•:.T.-`..YmF!:•F.85541
P..—S•:YA•JIE
70v PETER'S WAY
•eIMCCIh Ya_h -e'RgCT
�• P:SIIEPS 7S;.ANU - NY 06390
•:J-T'SS T:NR. - '!•AIE -.'P+Y1F
BUYER'S ATTORNEY
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I g F.0317.R'CS, X54, N...^.HAF?
I ..
�t �cal hA1F •ver h'AY:
226-492_5
TELE WE NU. -is: _ ._