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L 13166 P 508
SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED Recorded: 7/27/2022 Number of Pages: 4 At: 7 :39 :37 PM Receipt Number: 22-0121517 *ELECTRONICALLY RECORDED* Transfer Tax Number: 21-42834 LIBER: D00013166 PAGE: 508 District: Section: Block: Lot: 1000 038 .00 02 .00 010 .000 EXAMINED AND CHARGED AS FOLLOWS Deed Amount $849, 999. 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 $13, 999. 98 NO Transfer Tax $0 . 00 NO Transfer Tax Number: 21-42834 Fees Paid $14,394 . 98 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 7/27/2022 7:39:37 PM JUDITH A. PASCALE CLERK OF This document will be public SUFFOLK COUNTY record. Please remove all L D00013166 Social Security Numbers P 508 prior to recording. 21-42834 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 Real Property 22032423 1000-038.00-02.00-010.000 Consideration Amount $8 4 9,9 9 9.0 0 Tax Service P r s Agency st2Dr2�22 CPF Tax Due $ 13.999.98 Verification Improved X 6 Satisfactions/Discharges/Releases List Property Owners Mailing Address RECORD&RETURN TO: Vacant Land Fidelity National Title - Riverhead, NY TD 10 24 Ccomerce Drive Mastic NY 11950 TD TD Mail to: Judith A. Pascale, Suffolk County Clerk 7 Title Comwny Information 310 Center Drive, Riverhead, NY 11901 Co.Name www.suffolkcounVny.gov/clerk Title# g Suffolk County Recording & Endorsement Page This page forms part of the attached DL® 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 -7ya q-() 13��l f 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 Jr I day of 1'4, ( in the year 2022 BETWEEN WILLIAM S.SHANNON and RUTH E.SHANNON,having an address at 940 Gillette Drive, East Marion,NY 11939 party of the first part,and 41 —1-0;"-r Te,lanITs A VITALIY LOS and IRINA SIZOVA,having an address at 315 12th Street#3,Brooklyn,NY 11215 party of the second part, WITNESSETH,that the parry 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, Irjoo ALL that certain plot,piece or parcel of land,with the buildings and improvements thereon erected,situate,lying and being in the a3 o? ( o SEE SCHEDULE A ATTACHED HERETO AND MADE A PART HEREOF Being and intended to be the same premises described in a deed made by Mary Jacobs and recorded June 4,2014,in Liber 12776,at page 219. 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 0 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: Willia .Shannon Ruth E.Shannon FIDELITY NATIONAL TITLE INSURANCE COMPANY TITLE NO.7404-013871 SCHEDULE A-1 (Description of the Land) For Tax Map ID(s): 1000-038.00-02.00-010.000 AMENDED 5/9/22 ALL that certain plot,piece or parcel of land,situate,lying and being at East Marion,Town of Southold,County of Suffolk and State of New York,known and designated as Plot 24 on a certain map entitled"Map of Marion Manor,situated at East Marion,Town of Southold,Suffolk County,New York,surveyed November 25, 1952 by Otto W.Van Tuyl&Son,Licensed Surveyors,in Greenport,New York,owned and developed by Peter Blank and Son,East Williston,Long Island,New York" and filed in the Office of the Clerk of the County of Suffolk on March 18, 1953 as Map No.2038,said lot is bounded and described as follows: BEGINNING at a point on the westerly side of Gillette Drive at a point where the division line between Lots 24 and 25 intersects the said westerly side of Gillette Drive; RUNNING THENCE along the said westerly side of Gillette Drive South 25 degrees 08 minutes 50 seconds East 100.00 feet to the division line between Lots 23 and 24; THENCE along said last division line South 64 degrees 51 minutes 10 seconds West 100.00 feet to land now or formerly of the Town of Southold; THENCE along said last land,North 25 degrees 08 minutes 50 seconds West 100.00 feet to the division line between Lots 24 and 25; THENCE along last said division line North 64 degrees 51 minutes 10 seconds East 100.00 feet to the westerly side of Gillette Drive at the point or place of BEGINNING. THE POLICY TO BE ISSUED under this commitment will insure the title to such buildings and improvements on the premises which by law constitute real property. FOR CONVEYANCING ONLY: Together with all the right,title and interest of the party of the first part, of In and to the land lying in the street in front of and adjoining said premises. END OF SCHEDULE A Commitment for Title insurance Panted: 05.23.22@09:42 AM Commitment nt Description-riteins NY-FT-F RVH-0 1030.431 004-S P S-1-22-74 04-013871 Schedu 1 j USEACX/VOWLEDGMENTFORMBELOWWIHHNNEWYORKSTATEONLY: USEACKVOWLEIXiMENTFORMBELOWW17MNNEWYORKSTATEONLY: State of New York,County of Suffolk }ss.: State of New York,County of }ss.: On the a.Sday of M A`( in the year 2022 On the day of in the year before me,the undersigned,personally appeared before me,the undersigned,personally appeared William S.Shannon and Ruth E.Shannon , 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/she/they executed the same in his/her/their capacity(ies), and that by his/her/their the same in his/her/their capacity(ies), and that by his/her/their 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. ROBERT DEFRESE NOTARY FuSUC,STATE OF NEW YORK Nota Public Regmtradon No.01 UE50351 17 Qualified in Suffolk County bty Crxmdsewn Expires October 24,2671 ACKNOWLEDGMENT FORM FOR USE WITHm NEW YORK STATE ONLY: ACKNOWLEDGMENT FORM FOR USE Om NIDE NEW YORK STA TE ONLY• [New York Subscribing Witness Acknowledgment Certificate! [out of State or Foreign General Acknowledgment Certificate] State of New York,County of }ss.: ..................................................}ss.: (Complete Venue with State,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 whom 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 that he/she/they reside(s)in evidence to be the individual(s)whose name(s)is(are)subscribed to the within instrument and acknowledged to me that he/shelthey executed (if the place of residence is in a city,include the street and street number, the same in his/her/their capacity(ies),that by his/her/their signature(s) if any,thereof);that he/shehhey know(s) on the instrument,the individual(s),or the person upon behalf of 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 WrrH COVENANTS AGAINST GRANTOR'S ACTS TrrLENo. D[sTRtcr 1000 SECTION 38 BLOCK 2 William S.Shannon and Ruth E.Shannon LOT 10 COUNTYORTowN Suffolk County TO RECORDED ATREQUEST OF Vitaliy Los and Irina Sizova Fidelity National Title Insurance Company RETURNBYMAILTO FIDELITY NATIONAL TITLE David Worthington Olsen,Esq. INSURANCE COMPANY Olsen&Olsen,L.L.P. INCORPORATED 1928 P.O.Box 706 0Cutchogue,NY 11935 `c�� Fidelity.90&.1` Member New York State Land 7Flte Aa—lo. W U LL LL O a 2 0 ¢ O U w LL O W N 7 ¢ O u. w U Q a N N_ W ¢ W fA W ¢ FDR COUNTY USE ONLY Cl- swis Cade 14 1 7 1 3 1 8 1 8 1 9 I DF-tNS):www.orps-state.ny-us C2- nate need Recorded 7 27 2022 New York State Depxanrnent of Tana$ion and Finance Month Day Year C3_ Doak IC Hee of Real Ptrapeny Tax Services �,3,1 ,6, 6 I C4_ Page , ,5 , O, S RP- 5217-PT3F PROPERTY INFORMATION I Real Property Transfer Report(8110) L ■ I-Property 997 Gili,ette Drl. e Location •sTxisFT N:�NHsk •:S'I'HEiT fJA'nln East Manion 1 939 'C ITY PN lOw V I1.4..44r •G!P Cntl�mmT 2.8uyer Los Vitaliy Name -.... -u.sr NAM�nnaPnsuv F'rksr rvAF.tr 91.•r-,ova Irina 3'TeX Indicale where future"!ax Bills aro to be sant Billing if other than bu or address et bottom of form '•"" Adt[MaB Y ( } tA5'3'kAMEyC[3MYANT FIRST UAM[ •• a r'F—r1umR:.R ANP—W, C.Tv aR Trryw w STATE ym C[.L'7F d.Indicate the number of Assessment 1. O partof a Aarcel (Only if Part of a Parcel)Check as they apply: IRoIi parcels transferred an the d"er #of PafceEs OR P RA,Planning Hoard wSth Subdivision Authal7ty f»xista S•Dsod X (•� 0-23 46.Subdiv€slon Approval was Required for Transfer Property 'frtaN]'FF FT •DEP-ni 'ACRES Size [^^� dC.Parcel ApprgVR[E for SnbtRfpn divw€!h Map Provided E-1 hariI3Px? wiill1,am S. g•Sellar •Ch6T NhFdE1GONpANS' •_,,...._ ....,,.. FSHe7 3JAxF Mame Shannon i2u'C:t3. E, 1J T>JAMPILY]41f'-L.NY P'rf28]'NA G •••••••••••••• `7.Select the don cription wh to most BCC urate€y deac ribs€the chock the boxes below as they apply: uRe Of the property at the time of safe: 8,Ownership Type is Condommium El A. One-Faintly Residential e.New OonulTuction on a Vacant Land ❑ IOA.Pmpery Located wEthin an AgricultumE District ❑ 108,Buyer mcelvcd a dlsdosure notice Indicating that the property is In an ❑ Agricurtura3'Xstrct SALE 103MATION1 15,Check one or mora of th one condWone as applimbfe to transfer; A-Sats Between RelatlV n or Farmer Relatives 11.Sala Contract nate 03/30/2022 I3-Sale between Related Companies or Partners In 9uslrtess, C.One of the Buyers Is also a•SetW 05/25/2022 D-Buyer or 8oEl&r Is Ga mmrnent Agency or Lending ln&lmition 72.[lata of SalerTransfer 1 ,Deed Type not Warranty or Bargain and Sake(Specify Be€ow) F.Sa€e of Fractional or Legs than Fee Imams[(Spodfy Below) '13.Full Sale Price 8 4 9,99 9•()!3 [3_Slgnlfican€Change in Property Betrv®an"€'axat7le Status and Sale Cates {Full Sats Pr9m is the Fatal amount paid fpr tate proporty including persona€ roe N-Sale rr'Business F Is Irm Alf d in g Saais a Prim This payment P P do I. Other Unusual FactnrX Afrect€ng Salo Prioe(Specify 8elosv] p Y rosy Ira€n Sha form cf cash,other Property or gnnds,or IhR aSSumptlon of ,1-tdoFTe mortgages or ath or obi€gations-)Please Ivurra to the nearest whole do Har arneunt Comment(s)on Condition- 1 4, ondition:14,€ndticate the value of personal property included in the Sat* .© ASSESSMENT INFORMATION-Data should reflect the latest Fidel Ass essment Ro![and Tax Siff 1S,Yea[of Asaesamerrt Rvlt from which Infarmattpn tekan(3'Yl 21 117,Total Asseaestf Value 4,750 "to.Property Class 210 _ 't8,School motrfct Flame Qy�tP-x'Por7F�S "20.Tax Map Identlftar{s)IERo I E Identttier(s)(1f mora than four,attach shoot w€th addition al ld entiflsr(a)j M._..__.. 1CQQ--Q3S,pC—tJ2,pC—Q1�'.000 IMM91FICAnON I Certify that all of tho Items of Inform otlort entered on this forth are k'uB and Cemmut(to the boat of My knowledge and belief)and I understand that thw making of any wifsful fa Ears atatoment of material fact herein subject MO!pthR14X4y�91Qns SE(,tILW_pgtg�(.J.ay*zrdSattVe to the making and ffl In€t of fa ISR instruments. i � I N LT3L AVYEl3 CafdTAC"[_INFOR1l&1"IQN C ser infonn"on for the buyer.Note:V rasher is U-C,"dcty.essoctaelon,carpornt€nn,joint stock comp.",estate or j entity that in nal an in Wduel exam or ndvawy,then s nam.and cor tso inf."ativn or an Endhdduavreap—%lele any who cep enter queadons muardlr�p the Fra—tor—9t eo ontasnd.Type or print clearly.) Thos Vkt:,a.l Iy t3YER s€OirJPti£4!(?ia t �•'���i f__ —s SIR9T riP.NC �H 61C3T{A"rlilaE=. 315 3-2th Streets 43 •e FMT NU.Y.BER 'S"fREET NAME •••• �F3rooklyn .............. NY 1.1215 crwr T_ csrr OR'r •arAr -ZIP copF. f3LYKR%pttl-Ot2NEY. r c Olsen, Esq. David r mm 3 i.AST NAF.1E F'iRST'kAN� 1 n1aEZA 0C!]E MLPRJAONy rau-lnr,R[sx:90 991