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Home My WebLink AboutL 13200 P 13 1111111 IIII 1111111111 IIIII 11111 IIIII IIIII 111111111 ILII 1111111 IIIII IIIII 11111111 SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED WITH LIFE ESTATE Recorded: 05/03/2023 Number of Pages : 4 At: 03: 42 : 52 PM Receipt Number : 23-0058725 TRANSFER TAX NUMBER: 22-26442 LIBER: D00013200 PAGE : 013 District: Section: Block: Lot: 1000 079 . 00 03.00 031 . 000 EXAMINED AND CHARGED AS FOLLOWS Deed Amount: $10 . 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 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 $0 . 00 NO Comm.Pres $0 .00 NO Fees Paid $395.00 TRANSFER TAX NUMBER: 22-26442 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL Vincent Puleo County Clerk, Suffolk County 1 ❑2 RECORDED Number ofa es 2023 Mau 03 03:42:52 P11P B Vincent Puleo CLEF{ OF SUFFOLK COUNTY This document will be public L D00013200 record. Please remove all P 013 Social Security Numbers DT# 22-26442 prior to recording. Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps 3 1 FEES Page/Filing Fee Mortgage Amt. 1. Basic Tax Handling 20. 00 2. Additional Tax TP-584 Sub Total SpecJAssit. Notation or EA-52 17(County)� 1!!�-- tQ- Sub Total S Q (50 Spec./Add. EA-5217(State) 1,-�? D 0 TOT.MTG_TAX _ _ Dual Town Dual County— R.P.T.S.A. Held for Appointment T Comm.of Ed. 5. 00 Transfer Tax Affidavit Mansion Tax The property covered by this mortgage is Certified Copy or will be improved by a one or two NYS Surcharge 15. 00 _ family dwelling only. Sub Total 3�K Cc) YES or NO her Grand Total 3 If NO,see appropriate tax clause on page# of this instrument. -Q -ate 4 Dist.', 23011761 1000 07900 0300 031000 6 O 5 Community Preservation rand Real Prope: RPpTY� Consideration Amount$ I •GCS Tax Servic A I I I1W Agency, t7-MAR CPF Tax Due $ Verificatio / 6 Satisfactions/Discharges/Releases List Property Owners Mailing Address RECORD&RETURN TO: U Vacant Land A.C7 LUaflic_S of Fobin�urncr�a fec7 TD 1155 a5 A TD TD Mail to:Vincent Puleo, Suffolk County Clerk 7 Title Company Information 310 Center Drive, Riverhead, NY 11901 co.NimecO k .T I e_ www.suffolkcountyny.gov/clerk Title# IR 10 g Suffolk County Recor iniz & Endorsement Page This page forms part of the attached `'" g . made by: (SPECIFY TYPE OF INSTRUMENT) 1a Y IS The premises herein is situated in SUFFOLK COUNTY,NEW YORK. In the of Chrislo�rer MaCzt'JI.SF �i►l�lyMazulsK' In the VILLAGE 0S WM_L*�,S � Modal ckIL ZrrCV, Zhe or HAMLET of BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. 11.0104..1010@kk (over) GR Ia77A CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY BARGAIN AND SALE DEED WITH COVENANT AGAINST GRANTOR'S ACTS THIS INDENTURE, made the day of �e�.� �r/ , 2022 BETWEEN Barbara Moczulska, residing at 56-19 2016t street, Bayside, NY 11364, party of the first part, and Christopher Moczulski and Emily Moczulski as Trustees of the Barbara Moczulska Irrevocable Trust, residing at 56-19 201St street, Bayside, NY„ YFaTon party of the second part, SS35tN@3}io.o:,norn-le;,16A �Anra7 r.lut4�2 nl oathnuo 0S ♦S k11 eeitns3 no z-elmmoD WITNESSETH,that the party of the first part, in consideration ot ten o arspal y 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, SEE SCHEDULE"A"ATTACHED DISTRICT: 1000 SECTION: 079.00 BLOCK:03.00 LOT:031.000 Commonly known as: 575 Ships Drive, Southold, NY 11971, 1000 SAID PREMISES BEING THE SAME as premises conveyed to the party of the first part by t7?9.w deed recorded in the Suffolk County Clerk's Office in Liber 12816 page 870. d 3,eD Subject to a life estate reserved by Jan Pogorzelski and Teresa Pogorzelska for use during their natural lives. 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 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"when ever 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: Barbara�Mo c/zulska Standard N.Y.B.T.U.Form 8002-Bargain and Sale Deed,with Covenant against Grantor's Acts—Uniform Acknowledgment Form 3290 ri TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE IN NEW YORK STATE State of New York,County of �'�t"ss: State of New York,County of ss: On the 1?, day of )WMA,, in the year 2oa_ On the day of in the year before me,the undersigned,personally appeared Before me,the undersigned,personally appeared Barbara Moczulska personally known to or proved to on We basis of Personally.known to me or proved to me on the basis of satisfactory evidence to be the individual(s)whose name(s)is satisfactory evidence to be the individual(s)whose name(s) is (are)subscribed to the within instrument and acknowledged to (are)subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their me that he/she/they executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) on the capacity(ies), and that by his/herltheir signature(s) on the instrument,the individual(s),or the person upon behalf of which instrument,the individual(s),or the person upon behalf of which th individual(s)acted,exeC ted the instrument. the individual(s)acted,executed the instrument. ( ignature and office of indi idual taking acknowledgment) (Signature and office of individual taking acknowledgment) LEANNE KELLY NOTARY PUBLIC,STATE OF NEWNtW Re0811ratton No.01 KE6417827 Oualifled In Suffolk County Conunlsslon Egires MW 24.20 TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE OUTSIDE NEW YORK STATE State(or District of Columbia,Territory,or Foreign Country)of ss: On the day of in the year before me,the undersigned,personally appeared 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 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 signature(s)on the instrument,the individual(s),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 in (insert the City or other political subdivision) (and insert the State or Country or other place the acknowledgment was taken) (signature and office of individual taking acknowledgment) I'. ' SECTION:079.00 BLOCK:03.00 LOT:031.000 COUNTY OR TOWN BARGAIN AND SALE DEED Suffolk WITH COVENANT AGAINST GRANTOR'S ACTS STREET ADDRESS 575 Ships Drive Title No CR1077-S Southold,NY 11971 Recorded at Request of American Dream Abstract,Inc. RETURN BY MAIL TOO STANDARD FORM OF NEW YORK BOARD OF TITLE UNDERWRITERS Distributed by Law Offices of Robin Burner Daleo,LLC American Dream Abstract, Inc. dSs Route Mt.Sinai,New York 11766 'We enTitle you to the American Dream" FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK Ir Schedule A ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being at Bayview, near Southold, in the Town of Southold, County of Suffolk and State of New York, known and designated as Lot No. 11, on a certain map entitled, "Subdivision Map of Bayview Woods Estates", filed in the Office of the Clerk of the County of Suffolk on September 9, 1970 as Map No. 5520 a INSTRUCTIONS(RP-5217-PDF-INS):www.orps.state.ny.us FOR COUNTY USE ONLY .I New York State Department of c1.SIMS Code 14� , 0 I Taxation and Finance C2.Dau Deed Recorded I _::� /3 k;;� I Lq Office of Rea)Property Tax Services VNT Cu. TAR RP-5217-PDF C3.Book I ,?,gQ`QJ I C4.Pegs Reel Property Transfer Report(BRO) PROPERTY INFORMATION I.Property 575 Ships Drive Location 'S'REE:NUYRR 'STREET NAME Southold 11971 -Cm oR T6NN VLAGE -pP com 2.Buyer 'SEE ADDENDUM' Name •WfNANEIEaIPANT FRET NIVL [AVCytUIIsKi,Tasbe Chr *LpFhvr- WT NAML.COMPAW FIRST PAYE 3.Tax Indicate whore Ntum Tax Oft are to be sent Baang If other am buyer addmsslat boxam of fam) WT NAMEC4MPANv FIRST NAME Address SrRCEr NUMBER ANC NAPE CITY on TOWN STATE LPCaaE 4.Indicate the number of Asseesmwd 1 ❑Part of•Paloe1 lonb N Purl of a Paneen Check es tiny apply: Roll Parents trimahmed an the dad a of Pae:elo OR 40.Planning Board with Subdivision Audwrity Exists S'Deed K OR 0.56 48.Subdivision Approval was Required for Transfer Profen •FACNI PFET •oEPrH -ACRES sin 4C.Parcel Approved for Subdivision with Map Row ad ri Moczulska Barbara G.Seller 'LAST-MYCfAMPANV FIRST VAVE Name LAST NAVGCOVPAm FIRST NAME "f.Seloct the desadptbn whish most accurately describes the Check the boxes below as way appy: use afthe property st the time of win: a.Ownership Type IS Condominium ❑ A.One.Family Residential A New Carowebon on a Vacant Land ❑ ,OA.Property Located within an Agrict4haal Olobict 1 as.Buyer received a disclosure notice ITdlcalirg that the properly IS In an ❑ Agricultural District SALE INFORMATION 16.Check mm or mon of these candido m m appticablo to hmtefar A.Sale Between Relativas or FamNr Relative* N.Ser%Contract Daft 10/20/2022 B.Sole between Related Companies or Partners in Busim a. C.One of the Buyers is also a Sailor �•12.Data of Sa dTmTmfer L9/22/2022 D.Buyer or Seller Is Goveminem Agency or Landing InsebLtioTl E.Deed Type not Warmnly or Bargain and Sale(SPedy Babw) F.Sale of Fractional or Less than Fes Interest(Spa*Below) '13.Full Sale Price 10,(NI G.SignBci m Change in Property Between Taxable Suras and Salo Dales H.Salo of Business is Included In sale Pelee 1 Full Selo Price is the label amount paid for the property Widludlog personal Properly. 1.Other Unusual Factors Aaec4ng Selo Price(Specify Below) This payment may be in the farm of Sash,other property or goads.or the assumption of J Nom mor"-or other obsgamm.)Ploam round ho bee nearaa wnafe dollar amount. 'Comment(-)on Center, ad p r 14.Indlesft aha vela.a peraanel E x•t SM-&. i'~c G SFS propeFly Incli rded In the soft 0.00 Transfer Lo Trust ASSESSMENT INFORMATION-Data should refW the latest Final Assessment Roll and Tax Bill is.Year at Amom mmnt Roll from which IdmTw1k n taken" 22 47.Total Ansand Value 5,200 •1st Property Chm 210 _ •te.School Olatrid Nana Southold School 120.Tax Mop IdeTreeer(syRoll kimnMw(s)IN more tion bur.*sash shad with mMkia l ldentelor(s)) 1000-079.00-03.00-031.000 CERTIFICATION I CeAey that all of do Nems of Idormetlon adeeetl on this form am him and comea(10 the best army knowlodge and belief)and 1 understand that the making of any wtlifid lobe Statement of matadal fast heroin subject me to the p"lone.9l lha.alesUIRLmladve to the making and ming of false Instruments. SELLER ER SIGNATURE BUYER CONTACT INFORIBAT N (Ems,ft seonb the kW Noss.If buyer IS LLC,raWq,rsedadcn.crpora, Jokedod—pany.rumsv nary d1IR N cion r NIarM,W eprn a Ildrhry.turn a Nene end axienxdameaon den MwduWlaeansale .Z M parry who raI—euwawY naPrdkV M ra SAN m+M be wo ed.Type a prim decoy.) SEVEN AP. h BUYER SIGNATURE MOCLLLlSka Christopher I� •WT NAME F-31 NAME 'AREA woL 'TLLLPHOK NUMBER If.'PF000Fn R S,o"TtmS TM 575 Ships Drive 'STREET NUMBER 'STPF.Er NAME Southold NY 11971 'OTr ORTOwM -STATE 'aP COEE BUYERS ATTORNEY Burner Daleo Robin 1 e I LAST N MF FIRST NAVE (631) 392-6600 AREA CODE TELEPHDNE LAMER W.naIRnw) r 53 RP52 l 7 Addendum Grantees: and Emily Moczulski as Trustees of the Barbara Moczulska Irrevocable Trust