HomeMy WebLinkAboutL 13201 P 166 1111111111111111[[III IIIII (IIII IIIII 11111 IIIII IIII IIII
1111111(IIII 11111 IIII IIII
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEED Recorded: 05/10/2023
Number of Pages : 4 At: 02 : 45 : 10 PM
Receipt Number : 23-0062564
TRANSFER TAX NUMBER: 22-27392 LIBER: D00013201
PAGE : 166
District: Section: Block: Lot:
1000 117 . 00 09. 00 028 .001
EXAMINED AND CHARGED AS FOLLOWS
Deed Amount: $0 . 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 $395 . 00
TRANSFER TAX NUMBER: 22-27392
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
Vincent Puleo
County Clerk, Suffolk County
Number of pages RECORDED
2023 t-lay 10 02:4`:10 PN
Vincent Puleo
This document will be public CLERK OF
record.Please remove all SUFFOLK COUNTY
L D00013201
Social Security Numbers P 166
prior to recording. DT# 22-27392
Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps
3 1 FEES
Mortgage Amt.
Page/Filing Fee A-k ul�
1.Basic Tax
Handling 20. 00
2. Additional Tax
TP-584 Sub Total
Notation SpecJAssit.
or
EA-52 17(County) Sub Total. Spec./Add.
EA-5217(State)
TOT.MTG.TAX
Dual Town Dual County
R.P.T.S.A. Held for Appointment
Comm.of Ed. 5. 00 � Transfer Tax
Affidavit • . Mansion Tax
Certified Co The property covered by this mortgage is
Copy or will be improved by a one or two
NYS Surcharge 15. 00 �-- family dwelling only.
Sub Total YES or NO
Other Grand Total I NO see appropriate tax clause on
page#�� of this instrumefl-71
l�
4 Dist. CJS, 23011631 1000 11700 0900 028001 5 Com unity Preservation Fund I
Real Property P T S VERNONConsideration Amount$Tax Service RCWH A h�
Agency 17-MAR �� CPF Tax Due $ , )
Verification _ _.--- — --
Improved
6 Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD&RETURN TO: Vacant Land
Burner Law Group,P.C. TID
12 Research Way TD
East Setauket,NY 11733
TD
Mail to: 7 Title Company Information
11901 Co.Name
Title#
8 Suffolk County Recording & Endorsement Page
This page forms part of the attached Warranty Deed made
by: (SPECIFYTYPE OF INSTRUMENT)
MICHAEL SIMON&SHANNON SIMON.a/k/a The premises herein is situated in
SHANNON SLON SIMON SUFFOLK COUNTY,NEW YORK.
TO In the TOWN of Southold
In the VILLAGE
or HAMLET of New Suffolk
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
over
WARRANTY DEED WITH FULL COVENANTS
(INDIVIDUAL AND CORPORATION)
FORM 8003(short version),FORM 8008(long version)
CAUTION:THIS AGREEMENT SHOULD BE PREPARED BY AN ATTORNEY AND REVIEWED BY ATTORNEYS FOR SELLER AND
PURCHASER BEFORE SIGNING.
THIS INDENTURE,made the r .�__day of�Z(MIDPX 209@ between
MICHAEL SIMON and SHANNON SIMON,a/k/a SHANNON SLON SIMON,his wife, 17130 Main
Street,New Suffolk,New York l 1956,party of the first part,and
SHANNON SLON SIMON, 17130 Main Street,New Suffolk,New York 11956,party of the second part,
WITNESSETH, that the party of the first part, in consideration of Ten Dollars and No Cents
($10.00)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 Town of Southold, County of Suffolk and State of New York more
particularly described in Schedule A attached hereto;
SAID PREMISES BEING KNOWN AS AND BY 17130 Main Street,New Suffolk,New York 11956.
BEING AND INTENDED TO BE the same premises conveyed to the party of the first part by deed dated
December 5, 1988 and recorded on January 25, 1989 in the Office of the Clerk of Suffolk County of the
State of New York in Liber No. 10785,Page No.492.
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 HAVEAND 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,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 costs 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.
AND the party of the first part covenants as follows:
FIRST.—That said party of the first part is seized of the said premises in fee simple,and has good
right to convey the same;
SECOND.—That the party of the second part shall quietly enjoy the said premises;
THIRD.—That the said premises are free from encumbrances,except as aforesaid;
FOURTH.—That the party of the first part will execute or procure any further necessary assurance
of the title to said premises;
FIFTH.—That said party of the first part will forever warrant the title to said premises.
The word"party"shall be construed as if it read"parties"whenever the sense of this indenture so
requires.
Section: 117.00,Block:0009,Lot:028.001
NYSBA's Residential Real Estate Forms(92000) 1- 0 2022 Matthew Bender&Company,Inc.,a member of LexisNexis.
IN WITNESS WHEREOF,the party of the first part has duly executed this deed the day and year
first above written.
ftdh�ei Ate " jl-' . �uum
By:MICHAEL SIMON,by Sh non Sion Simon,as Agent
--A im "
By:SHANNON IMON
Acknowledgment by a Person Within New York State(RPL§309-a)
STATE OF NEW YORK )
)ss.:
COUNTY OF SUFFOLK )
On the M day of d in the year before me, the
undersigned, personally appeared MICHAEL SIMON and SHANNON SIMON, a/k/a
SHANNON SLON SIMON,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 they executed the same in their capacity(ics), and that by their
signature(s) on the instrument, the individual(s), or the person upon behalf of which the
indiv'dual(s)acted,executed the instrument.
evwu I ,
Marisa Caro
(signature and office of indii1dual taking ac ow edgment) hmwy"'bore "
oualmed to Smoot CourRy
WARRANTY DEED Commission Expires Apd1 18,IDQ4(0
Title Nn.- Section 117.00
Block 0009
MICHAEL SIMON and SHANNON Lot 028.001
SIMON,a/k/a SHANNON SLON County or Town Suffolk,Southold
SIMON Street Address 17130 Main Street
To New Suffolk,New York 11956
SHANNON SLON SIMON
Return By Mail To:
Nancy Burner
Burner Law Group,P.C.
12 Research Way
East Setauket,New York 11733
Reserve This Space For Use Of Recording Office
Section: 117.00,Block:0009,Lot:028.001
NYSBA's Residential Real Estate Forms(912000) -2- ®2022 Matthew Bender&Company,Inc.,a member of l,exisNexis.
SCHEDULE "A"
TAX MAP: 1000 - 117.00—09.00 -028.001
ALL that certain plot, piece or parcel of land, with buildings and improvements thereon erected,
situate, lying and being in the Town of Southold, County of Suffolk and State of New York more
particularly bounded and described as follows:
BEGINNING at a point of intersection of the easterly line of Second Street with the southerly
line of Main Street and;
1) RUNNING THENCE South 85 degrees 25 minutes 00 seconds East along the southerly
line of Main Street a distance of 76.13 feet to a monument;
2) THENCE South 05 degrees 05 minutes 50 seconds West along lands now or formerly of
Vangi a distance of 125.65 feet to a monument;
3) THENCE North 85 degrees 27 minutes 10 seconds West along lands now or formerly of
Polashock a distance of 76.06 feet to a monument in the easterly line of Second Street;
4) THENCE North 05 degrees 03 minutes 50 seconds East along the east line of Second
Street a distance of 125.69 feet to the point or place of BEGINNING.
INSTRUCTIONS(RP-5217-PDF-INS):www.orps.statemy.us
FOR COUNTY USE ONLY Now York State Department of
Ci.awls coda q Taxation and Finance
C2.Data Deed Recorded , 5 C'J /a Office of Real Property Tax Services
Neel C" Yen RP-5217-PDF
CS°Book ,,�j,,Qn,U Ca.Pegg UJ Real Property Transfer Report(8110)
PROPERTY INFORMATION
1.Property 17130 Main Street
Loeafbn
°STREET NIa6ER •STREET NAME
Southold New Suffolk 11956
•Cm OR TOM VEIAGE •ZP CODE
p'Guyer
Nam SIMON SHANNON SLON
Name
•Iasr NAMecosvANr nasi caw[
LAST HAMEIGOMRArrr FIRST NIwE
3.Tax Indicate where future Tax Bills are to be Bard
Wiling y other than buyer address(at bottom of form) LAST NMIER°GPAhw FIR87 NAME
Address
emEETNWLERA1DNAME CITY OR TOWN STATE ZP Coca '
4.Indicate the number at Assessment 1 a or parcels OR ❑Part of a Paroel Jointly II Pert of a ParosQ Cheek as they apply:
Roll parcels transferred on the dead 4A.Planning Board with Subdivision Authority Exists ❑
a.Dud \ OR 0.22
46.subdiviaionAppmvalwaaRequired for Transfer El
'FRONT FEET •brrN 'ACRES
size 4C.Parcel Approved for Subdivision with Map Provided ❑
SIMON.MICHAEL and SIMON,SHANNON SLON R ic A S1•let a4&7 Srn10"
6.Bailor 'LAST NMIFJC rrP/ FIRST IME
Name
,AST NARWJCOtPAII! FIRST MME
7.Bolsot the description which most accurately describes the Chock the boxes below as they apply:
use of the property at the time of sale: S.Ownership Type is Condominium ❑
9.Now Construction an a Vacant Land ❑
A.One Family Residential ICA.Property Located within on Agricultural District ❑
IDS.Buyer received a disclosure notice indicating that the properly is in an
Agricultural District ❑
SALE INFORMATION1 16.Cheek one or mom of thew conditions as applicable to transfer.
A Sale Between Relatives or Former Relatives
11.S.le Contract Dab B.Sale between Related Companies or Partners it Business.
C.One o1 the Buyers is also a Seller
'1 Z.Data of BafaRranekr U a. D.Buyer or Seller is Government Agency or Lending Institution
E.Deed Type not Warranty or Bargain and Sale(Specify Below)
F.Sale of Fractional or Less than Fee Interest(Specify Below)
'13.Full Set Price $0.00 G.Signikent Change In Property Between Taxable Status and Sale Dates
H.Site or Business is Induded in Sale Pita
(Fut Sale Price Is the total amount paid for the property including personal property. 1. Other Unusual Factors Affecting Sale Price(Specify Below)
This payment may be in the form at cash,other property or goods,or the assumption of X J.Hone
mortgages crosier oblagesons.)Freese round ro dye nearest whore darlaren sourli
Comrran(e)on Condition:
14.Indicate the value of personal
property Included In the sale $0.00
ASSESSMENT INFORMATION-Data should reflect the latest Final Assessment Roll and Tax Bill
16.Year of Asommanl Roll from which Intention talem"I 22 '17.Total Assessed Value 6.600
'tie.Property Class 2 1 0 _ '19.School District NanLe
New Suffolk School
'20.Tax Map IdentflegeyRoB Identiflar(s)(If mom then four,atech shoot wth oddmonel IdsmMer(s))
1000-117.00-09.00-028.001
CERTIFICATION
I Certify that as of the lam of Information entered on this form ars true and correct(to the bast of my knowledge and begat)and I understand that the making of any willful
fico statement of materiel fact hareln subject me to the Orovislon6 Ot ftt RNIA law relates to the making and filing of false Inst uments.
seg t eR SIGNATURE BUYER CONTAI INFORMATION
(En to uewmsom for ass buyer Nola if buyer is I.W.Saaaly.BUM&dn,ConpOre'M lost nor*co"Ary.Mesa or
adty that is not en nbedaa at or 8duamy.l.'Rn a name and ronwd sitirmton of an itslviilA.espmysde
fparry wrlo Can answer quasi ns nagardrlp ass urinder mar 6s ertwed Type orpdnl dNnty.l
EE. SIGNATURE FATE
BUYER SIGNATURE SIMON SHANNON SLON
•aAST NMK FIRST NAME
631 734-7237
•MFACODE 'TaERgNE NUMrERrEr.a UB)
r e111'LJregNRT E 7E
17130 Main Street
4 -RTREETNLMSER EFFECT NAM[
r •�PS f r
a New Suffolk NY 11956
•CiTVORTOLAN -STATE •ZIP CODE
BUYER'S ATTORNEY
1
Burner Law Group _
UM NMF FIRST NMZE
r +� �ecD941-3434 TELEPHONE!JLW IEL:MMMI