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...._~ the TOWN or SOUTHOLD. a ~nlci,.1 corpo!'"lltlon of tI"l4I Stat. of New York.
County of Suffolk, havlnq it. prlftcl~l office at 51095 MalnRoad, Southold, New
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,...,......... fIIt." the .'01,", f'CP.K H'JUSlOO ALLIAnCE, havtnQ' it. principal orUe.
at II South St~..t. Gr..nport, H4w York ll~...
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.,.........tnthc T"wn ot ::;n'Jthold, County of Suffolk and Stat.. of N..w York, and
ac:qu1r~) by T"x r....r1 on April S, 19"9, fTom th.. Cc-U!'llf of Suffolk, r:.w Yotk, and
J:Kotd..d on Apt!! S, lQ~Q i... L1bo@or ':'OAl 1'1 , Pag. HI, and oth.r-wtse '.ncwn all and by
Town of South"l" $rh ~.~t Q N.V Teo.trl-:-k E-.l~4Y Inc. S-Oak PI w--, '.1 Nine,
nnrnt'E1iI, not~ith...t...n:Jin'1 th.. fl['')..... d_!Ilrtiptt",n, it I. the Int-ntion of thi.
con~.yanc. to Qiv.. tlt!_ only t~ ~u~h prop-Ity ~~ wa~ acquir.d by th~ Town of
Southold hy TlX f'-~d on 1o.plil S, )QR<I. ftnr.l th" County of Suffolk, N..w .......rk. art
r~oJ:d",d c.n April ~. lQkQ In LL~I 101\30, P"Q'" H.
PRovtDED, hOWil"v"r. th""t th.. party of th.. 5.eond part, -ill boP u,.trictf"d in it.
u.e of th_ .uhj..ct pr.rni:t".., ..nd will Uq. "a1<1 rr.mi.... .olely and .xclulI!"..1','
for "Ue.d""bl.. hNI"ln<] 1..Ulor)....!Il: ,,11 liQht, titl.., anti int.r"l'It will r.v.rt t..,
the party of th.. fU:oIt p....lt. ..t th... !tol.. option of th.. party of ~he (JllIt pal~;,
in the "v~nt tli....t th.. ~'''Ity of th.. f'''c>::lnd part. "t any tift\f" u... or att.mpt. to
u.. ..1el .ubj..r:t prP1nis..!'! for eoth..r thar. JJffordl\bl.. hou,inr;l pt!rpoll.!I, in
eccordane. wtth th- ^~rlov..d plan lIunm:tt.<1 ~ the party of the "..cend part~
'TtI. t.v.,rt4>r ..1 U:ol..... c':"'ntltin"d h"r_in .h411 apply to the Qll'ant... or any
tranllf.r_" flOI" th.. 'lr....nt.... forfll""d punll..,nt tn Attic'" xtx - J-flord"bl.. H~
own.rl'hlp [)fo',..loI,"""nt hoo:;ll"l'lI of th" Pr'v'.Ittt Hou!'Itng Finane'" L,olw of th... State of
""'" York, or a not-for"plf"Jfit cotporatil.'I, forJ!'ofOd under 5402 of the
~t.for-Prt !tt Corporation Law for aftordaDl. hot.!dng purpo....
additionally. if any on. or mol" cf th. follcwinQ occur., the pr~~rty ..cured
by this deed 'hall r.~..rt a, h.:.in~fore ..t fc-rtht
1. If the party of th.. ,-cond part
ot .ffordab~.. he>u!dnQ unit or .mit.
the dat" of this d.... I;
f~.l. to construct or comp~et. construction
1~ .aid prep~rty wtthiri thr.. III Y84r. fr~
2. If th~ f,...rty "f hI" ,...'......nd "...tt ....I1J11 nr c: h_MoI1111" tran"e",,, an a(frrdllbl.
hcnJ..tnq un 1 t 0: un i t ~ I,.,. " ,,\uell/lIl1_! or pur( ha....'" who.. tot a 1 annu41 hOoJ"eholoi
lncor., h01\'l all "OUlr'" j." at-c-.... t". IM.)O"'UIll incC1l'<!J li",j,tl' fe>r n:Ift-'!:arQet.d
ar.". 1n th. ~t.,t.. ('~ Il""" y.,tk H:>lta....,. Aa..n"'r'!!l Alf;r:!...bl. H':"J.'1tn';J Prc-9ram ter
Suffolk COlln!~':
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11436Pb577
tr the party l'"f th_ ..cord put pe",IUi
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!j1~(lftt..rQet-.J .u....." d rhf' ~t.... of Ill!'w {">,Ir;
!.11t1lfhlL. County,
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_11 .our"""'., II "bolff! th. _at""... 1nC'~ u- It. ~:~_
M~rt~.Q~ Aq~ry'~ Arror~b:. "O~~~~~ r;~r..!Q
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IInll: to ...r:-_.-' t~,1' "IJ/?\ c! rlne HI,,~r..d Th~II..n1 ncll~I" ($lr,o.cr,C.'~',f:
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II th. del.." ,-.f c~'"'rl('f 1,,1'". 1Ir.1 O'7:""plncy fer "~'Y .frOI abl. h()usln~ unit or IInl-::.
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11436r~580
StATE OF NEW YOPY. COUlrr! Of SUFFOLK. 59.:
on th~?P. day of H~eA 1991. before me personally carne
BEVERLY J. HALLOCK. to me known, who. bpinq by me duly sworn. did
depol!l~ and say th.H nhe rp.sides at Uo. 18 south Stref"t. Greenport.
New York 11944. that ~he is the preo;idpnt of the NCRTH FO~.'
HOUSING A~LIANCE. the corporation described i~ and wnich executeJ
the foregoing isntrurnent: that she k.nowS the seal of sail'
corporation; thC\t rhf' SPill ,)~fixed to said inRtrulTlPnt is such
corporatf' 8t'al; th.lt It "',1'" ~o affixed try oI"der o{ the rodr~1 of
directors of sdid corpor.\t ir.n. cH,:d that ahe signed her name
thereto by like order.
~ ~ ft~~
Notary Public
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. TP.~'s4 (4/89)
New York Slate
'v ~6;t Department 0'
nL\ Taxation
....;J and Finance
New York 'State
Combined
Real Property Transfer Gains Tax Affidavit
Real Estate Transfer Tax Return
Credit Line Mortgage Certificate
For depertment use only
See instructIons (TP-S84-J) before completinq this form
Schedule A - Information Relatin9-!Q. Convevance
Please print or type - Social security number
Name
(Tra n stemr /g fa nlor) TOWN OF SOUTHOLD I I I
Address ZIP code Federal employer Identificalion number
53095 MAIN ROAD, SOUTHOLD, NEW YORK 11971
Name Social security number
(Tra n sferee/gra ntee) NORTH FORK HOUSING ALLIANCE
Address ZIP code Federal employer identification number
18 SOUTH STREET, GREEN PORT , NEW YORK 11944 1
Location and description of property conveyed
Tax map designation Address CityNillage Town County
1000-48-2-26 Flint Street Greenport Southold Suffolk
Type of property conveyed
(Check applicable box)
1 0 1 . 3 family house
2 D Residential cooperative
3 D Residential condominium
4 00 Vacant land
5 0 Other
Date of conveyance
I 04 04 I 91
Condition of conveyance (Check all that apply)
a. _ Conveyance of fee interest f.
month
day
Percentage of real property
conveyed which is residential
real property %
year
b. _ Acquisition of a controlling interest (state
percentage acquired %)
c. _ Transfm of a controlling interest (Slate
percentage transferred
d. 1(Conveyance to cooperative housing
corporation
%)
- Conveyance which consists of a mere
change of identity or form of ownership or
organizallon
(Attach Form TP.S84.1, Schedule F)
g. _ Conveyance for which credil for tax
previously paid will be claimed
(Attach Form TP.584,1, Schedule G)
h. _ Conveyance of air rights or development
rights
_ Contract assignment
_ Option assignment or surrender
k. _ Leasehold assignment or surrender
I. _ Leasehold grant
m. _ Conveyance of an easement
n. _ Conveyance for which exemption from
transfer tax is claimed. (Complete
Schedule C, Part III)
o. _ Conveyance by gift
p. - Conveyance of property partly within and
partly without the state
q. __ Other (Describe)
e. _ Conveyance pursuant to or in lieu of
foreclosure (At1ach Form TP-584, " Schedule E)
I.
j.
Schedule 8 - Real Property Transfer Gains Tax Affidavit (Article 31-8 of the Tax Law)
o Check this box if a Tentative Assessment and Return is being filed with respect to your current transfer, and proceed to Schedule C
without completing the following affidavit. Also, enter the assessment number shown on the Tentative Assessment:
I (we) certify that: (check appropriate box)
C The transfer of real property consists of the execution of a contract to sell real property without the use or occupancy of such property or the
granting at an option to purchase real property without the use or occupancy of such property
2
o
The transfer is a transfer of real property where the consideration is less than $500.000 and which is neither (A) pursuant to a cooperative or
condominium plan, nor (8) a partial or successive transfer pursuant to an agreement or plan 10 eHectuate by partial or successive transfers a
transfer which would otherwise be included in the coverage of Article 31-8 of the Tax Law.
3
o
The transfer is a transfer of real property by tenants in common, Joint tenants or tenants by the entirety where the aggregate consideration is
less than $500,000. (All such trans/erors must sign this form.)
4
o
The conveyance is not a transfer of real property within the meaning of section 1440.7 of Article 31-8 of the Tax Law. (Attach documents
supporting such claim, and sign on back as required.)
5
o
The transfer of real property consists of premises wholly occupied and used by the transferor exclusively as his residence. including a
cooperative apartment or condominium occupied by the transferor exclusively as a residence. (This exemption may only be claimed by an
individual, estate or trus!.)
6
G<I
The governmental entity (transferor) is the State 01 New York, or any of its agencies, instrumentalities, political subdivisions, or public
corporations, including a public corporation created pursuant to an agreement or compact with another state or Canada.
7
n
~
The governmental entity (transferor) is the United Nations or any other international organization of which the United States is a member, the
United States of America or any of its agencies or instrumentalities,
Schedule C - Real Estate Transfer Tax Return (Article 31 of the Tax Law)
Part I . Computation of Tax Due
1 Enter amount of consideration for conveyance. (If you are claiming a total exemption from lax. enter consideraNon
and proceed to Part /If)
2 Continuing lien deduction (See instructions if property Is taken subject to mortgage or lien).
3 Taxable consideration (Subtract line 2 from line 1) .
4 Tax due: $2 for each $500, or fractional part thereof, of consideration on line 3.
5 Amount of credit claImed (See instructions and attach Form TP-584.1. Schedule G).
6 Total tax due* (Subtract line 5 from line 4) .
Part II - Computation of Additional Tax Due on the Conveyance of Residential Real Property for $1 Million or More
1 Enter amount of consIderation for conveyance (same as amount in Part I, line 1) .... . . . . . . . . . . . . . . . . . [tl
2 Taxable conSideration (Multiply Ime 1 by Ihepercenlage ollhe prem'5es which is reSidential real prope.1y) (see mSlructions) 2
3 Total additional transfer tax due* (1% of Ime 2) . .. . . ... . . .. .. . . . . . . . . . . . . . . . . . . . . . .. ..... 3. -0-
* Please make check(s) payable to the county clerk where the recording is to take place or the Department of Taxation and Finance if
payment is being made directly to the Tax Department.
For recording oftlcer"s use Amount .... Pan I $
received r Pan Il S
1 -0-
2 1
3
4
5 1
6
~
0". ":'Od _. ~ T""",,,o" ""mb.'
~~- -~-_._-_.-
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TP-584 (4/89) (back)
Schedule C - (continued)
Part III _ Explanation of Exemption Claimed in Part I, line 1. (check any boxes that apply)
The conveyance of real property is exempt from the real estate transfer tax for the following reason:
a Conveyance is to the United Nations, the United States at America, the State of New York or any of their instrumentalities.
agencies or political subdivisions (or any pubhc corporatIon. including a public corporation created pursuant to agreement or
compact with another state or Canada) .
b. Conveyance is to secure a debt or other obligation.
c. Conveyance is without additional consideration to confirm, correct, modify or supplement a prior conveyance. .
... aD
... .....bO
cD
d. Conveyance of real property withoul consideration and otherwise than in connection with a sale, including conveyances conveying
realty as bona fide gifts . . d KJ
e. Conveyance is given in connection with a tax sale. e 0
f. Conveyance is a mere change of identity or form of ownership or- organization where there is no change in beneficial ownership.
(This exemption cannot be claimed for a conveyance to a cooperative housing corporation of real property comprising the
cooperative dwelling or dwellings.) .
g. Conveyance consists of deed of partition
h. Conveyance is given pursuant to the federal bankruptcy act
...fO
gO
.. hO
1. Conveyance consists of the execution of a contract to sell real property without the use or occupancy of such property or the
granting of an option to purchase real property without the use or occupancy of such property . I 0
j. Conveyance of an option or contract to purchase real property wIth the use or occupancy of such property where the
consideration is less than $200,000 and such property was used solely by the grantor as his personal residence and consists of a
1, 2, or 3 family house, a residential individual condominium unit. or the sale of stock in a cooperative housing corporation in
connection with the grant or transfer of a proprietary leasehold covering an individual residential cooperative unit. J 0
k. Other (attach explanation) . k 0
Schedule D - Credit Line Mortgage Certificate (Article 11 of the Tax Law)
Complete the following only if the interest being transferred is a fee simple interest.
I (we) certify that: (Check appropriate box)
o
The real property being sold or transferred is not principally improved nor WIll it be improved by a one-to six-family owner-
occupied residence or dwelling.
The real property being sold or transferred IS not subject to an outstanding credit line mortgage
The real property being sold or transferred is subject to an outstanding credit line mortgage. However, an exemption from the tax
is claimed for the following reason:
2 KJ
3 0
C'
The transfer of real property is a transfer of a fee simple interest to a person or persons who held a fee simple interest in
the real property (whether as a joint tenant. a tenant in common or otherWIse) immediately prtor to the transfer:
The transfer of real property ~s (A) to a person or persons related by blood. marriage or adoption to the original abligor or
io one or more of the original .')bllgors or (B) to a person or entity where a majOrity of the beneficial interest in such real
;:>roperty after !he transfer IS held by the transferor or such related person or persons:
The ~ransfer of real ;Jropert')-' IS a transfer to a trustee In bankruptcy. a receiver, assignee or other officer of a court:
Other (attach detailed explanation).
c
n
C'
4 ;1 The real property being transferred is presently subject to an outstanding credit line mortgage. however, no tax is due for the
following reason:
o A certificate of discharge of the credit line mortgage is being offered at the time of recording the deed: or
o A check has been drawn payable for transmiSSion to the credit line mortgagee or his agent for the balance due and a
satisfaction of such mortgage will be recorded as soon as It is available.
5 [J The real property heing transferred is subject to an outstanding credit line mortgage on record at
(insert liber and page or reel or other identification of the mortgage). The maxImum principal amount expressed in the mortgage
is No exemption from tax is claimed and the tax of IS
being paid herewith. (Make check payable to county clerk where deed will be recorded.)
Signature and Affirmation (Both the transferor(s)/grantor(s) and transferee(s)/grantee(s) must sign).
The undersigned, being duly sworn. depose and say under penalty of perJury that the above return, including any affidavit, certification.
schedule or attachment, has been examined by the undersigned, and is. to the best of his/her knowledge, true and complete and made
in good faith pursua to Articles 1:1, 31 and 31-8 of the New York State Tax Law.
Title
Title
Transferee/grantee
Supervisor
Beverly J. Hallock
President
Scott L. Harris
Town of Southold
Nortfork Housing Alliance
Subscribed to and sworn before me
Subscribed to and sworn before me
'4'S- 'ttJk day of (;'iL--.;
.m.~) .K\
,
19_~
thIS
day 01
,19__
;,7,,~_
Slale of -New YOr.K.-.- MATTHEW G. KIERNAN Slale 01 -----
NOTARY PUBLIC. State of N_ Yor&
No. 30-4948178
County of .__ S~(f~~__ Qualtfled In Nassau County County of -,
CommiaIlon Elcpltea Mlroll 6. 188
Reminder Did yOU compl,!le all of the required information in Schedules A and B? Were you required to complete Schedules C and D?
If YOll checked e. , and 9 in Schedule A, did you complete TP-584.1? Have you attached your check(s) made payable to the
COLHlty clerk where recording will take place or the Department of Taxation and Finance if payment is being made directly to
the Tax Department?