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FOR COUNTY USE ONLY
C1. SWlS Code
PLEASE TYPE OR PRE'SSFIR-ML Y WHEN WRITING ON FORM
INSTRUCTIONS: http://www.orps.state.ny.us or PHONE (518) 473.7222
REAL PROPERTY TRANSFER REPORT
y, 7, J,<[?,.g, '11
/ I
MOnth
S.
"
.,
. c,,,,, . "
C2. Date Deed Recorded
:2 t1 t2J' I
UilIIV YOlr
<;,,2 I C4. Pa.e I ,..5:/ .2 I
C3. Book 1/ ,2,":) ,
.
PROPERTY INFORMATION
1. r:~~~ I
7990
STMETNUMllEFI
Oreaon Road
STl'IEETNAME
Southold
CITYQATOWN
Oltchncmp
V1LLA"O:
2. Buyer
Name
SEE ATI'ACHED RIDER
_AST NAME! COMPANY
fIRS!"IAM[
LAST NAME) COMPANY
fIFlST~"'ME
3. Tax Indicate where futUrE! Tftx Bills are to be Hnt
BIlling if other than buyer address (at bottom of form)
Address
. Ficner
LAS! NAME I COMP,t.NY
7990 Oregon Road
STREET NUM6CflANOSTl'IEeTN,t.ME
Cutchogue
CfTYORTOWN
4. Indica1ft the number of Asse$$ment
Roll percela transferred 0" the deed
2
I # of Parcels OR D Part of a Parcel
}
,
5. Deed
Property
Size
"""
8
o
.
o I
Ixl
lOR I
'ACRES
FRONTFEfT
..
6. Seller
Name
Flener
LAST NAME J COMPANY
Fm8TNAME
Stacia
_"'5T NAM~! COMf'ANY
flFlSTNAME
7. Check the box below which. most accurll1ely describes the use of the property lilt the time of sale:
A~ One Family Residential 6.0
B 2 or 3 Fllmlly Residential
C Residential Vacant Land6.1
D Non.Residential Vacant L'Ind
;~
G
H
AgriC\llt\lral
Commercial
Apartment
Entertainment / Amusement
I ~ Community SerYice
J Industriel
K Public Service
L Forest
SALE INFORMATION
STATE Of NEW YORK
STAlE BOARD OF REAL PROPERTY SERVICES
RP - 5217
Rr.5217a...... '3iY7
11935
ZlPCODE
Stacia
FIRST NAME
NY
11935
11. Sale Contract Date IN/A I
Month Do, Ye,
12. Date of Sal. { Tronper /;;l..1 ('7 I 02
Month Do, Ye,
A X
B
C
D
E
F
G
H
I
J
15. Check one or more of th... condltlo"_ as epplicable to n.,.....:
Sale Between Aelatives or Former Aellltives
Sale Betweon Aelated Companie!: or Pertners in Business
One of the Buyers is also a Seller
Buyer or SaUer is Government Agency or Lending Institution
Deed Type "ot Warranty or Bl1rgain and Sale (SpecJfy Below)
Sale of Fractional or Less than Fee Interest (Specify Below)
SignifICant Change in Property Between r"xabla Status al1d Sale Oates
Sale of BU5iness is Included in Sale Price
Other Unusual Factors Affecting Sale Price (Specify Belowl
None
Retained life estate
13. Full Sale Price " 0 , 0 I
, , .
(Full Sale Price is tile totalllmount paid for the property including personal property.
This payment may be in the form of cash. other property or goods, or the essumption of
mortgages or other obligations.! Please round to ln9 n98wBt whole dollar amOCint.
14. Indica1e the vi!llue of personlll , 0 , 0 I
property Included In the sale, , e
ASSESSMENT INFORMATION. Data should reflect the latest Final Assessment Roll and Tax Bill
16. Vear of ASHssmel1t Roll from I 0 , I
which informetl0" taken
210 Lot 6.0
3~1 ~t;-U
17. Total ASM!Qed Value {of all parcels in transler} i
Mattituck-Cutchogue
19. School District Name I
18. Property Class
20. Tax Map ldentifierlsl { Aollldentifier{sl Ilf more than four, attacn &heet with additional identfr.er[sll
1000-095.00-04.00-006.000
STATI'
ZIP (;OU~
(Only if Perl of a Parcell Check es they epply:
4A Planning Board with Subdivision Authority hisN
48. SubdivisIon Approvel was Required for Transfer
'C. Percel Approved for Subdivision with Map Provided
o
o
o
Check the boxes below as tlMy apply:
8. Ownership Type is Condominium
9. Naw Construction on V"cant Land
lOA. Property Locat(l(! within en Agricultural District
108. Buyer received a disclosure notice indicating
that the property is in an Agricultural District
o
o
o
o
;
6 ,5
,
o
o
1000-095.00-04.00-006.001
I
J CERTIFICATION
1 l.:cTtffy Ihul all of tile items of infonmdlnn cntl.^rt'd on Ihis f"nn 1Il:'~ lrue and rorrcl'1 (to .he hL-M of m~ knuwledW- nnd heUd') ~nd I lIndn'5tllnd thMt tbl' m>1kill~
of any willl'ul l'al<ie MateJncJ1t or material fact hercln will rmhjed me to the provisions ....f the oenallaw relatln to the making rdnd tUhlK of frdl~ Iml11rumcnu..
L-
BUYER
/;~R,-~^-<- ~.,A:'i./) (~
BUYe~SJ(;NATIJRe'
h/,u../C.7.-
M"
Mclaughlin
LAST NAMe
53-7
(631)
Long Tree Lane
STREET NAME lAfTE!I $A.LEI
AREA CODE
STREET NUMflF~
Moriches
NY
11955
CITV OR TQWN
srM~
71"COOE
SELLER
^rL/~:t-~ ;.f~C-IJ.~
SELLERSIGfI:^.IURC
j.;Z/i'7/oa....
OATE
BUYER'S ATTORNEY
Kevin
fiRST lliAW'
765-6085
rrLEPHON~ NIJMBEfI
NEW YORK STATE
COpy
,'.:
...
~2
3
Numberor_ . .3
TORRENS
Serial II
RECORCEl)
2000 Jan 28 09::s6:56 All
EcYard P. ROIl~i""
CLERK IF
Sl.FFOUC COONTY
L 1)000122"'..2
P '12
I)TI 02-24~
Certir.....1I
Prior or. II
Deed / Mortpge Instrument
Deed / Molt.... Tax SIamp
FEES
Recordlnl , 1'i1lnl Slain...
4
l'age , l'iIing I'ee
Handlinl
TP-S84
900
6~
5~
Mortpae Amt.
I. Basic Tax
2. Additional Tax
Notation
EA-S2 17 (County,
EA-S217 (Slale)
5 ~ , ,_(2
0':' Sub TOIaI c....~
2S a:>
3D=-
Sub Total
R.P.T.5.A.
Conan. or Ed.
Affidavit
S~
SpecJAuit.
Or
Spcc./Add.
TOT. MTO. TAX
Dual Town Dual Counly_
Ileld rur Apportionment _
T....rerTax ~
Mansion Tax _
The property covered by lIIis n_..... is or
will be Improved by a ona or two ramily
d",,,lIlnl only.
YES 01' NO
IrNO. 1ft approprlale tax c...... on PIlle II
_orllliJ Inltro
Ccrtirled Copy
Rea. Copy
Other f1J'fS
IS CIb
Sub Total 75."
ORAND TOTAL 9'1:""
s
Real Property Tax Scrvi~ Agency VerifiCllllon
Dill. Sectl.... . . B)oo:!!.
6
.
Lot
----.
Consideration A.nount S
~ 03CNNM)02 1000 08500 0400 006000 b
~ .j ~;>
Initials
1 SatisfaclionolDisc:harseslReIc.- Lilt Property OwnerS-Mallin. Addres
RECORD'" RETURN TO:
cpr- Tax Due
j
/
S 0.00
IrnpnlvedIDt 6.0
J. KEVIN K'I.ar1GHLIN" ESO.
P.O. Box 1210
Sout>hoJ.d,1 NY 11971
Vacanl Land IDt 6.1
ID JD
TO
TO
9
Suffolk Coun
I Title Company Inrormation
Co. Name
Title 1#
Recordin & Endorsementl Pa e
1bis II8F forms part of the ltlIItchc:d
STACIA FrCNEll
Daed
(SI'OOI'Y"IYrH OF INS'IRUMENT)
made by:
TO
CAROLYN BLAS\UI.WICZ,I BiIRBARA BOKINA,
100 pmnises hemn is siluated in
SUFI'OlK CDUNIY. Nh"W YORK.
In the Town.slUp of Scutho1d
In the V'ILLAGE cutc:hogue
or HAMI.ET of
m2c!0au I"'I.I'I:'c.!uDIl' .-... Tln,~ UV"D1i'
BOXES S 'IHRU 9 MUST BE TYPED OR PRINI'ED IN BLACK INK ONLY I'RIOR TO RECORDING OR FlUNG.
(OVER)
, .
IIIIIIIIII~ II~ U~IIIIIII~~ IIIII ~IU IIIIIII
1111111111111111111111111
StJll'FOLIC CODNTY CLERIC
RECORDS OFFICE
RECORDING PAGE
Type of Instrument. DBlDS/DDD
.umber of Pages: 3
TRANSFER TAX HUMBER: 02-24945
Recorded:
At:
LIBER:
PAGE:
01/28/2003
09:36:56 All
D00012232
512
Diatrict:
1000
Section. Block:
095.00 04.00
TlYllJIIHBD AIID CHAllGID AS FOLLOWS
$0.00
Lot:
006.000
Deed AIIIouDt:
Page/Piling
COB
BA-CTY
TP-584
RPT
TrlUlsfer tax
Received the 'ollowing 'ees 'or Above Instrument
Bx""'lpt
NO R."dling
NO HYS SURCHG
NO BA-STATI
NO Cert.Co,pies
NO SCTM
NO Camm.Pre.
'88. Paid
$9.00
$5.00
$5.00
$5.00
$30.00
$0.00
$5.00
$15.00
$25.00
$0.00
$0.00
$0.00
$99.00
Iho""'lpt
NO
NO
NO
NO
NO
NO
TRANSFER TAX HUMBER: 02-24945
THIS PAGI IS A PART 0' THI DlSTRUMIIlT
Edward P. Romaine
County Clerk, Suffolk County