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S.nd.reS N.Y.B.T.U. Form 8005 - Executor'. Deed - UnifonnAcknow1edg-.nt
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CONSULT YOUR LAWVER BEFORE SIGNING THIS INSlRUMENT..THI8INSTRUIIENT SHOULD BE USED BY LAWYERS ONLY
THIS INDENTURE, made the 241"-day of October, 2003
BETWEEN
THOMAS ... MATRICK, aa admlnlatrator of the Estate of John S. Matwleczyk, dece..ect
2/26102, Certificate of Letlltra of Admlnlatratlon laauecl by Suffolk County Surrogate'. Court
on September 10, 2003, File No. 615A2003, A003523, residing at 171 Carter Street, Manchester"
Connecticut 06040, party of the firat part, and
,
KIMBERLY ZAHRA, residing ~Pike Street, P.O. Box 1B13. MaUituck, New York 11952, party of
the second part, nc,fF
WITNESSETH, that the party of the first part. in consideration of Two Hundred Sixty-Five Thousand and
00l100-(S265,OOO.00Hlollars, and other good and valuable consideration paid by the party of the second part.
does hereby grant and relesse unto the party of the second part. the heirs or succeSSOra and assigns of the
party of the second part forever,
ALL that certain plot, piece or parcel 01 land, situate, lying and being in the Town 01 Southold. County of
Suffolk and StaIB of New York, being more particularly bounded and desclibed as follows:
BEGINNING at a point on the northwesl8lly sida of Middle Road (CR 48), distant 282.18 feel northeasterly as
measured along the northwesterly side of Middle Road (CR 48) from the exlleme easterly end of the curve
connecting the northwesterly side of Middle Road (CR 48). with the northeasterly side of Horseshoe Drive;
RUNNING THENCE North 38 degrees 52 minutes 30 seconds West along the easterly side of Lots 23 and 22
as shown on said map entiUed. "Map of Oregon View Estates" a distance 01187.11 ""'t to othar land of
Matrick;
THENCE North 58 degrees 23 minutes 30 seconds East along land of Matrick, 100.00 faeI;
THENCE South 38 degrees 52 minutes 30 seconds East along land of Matrick, 179.49 feet to the
northweslarly side of Middle Road (CR 48);
THENCE southweslarly elong the northwesterly side of Middle Road (CR 48) along an arc of a curve bearing
to the right having a radius of 5669.58 feel and a length of 99.33 feel to the point or place of BEGINNING.
BEING AND INTENDED TO BE the sarna premises as conveyed to John S. Matwleczyk and Mary Lillian
Matwleczyk by deed dated 11130159, recorded in Liber 4737 page 82.
TOGETHER with all righl. tiUe and interes~ il any, of the party of the first part in and to any streelS and roads
abulling the above described premises to the center lines thereot. TOGETHER with the appurtenances and all
the estate and righlS of tha 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 01
the second part fonsver.
AND Ihe party of the first part covenants that the party 01 the first part has nol done or suffered anything
whereby the said premises have been ancumbered in any _y whataver. except as aforesaid.
AND the party of the first part. In compliance wilh Section 13 of the Lien Law. covenants thallhe party of the
ftrst part will receive the consideration for this conveyance and will hold the right to receive such consideration
as a lrusl fund to be applied first for the purpose of paying the cost 01 the improvemant and will apply the same
first to the payment of the cost of the improvement before using any part of the tolal of the same for any other
purpose. The word "party" shall be construed as if il read "parties" when ever the sense of this Indenture so
requires.
IN WITNESS WHEREOF, the party of the firsl part has duly execulad this deed the day and year first above
wrillen.
T
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TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE IN NEW YORK STATE
Stale of New Yorl<, County of Suffolk os:
On lhedi(" day of Odober. in the reer 2003.
before me. the underBlgned. _11jI appeated
THOMAS J. MATRICK
peraoruolljl known to me or proved to ma on the basis of
aeliafactorr avidence to be the individual(s) whose name(s) ia
(are) aub&crlbed to the within instrument and acknowledged to
me that helahelthey executed the ..me in hislherJthelr
cepacitrliea). and Ih8t by hlo/herllhelr algnature(a) on the
inalrument. the IndividU8~a). or the person upon behalf of which
the Indlvldual(a) acted. executed the instrument.
~
(algnalUl1l end oftioa 01 individual taking ac:knowIadgment)
Notary Public ROBERT DEFRESE
N-.y Public, Slate of New 'lbrk
No. 01DE5035117
Qualified In Suflolk County ".,,._
Comm_ Elcpilea October 24.___
Stala of New Yorl<. Countr 01 SUffolk os:
On tha day of , In the year ,
be""" ma. the undaraignad. peraooally appeated
peraonalty known to me or proved 10 me on the basis of
aatiafeclory evidenoe 10 be the Individual(s) _ name(a) ia
(are) subscribed to the within instrument and acknowledged to
me thel halahellher axecuIed the same in hi_air
capaclly(iea), and that by hialherllhair slgnature(a) on tha
inatrument, the Individual(a). or the pa""'" upon behalf of which
the indlvldU8~a) acted. _the Inatrumanl.
(a1gnalure and oIlic:e 01 Individualleking acknowtedgment)
TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE OUTRIDE NEW YORK STATE
Stale (or Dlatrict of Columbia, Terrlforr. or Foreign Country) of
as:
Onlha
day of
in theye.r
before me, the undaraignad. peraooalljl eppeared
personalljl known 10 me or proved to ma on the basia of ..lialaclory evidence to be tha indivldua1(a) who.. name(a) la (are)
aubecribed 10 the wtlhin lnalrumenl and _nowIadged 10 malh8l halahellher elC8CU1ed the ..me in hialher/lhelr capacltrC_). and
lhat by hia/her/lheir algnalurela) on the inallUment the individual(a). or the person upon behalf of which the IndividU8~a) acted,
executed the inalrument, and that auc:h Indlvtdual made auch a""""ranee before the unctarslgnad In the
in
(and In..1l the Slate or Country or other place Iha Kknowlocfgmanl W88 taken)
(insert the City or other politicalllUbdlvlslon)
(Iignmure and offICe of individUllll8klng acknowledgment)
BARGAIN AND SALE DEED
WITH COVENANT AGAINST GRANTOR'S ACTS
SECTION
BLOCK
LOT
COUNTY OR TOWN
STREET ADDRESS
TIUe No.
THOMAS J. MATRICK. AS ADMINSITRATOR
OF THE ESTATE OF JOHN S. MATWIECZYK
TO
KIMBERLY ZAHRA
Recorded at Requesl of
COMMONWEALTH LAND TInE INSURANCE COMPANY
STANDARD FORM Of' NEW YORK BOARD Of' nn.R UNDERWRITERI
DialnbuIed by
o Common'^.:~~~"~'~A"
~fl f?oss, t!'sa..
3/'5"' v.)es'ff>"&:I ",(L Pn.efl....C.
tna-Hi-fwd; ";.:1. "cts;y
CWMOS"''F..o\1.TIrl.A.''o:Dll1'U:: I:rroSU.ASCE CO\IPAAOY
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RECORDED
2004 IIpr 16 02.35,42 PH
Ed,",rd P.Romain.
CLERK OF
SUFFOLK COUHTV
L ??oo12314
P078
011 03-38861
Number of pages
TORRENS
Serial N
Certificate II
Prier O[ N
Deed / Mangage Instrument
Deed / Man&age Tax Stamp
FEES
R<:conlin& / Filin& SllIm""
4
Page I Filing Fee
Mongase Amt.
IlaneIlin&
TI'-584
I. Basic Tax
F)
2. Addilional Tax
R.P.T.8.A.
~
~
Sub Total
Notation
EA-52 17 (County)
Other
----l2 _ Sub Tolal
GRAND TOTAL
Spo.'C./Assit.
Or
Spee./Add.
TOT. MTO. TAX
Dual Town_Dual County_
Held for Arrxntionm/f"I __
Transfer Tux U~)
Mansion Tax
The prope'rty coverN. b)' this mOl1goge is or
will be Improvrd by . one or two family
dwelling only.
YES or NO
If NO. see apprupriale tax clause on page U
_oflhis instrummt./O
6 Community Preservation Fund
Consideration Amount $ ~~
CPF Tax Due S<9t'X')C)
Improved
Sub Total
EA-52 17 (Slate)
Comm. of Ed. 5 ~
Affidavit
~n~.dC~ ':J _.
Rea.Copy
Slamp
Real Properly Ta" Serviee Agency Verification
ni... ~__.tinn R Inc:k 1.01
04016067 1000 Og600 0400 003000
Dale
Vacant Land
J()
TO
TO
'I'D
Initials
7 SatisfactionsIDiseiii.;g.slRel.ases List Properly O""'er5 Mailing Addrcs
. . RECORI)... RETURN TO:
REPUBUC ABSTRACT CORP.
976 ROANOKE AVENUE .
RIVERHEAD. NY 11901
8
Title Company Information
9
Co. Name
Title /I {., I -.5- 0<(1'
Suffolk Count Recordin & Endorsement Pa e
'Ihis pIIge fonns part oftl1e altac:hed
made by:
-M~-:'~s'~
(SPECIFY TYPE OF INSI1UJj\IlENr)
The premises herein is situaled in
SUFFOLK COUNIY. NEW YORK.
TO
.e:-.~~Ir ;:>a~44<
In tI1e Township of
In the VILLAGE
or IIAMLET of
~~~-p ~-l.52.
L?v -;t,f=y.#
UOXES 5 TI IRU 9 MUST DE -IYI'ED OR PRlNffiO IN BLACK INK ONLY I'RJOR TO RECORDING OR FILING.
(OVER)
1111111111111111111111111111111111111111111111111111111
1111111111111111111111111
SUFPOLK COUNTY CLERK
RECORDS OFPICE
RECORDING PAGE
Typ~ of Instrument: DBBDS/DDD
Number of pages: 3
Receipt Number : 04-0043989
TRANS PER TAX NUMBER: 03-38861
Recorded:
At:
04/16/2004
02:35:42 PM
LIBBR:
PAGE:
D00012314
078
District:
1000
Section: Block:
096.00 04.00
IlYaxINBD AND CKARGBD AS rOLLOWS
$265,000.00
Lot:
003.000
Deed Amount:
Received the rollowing rees ror Above Instrument
Exempt
NO
NO
NO
NO
NO
NO
Page/riling
COB
EA-CTY
TP-584
RPT
Trllllsfer tax
$9.00
$5.00
$5.00
$5.00
$30.00
.$1,060.00
HllIldling
NYS SRCHG
EA-STATB
Cert.Copies
SCTM
COIIIIIl.Pres
rees Paid
$5.00
$15.00
$50.00
$5.00
$0.00
$2,300.00
$3,489.00
Exempt
NO
NO
NO
NO
NO
NO
TRANsrBR TAX NUMBER: 03-38861
THIS PAGB IS A PART or TBB INSTRUMBNT
THIS IS NOT A BILL
Bdward P.Romaine
County Clerk. Suffolk County
t'L~A"~ I yt'~ UH "'HESS FIRMLY WHEN WRITING ON FORM
INSTRUCTIONS: hllp:// www.orps.slale.ny.us or PHONE 15181 473-7222
FOR COUNTY USE ONLY
C1. SWIS Code
~, 3, ~, 1\: cfl
'-\ /
Monlh
REAL PROPERTY TRANSFER REPORT
,w
-
RI'-5217R"vJJ'iYT
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
C2. Date Deed Recorded
IL.
Do,
/ q'i
ear
RP - 5217
C3. Book I \,;)., ~, i ,Lt I C4. P.g. I
PROPERTY INFORMATION
0:'1 :'6
r~~~~:~ I 19105 County Road 48
ST~EHNUM(I~R STfIEHNAME
Southold
CITY OR TOWN
2. Buyer Zahra
Name LAST NAME ICDMPANY
Cutchogue
VI~LAGE
11935
ZIP CODE
Kimberly
FI~STNAME
LAST NAME I COMPANY
3. Tax Indicate where future Tal( Bills are to be ll€Int
Billing if other than buyer address (at oottom of form;
Address
FIASTNAME
LAST NAME f COMPANY
FIRST NAME
STREET NUMBER AND STREET NAMo
CIN OR TOWN
STATE
ZIP CON
4. Indicate the number of Assessment
Roll parcels tran$ferred on the d_d
OR D
COnty If Part of a Parcel) Chee61: as they apply:
4A. Planning Board with Subdivision Authority Exists
48. Subdivi!>ion Approval was Required for Transfer
4C. Parcel Approved for Subdivision with Map Provided
1
# of Parcels
Part of a Parcel
o
o
o
,. Dead
Property
S1:!:e
6. Seller
Name
10RL.
.
4 6
Ix I
FRONTHH
,,~
ACl'l~S
Matrick, Thomas J., as Administrator of ~he Estate of John S. Matwieczyk
lAST NAME I COMPANY FIRST NAME
~AST NAME I COMPANY
Flf1STNAME
7. Check the box b~ow which moat .ceur.taly describes the ulie of the property at the time of sale:
Check the boxes below a. they apply.
a. Ownership Type is Condominium
9. New Construction on Vacant Land
o
o
o
o
A~ On8 Family Residential
B 2 or3 FsmilyRes.dential
C Residential Vacant land
D Non-Residential Vacant Land
E~Agricultural
F Commercial
G Apartment
H Entarteinment I Amusement
I ~ community.serVica
J Indulitriat
K PubllcSerVlca
L Forest
10A. Property Located within an Agricultural District
1OS. Buyer received 8 disclosure nolice indicating
that the property is in an Agricultural District
SALE INFORMATION
15. Check ontI or morcr of these conditiOll8 as appJilleble to transftw:
10
Mo"'"
6
/ 03
Year
/
11. Sele Contrltet Dete
A
B
C
D
E
F
G
H
I
J
Sule Between Relatives or Former Relatives
Sale Between Related Compunies or P,lrtners in Business
One of the Buyers is also a SeUer
Buver or SelJer Is Government Agency or lending Institution
Deed TYP8 not Warranty or Bargain and Sale (Specify Below)
Sale of Frection81 or Less than Fee Interest (Spscify Below)
Significant Change in Property Between Taxable Status and Sale Dates
Sale of Business is Included in Sale Price
Do,
12. Date of Sale I Transfer
10
Monlh
Yea'
/ 24
Do,
/
03
,2,6,5,00,0,0,01
, , .
(Full Sale Price is the total amount paid for the property including personal property.
Thjs payment may be in the form of cash, other property or goods, or the assumption of
mortgages or other obligations.) Plea$fJ round fO the nearest whole doffsr amount.
14. Indicate the vulua of perllonal ~ 0 0 I
-I Idd' th I ,'.' ,
prQ"w"r 'lcu a In eHe
ASSESSMENT INFORMATION - Data should reflect the latest Final Assessment Roll and Tax Bill
13. Full Sale Price
Other Unusual Factors Affecting Sale Price [Specify Below)
None
16. :~~~:,==:n:a~:~ from P2/,03 I 17. Total Ass8$$ed Value lof all parcels in transfer! I
2
,
Mattituck/Cutchogue/Laurel
4 1
,
o
o
1 0
I..LJ 19. Sohool Di$trlct Name I
18. Property CI_
20. Tax Mep ldentifillf'(lill Rollldent/fier(.' (ff more than four, attsch sheet with additional identlfied,ll
1000-96-4-3
I CERTIFICATION
I ceriify tbat aD of the Items of information entered on this fonn are lrull Wid correct (to tbe best of my knowled~ and ~lief) and I undel1'lIand iliat the making
of any willful false statement of material fact herein wlU subject me to Ute provisions of the penal law relative to the making and tilinaz of false instruments.
BUYER BUYER'S ATTORNEY
Ross
Dan1.el c.
lASTIiAME
Ki
fII'lSTNAM"
S0~-;!:lRSA~~ if Y
631
298-1200
AREACOOE
rEu;:p~ONE NUMllE'"
119J)~
~PCOOE
NEW YORK STATE
COPY
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se~U;:IlS'GN"TUIlET
J. Matrick