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DISTRlcr:
1000
SECrION:
10000
BLOCK:
0100
LOT:
018000
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CON5ULT YOUR LAWYER BEFORE 5IGNIN~5 IN5TRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY.
THIS INDEN'IlJRE, made the / if' ft.;cIay of A fI /1(, J ,in the year 2002
BElWEEN Richard Belford of 142 Kohr ~,V~ings Park, New York, as 50% tenant
in common, and Robert Belford,' of 15 Dairy Farm Road, Stonybrook, NY
as a 25%, tenant in common and Bonnie Belford of 15 Dairy Farm Road,
Stonybrook, NY, as a 25% tenants in common
lOf)- I - /5
party of the first part, and (
Robert Belford and Bonnie Belford of 15 Dairy Farm Road,
Stonybrook, NY, as tenants by the entireties.
party of the second part.
WITNESSETH, that the party of the first part, in consideration of Ten Dollars and other valuable considerati?n
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 cer;;in' ploi,.piece'o; par~el of' iand:with' lh;il\lilding;and improvements thereon erected, situate,
lying and being in the' Town of Southold, County of Suffolk and State of New York, known
and designated as and by Lot No, 21 on a certain map entitled, "Map of Saltabe
Estates" and filed. in the. Suffolk County Clerk's Office on August 3rd, 1966 as
Pc ._"
Map No, 4682.
SUBJECT to any state of facts an accurate survey may disclose.
TOGETHER with the use of the "right of way" as shown on said map for access to
Long Island Sound and Lot No. 32 for recreation purposes, subject to such reasonable
rules and regulations as may be imposed by the party of the first part, its
successors and assigns, including a maintenance charge not to exceed $15.00 per year
unless agreed upon by majority of the lot owners on said map,
SUBJECT to covenants and restrictions as contained in Declaration of Protective
Covenants dated August 5, 1966 and recorded in Suffolk County Clerk's office of
August 10, 1966 in Liber 6099 of deeds at page 320.
SAID premises are the same premises as conveyed into the grantors, by deed dated September 6,
1979, recorded with the Suffolk County Clerk on September 14, 1979, in Liber 8693, Page 538.
TOGETJl~R with all right, title and iI~terest, if any, of the party of the first part in and to any streots and
roads almthng the above. descrIbed premises to the center lines thereof; TOGETHER wi1h the appurtenances
and all the estat~ and rIg.hts of the party of the first part in and to S<lid premises; TO HAVE AND TO
HOLD the premISes herem granted unto the party of the second part, the heirs or successors and assigns of
the party of the second part forever.
AND the part>: of the .first part covenants that the party of the firs1 part has not done ~r suffered anything
whereby the said premises have ~eenenc~mbered. in any. way whatever, except as aforesaid.
AND the party. of the. first part, '? com.phance w~th Secllon 13 of the Lien Law, covenants that the party of
the .first part Will receIve ~he con.slderatlon ,(pr thiS conveyance and will hotel the right to receive such consid-
eration as a trust fund to De applIed first for the purpose of paying the cost of the improvement and wilt 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 ~ead "parties" whenever the sense of this indenture so requires.
IN,WlTNESS WHEREOF..the party of the first part has duly executed this deed the day and year first above
wntten. ,
IN PRESENCE OF:
~2
J
Number of pages
-5
RECORDED
2002 May 10 08:48:51 RM
Edward P.Romaine
CLERK OF
SUFFOLK COUNT'!
L D00012185
P 182
DT# 01-38790
TORRENS
Serial #
Certificate #
Prior Ctf. #
Deed / Mortgage Instrument
Deed / Mortgage Tax Stamp
FEES
Recording / Filing Stamps
4
Page / Filing Fee
Handling
TP-584
6,
~
Mortgage Amt.
I. Basic Tax
2. Additional Tax
Notation
EA-52 17 (County)
~ = SubTotal
3J~
d-~
Sub Total
Comm. of Ed.
50~
Spec.! Assit.
Or
Spec. / Add.
EA-52 17 (State)
R.P. T.SA
TOT. MTG. TAX
Dual Town Dual County
Held for Apportionment /
f')
Affidavit
Transfer Tax
Certified Copy
Other
Sub Total
(Po
8'i
DC
Mansion Tax
The property covered by this mortgage is or
will be improved by a one or two family
dwelling only.
YES or NO
If NO, see appropriate tax clause on page #
of this instrument.
Reg. Copy
GRAND TOTAL
Stamp
1000 10000 0100 018000
6 Community Preservation Fund
j
Real Property Tax Service Agency Verification
Dist. Section Block
Consideration Amount $
7
Satisfactions/Disc arges/Releases LIS[ rrupt::ny Vwn!;;;l;:) IVUlIlIII5 nddress
~#- :CO:7:~~, Uif"
:)3 rJ /LLVyL;1-f -
c;(/~ ,It 1.117 &
CPF Tax Due $
a
t\.
Date
Improved
Initials
Vacant Land
)
TD
TD
TD
8 Title Company Information
Co. N am eMlV ANIoAGli 1I"LI: AG eYt 1He.
9
Suffolk Count Recordin
made by:
Title #
Tm(JJt~L~
I3JJ 11 d
, .
The premises herein is situated in
SUFFOLK COUNTY, NEW YORK
In the Township of
In the VILLAGE
or HAMLET of
.?"~\'^ "W
BOXES 51HRU 9 MUST BE TYPED OR PRlNIED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
(OVER)
.
,.I'.,h
,.i
11111111111111111111111111111111111111111111111111I1111
1111111111111111111111111
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEEDS/DDD
Number of Pages: 3
TRANSFER TAX NUMBER: 01-38790
Recorded:
At:
LIBER:
PAGE:
05/10/2002
08:48:51 AM
000012185
182
District:
1000
Section:
100.00
EXAMINED AND
$0.00
Block:
01. 00
CHARGED AS
Lot:
018.000
FOLLOWS
Deed Amount:
Received the Following Fees For Above Instrument
Exempt Exempt
Page/Filing $9.00 NO Handling $5.00 NO
COE $5.00 NO EA-CTY $5.00 NO
EA-STATE $25.00 NO TP-584 $5.00 NO
Cert.Copies $0.00 NO RPT $30.00 NO
SCTM $0.00 NO Transfer tax $0.00 NO
Comm.Pres $0.00 NO
Fees Paid $84.00
TRANSFER TAX NUMBER: 01-38790
THIS PAGE IS A PART OF THE INSTRUMENT
Edward P.Romaine
County Clerk, Suffolk County
,.~,...
~
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PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
INSTRUCTIONS: http:// www.orps.state.ny.us or PHONE (518) 473-7222
FOR.tOONTY !JSE ONLY
{;~ Code }
./ ~,'
C2. Dat.boed R~
C3. Book
1. Property I
location
REAL PROPERTY TRANSFER REPORT
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
RP-5217 Rev 3197
STREET NAME
STREET NUMBER
f'B t::.i tUC,'(
koocct
ZIP CODE
2. Buyer
Name
CITY OR TOWN
Br~l:tord
LAST NAME I COMPANY
Ballard
VILLAGE
FIRST NAME
d,.,I1..nie
ROtY2:r-t
LAST NAME I COMPANY
FIRST NAME
3. Tax Indicate where future Tax Bills are to be sent
Billing if other than buyer address (at bottom of form) I
Address
Belford
'c..',
1:J :Jd.iry Zarm Road
LAST NAME I COMPANY
SconI ;3r:x)}~
CITY OR TOWN
STREET NUMBER AND STREET NAME
4. Indicate the number of Assessment
Roll parcels transferred on the deed
OR D
Part of a Parcel
# of Parcels
5. Deed
Property
Size
1 I
Ixl
lOR I
'ACRES'
.
FRONT FEET
DEPTH
Belford
RlC'Elcd
6. Seller
Name
FIRST NAME
N "i 11790
, I
STATE ZlPCODE
(Only if Part of a Parcel) Check as they apply:
4A. Planning Board with Subdivision Authority Exists
48. Subdivision Approval was Required for Transfer
4C. Parcel Approved for Subdivision with Map Provided
D
D
D
LAST NAME I COMPANY
FIRST NAME
LAST NAME I COMPANY
FIRST NAME
7. Check the box below which most accurately describes the use of the property at the time of sale:
A ~ One Family Residential
B 2 or 3 Family Residential
C' Residential Vacant Land
o Non-Residential Vacant Land
I ~ Community Service
J Industrial
K Public Service
L Forest
E ~ Ag,''"''"'"
F Commercial
G Apartment
H Entertainment I Amusement
Check the boxes below as they apply:
8. Ownership Type is Condominium
9. New Construction on Vacant land
10A. Property located within an Agricultural District
108. Buyer received a disclosure notice indicating
that the property is in an Agricultural District
D
D
D
D
SALE INFORMATION
11. Sale Contract Date
15. Check one or more of these conditions as applicable to transfer:
03 I~' I 02
/ '.-Ab /
Month D,y Year
u4 r /f..J 02
/
Month D,y Year
A
B
C
D
E
F
G
H
I
J
12. Date of Sale I Transfer
o
13. Full Sale Price I I I I 0 I 0 I
, , .
{Full Sale Price is the total amount paid for the property including personal property.
This payment may be in the form of cash, other property or goods, or the assumption of
mortgages or other obligations.) Please round to the nearest whole dollar amount.
Sale Between Relatives or Former Relatives
Sale Between Related Companies or Partners in Business
One of the Buyers is also a Seller
Buyer or Seller is Government Agency or tending Institution
Deed Type not Warranty or Bargain and Sale (Specify Below)
Sale of Fractional or less than Fee Interest (Specify Below)
Significant Change in Property Between Taxable Status and Sale Dates
Sale of Business is Included in Sale Price
Other Unusual Factors Affecting Sale Price (Specify Below)
None
<,'"
14. Indicate t~e value ~f personal I I I I U I 0 I 0 I
property Included In the sale, , .
I ASSESSMENT INFORMATION - Data should reflect the latestF;nal ASseSsment Roll and Tax Bill I
16. Year of Assessment Roll from I (
which information taken
C,
I .A_ I 17. Total Assessed Value lof all parcels in transferll
18. Property Class
1/\ ,~? I-~
19. School District Name I
NattitUi-::::
20. Tax Map Identifier(sll Rollldentifier(s) (ff more than four, attach sheet with additional identifier(s))
lOQU-i0DlJO-010Q-Jlj000 \
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'CERTIFICATION I
I certify that aU of the items of infonnation entered on this form. are true and correct (to the best of my knowledge and belief) and I understand that the making
of any willful faIse statement of material fact herein will subject me to the Drovisions of the oenallaw relative to the making and filing of false instrnments.
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BUYER
( /
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- !" - 02
/,/
.I..uwrence
BUYER'S ATTORNEY
Andrew W.
LAST NAME
FIRST NAME
ATE
IS
Deli r "',no'! Road
I
STREET NAME (AFTER SAlEl
\>31
423 hliJ
AREACOOE
TELEPHONE NUMBER
STREET NUMBER
S4.:KXlj 3root:
iIl'i
11790
CITY OR TOWN
./
STATE
ZIP CODE
SELLER
I
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SELLER SIGNATVRE
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DATE
CITY/TOWN ASSESSOR
, . ' , " ," ~, " ' . . ' ~ , , , , " "
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...0.. 'cop"" .
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