HomeMy WebLinkAboutL 12362 P 723
L /~ ~bL 103-Y-3>2-
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~"'IIIIC. CJuih:L:lirn 1lL-N IIl1.hvidUII! ..rCIlIp."uliur.ISi~k' Sh.=\.'IIIS\'U'n' N'...n
c..'f'l\'Slil.T 1"<,.:11: IA" \'.:. H.:."nIU: SUOSIl'liI; 1"IUS I~TKI'~n:''T. nmt IsoorrICl;a....:.'.,. SIIO':UJ B~ USKI) BY I.,\W\'.:RS ()1\Ii1.\'
,.11
TillS 1:\II>F.NTl:KF~ ma,le ,he 'J,3' ~ay "r Orlober "in ,II.: year 2004
8F.TWF."'"
AI.B..:RT A !\t. JACOBS, owner ora li2.!'i0% interest. residing at 550 Depot Lane. CutrboRue,
NY 11935
par1~' Itf thL" fino. (lm1. and
ALBERTA !\t. JACOBS. as to a 35.20 % Interest, residing at 550 Ot!pot Lane. Cutrhogue. NY
11935, and LIS,\ H. JACOBS. as to a 27.30 % Interest, residing at 170 Emory Rd. Cutrbogue,
NY 11935
pan,.' of Itlt" !<f.:llnd I'l:ln.
\YJT:"IIF..8SETH.lhullhc part)' urlhc.~ JirsL ran. in ",'llnsiLk'r.llhm l,rTcn o.dlurs ark.! lither vuluahle L'un5idcrUliun paiu by Ihe
pur1y (d'lh~ ~""IUJ pun. .Joe~ hcn:by n:llli,oc. ~hm~ .mdlluitt:I.1i1ll UIIII11M puny ufllu," St............. ran. Ilk- tal'in. ur "lk.'1."~1Ili
and Uo"Si1UJ=' urlh~ run)" "rlh~ s......ul1l..l pan JilR,'''',,'r.
AI..I.. lhall-Cnilin pll'.. piC\.'c ur pan.."C'1 or 10.111,,1. wilh Ihc Niilllina;'- .ul,,1 iml'....J\'C'lI1cnu Ihcn"tlu 1:R!l.:led. ~iluOllc.I)'lna:. and beln"
in IIIe'
at Southold, Town or Southold, County or Suffolk and State or /liew York, known and
designated as Lot No.5 on "Map of Sunny Shores at East Cutcbolue, Town of South old.
Suffolk County. NY" prepared by Otto W. Van Tuyl &. Son from surve)". completed lII9/6O
filed In the Suffolk County Clerk'. Omce on 11/30/60 as Map No. 3231.
Alberta M. Jarobs i. curl'C'ntly the owner or a 62.50 % interest In the subject premises and Usa
II. Jacobs is currently the owncr or an 37.50 % interest as tenantlln common by deed dated
August 8, 1003 and recorded In L1ber IZZ79 Page 306.. It Is the Intention or Albena M. Jambs
to convey by this deed an additional 17.30 % Interest to Lisa II. Jacobs so that Albena M.
Jacobs ,,'ould have a remalnlnl 35.20 % Interest and l.I.a II. Jarobl .."auld h...e a total or
64.80 % Interest as tenants In common, In the subject premises.
TU(.ETIIEK wilh idl ri~hl. lilll" uuLl inLcn."st. if any, nl" Lhc pany uf Ihe 1ir..1 part "r. in and III uny slR:eb; and moo,c :J.buning
Ihe t1n..,\'e-deM.:'riht...J II~l1Ii~ h, the .:clIIer lilk'" Ihen...,r: TCK'iETHER wilh Ih~ urrun"'nuth....."2fi und alllbe ~lUtc 4nd righbo lIf
Ihl' rany "flhe Iinot run in and hI Sli.... pl"C'n1i~~: TO HAVE ^I'On) HOLD lIu: pNl1Ii~lI hc'rcin 8funh:lI Unll.1lh.: ran~'I,fl~
~'''"I1t1 parl.lhc h.:iD ur su...-.:L.S.....'OI and u!<t'l;ipn'l;t.I(lhc part)' Ilflhe ~ul1L1 pw1"u~vcr.
ANI) lhe pun)' 11flh... finol pun. in ....ump1iam.-e with SI."Clhm 13 Ilfthe Ijen l.aw.I....'\-ernmb; Ihallhe party of 1M linn pan will
r<<'eive Ihe ....IIRlOider..lliun lhr Ihi!l cun\'t.y:.n....... and will h'lhJ lhc ri!:':hllu rel.."C'ivC' lIlu....h l.."Cmsiderulhm IQI a UUIII fuulJlo be urrlit.....
Iir"L fur the purJ111:cc "f paying thC' t't1SI lIf Ihc in11)ru\"C'mrl1l and will apply lhe l't....ne fir~t 10 Ihe pu)'I1Cnl,',. lhl- ....1101 uf Lhe
impnl\~11ICllt hcCi.IN u~inp an,)' pan Ilrlht.. hllilll1r the same f,'r an)' lIther pUTf'I''N:. '1l1c ".,"(,rd "I'lClny" "h.111 be: cCln"'lruL.... Wi if i.
re...... -punk-s" whl:ncycr Ihe l-Cn!oC ,.fthi" in.JCIIIUn:' "l'I"t'l.IUirelO.
lri \\'IT~t:SS \VHERKOF, Ihe (lU11)' (,If Ihe 11...... polin halo .July .:;"c..:ul'''ll thiloi dl...-d Iht:
IS'"kli."'Ii"ol("IiO(o::
.,
.. USEA~\"IWI.Jo:lllar,.;;vrFtJll." .,.311'" U7TIU.Y NE"" t'(JRK.\~'"ffl(J.'Y/.Y:
S.....oI'NL....V.......Cnunlyor Suffolk I...:
On the J,I.~t.y "r October inlla= Y'=:lr 2004
hernn: mc:. the unr.krsignc.-d. pL'l"foo4.lI1UlI~' upp:8Md
Albe~ta M. Jacobs ..
pCBunaJly knn\l.'n .." Ilk: ,)f prun.."l.I In II~ llf1 l~ hasis nt" ~li~r--"hWY
c\'i~~ 1\1 h.-the individuul..) \A.'h,,,,' l1un"'"i'l'l' i... fan: J "lIt\0i4.Ti~-d 'l'the
wilhin inSlrUl11c.I1l and uckmlwlL"\JgoJ In me Lhul hcM:M.:'lthc)' l.""'L'\.'Uk:U
Lhc mune in hiNherllheir CllpOt'ilYIK:/iot Rm! lhnt by hWhcrllheir
~il!llDlurc(") UII d' menL lhe indivhhwlls). or the pel'!Gl.lll IIJX.'1I
~h:1lr ur w . . ivWw. .. 'XC\.'uled tilt" instrulIlI."IIL
c
DAVID W. 0LlIEM ......
PublIC. SlaI8 of - --
No. O2OL.lI020974
~ In Sullalk CaunIY ,.?
-. ,..... ElcpIIee Much.. 2O.!4-
,\".....wnn.Jo:JIti.",.::vr ""0Il." nJlt US#! WIT"'^, ,vI!'" )"MI: .4tT.4.TI:'(J,'t;/.';":
(.v~",. t'..Ilt SMhlol'"WnJt W/fl'JrJ" A.,t".,,,./roJ,c_.,,, ('rrr(If...,../
SlIIIrClrNL"W York.. CAMIIlly ..r )-.:
On the day tlf iUlhc wur
hcforc 1111:. ltIC- undc:Big.Jk.-d. p.."rsunully uPJ1CW"l;-a .
the aabK.TibinJ: wilneu lO the fQI"CgoinJ:, iO!ClNrn&:nl,. willi whom I am
p,'rsunall)' ........uaillh...... whl.t. R:ing hy 1Itf' duly,.s\l,'UriT.1lid"'JL'I"~ muJ
s:1)' WII hc:IJiltehhcy Rll:idct$J in
t iflbe'll/flCI' 'QTr'si,I,'nl't' i~ in" r:il)". ilh '1,"A'lhc' ...".,.,., flllfl JI.tl'l'f'l "'1II~r,
iran.,'. 11'':1\.'(11: lhal hcJ~)' Lnn"'(5)
lU b: lhe indi,'itJual de:scribc:d in und wtw CM.ocutL"ll Ihe r'W'L"I!uing
in"tnu11I:nt; lhal ,r,uid MUbM:rihinp. \\'ill1L~ W'..L" pre.'nl ;and .:oIQW !iQW
execute the same: unci thai said wil~ :u. I~ ltame lime :wbM:ribed
hisJl1cr/thcir narJ'K"(,,) us a wi~ Ihcrcl(l.
QliITC.'I.AIM OF.Jo:n
TrrLF. ,vo.
Jacobs
TO
Jacobs
FIUF.I.IT\' NATIONAl. TITI.F. I!'iSUNA,,"Ct:
~ COMJ''''''Y 0.- N.:w YON"
'WI" I..."........rm IU:Jf
'/") Wn........ AI.. Fidelity .l<~._r.,.
..........""..NwI.~,.-I,iIIr"'....,.....
UtiF. "t"A..'Y,IM'LE/K:.IIENrFtIl"" BEIAIH'"m"N NAY )'(.6" .\"TATHO{\'U":
Sllll~ ...."""'. York, Coumy or
I....:
On Ihe d.I'" IIf in 1M )'Coer
oorurc 1llC'. Ihc unc.kndlJled. pcn;nnally :IJ'I1Can:d
1lL"l"SUIlally tCk'",1I In me ur pnWc:d In me on the hasu. .... ,calbor.....1.1I}.
evidcnl."C 11,1 be the in,Ji,'idu:d(lC) wht~ "'lme(~1 ill: (aN') M1hkribcd I" lhe
wilhin ill5tnmlL"l1l and ar:knuwICLIIfL'lI k' me Lllul hc:h.hcI1ht:~ eM.'l.'uIL-d
III(' !lkUl1e in hiNhaftheir Capuctly( ie"t ond Ihtd by hWherltheir
5i.,:nuwrcc',,) 'UI Ihc ilUllrUmmL 1.hc: indi\'iduulbL 1,1I' the. pen;tMI Up1l1
bela:llr uf",'hi"..h Itk- inc.lividU:ll(2Io) ~aed. e~lIIN lhe iNlNl1lCnl.
.
,ttA,\'OM'I.IWt;..Ve..vr ,..(JIl." FIlii USF.(~/"': NI:"H' Y''''A' .\TATIl(J/t,'I.r:
If""../ .'i""...., r,m"" (;~III'NI ,"'Uont-/NH""'IU Ct'nl/hufo'l
..................................,.............. .)...:
tCfony""'" \''''''.... nil. .'IItH... C......,,,. r""'fM'.H' .\lIBIio;p..lit.IfJ
On .he .Jay uf in the )'Cor
bel\lf't: me. 1m: wlf.lm;igncd. personally IIPl1Ci.lR.ocI
('IL~I)" knuwn lu ~ '11' pl'\woJ t,. me un the hui.il'li ur s:ar.isfa..tuI';
cvickn,..e II. hJ Ilk- individual(,,) whc'ItiC I1wDLi:c) is (are)suhKrituJ ktthc
~~JJpllnlmcnlllI1l.l adC:I1O\a.'lcd;ed ", me dull hel5hc/lhey exe..~led
111C In hi~rltlu-ir capadlytic."ll. thai l1y hifJhcr/ lhcir slgnuLun:c",
.m lhe ilUOU'Ul11l.'nL the individuatulI. III' the p.."f'5ItII upun hehalf uf which
Ihc indivic.!uIIICs) uclcd. cxL....uwd the inKtrUIt1t.11t. D.nd Iholl ~h inc1i~'iduul
1I...de such 3pp.""..rmk."C ~rc.m: tlllt" unck.'T1'ip.nc.-d in the
(l11JiI.rt ,,,.. ("'II)''''' mil,.", I,,""ical suht/i,oixi.Nt "nJ 1M ~Ullc' ,,,. l'fMllllr)' f"
,,,"", II/,IC.,. IlK- dc.'luIf,,,'1.v/sfIlI,mlll'll.l' 'fllmJ,
I)lSTRICT 1000
Sl!('"no.... 103
BUll'" 4
Len 32
COl'''''. OR "1'0\1\'" Su ff olk
NECI 1IlIIEIJ.4T NIiJ..JlI/;'tJ"""
t1dL~lIy Sullonul TIlle I_ru.." <:C_l' 01'11;...- \"CII~'
RE:lVN,'YN.'MAII. n,
Olsen & Olsen. LLP
P.O. Box 706
32495 K8:ln Rd.
Cu~choBue. NY 11935
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Ra;(Jp.I>Er-
2004 ~ 29 12'~'45 PM
Edl.oard P.R<>o>al""
ClERK OF
SUFFOlK COUNTY
L llOOo12362
P 723
v:. 04-2J 925
Number of pales
TORRENS
Serial"
Ctnificale ##
Prior Of. W
Deed I Mortgage Instrument
Doed I Monlll&e Tax Stamp
FEES
Recordina I Pili.. Slamps
4
Fagel Piling Pee
Handling
TP-SB4
Monlll&e Amt.
I. Basic Tax
2. Additional Tax
Notation
Sub Total
EA-S2 17 (County)
EA-S217 (S....)
R.P.T.S.A.
Sub Total
Comm. of. Ed.
S~
Spec.lAssiL
Or
Spec. IAdd.
TOT. MTG. TAX
Dual Town Dual County_
Held f.or Apportionment _
Transrer Tell
Mansion Tax
The property covered by this mortgop i. or
will be linproved by. one or two ramily
d_lIing only.
YES or NO
UNO. Ice appropriate lax clause on pale #
_Of this instrument.
~-
Affidavit
Certified Copy
Reg. Copy
Other
SubTotal ~
GRAND TOTAL. '-1 '1
---,....
l
Real Property TIIX Service Agency Verificalion'
Di!l. SlIetion D lock Lot
6 Community Preservation Fund
:.ConsiCleration Amount S
Stamp ~552~ 1000 10300 0400 032000
0... ~Kc~
Initials
"";"1 SatisfactionslDischargesIReleascs Lisll'ropcrty Uwne.. MalllnK Add....
....:.J RECORD" RETURN TO:
OLSEN & OLSEN LLP
P. O. BOX 706
CUTCHOGUE, NY 11935
. CPF Tax Due
S
IInprovcd
,
/
Vacant Land
TO
TO
TO
9
B Title Company Inform~tioD
Co. Name COM.'10NllEALTH
Tlllcll
Suffolk Count Recordin e
'This page foOIlS pari oflhc BIlIIched
DEED
made by:
(SPEOFY TYPE OF INSlR.UMENT)
ALBERTA l!I. .JACOBS
The pranises hcn:in is situated in
SUFFOLK COUNlY, NEW YORK.
TO
ALBERTA K. JACOBS AND LISA H. .JACOBS
In the Township of
In the VILLAGE
or HAMLET of
SOUTHOLD
BOXES 51HRU 9 MUST BE TYPED OR PRINI'ED IN BLACK INK ONLY PRIOR TO RECORDING OR FlUNG.
(OVER)
/.
111111111111111111111111111111111111111111111111111111
IIIIIIIIIIIIIIIIII~ I11I
SUFFOLK COUNTY CLERK
RECORDS OFFICB
RECORDING PAGE
Type of Instrument: DEBDS/DDD
Number of Pages: 3
Receipt Number : 04-0140967
TRANSFBR TAX HUMBER: 04-21925
Recorded I
Atl
12/29/2004
12153145 PM
LIBER:
PAGE:
D00012362
723
District:
1000
Section: Block I
103.00 04.00
12YI\HINBD AND CHARGED AS FOLLOWS
$0.00
Lot:
032.000
Deed Amount:
Received the Following Fees For Above Instrument
Bx-.pt
NO
HO
NO
NO
NO
NO
Page/Filing
COE
EA-CTY
TP-584
RPT
Transfer tax
$9.00
$5.00
$5.00
$5.00
$30.00
$0.00
Handling
NYS SRCHG
EA-STATE
Cert.Copies
SCTM
COIIIIII.Pres
Fees Paid
$5.00
$15.00
$75.00
$0.00
$0.00
$0.00
$149.00
Bxempt
NO
HO
NO
NO
NO
HO
TRANSFER TAX NUMBIRI 04-21925
THIS PAGE IS A PART OF TBI IHSTRtINIDIT
THIS IS HOT A BILL
laward P.Romaine
County Clerk, Suffolk County
FOR COUNTY USE ONLY
I'LI:A:;!: I YI'!: UH PRESS fiRMLY WHEN WRITING ON FORM
INSTRUCTIONS: http://www.orps.state.ny.u. or PHONE (518) 473-7222
REAL PROPERTY TRANSFER REPoRT
$';7.;', YJ,g-,r' *
C2. Date Deed Recorded U J':;; J ~~ I
C3. Bo.k L /.~ 5, C, 71 C4. P...I '"}, ,;;2.,3 I
,
PROPERTY INFORMATION
C1. SWJS Cod.
STATE Of NEW VORK
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
RP-52l'..."",
'._1 170 Emory Rd
"""'on smEETNUMIEIt SlREET~1i
Southold
cnv OR TOWN
2. ...... Jacobs
Nom, LAST NAME I COMPANY
Cutcho~ue
""'-
11935
...""'"
Alberta M.(as to a 35.20% interest)
flRSTNAME .
Jacobs
I.AST NAM~ I COMPANY
Lisa H. (as to a 27.30% Interest)
.-.....
3. Tax Indicale wh8f8 futul1l Tax BiUIII1I to be lint
Riling if other than buyer addlllSl Cat bottom offorml r
Add....
I.AST NAME , COMl'ANY
""".....
smEET NUlllBER ANO smEET NAME
STATE
cnv OR TOWN
""''''
4. Indlcne the number of AneAment
Roll P8n*1s transferred on 1I1e aeel
00 0
10nIy if Part 01. hrwI.I CMck _they IlIIPIr:
4A. Planning Board with SubdivisionAuthorityExisls
4B. Subdivision Approval WII Requil1ld forTrBIIIfer
4C. P1Nce1 Apprwed for Subd"1VilI1on with Map Provided
tofParce!s
hrtofaPlroel
o
o
o
5.Deeel
Property
Siu
lx'
1001
~s'
.
"""'~,
""'"
.......
Name
T.<:IC'ohl":
LAST NAME I COMPANY
A'~~ M (J3C! l"f'I "" f,? "n.,. 4...t-.........ct-)
lASTI>iAME/COMP","
,- ....
7. Ch8Gk the box below whlGh most aec:urBte!y descrlQes th8 un of ttM prop.rty at the time of sale.
A~n. Family ReeidlJOtill1 E~ Agriculrurlll ~ Community Service
B 2 or 3 Family RIl8identilll F Commercial J Industrial
C Residentlll Vacant Land G Apartment Public Service
D ""-O..'d..",, V,,,", ",' H "to""'"",,",, Am,,,....", L Fo~"
I SALE INFORMATION ~
11. Sale Con1rllct Dete
Check .... boDs bekrw _ they BPPIv=
a. Ownel1lhip Type Is Condominium
9. New Construction on Vacant Land
1OA. Property loca1ad wilhin an Agrlcultul1ll Olstticl
108. Buyerrecei\led a disclosure notIcelndlcatll"!9
th8t1he property is In an Agricuhural Ollltril::t
o
o
o
o
15. Check _ or more of theee conditions .. IpplioabM 10 transler:
-~
f
00,
f
A
B
C
D
E
F
G
H
I
1
Sale Between Relltivee or Fonner RelItivea
Sale Between Ralahld Companies or PartnenJ in Buainees
One of the Buyers . also . S.lIer
Bu..... or Senar is Government Agancy 0( lending InsdtutIon
Deed Type not Warranty or Bargain and Sale {Specify Belowl
Sale of Fractional or lltSl than Fee Irrterast (Specify Below)
Significant CbanlJ8 in Property Bet.veen TlIX8ble Status and Sale Dates
Sale of Businus Is Included in Sale Price
Other Unusual Factors Affecting Sale PriOll (Specify Below)
None
v,.
12. Date of S.le I Transfer
/0
-~
f ;l:Lf
COy
04
v_
, -~. ,0,01
, , .
IFulJ Sale Price is the IOlal amount paid for the property including personal property.
This payment mav be in the form of cash, other property or goods. or the assumption of
mortgagB4 or other obligillions.J Pf_ roonrJ to the ORerem who/a doIlsr amount.
1J. Full Sale Price
14. Indicate"'" value of personal r , 0 I 0 I
property Indud8d in the sale, , .
ASSESSMENT INFORMATION. Data should reflect the latest Final Assessment Roll and Tax Bill
18. Vtlllr of AMeament RoD from ~ 17. Total AasusecI Value (of I"..... in trandarjl
which Infomlldion talcen
3 7' 0
;
01
,
CvTG~v'...<.
,
18. Property a_
I)., I ,U I-LJ '9.500001__1
/0'1//11 t7 v <i(
20. Ta Milt Iderrl:ifierpl/ Rollldltntifier(.jllf more than tour,.u.ch aheet with IddItJonal idInt:Ifier(I:lJ
1000-103-4-32
I
I CERTIFICATION
I certity thai all or tile itma of iDf'ormatiou eatered on ..... form are true ... correct (to .. belt of my knowIedae and belief) and IIIIIdentaad dl8t Ihe maIdaa
of any wlDrul false statemeut of material fact htTda wUI subJect me to the onnisioas at the peoallaw nladve 10 the mIking and 6IiDg or false iII:Itrum.mcs.
BUYER BUVER'S AlTORNEV
/~~
Il~ NATU
I lob'-//o'-{
DATE' I
~.....
f1RSTNAMI
lmtEETf+UMIER
STl'.ESTN.f.MEWTERSot.l.tI
fT-s. 11" s., 'v-P
1
AAUoCODf.
TEUl'HClNENUMIIER
.s.~<
="",....
.<A"
..."""
~
-~~ -
NEW YORK STATE
COPY
I 'J-u./,~
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