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'. I Swn.old N.Y.B.T.U. Form 8002 - Ba",oln on. Sole DHd. wilh CcMlnont ogo;n" G,.ntor'o _ - Unlfonn _groonl
Fonn 3290
CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENTMTHIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY
THIS INDENTURE, made the I ~day of June. 2003
'I'.
BETWEEN
JOHN W. CARLSON, JR. and DOROTHY S. CARLSON, his wife, residing at 186 Bumey
Boulevard, Mastic, New York 111150 and 840 Bridle Lane, Cutchogue, New York 11935, respectively.
party of the first part, and
\ 0 2 ,> ~. f (
DOROTHY S. CARLSON. residing at 840 Bridle Lan!" Cutchogue, New York 11935, party of the
second part,
WITNESSETH, that the party of the first part, in consideration of TEN and 00/100
($10.00)
dollars, and other good and valuable consideration 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 certain plot, piece or parcel of land with the buildings and improvements thereon
erected, situate, lying and being at Cutchogue. Town of Southold, County of Suffolk and
State of New York, known and designated as Lot 19 on "Map of Highland Estates. which
was filed in the Suffolk County Clerk's Office on April 26. 1977 as Map No. 6537, said lot
being bounded and described as follows:
BEGINNING at a point on the southeasterly side of Bridle Lane distant the following four (4)
courses and distances from the extreme southwesterly end of the curve connecting the
southeasterly side of Bridle Lane with the southwesterly side of Highland Road;
1. Southwesterly along an arc of a curve bearing to the right having a radius of 411.72
feet a distance of 162.04 feet;
2. South 42 degrees 26 minutes 10 seconds west 60.00 feet;
3. Southwesterly along an arc of a curve bearing to the right having a radius of 428.71
feet a distance of 99.56 feet;
4. South 55 degrees 44 minutes 30 seconds west 28.40 feet to the true point or place of
beginning;
RUNNING THENCE South 37 degrees 50 minutes 25 seconds east 231.57 feet;
THENCE South 35 degrees 52 minutes 27 seconds west 143.00 feet;
THENCE North 46 degrees 41 minutes 37 seconds west 271.36 feet;
THENCE North 47 degrees 57 minutes 17 seconds west 14.94 feet to the southeasterly side
of Bridle Lane;
THENCE North 55 degrees 44 minutes 30 seconds east along the southeasterly side of
Bridle Lane 182.00 feet to the point of place of BEGINNING.
BEING AND INTENDED TO BE the same premises conveyed to the party of the first part by
deed dated 10/14/93, recorded in Liber 11650 page 225 in the office of the Suffolk County
Clerk.
TOGETHER with all right, title and interest, if any, of the party of the first part In and to any
streets and roads abutting the above described premises to the center lines thereof;
TOGETHER with the appurtenances and all the estate and rights of the 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 of the second part
forever.
",
.'
AND the party of the first part covenants that the party of the first part has not done or
suffered anything whereby the said premises have been encumbered in any way whatever.
except as aforesaid,
AND the party of the first part. in compliance with Section 13 of the Lien Law. covenants that
the party of the first part will receive the consideration for this conveyance and wtll hold the
right to receive such consideration as a trust fund to be applied first for the purpose of paying
the cost of the improvement and will 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 read .parties. whenever the sense of this indenture so
requires.
IN WITNESS WHEREOF. the party of the first part has duly executed this deed the day and
year first above written.
IN
,
,
,
. .
..
TO BE USEQ.QW,Y WHEN THE ACKNOWYiQ!lMENT IS MADE IN NEW....YQBK STATE
. State 01 New York. County 01 SuIIoIk n:
on;"" ,., ~ay 01 'J:.,- In the yaar 2003,
belora me, the undersigned. penlOI1lIlly apP8818d
JOHN W. CARLSON. JR.
personally known to me or proved to me on the baall of
Batlsfactory evidence to be the individual(s) whose nemees) is
(are) 8ubacribed to the within Instrument and acknowledged to
me that hel8heltheV executed the ..me In hi-'herllheir
capecity(iH). and 1h81 by hlolherllh8lr oIgnature(e) on tha
Instrument, the Indlvldual(.), or the person upon behalf of which
the indivtdual~executed the i
(slgnatur. and orrlCe of Individ I taking acknowledgment)
Notary Pu
S18le oJ New York. County of Suffolk ss:
onlhB/')" daYol~"'.lntheY88r2003.
before me. the undersigned. pel'80Nllly IppeBred
DOROTHYS.CARLSON
personally k.-n to me or proved to me on the besls 01
s8lisl8ctory avidence to be tha Individual(e) whosa name(s) is
(are) subscribed 10 tha wIlhln Instrument end cknowledg..:l 10
me th81 helehel\hay exacuted the seme in his/herllhelr
capeclty(les). end Ihat by hislherllh8lr slgneture(e) on the
instrument, the IndIvidUIIIC. or the person upon behalf of which
the i Nidual(.) . ex the Instrument.
-~~-
_InS_lli!!Rr
a.. . . -.........., ~'2 a:>"
(81 nature nd office
Notary Public
-~-rJ~:t--
N..Ol -:h
.J~""'" . 'U:Jd1
TO BE USED ONLY WHEN THE ACKNOWLEDGMENT.lS MADE OUTSIDE NEW YORK STATg
State (or Dletrld 01 CoIumllill. Tarritory. or Foreign Country) 01 , ee:
OnlhB
day of
. in the year
before me. the undersigned. parsonally appeared
personally k.-n 10 me or proved to me on IhB bee" 01 _sf8dory avidence to be Iha Indivldual(s) whose nama(l) ie (are)
subscribed 10 the within instrument end acknowledged to me that helshelthey executed the same In hlalherllhelr capactty(le.). and
that by hialherllheir llignature(.) on the instrument. the individual(s). or the person upon behalf of which the Indivldual(s) acted,
executed the instrument. and that such individual made such 8ppe8rance before the undersigned In the
(i.....rt the City or other political subdivision)
in Floride .
Cend insert the st.t. Of Country or other place the acknDWledgment was taken)
(aign.lurw and office of individual laking ackno.Jllldgemenl)
Notary Public
SECTION 102.00
BLOCK 08.00
LOT 016.00
COUNTY OR TOWN Suffolk
STREET ADDRESS 840 Bridle Lane
BARGAIN AND SALE DEED
WITH COVENANT AGAINST GRANTOR'S ACTS
TitleNo.
JOHN W. CARLSON, JR. and
DOROTHYS.CARLSON
TO
DOROTHYS.CARLSON
Recorded at Request of
COMMONWEALTH LAND TITLE INSURANCE COMPANY
IrANDARD FORM OF NEW YORK BOARD cw mu UHDERWRITERS
DIoIrlI>Ur.dIly
o Common~~~o..,.....
<'"OMMC):rt.""t'.ALl1l LA..."!) TITI.E: I:\"SUltANCH CO"'PAMY
I DV...AII TI"\.
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I11111111111111111111111111111111111111111111111111111I
II11I11111111111111111111
SUFFOLK COUNTY CLERK
RECORDS OFFICB
RECORDING PAGB
Type of IDBtrumemtl DEEDS/ODD
Number of PageB: 4
TRANSFBR TAX NUMBER: 02-48783
Recoreied:
Atl
LIBER:
PAGE:
07/28/2003
09131:58 AM
D00012263
406
District:
1000
SectioD: Blockl
102.00 08.00
EXAMINED AND CHARGED AS POLLOWS
$0.00
Loti
016.000
Deed Amountl
Received the Pollowing Pees Por Above IDStrumeDt
Exempt
NO HandliDg
NO NYS SURCHG
NO EA-STATB
NO Cert.Copies
NO SCTII
NO CQIIIID. Pres
Pees Paid
Page/Piling
COB
EA-CTY
TP-584
RPT
Transfer tax
$12.00
$5.00
$5.00
$5.00
$30.00
$0.00
$5.00
$15.00
$50.00
$4.00
$0.00
$0.00
$131.00
Exempt
NO
NO
NO
NO
NO
NO
TRANSPBR TAX NOMBER: 02-48783
THIS PAGE IS A PART OP THB INSTRUMBNT
Edwarei P.RomaiDe
County Clerk, Suffolk County
Number of Pili"
TORRENS
Seri.11I
Certificate II
Prior Ctf. II
s
RECORDED
2003 Jul 28 09.31:58, All
Edward P._I...
a..EIlK OF
SlFFOLK COltITY
L 000012263
P 406
on 02-48783
4
Deed I Mortpae Inslnllllenl
Deed I Mortp&o Tax Slimp
FEES
Rac:onIina I Filina SlampS
S1amp 10'1 03028523
:.b ~~;;
7 S.ti.factlonsIL....,~""' ....1....... LIst I'rOpcrtY 0WiIers MAiling Addr
. . RECORD A RETURN TO:
Page I Fllina Foe
Handlina
TP-S84
NOIlllion
EA.S2 17 (Couo\)')
EA-S217 (Swo)
RP.T.5.A.
Comm. of Ed.
Affidavil
Certified Co~/
Rea. Copy --TJ'
Other
~
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.::r
-
~<-
-
Mortpgo AmI.
1. Basic Tax
2. Addidonal Till
Sub TOIIII
SpecJAssiL
Or
Spec. 1Add.
-
oS -
...~ --
~~
:2'1 -
Sub Total
S~
TOT. MTG. TAX
Dual Town Dual Colin\)'_
Hold for APportionmoW
Tranofilr Tax
or
Mllnaion Tax .
Tho propel\)'
will be Imp
c1weItinS DO .
If -
by this mortllao is or
od by a one or two f.m i1y
/~ ----SubTotal
ORAND TOTAL
Real Property Tax Scrvi,," Aypw:y Verification
DilL SeotiOll Block __Lot.
1000 10200 0800 016000
d
TO /oao
TO
TO
Wickham. Rressler. Gordon' Geaaa. P.C.
13015 Ma~n Road - P.O. Box 1424
Matt1.tuck. New York 11952 r l.-
"-
"
,
9
Suffolk Coun
a Title Company Information
Co. Name
Titlo #I
Recordin & Endorsement Pa e
'Ibi. P8lIO fonns pBrt of the p.....ftfrl
made by:
DEED
(SI".cu!' y TYPE OF INSIRlJMENl')
The premises herein is situattld in
SUFFOLKCOUNIY. NEW YORK
JOHN W. CARLSON. JR. and DOROTHY S.
CARLSON
TO
In the Township of
In the VILLAGE
or HAMLET of
South01d
Cutchogue
nnDn~uv c ~AD.CQM
BOXES 5 THRU 9 MUST BE TYPEDORPRlNIED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
.
PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
INSTRUCTIONS: http:// www.orps.slale.ny.us or PHONE (518) 473-7222
FOR COUNTY USE ONLY
Cl. SWISCod. <f; 7,.3, g,,?, 51,
/
C2, Date Deed Recorded -;1 ~ flj O:r I
Month Day ~lIr
C3. Book 1 ,,<~0' 6,3'[ C4. Pagel , s<O.;(
PROPERTY INFORMATION
REAL PROPERTY TRANSFER REPORT
*
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
RP-5217 Rey 3N1
"r:::::~1
840
Bridle Lane
STflEETNAME
STIlEETNUMIlEfl
Cutchogue
VillAGE
Cutchogue/Southold Town
CITY OR TOWN
2. Buyer
Name
CARLSON
l,ASTNAME/COMPANY
DOROTHY S.
FIRSTIIIAME
I.ASTNAMf/COMPANY
FlflSTNAME
3. Tax Indicate where future TBJ( Bills are to be ~nl
Billing if other than buyer address (at bottom of form]
Addr.,"
LAST NAME I COMPANY
flRSTNAME
SffiEET NUMBER AND STREET NAME
CIn'OflTOWN
STATE
21F'COOc
4. Indicate the number of Assessment
Roll parcels transferred on the deed
1 # of Parcell. OR 0 Part of 8. Parcel
IOnly If Part of . Ptn'C81J Check as they apply:
4A. Planning Board with Subdivision Authority Exists 0
48. Subdivision Approval was Require<! for Transfer 0
4C. Parcel Approved far Subdivision with Map Provided 0
5. Deed
Property
Sl~
lOR I
Ixl
'ACRES'
.
a~rTH
FRONTFEH
8. Seller
Name
CARLSON. JR.
I.ASTN.......~ICOMPA~
JOHN W.
fI1l5TNAM~
LAl; ~lM 1~&1Mr:ANV
nnlUlTlIV c;:
FlIlSTNAME
Check the boxes below lIS they apply:
8. Ownership Type is Condominium
9. New Construction on Vacant Land
lOA. Property Located within an Agricultural District
lOB. Buyerrecaived a disclosure notice indicating
that the property is in an Agricultur.al District
7. Check the box below which most eccurat~v deacrib_ the use of the property at the time of sale;
o
o
o
o
A~ One Family Residential
B 2 or 3 Family Residential
C Rasidential lJacant Land
D Non-ResidentiallJacant land
E~Agricultural
F Commercial
G Apartmant
H Entertainment I Amusement
I ~ Community Sarvice
J Industrial
K Public Service
L Forest
15. Check one or more of these conditions BlI applieable to transfM;
SALE INFORMATION
11. Sale Contract Date
N/AI
Monlll Do)' Vltar
6 11'7 I 03
Monlll Do, Vear
A
B
C
D
E
F
G
H
I
J
Sale Between Relatives or Former Relatives
5111e Between Related CompanlB6 or Partners in Business
One of the Buyetrs is a\80 a Sellar
Buyer or Seller is Government Agency or Lending Institution
Deed Type not W.aITenty or Bargain and Sale (Specify Below)
Sale of Fractional or Less than Fee Interest (Specify Below)
Significant Changa in Property Betw&en Taxable Status and Sale D3tes
Sale of Business is Included in Sale Prica
Other Unusual Factors Affecting Sale Prica (Specify Below)
None
12. Date of Sale I Transfer
13. Full Sale Price
.y{o
, 0 I
, ,
iFull Sale Price is the total amount paid for the property including personal property.
This payment m.ay be in the form of clIsh, othar property or goods, or the a~$umptlon of
mortgages or other obligations.) Pleasa found to thet nBSrest whole dollaf amount.
Pllrl::!lI~nt- t-..... m;:lrit-~'
12t--lpI11;:at-i.....n
14. lndlCllte the value of penonel . 0 . 0 I
propertV Included in Ule ...Ie, , .
ASSESSMENT INFORMATION. Data should reilect the latest Final Assessment Roll and Tax Bill
16. Year of A8Ms$mant Roll from I
which Information taken
17. Total Aasessed Value {of all parcels In transferl \
;
;
18. Property Class
12... 1 . Dl-u 19. School District Name I
Cutcho~ue
20. Tax Map ldentifiertall Rollldentifiar(slltf more than four, attach sheet with addjtil;)nalldentiflerlsll
1000-102.00-08.00-016.00
I CERTIFICATION
I certify that aU of the items of infonnation entered on this fonn are InK and corooct (to the be5t of my knowledge and belief) and [ understand that the making
of any willful false statement of ma1erial fuct herein will subject me to Ihle urovlslOlL'> or the oenallew relative to the making and nUng of false instnunen1s..
~ BUYER'S ATTORNEY
OAT~
GEASA
lASTNAMf
JANET
FIRST NAME
298 8353
TfLEPHONfNlIM8ER
840
STIlEfTNVMIlER
Bridle Lane
STlIfHNAME(AFTfRSAlfI
631
AR~COOE
Cutchogue
aTV OR TOWN
NY
STATE
11935
ZlPCOOf
NEW YORK STATE
COPY
SELLER
~ ~L-at d
/SELl.ERSlG~ ./
{'/ .;..../
DATE