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BARGAIN AND SALE DEED WITH COVENANT AGAINST GRANTOR'S
ACTS (INDIVIDUAL OR CORPORATION)
STANDARD NYBTU FORM S007
CAUTION. TillS AORliI!AU:WfSIIOULD 01:: PREPARED BY AN ^.ITOR~F.Y ANI) KeVIl::WI!D BY ATI"ORNEYS FORSI:'UJi:K ANI)
PURellASl!R BEFORE: SIGNING.
THIS INDENTURE, made the /JUI,,")"J{J 2003
between J
RAYMOND J. SLAVIN, .. Trustee of Ihe RAymond J. Slavin Revocable
Inter"Viv... Trual dated Jonual)' 17, 1995, raiding al4610 Holly Tree Rd.,
Wilminglon, NC28409
party of the firsl part. and
RAYMOND D. SLAVIN
residing al4 MeLaren Rd. S.,
Darica, CODnecticut 06820
pany of Ihe second part.
WITNESSETH, thai the party of the tirsr part. in eonsideralion of Ten Dollars and other lawful
eonlidenalion, lawful money of the United Stales, paid by lhe pany of the seeond part, does hereby granl and
release unto the party of the second part. the heirs or successors and assigns of the party of the second pan
forever I
ALL that certain plOl, piece or parcel of land, with Ihe buildinlll' and improvements thereon ereeled.
siluale, lying and being al Peconie. near Nassau I'oinl, Town of Soulhold, Counly of SulTolk and Slale of New
York, bounded and deseribed as follows:
BEGINNING at a pipe set al the interseelion of the easlerly line of Broadwalers Drive and lhe southerly line of
Oak Drive and running along said loulherly line of Oak Drive North 79 degrees 12 minules 10 seconds East I
dislanee of 100.02 feel 10 land now or formerly of Joan Langenyr;
RUNNING THENCE along said lasl menliuned land Soulh 12 degrees 08 minutes 10 seconds Ea." a dislance of
123.34 feel 10 land now or formerly of William J. Breen and Eileen M. Breen;
THENCE along dIe lasI menlioned land and lhe land now or formerly of Mary E. Ilelz Soud, 79 degrees 58
minules 50 seconds Wesl a distance of 25.0 I feel:
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TI.IENCE along said lasl mentioned land the following Iwo (2) courses and distances:
(I) Soulh 12 degrees 08 minutes 10 scco(lds Easl a distance of24.50 feel: and
(2) South 75 degrees 46 minules 00 seconds West a distance of 75.05 fcellO
Ihe easlerly line of Ilroadwaters Drive:
TH!;NCE.ulong said easlerly line of Broadwalers Drive Nonh 12 degrees 08 minUleS 10 sceonds Wesl a distance
of 152.00 feel to the poinl or place of BEGINNING.
SubjecllO Covenants and Restrictions of record.
TIle grantor herein reserves a life es181~ in the subject premises.
Premiscs arc Ihe same as described in deed dated September 25. 1996 recorded in Liber 11795 Page 143.
TOGETHER with all righl. lille and inlerest, ifany. oflhe pany oflhe firsl part in and 10 any slreels and
roads abuning the above described premises to the cent~r lines thereof,
TOGETHER with the appunenances and alllhe estale and rights ofthe party of Ihe tirsl part in and 10
said premises,
TO HAVE AND TO HOLD the premises herein granted unlO the pany of the second part.lhe heirs or
successors Bnd assigns of the party of the second pan torever.
AND the party Oflhe firsl pan, covenanls that Ihe pany oflhe first part has not done or sulTered anything
whereby the said premises have been encumbered in any way whatever. except as aforesaid.
:"IIIYSBA Knidmr.ial N.eall!slate J:Om1S on I knOocs" (9100) Cop~.riahl cllps~lnl 1)ey~lopmcn~
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AND the party of the first pan. in compliance with Section 13 of the Licn Law, covenants thai the party
of the first pan will receive the consideration for this conveyance and will 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 lirslto the payment oflhe cost of the improvement before using any pan ofthe total of the same
for any other purpose.
The word "pany" shall he cf.lnslrued as if it read "par1ics" whenever the sense oflhis indenture so
requires.
IN WITNESS WHEREOJo; the part)' ofthe lirst pan has duly executed Ihis deed the day and year lirst
above writl~n.
4--' ~L
Y I) J. S~IN
STATEOF NEW YORK )
)55.:
COUNTY OF SUFFOLK )
On the 1--'1 do)' of jl}v1 v;;r , 2003, before me, the undersigned. personally appeared
RAYMOND J. SLAVIN. personally known 10 me or proved to me on the basis of satisfactory cvidence to be the
individual whose name is sub I d to thc within instrument and acknowledgcd 10 me that he executed thc
same in his capacity.. and th by is signature on the instrument, the individual, or the person upon behalf of
which the individual aclO , ted the i ~
Tide No.
....~RY AANNER OLSEN
-,~SI,&ofN_VclIIc
c...~~r2:.~.s--
Seellon 104.00
Bloek 06.00
Lot 012.003
County or Town SUFFOLK
DEED
SLAVIN
To
SLAVIN
Return By Mall To:
OLSEN & OLSEN, LLP
P. O. BOX 706
CVTCHOG VE,.NY 11935
Rnerve Thil Space For Vse Of Reeording Office
Nl'SUA Residential Real EstDlc I~orms on IlotDocs" (9100)
-2-
Cop)'ri&ht ClIpsoft" DcftlDpn1C'nl
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Number of pages
TORRENS
.;
Serial II
Cenificate #
Prior Clf. 1#
Deed. MongDge Instrument
Deed I Mortgagc Tux Stamp
3
FEES
Page I Filing Fee
Handling
5. .QlL
TP-584
1'otation
EA-5217 (County)
EA-5217 (SllIIC)
Sub TOIal
R.P.T.S.A.
~-
5...Q!L
Comm. of Ed.
Affidavir
Cenified Copy
Reg. Copy
SUbTot31_._~.__
Gmnd Total I,) .....- f-?
06.00 1
B lock Lot
OIher
1000
4 District
Real
Propeny
Tax Service
Agency
Verification
104.00
Section
1000 10400 0600 012003
6
SatisfuctionIDischurgeslRelease List Property Owners Mailing Addre.ll\is
RECORD & RETURN TO:
OLSEN & OLSEN, LLP
P. O. 80X 706
CUTCHOGUE, NY 11935
7
Co. Name
TItle II
RECORDED
2003 Sep 1609.08,04 RIl
Edward P.~3in~
CLERK OF
SUFFIl..K COUNTY
L 000012272
P 236
D TI 03-06205
Recording I Filing Slamps
Mortgage AmI.
I. Basic." Tax
2. Addition;]1 Tnx
Sub Total
Spec. I Assit.
or
Spec. I Add.
TOT. MTG. TAX
Dual Town _ Dual CounlY _
Held for Appoinllnent _
Transfer Tax ~
Mansion Tax
The property covered by this mOlgage is
or wi II be improved by .1 one or I WQ
family dwelling only.
YES or NO
5 Communitv Preservation Fund
6-
Consideration Amount S
CPF Tax Due $
Improved
VaC;.1nt L;tnd
TD
TD
TD
Title Company Information
COHKONWEALTH
8
Co.3
Suffolk County Recording & Endorsement Page
DEED
This page tonns pan of the 3tl::J.chcd
nlnde b)',
(SPECIFY TYPE OF INSTRUMENT)
RAYMOND J. SLAVIN AS TRUSTEE
The premi:iis herdn is situuled in
TO
In the Township or
SUFFOLK COUNTY. NEW YORK.
SOUTHOLD
RA~>>Oun n Q1AVTM
In the VIl.l.AGE
or HAMLET of
BOXES 6 THROUGH 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
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1111111111111111111111111111111111111111111111111111111
11111111111111I1111111111
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEEDS/ODD
Number of Pages: 3
TRANSFER TAX NUMBER: 03-06205
Recorded:
At:
LIBER:
PAGE:
09/16/2003
09:08:04 AM
D00012272
236
District:
1000
Section: Block:
104.00 06.00
EXAMINED AND CHARGED AS FOLLOWS
$0.00
Lot:
012.003
Deed Amount:
Received the Following Fees
Page/Filing
COE
EA-CTY
TP-584
RPT
Transfer tax
$9.00
$5.00
$5.00
$5.00
$30.00
$t.OO
For Above Instrument
Exempt
NO Handling
NO NYS SURCHG
NO EA-STATE
NO Cert.Copies
NO SCTH
NO CODDII.Pres
Fees Paid
$5.00
$15.00
$50.00
$0.00
$0.00
$0.00
$124.00
Exempt
NO
NO
NO
NO
NO
NO
TRANSFER TAX NUMBBR: 03-06205
THIS PAGE IS A PART OF THE INSTRUMENT
Edward P.Romaine
County Clerk, Suffolk County
.
.
FOR COUNTY USE ONLY
PLEASE TYPE OR PRESS FIRMLY WHEN WRITINGON FOR~M
INSTRUCTIONS: http://www.orps.state.ny.us or PHONE 15181 473~7222
Cl. SWIS Code
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C2. Date Deed Recorded I DC; / 10 / !l3 I
Month bay Yell'
C3. Book I / ,..;z ,::( , 7, :CI C4. Page I ~ ,3 ,& ,
PROPERTY INFORMATION
,. ~=i:~1 660 Oak Drive
STR~E;T NUMBER STFlEHNAME
Southold
CITY OR TOWN
2 Buyer Slavin
Name lAST NAME/COMPANY
Peconic
VillAGE
Raymond D.
~IRST NAME
LAST NAME I COMPANY
FIRST NAME
3. Tax Indic/lle where futl.lre Tax Bills are TO be sent
Billing if other than buyer address (at bottom of form)
Addrns
V.STNAME/COMI'ANY
STREET NUMa.ER AND STREET NAME
CITY OR TOWN
4. Indicate the number of Assessment
Roll pan::els transferred onth. deed
L
I # of Parcels OR D Part of a Parcel
5. Deed
Property
Si,e
((>-0
It(~ 10RI
. ClOP,""
.
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I X I
fFlONTFEET
ACRES
REAL PROPERTY TRANSFER REPORT
STATE OF r~EW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
10'."'217 1.:,.. "~,~7
ZIP CODE
fIR$TNAME
STATE
z,peaPE
(Only it Part of a Parl;:el) Check as they apply:
4.11" Planning Board with Subdivision Authority Exists
49. Subdivision Approval was Required for Transfer
4C. ;:>arcel Approved lor Subdivision with Map Provided
o
o
D
of the
nter
Raymond Ji..
vos rust
6. Seller
Name
Slavin
LAST NAME I COMPANY
Raymond J.., As Tru5 t ee
FlRST NAME Savin Revoca e
LAST NAME I COMPANY
F'RSTNAME
7. Check the box below whlcn most accurately describe8 the use of the property at the tIme of sale:
A~ One Familv Rasidentilll
B 2 or3 Family Residentiill
C ResidantialVllcantLand
o Non-Residential Vacant land
E~ Agricultural
F Commercial
G Apartment
H Entertainment! Amusement
I ~ Communily Service
J Industrial
K Public Service
L Forest
SALE INFORMATION
Check the bOM:es below as they apply:
8. Ownership Type is Condominium
9. !\Jew Construction on Vacant Land
10A. Property Located within an Agricultural District
lOB Buyerrecaivad a disclosure notka indicating
tha~ the property is in an Agricultu'al District
o
o
o
o
15. Check one or more of these conditions as applicable to transfer:
11. Sale Contract Date
! !
Month 0" Year
~ ; Vb; 03
Monlh 0., Year
A
B
C
D
E
F
G
H
I
J
12. DlIte 01 Sale I Transfer
13. Full Sale Price
- 0 -
0,01
; , .
(Full Sale Price is the total amount paid fOf the property including personal property.
This paymer.t may be in the form of cash, other property or goods, or the aS$umption of
rr,ortgages or other obligations.! Pletlse round to the neareSf whale dollar 8mounr.
14. Indicate the valuB of personal
property included in the sale
o I
, 0
, , .
ASSESSMENT INFORMATION - Data should reflect the latest Final Assessment Roll and Tax Bill
16. Year of Assessment Roll from I C). 1, 1 17. '
which information taken ' . --'. Total Auessed Value lof all pareels in transferl L--....I....-_
18. Property Class
I ~l OI_U 19. School District Name I
s ~ v T 'Iv i I}
20. Tax Map IdentlfiwlsJ I Rollldentifier[sJ {If more than four. attach sheet with additionalldentifierlsll
1000-104.00-06.00-012.003
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CERTIFICATION
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 Go'Vernment Agency or lending Ins~Ttution
Deed Type not Warranty or Bargain <lnd Sale [Specify Below)
Sale of Fractional or Less than Fee Interest {Specify Below)
Significant Change in Property Between Taxable Status and Sale Oates
S&le of Business is Included in SlIle Price
Other Unusual Factors Affecting Sale Price {Spel;ify Be:ow)
None
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BUYER
I certify that all of the items of information entered on this fonn are true and corrl.'Ct (tu the best of my knoy;1edge and belief) and I Wlderstand that the making
uf any y;lIlful false statement of material fact herein Yiill subj",,:t me to tht' pn:"i.~iur!.-~ of the penal I:!", relalhe In Ihe frulkin~ and filin{! of fal.1.t' jn'>trumcnt~.
BUVER'S ATTORNEV
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